Antibodies to I2 predict clinical response to fecal diversion in Crohn's disease

Jacob Spivak, Carol J. Landers, Eric A. Vasiliauskas, Maria T Abreu, Marla C. Dubinsky, Konstantinos A. Papadakis, Andrew Ippoliti, Stephan R. Targan, Phillip R. Fleshner

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

OBJECTIVES: Fecal diversion is occasionally indicated in patients with advanced perianal or colorectal Crohn's disease (CD). Because CD may result from an aberrant immunologic response to bacteria within the gut lumen, fecal diversion should be effective in managing these complications. However, not all patients achieve a clinical response after fecal diversion. CD patients can be characterized by their antibody responses against Pseudomonas fluorescens (I2), E.coli outer membrane porin C (OmpC), oligomannan (anti-Saccharomyces cerevisiae antibodies [ASCA]), and antinuclear antigens (perinuclear antineutrophil cytoplasmic antibodies [pANCA]). This study examines the association between clinical features and seroreactivity to these microbial and auto-antigens in predicting a clinical response to fecal diversion. METHODS: Twenty-seven consecutive CD patients undergoing fecal diversion were included. Sera were drawn and tested for anti-I2, anti-OmpC, ASCA, and pANCA in a blinded fashion. Response was assessed using clinical parameters. RESULTS: Seventeen (63%) patients underwent fecal diversion for medically resistant proctocolitis and 10 (37%) for severe perianal disease. Median follow-up was 41 months. Seventeen (63%) patients achieved a clinical response. No preoperative clinical or surgical factor predicted response to diversion. Clinical response after fecal diversion was seen in 15 of 16 (94%) patients who were I2 positive compared with only 2 of 11 (18%) patients who were I2 negative (P = 0.0001). Seroreactivity to OmpC, ASCA, or pANCA was not associated with a clinical response to diversion. CONCLUSION: Expression of I2 antibodies against a bacterial antigen of Pseudomonas fluorescens was highly associated with clinical response to fecal diversion in CD patients.

Original languageEnglish
Pages (from-to)1122-1130
Number of pages9
JournalInflammatory Bowel Diseases
Volume12
Issue number12
DOIs
StatePublished - Dec 1 2006
Externally publishedYes

Fingerprint

Crohn Disease
Antibodies
Porins
Antineutrophil Cytoplasmic Antibodies
Saccharomyces cerevisiae
Pseudomonas fluorescens
Membranes
Proctocolitis
Bacterial Antigens
Antigens
Antinuclear Antibodies
Antibody Formation
Escherichia coli
Bacteria
Serum

Keywords

  • Crohn's disease
  • Fecal diversion
  • Serologic markers

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Spivak, J., Landers, C. J., Vasiliauskas, E. A., Abreu, M. T., Dubinsky, M. C., Papadakis, K. A., ... Fleshner, P. R. (2006). Antibodies to I2 predict clinical response to fecal diversion in Crohn's disease. Inflammatory Bowel Diseases, 12(12), 1122-1130. https://doi.org/10.1097/01.mib.0000235833.47423.d7

Antibodies to I2 predict clinical response to fecal diversion in Crohn's disease. / Spivak, Jacob; Landers, Carol J.; Vasiliauskas, Eric A.; Abreu, Maria T; Dubinsky, Marla C.; Papadakis, Konstantinos A.; Ippoliti, Andrew; Targan, Stephan R.; Fleshner, Phillip R.

In: Inflammatory Bowel Diseases, Vol. 12, No. 12, 01.12.2006, p. 1122-1130.

Research output: Contribution to journalArticle

Spivak, J, Landers, CJ, Vasiliauskas, EA, Abreu, MT, Dubinsky, MC, Papadakis, KA, Ippoliti, A, Targan, SR & Fleshner, PR 2006, 'Antibodies to I2 predict clinical response to fecal diversion in Crohn's disease', Inflammatory Bowel Diseases, vol. 12, no. 12, pp. 1122-1130. https://doi.org/10.1097/01.mib.0000235833.47423.d7
Spivak, Jacob ; Landers, Carol J. ; Vasiliauskas, Eric A. ; Abreu, Maria T ; Dubinsky, Marla C. ; Papadakis, Konstantinos A. ; Ippoliti, Andrew ; Targan, Stephan R. ; Fleshner, Phillip R. / Antibodies to I2 predict clinical response to fecal diversion in Crohn's disease. In: Inflammatory Bowel Diseases. 2006 ; Vol. 12, No. 12. pp. 1122-1130.
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abstract = "OBJECTIVES: Fecal diversion is occasionally indicated in patients with advanced perianal or colorectal Crohn's disease (CD). Because CD may result from an aberrant immunologic response to bacteria within the gut lumen, fecal diversion should be effective in managing these complications. However, not all patients achieve a clinical response after fecal diversion. CD patients can be characterized by their antibody responses against Pseudomonas fluorescens (I2), E.coli outer membrane porin C (OmpC), oligomannan (anti-Saccharomyces cerevisiae antibodies [ASCA]), and antinuclear antigens (perinuclear antineutrophil cytoplasmic antibodies [pANCA]). This study examines the association between clinical features and seroreactivity to these microbial and auto-antigens in predicting a clinical response to fecal diversion. METHODS: Twenty-seven consecutive CD patients undergoing fecal diversion were included. Sera were drawn and tested for anti-I2, anti-OmpC, ASCA, and pANCA in a blinded fashion. Response was assessed using clinical parameters. RESULTS: Seventeen (63{\%}) patients underwent fecal diversion for medically resistant proctocolitis and 10 (37{\%}) for severe perianal disease. Median follow-up was 41 months. Seventeen (63{\%}) patients achieved a clinical response. No preoperative clinical or surgical factor predicted response to diversion. Clinical response after fecal diversion was seen in 15 of 16 (94{\%}) patients who were I2 positive compared with only 2 of 11 (18{\%}) patients who were I2 negative (P = 0.0001). Seroreactivity to OmpC, ASCA, or pANCA was not associated with a clinical response to diversion. CONCLUSION: Expression of I2 antibodies against a bacterial antigen of Pseudomonas fluorescens was highly associated with clinical response to fecal diversion in CD patients.",
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T1 - Antibodies to I2 predict clinical response to fecal diversion in Crohn's disease

