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Autoimmune features are associated with chronic antibiotic-refractory pouchitis.
Darren N Seril1, Qingping Yao, Bret A Lashner
1Departments of *Gastroenterology/Hepatology and †Rheumatic and Immunologic Disease, the Cleveland Clinic Foundation, Cleveland, Ohio.
Inflammatory Bowel Diseases
|December 2, 2014
Summary
Patients with ileal pouch-anal anastomosis (IPAA) and chronic antibiotic-refractory pouchitis (CARP) show increased immune markers. Microsomal antibody and IgG4 plasma cell infiltration are key risk factors for CARP.
Area of Science:
- Gastroenterology
- Immunology
- Surgical Pathology
Background:
- Chronic antibiotic-refractory pouchitis (CARP) is more prevalent in patients with ileal pouch-anal anastomosis (IPAA) and autoimmune disorders.
- Understanding the immune dysregulation in IPAA patients is crucial for managing CARP.
Purpose of the Study:
- To investigate the overlap of immune features in IPAA patients.
- To determine the association between specific immune markers and the development of CARP.
Main Methods:
- 150 symptomatic IPAA patients were analyzed for autoimmune serology.
- Demographic and clinical data were compared between CARP and non-CARP groups.
Main Results:
- CARP patients had higher rates of autoimmune thyroid disease, primary sclerosing cholangitis, and microsomal antibody positivity.
- Increased IgG4-expressing plasma cell infiltration was significantly higher in CARP patients (54.8% vs. 14.9%).
- Microsomal antibody positivity and elevated IgG4 plasma cells were independent risk factors for CARP.
Conclusions:
- A significant overlap exists between immune markers and pouch dysfunction, particularly in CARP.
- Microsomal antibody expression and IgG4 plasma cell infiltration are identified as independent risk factors for CARP.
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