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Anti-Saccharomyces cerevisiae Antibodies as a Prognostic Biomarker in Children With Crohn Disease

Abin Chandrakumar1,2,3, Michael Georgy3, Prasoon Agarwal1,4,5

  • 1Department of Pharmacology and Therapeutics, University of Manitoba.

Journal of Pediatric Gastroenterology and Nutrition
|February 22, 2019
PubMed

Insights

Anti-Saccharomyces cerevisiae antibodies (ASCAs) indicate more severe pediatric Crohn disease (CD). However, ASCA immunoglobulin G (IgG) positivity predicts a lower relapse rate in children with CD treated with biologics.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Inflammatory Bowel Disease Research

Background:

  • Anti-Saccharomyces cerevisiae antibodies (ASCAs) are potential biomarkers for differentiating Crohn disease (CD) from ulcerative colitis (UC).
  • The prognostic significance of ASCA status in pediatric CD patients remains under-investigated.

Purpose of the Study:

  • To evaluate the prognostic value of ASCA status in children with CD receiving biologic therapy.
  • To assess the association between ASCA status and disease severity and treatment response.

Main Methods:

  • A longitudinal prospective observational study of children diagnosed with CD between 2012 and 2018.
  • Cox regression models were used to compare anti-tumor necrosis factor (TNF) biologic therapy response between ASCA-positive and ASCA-negative patients.

Main Results:

  • ASCA-positive patients exhibited higher risks of moderate-to-severe clinical disease (OR 2.88) and extensive endoscopic disease (OR 3.30) at baseline.
  • ASCA immunoglobulin G (IgG)-positive patients treated with biologics showed a significantly lower relapse rate (aHR 0.12).
  • A notable proportion (14%) of patients had unstable ASCA values over time.

Conclusions:

  • ASCA-positive pediatric CD patients present with more severe clinical and endoscopic disease.
  • ASCA IgG status serves as a valuable prognostic marker for children with CD undergoing biologic treatment.
Abstract

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