AU - Spivak, Jacob

AU - Landers, Carol J.

AU - Vasiliauskas, Eric A.

AU - Abreu, Maria T

AU - Dubinsky, Marla C.

AU - Papadakis, Konstantinos A.

AU - Ippoliti, Andrew

AU - Targan, Stephan R.

AU - Fleshner, Phillip R.

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N2 - OBJECTIVES: Fecal diversion is occasionally indicated in patients with advanced perianal or colorectal Crohn's disease (CD). Because CD may result from an aberrant immunologic response to bacteria within the gut lumen, fecal diversion should be effective in managing these complications. However, not all patients achieve a clinical response after fecal diversion. CD patients can be characterized by their antibody responses against Pseudomonas fluorescens (I2), E.coli outer membrane porin C (OmpC), oligomannan (anti-Saccharomyces cerevisiae antibodies [ASCA]), and antinuclear antigens (perinuclear antineutrophil cytoplasmic antibodies [pANCA]). This study examines the association between clinical features and seroreactivity to these microbial and auto-antigens in predicting a clinical response to fecal diversion. METHODS: Twenty-seven consecutive CD patients undergoing fecal diversion were included. Sera were drawn and tested for anti-I2, anti-OmpC, ASCA, and pANCA in a blinded fashion. Response was assessed using clinical parameters. RESULTS: Seventeen (63%) patients underwent fecal diversion for medically resistant proctocolitis and 10 (37%) for severe perianal disease. Median follow-up was 41 months. Seventeen (63%) patients achieved a clinical response. No preoperative clinical or surgical factor predicted response to diversion. Clinical response after fecal diversion was seen in 15 of 16 (94%) patients who were I2 positive compared with only 2 of 11 (18%) patients who were I2 negative (P = 0.0001). Seroreactivity to OmpC, ASCA, or pANCA was not associated with a clinical response to diversion. CONCLUSION: Expression of I2 antibodies against a bacterial antigen of Pseudomonas fluorescens was highly associated with clinical response to fecal diversion in CD patients.

AB - OBJECTIVES: Fecal diversion is occasionally indicated in patients with advanced perianal or colorectal Crohn's disease (CD). Because CD may result from an aberrant immunologic response to bacteria within the gut lumen, fecal diversion should be effective in managing these complications. However, not all patients achieve a clinical response after fecal diversion. CD patients can be characterized by their antibody responses against Pseudomonas fluorescens (I2), E.coli outer membrane porin C (OmpC), oligomannan (anti-Saccharomyces cerevisiae antibodies [ASCA]), and antinuclear antigens (perinuclear antineutrophil cytoplasmic antibodies [pANCA]). This study examines the association between clinical features and seroreactivity to these microbial and auto-antigens in predicting a clinical response to fecal diversion. METHODS: Twenty-seven consecutive CD patients undergoing fecal diversion were included. Sera were drawn and tested for anti-I2, anti-OmpC, ASCA, and pANCA in a blinded fashion. Response was assessed using clinical parameters. RESULTS: Seventeen (63%) patients underwent fecal diversion for medically resistant proctocolitis and 10 (37%) for severe perianal disease. Median follow-up was 41 months. Seventeen (63%) patients achieved a clinical response. No preoperative clinical or surgical factor predicted response to diversion. Clinical response after fecal diversion was seen in 15 of 16 (94%) patients who were I2 positive compared with only 2 of 11 (18%) patients who were I2 negative (P = 0.0001). Seroreactivity to OmpC, ASCA, or pANCA was not associated with a clinical response to diversion. CONCLUSION: Expression of I2 antibodies against a bacterial antigen of Pseudomonas fluorescens was highly associated with clinical response to fecal diversion in CD patients.

KW - Crohn's disease

KW - Fecal diversion

KW - Serologic markers

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