Detection of anti-Saccharomyces cerevisiae antibodies in Crohn's disease:: is it a reliable diagnostic and prognostic marker?

Background. In the past few years, serologic markers have been proposed in inflammatory bowel disease. Anti-Saccharomyces cerevisiae antibodies showed high specificity for Crohn's disease. A prognostic role for serology has also been hypothesised. Aims To evaluate anti-Saccharomyces cerevisiae antibody distribution in an unselected Italian inflammatory bowel disease population. To analyse whether anti-Saccharomyces cerevisiae antibody status [positive/negative] and/or anti-Saccharomyces cerevisiae antibody titres are associated with clinical variables and outcome measures in Crohn's disease patients. Patients and Methods. A series of 299 inflammatory bowel disease patients were evaluated; serum samples were taken and a short clinical history was recorded. anti-Saccharomyces cerevisiae antibodies IgG enzyme-linked immunosorbent assay Medilab((R)) (Milan, Italy) kit was used in order to determine anti-Saccharomyces cerevisiae antibody status. Results. Sensitivity specificity and likelihood ratio for positive test in the differential diagnosis of inflammatory bowel disease was 59%, 89%, B. 1, respectively. Clinical variables significantly associated with anti-Saccharomyces cerevisiae antibody status in logistic regression were found to be ileal location [p=0.01] and earlier age at diagnosis [p<0.01]. Among ileal Crohns disease patients, there was a trend in concordance between anti-Saccharomyces cerevisiae antibody titres and higher number of surgical procedures which was not statistically significant applying more complex statistics. Conclusions. In an Italian inflammatory bowel disease population, anti-Saccharomyces cerevisiae antibodies status showed characteristics similar to those previously reported. Anti-Saccharomyces cerevisiae antibody positivity is associated with ileal involvement and with earlier onset of Crohns disease.