Related Experiment Video
Updated: Feb 11, 2026
Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
Published on: May 16, 2025
Serologic Reactivity Reflects Clinical Expression of Ulcerative Colitis in Children
Elizabeth A Spencer1, Sonia M Davis2, David R Mack3
1Icahn School of Medicine, Mount Sinai Hospital, New York, New York, USA.
Insights
Pediatric ulcerative colitis (UC) serology, like pANCA and Anti-CBir1, shows distinct patterns. High pANCA indicates more severe disease, while Anti-CBir1 is more common in younger children, suggesting age-related immune responses.
Area of Science:
- Pediatric gastroenterology
- Immunology
- Microbiome research
Background:
- Limited understanding of serologic reactivity to microbial antigens in pediatric ulcerative colitis (UC) compared to pediatric Crohn's disease (CD).
- Investigating the link between disease phenotype and serological markers in pediatric UC is crucial for diagnosis and treatment.
Purpose of the Study:
- To analyze disease phenotype and serological markers in a cohort of children newly diagnosed with UC.
- To explore the relationship between specific antibodies (pANCA, ASCA, Anti-CBir1, Anti-OmpC) and clinical characteristics in pediatric UC patients.
- To identify potential age-related differences in immune responses and their correlation with disease presentation.
Main Methods:
- A well-characterized inception cohort of pediatric UC patients (ages 4-17) was studied within the PROTECT Study.
- Data collected included demographics, clinical information, and serological markers: perinuclear anti-neutrophil cytoplasmic antibodies (pANCA), anti-Saccharomyces cerevisiae antibodies (ASCA) IgA/IgG, Anti-CBir1, and Anti-OmpC.
- Statistical analyses were performed to correlate serological findings with disease phenotype, age, calprotectin levels, and Vitamin D status.
Main Results:
- 65% of pediatric UC patients tested positive for pANCA, with no specific phenotype correlation, although high titers (≥100) were linked to pancolitis (19% of patients).
- Anti-CBir1 antibodies were positive in 19% of patients, more prevalent in younger children (<12 years old), and associated with relative rectal sparing and lower calprotectin levels.
- Vitamin D 25-OH sufficiency was significantly associated with the presence of Anti-CBir1 antibodies.
Conclusions:
- The prevalence of pANCA in pediatric UC aligns with adult findings, and high titers suggest disease severity.
- The increased frequency of Anti-CBir1 in younger children suggests that host-microbial interactions in UC may vary with age.
- These findings highlight the importance of serological markers in understanding pediatric UC, potentially guiding personalized treatment approaches.
Background:
In contrast to pediatric Crohn's disease (CD), little is known in pediatric ulcerative colitis (UC) about the relationship between disease phenotype and serologic reactivity to microbial and other antigens.
Aim:
The aim of this study was to examine disease phenotype and serology in a well-characterized inception cohort of children newly diagnosed with UC during the PROTECT Study (Predicting Response to Standardized Pediatric Colitis Therapy).
Methods:
Patients were recruited from 29 participating centers. Demographic, clinical, laboratory, and serologic (pANCA, ASCA IgA/IgG, Anti-CBir1, and Anti-OmpC) data were obtained from children 4-17 years old with UC.
Results:
Sixty-five percent of the patients had positive serology for pANCA, with 62% less than 12 years old and 66% 12 years old or older. Perinuclear anti-neutrophil cytoplasmic antibodies did not correspond to a specific phenotype though pANCA ≥100, found in 19%, was strongly associated with pancolitis (P = 0.003). Anti-CBir1 was positive in 19% and more common in younger children with 32% less than 12 years old as compared with 14% 12 years old or older (P < 0.001). No association was found in any age group between pANCA and Anti-CBir1. Relative rectal sparing was more common in +CBir1, 16% versus 7% (P = 0.02). Calprotectin was lower in Anti-CBir1+ (Median [IQR] 1495 mcg/g [973-3333] vs 2648 mcg/g [1343-4038]; P = 0.04). Vitamin D 25-OH sufficiency was associated with Anti-CBir1+ (P = 0.0009).
Conclusions:
The frequency of pANCA in children was consistent with adult observations. High titer pANCA was associated with more extensive disease, supporting the idea that the magnitude of immune reactivity may reflect disease severity. Anti-CBir1+ was more common in younger ages, suggesting host-microbial interactions may differ by patient age.
More Related Videos
09:11Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model
Published on: February 14, 2021
09:18Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Related Concept Videos
01:29Drugs for Treatment of Ulcerative Colitis in IBD
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
02:57The Sense of Self: Reflected Self-Appraisal and Social Comparison
01:07Reflection of Waves
01:28Peptic Ulcer Disease II: Pathophysiology
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.