These two authors contributed equally to this work.
Antibodies to flagellin indicate reactivity to bacterial antigens in IBS patients
Article first published online: 6 AUG 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Neurogastroenterology & Motility
Volume 20, Issue 10, pages 1110–1118, October 2008
How to Cite
Schoepfer, A. M., Schaffer, T., Seibold-schmid, B., Müller, S. and Seibold, F. (2008), Antibodies to flagellin indicate reactivity to bacterial antigens in IBS patients. Neurogastroenterology & Motility, 20: 1110–1118. doi: 10.1111/j.1365-2982.2008.01166.x
Parts of the results were presented in abstract form (poster) at DDW 2007 in Washington DC, May 23.
- Issue published online: 15 SEP 2008
- Article first published online: 6 AUG 2008
- Received: 2 March 2008 Accepted for publication: 26 May 2008
- anti-Saccharomyces cerevisiae antibodies;
- irritable bowel syndrome;
- mucosal inflammation;
- perinuclear antineutrophil cytoplasmatic antibodies;
- postinfectious irritable bowel syndrome
Abstract One of the several possible causes of irritable bowel syndrome (IBS) is thought to be low-grade mucosal inflammation. Flagellin, the primary structural component of bacterial flagellae, was shown in inflammatory bowel disease patients to activate the innate and adaptive immunity. It has not yet been conclusively established if IBS patients show reactivity to luminal antigens. In 266 patients [112 IBS, 61 Crohn’s disease (CD), 50 ulcerative colitis (UC) and 43 healthy controls (HC)], we measured antibodies to flagellin (FAB, types A4-Fla2 and Fla-X), anti-Saccharomyces cerevisiae antibodies (ASCA) (both ELISA), antipancreas antibodies (PAB) and perinuclear antineutrophil cytoplasmatic antibodies (p-ANCA) (both IF). All IBS patients had normal fecal calprotectin (mean 21 μg mL−1, SD 6.6) and fulfilled the ROME II criteria. Frequencies of antibodies in patients with IBS, CD, UC and HC, respectively, are as follows (in per cent): antibodies against A4-Fla2: 29/48/8/7; antibodies against Fla-X: 26/52/10/7; ASCA: 6/59/0/2; p-ANCA: 0/10/52/0; and PAB: 0/28/0/0. Antibodies against A4-Fla2 and Fla-X were significantly more frequent in IBS patients than in HC (P = 0.004 and P = 0.009). Antibodies to A4-Fla2 and Fla-X were significantly more frequent in IBS patients with antecedent gastroenteritis compared to non-postinfectious IBS patients (P = 0.002 and P = 0.012). In contrast to ASCA, PAB and p-ANCA, antibodies against A4-Fla2 and Fla-X were found significantly more often in IBS patients, particularly in those with postinfectious IBS, compared to HC. This observation supports the concept that immune reactivity to luminal antigens has a putative role in the development of IBS, at least in a subset of patients.