Antibodies against glycoprotein 2 are novel markers of intestinal inflammation in patients with an ileal pouch
2013
Background and aims: The Crohn's disease (CD)-specific pancreatic auto-antibodies (PAB), have been recently identified to target glycoprotein 2 (GP2). Pouchitis is an inflammation of the small bowel developing in up to 60% of ulcerative colitis patients undergoing proctocolectomy and ileal pouch anal anastomosis. Occurrence of CD-specific antibodies was reported to be a predictor of pouchitis. We aimed to assess the prevalence of anti-GP2 antibodies (anti-GP2) in the serum and feces of pouch patients and to correlate them with clinical parameters. Furthermore, we examined mucosal expression of the GP2 protein in the pouch.
Methods: Pouch patients were prospectively recruited and checked for clinical, endoscopic, and laboratory markers of inflammation. IgG and IgA anti-GP2 levels in serum and fecal samples were determined using ELISA. GP2 protein was assessed by immunohistochemistry.
Results: Anti-GP2 was elevated in both serum and fecal samples of patients with inflamed compared to those with non-inflamed pouches and patients with familial-adenomatous polyposis after surgery (p < 0.05, respectively). Moreover, patients with CD-like complications exhibited significantly higher anti-GP2 titers than those without CD-like complications (p ≤ 0.01). High levels of anti-GP2 correlated with more frequent bowel movements per day and with the presence of at least one anti-glycan antibody (p ≤ 0.05). GP2 itself was more abundant in the mucosa of patients with chronic pouchitis.
Conclusions: Anti-GP2 exists in the serum and feces of pouch patients and correlates with pouch inflammation, and presence of other serological markers. Thus, anti-GP2 may contribute to better stratification of pouchitis, more-so when the inflammation exhibits CD-like complications.
* Abbreviations
: ACCA
: anti-chitobioside carbohydrate antibodies
ALCA
: anti-laminaribioside carbohydrate antibodies
AMCA
: anti-mannobioside carbohydrate antibodies
ASCA
: anti- Saccharomyces cerevisiae antibodies
CD
: Crohn's disease
CRP
: C-reactive protein
FAP
: familial adenomatous polyposis
GP2
: glycoprotein 2
IBD
: inflammatory bowel diseases
IPAA
: ileal pouch anal anastomosis
PAB
: pancreatic (auto)-antibody
PDAI
: pouchitis disease activity index
UC
: ulcerative colitis
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