Format

Send to

Choose Destination
See comment in PubMed Commons below
Arthritis Res Ther. 2009;11(6):R177. doi: 10.1186/ar2866. Epub 2009 Nov 23.

Inflammatory bowel disease serologies in ankylosing spondylitis patients: a pilot study.

Author information

1
Rockford Orthopedic Associates, 324 Roxbury Rd, Rockford, IL 61107, USA. mmundwiler@msn.com

Abstract

INTRODUCTION:

Ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) share similarities and are classified as spondyloarthropathies. In IBD, anti-Saccharomyces cerevisiae antibody (ASCA), anti-I2 (associated with anti-Pseudomonas activity), anti-Escherichia coli outer membrane porin C (anti-OmpC), anti-flagellin (anti-CBir1), and antineutrophil cytoplasmic antibodies (ANCA) possess clinical significance. Because of the overlap between the two conditions, a pilot study was designed to compare the frequency of these antibodies in AS patients compared to normal controls.

METHODS:

Serum stored from 80 AS patients and 80 control subjects was available for analysis. ASCA, anti-I2, anti-OmpC, anti-CBir1, and ANCA studies were completed on all serum samples using Enzyme-Linked Immunosorbent Assay (ELISA) methodology. The following analyses were performed: comparison of positivity based on the established values in IBD, median values, the number of subjects in each serology in the 4th quartile of a normal distribution, and the mean quartile sum of all the antibodies.

RESULTS:

There was no difference in positivity rates between AS and control groups with the established IBD values. The median anti-I2 response was significantly higher in AS than in controls (11.78 vs 7.86, p = 0.017). Significantly more AS patients had quartile scores of 4 for the following antibody responses: ASCA IgG (26% vs 13%, p = 0.016, OR = 2.49, CI 1.168 - 5.313), ASCA IgG and IgA (27% vs 12%, p = 0.006, OR = 2.9, CI: 1.342 - 6.264), and anti - I2 (25% vs 14%, p = 0.0424, OR = 2.15, CI: 1.018 - 4.538). The mean quartile sum of the antibody responses was elevated in AS patients when ANCA was excluded (10.526 vs 9.519, p = 0.03). When ANCA was included, this difference lost significance.

CONCLUSIONS:

The data from this pilot study points towards mucosal dysregulation as an important pathway in AS. We were able to demonstrate that anti-I2 could play a pathologic role in AS. The elevated mean total antibody response being significant only with ANCA exclusion is consistent with the histopathological evidence that intestinal inflammation in AS is similar to Crohn's disease. To better define the roles of these antibodies in AS, larger studies with more precisely defined patient characteristics are required.

PMID:
19930665
PMCID:
PMC3003540
DOI:
10.1186/ar2866
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for BioMed Central Icon for PubMed Central
    Loading ...
    Support Center