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New serological markers in pediatric patients with inflammatory bowel disease

World Journal of Gastroenterology 2014年第17期20卷 4873-4882页

作者： Márta Kovács Katalin Eszter Müller Mária Papp Péter László Lakatos mihály cs?ndes Gábor Veres Department of Pediatrics Petz Aladár County and Teaching Hospital9023 Gy?rHungary 1~(st) Department of Pediatrics Semmelweis University1083 BudapestHungary 2~(nd) Department of Medicine University of Debrecen4032 DebrecenHungary 1~(st) Department of Medicine Semmelweis University1083 BudapestHungary Department of Gastroenterology Petz Aladár County and Teaching Hospital9023 Gy?rHungary

The spectrum of serological markers associated with inflammatory bowel disease (IBD) is rapidly growing. Due to frequently delayed or missed diagnoses, the application of non-invasive diagnostic tests for IBD, as well as differentiation between ulcerative colitis (UC) and Crohn’s disease (CD), would be useful in the pediatric population. In addition, the combination of pancreatic autoantibodies and antibodies against Saccharomyces cerevisiae antibodies/perinuclear cytoplasmic antibody (pANCA) improved the sensitivity of serological markers in pediatric patients with CD and UC. Some studies suggested that age-associated differences in the patterns of antibodies may be present, particularly in the youngest children. In CD, most patients develop stricturing or perforating complications, and a significant number of patients undergo surgery during the disease course. Based on recent knowledge, serum antibodies are qualitatively and quantitatively associated with complicated CD behavior and CD-related surgery. Pediatric UC is characterized by extensive colitis and a high rate of colectomy. In patients with UC, high levels of anti-CBir1 and pANCA are associated with the development of pouchitis after ileal pouch-anal anastomosis. Thus, serologic markers for IBD can be applied to stratify IBD patients into more homogeneous subgroups with respect to disease progression. In conclusion, identification of patients at an increased risk of rapid disease progression is of great interest, as the application of early and more aggressive pharmaceutical intervention could have the potential to alter the natural history of IBD, and reduce complications and hospitalizations.

关键词： Inflammatory bowel disease, Crohn’ s disease, Ulcerative colitis, Pediatric, Serologic markers, Antimicrobial antibodies, Anti-glycan antibodies, Pancreatic antibodies, Inflammatory bowel disease

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