Clinical utility of anti-glycan antibodies in pediatric crohn's disease in comparison with an adult cohort

Background: We tested a panel of serological anti-glycan antibodies including the novel anti-laminarin (Anti-L) and anti-chitin (Anti-C) antibodies in pediatric Crohn's disease (CD) patients for diagnosis of CD and association with complicated CD behavior. In addition, we compared this panel in pediatric CD with adult CD patients for possible changes in accuracy over time. Methods: Anti-L, Anti-C, anti-chitobioside (ACCA), anti-laminaribioside (ALCA), anti-mannobioside (AMCA), and anti-Saccaromyces cervisiae (gASCA) antibodies were tested in serum samples of 131 pediatric participants (59 CD, 27 ulcerative colitis [UC], and 45 noninflammatory bowel disease [IBD] controls) with enzyme-linked immunosorbent assay (ELISA). The results were compared to an adult cohort of 728 participants (355 CD, 129 UC, and 244 non-IBD controls). Results: In all, 78% of the pediatric CD patients were positive for at least one of the anti-glycan antibodies. gASCA was most accurate for the diagnosis of CD, but combined use of the antibodies improved differentiation of CD from UC. gASCA, AMCA, ALCA, or Anti-L and an increasing antibody level were independently linked to complicated CD behavior, CD-related surgery, and ileal disease location (odds ratio 3.98.7). Considering the age at sample procurement the accuracy of the markers compared to an adult cohort remained stable for the differentiation of CD versus UC as well as for the association with complications, CD-related surgery, and ileal disease involvement. Conclusions: A panel of anti-glycan antibodies including the novel Anti-L and Anti-C may aid in the differentiation of pediatric CD from UC and is associated with complicated CD behavior. The marker accuracy remained constant over time. (Inflamm Bowel Dis 2011;)