Presence of Anti-proteinase 3 Antineutrophil Cytoplasmic Antibodies (Anti-PR3 ANCA) as Serologic Markers in Inflammatory Bowel Disease

被引:55
作者
Teresa Arias-Loste, Maria [1 ]
Bonilla, Geovana [2 ]
Moraleja, Irene [1 ]
Mahler, Michael [3 ]
Angel Mieses, Miguel [1 ]
Castro, Beatriz [1 ]
Rivero, Montserrat [1 ]
Crespo, Javier [1 ]
Lopez-Hoyos, Marcos [2 ,4 ]
机构
[1] Hosp Univ Marques de Valdecilla, Dept Gastroenterol & Hepatol, IFIMAV, Santander 39008, Spain
[2] Hosp Univ Marques de Valdecilla, Dept Immunol, IFIMAV, Santander 39008, Spain
[3] INOVA Diagnost, Res & Dev, San Diego, CA USA
[4] Hosp Univ Marques de Valdecilla, Serv Inmunol, Santander 39008, Spain
关键词
Inflammatory bowel disease; Anti-PR3; antibodies; Chemiluminiscence; WEGENER GRANULOMATOSIS; INDETERMINATE COLITIS; ULCERATIVE-COLITIS; VASCULITIS; PROTEINASE-3; POLYANGIITIS; UTILITY; NAME; IBD;
D O I
10.1007/s12016-012-8349-4
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Anti-proteinase 3 anti-neutrophil cytoplasmic antibodies (anti-PR3 ANCA) represent an established serologic marker of active granulomatosis with polyangiitis, but their role as a serologic marker in inflammatory bowel disease (IBD) remains uncertain. This study evaluates the presence of anti-PR3 ANCA and their validity as a serologic marker to aid in the diagnosis of IBD. Retrospectively, 142 serum samples obtained at early stages of the disease were analyzed with a new chemiluminiscent assay for the measurement of anti-PR3 ANCA. The results were correlated to the diagnosis, clinical, and therapeutic data, and ANCA and anti-Saccharomyces cerevisiae antibody (ASCA) measurements available from routine clinical practice. Anti-PR3 ANCA were significantly more prevalent (p < 0.0001) and their titers significantly higher (p < 0.0001) among ulcerative colitis compared with Crohn's disease patients. Receiver operating characteristic curve analysis performed with anti-PR3 ANCA titers to assess the diagnostic accuracy of the assay gave an area under the curve of 0.81 (95 % CI (0.76-0.89); p < 0.0001), with a cut-off titer of 11.8 chemiluminescent units displaying 52.1 % sensitivity and 97.3 % specificity for ulcerative colitis. Combining anti-PR3 ANCA positivity with IgA ASCA negativity as the diagnostic parameter demonstrated highest diagnostic utility, with a sensitivity and specificity of 47.5 % and 98.2 %, respectively. In our cohort, anti-PR3 ANCA was significantly more prevalent in ulcerative colitis than in Crohn's disease patients, which suggests a possible role of anti-PR3 ANCA as a serologic marker to aid in the diagnosis of IBD.
引用
收藏
页码:109 / 116
页数:8
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