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https://hdl.handle.net/2440/106319
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Type: | Journal article |
Title: | Serologic antibodies in relation to outcome in postoperative Crohn's disease |
Author: | Hamilton, A. Kamm, M. De Cruz, P. Wright, E. Selvaraj, F. Princen, F. Gorelik, A. Liew, D. Lawrance, I. Andrews, J. Bampton, P. Sparrow, M. Florin, T. Gibson, P. Debinski, H. Gearry, R. Macrae, F. Leong, R. Kronborg, I. Radford-Smith, G. et al. |
Citation: | Journal of Gastroenterology and Hepatology, 2017; 32(6):1195-1203 |
Publisher: | Wiley/Blackwell |
Issue Date: | 2017 |
ISSN: | 0815-9319 1440-1746 |
Statement of Responsibility: | Amy L Hamilton, Michael A Kamm, Peter De Cruz, Emily K Wright, Fabiyola Selvaraj, Fred Princen, Alexandra Gorelik, Danny Liew, Ian C Lawrance, Jane M Andrews, Peter A Bampton, Miles P Sparrow, Timothy H Florin, Peter R Gibson, Henry Debinski, Richard B Gearry, Finlay A Macrae, Rupert W Leong, Ian Kronborg, Graham Radford, Smith, Warwick Selby, Sally J Bell, Steven J Brown and William R Connell |
Abstract: | Background and Aim: Disease recurs frequently after Crohn’s disease resection. The role of serological antimicrobial antibodies in predicting recurrence or as a marker of recurrence has not been well defined. Methods: A total of 169 patients (523 samples) were prospectively studied, with testing peri-operatively, and 6, 12 and 18 months postoperatively. Colonoscopy was performed at 18 months postoperatively. Serologic antibody presence (perinuclear anti-neutrophil cytoplasmic antibody [pANCA], anti-Saccharomyces cerevisiae antibodies [ASCA] IgA/IgG, anti-OmpC, anti-CBir1, anti-A4-Fla2, anti-Fla-X) and titer were tested. Quartile sum score (range 6–24), logistic regression analysis, and correlation with phenotype, smoking status, and endoscopic outcome were assessed. Results: Patients with ≥ 2 previous resections were more likely to be anti-OmpC positive (94% vs 55%, ≥ 2 vs < 2, P = 0.001). Recurrence at 18 months was associated with anti-Fla-X positivity at baseline (49% vs 29%; positive vs negative, P = 0.033) and 12 months (52% vs 31%, P = 0.04). Patients positive (n = 28) for all four antibacterial antibodies (anti-CBir1, anti-OmpC, anti-A4-Fla2, and anti-Fla-X) at baseline were more likely to experience recurrence at 18 months than patients negative (n = 32) for all four antibodies (82% vs 18%, P = 0.034; odds ratio 6.4, 95% confidence interval 1.16–34.9). The baseline quartile sum score for all six antimicrobial antibodies was higher in patients with severe recurrence (Rutgeert’s i3-i4) at 18 months, adjusted for clinical risk factors (odds ratio 1.16, 95% confidence interval 1.01–1.34, P = 0.039). Smoking affected antibody status. Conclusions: Anti-Fla-X and presence of all anti-bacterial antibodies identifies patients at higher risk of early postoperative Crohn’s disease recurrence. Serologic screening preoperatively may help identify patients at increased risk of recurrence. |
Keywords: | antibodies Crohn's disease postoperative serology smoking |
Description: | Accepted for publication 11 December 2016 |
Rights: | © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd |
DOI: | 10.1111/jgh.13677 |
Published version: | http://dx.doi.org/10.1111/jgh.13677 |
Appears in Collections: | Aurora harvest 3 Medicine publications |
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