[en] Background: Crohn's disease (CD) is a polygenic multifactorial heterogeneous disease. Anti-Saccharomyces Cerevisiae antibodies (ASCA) correlate highly with CD and are present in 50-80% of patients. The reason for ASCA positivity or negativity in CD is unknown. The aim of our work was to analyse clinical, epidemiological and genetic characteristics in ASCA + or ASCA- CD patients. Methods : 113 patients with CD were tested for ASCA (IgA and IgG) by using a commercial kit (Medipan Diagnostica). Age, gender, systemic manifestations, familial form of disease, age at diagnosis, location and behaviour of the disease, smoking habit as well as genotyping for -308 TNF gene polymorphisms were determined. Results : 38.9% CD patients were negative for both IgA and IgG ASCA while 61.1% were ASCA positive (respectively IgA and IgG : 31.9%; IgA only : 9.7%; IgG only : 19.5%). The only significant difference between ASCA+ and ASCA- patients was for smoking habit : there were 29% smokers in ASCA+ versus 50% in ASCA- CD patients (P = 0.03). This low proportion of smokers was more prominent in ASCA IgA+ patients than in isolated ASCA IgG+ patients (25.6% versus 45.5%) and was minimal in patients with high titers of ASCA IgA (0/8). Logistic regression showed smoking habit still borderline for significance (P = 0.057). Conclusions : Our results suggest a negative association between smoking and ASCA positivity in CD. This association was more prominent for ASCA IgA+. It indicates that smoking habit should be taken into account when analysing ASCA status in CD patients and may suggest an influence of smoking on immunization against intestinal material.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Van Kemseke, Catherine ; Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Belaiche, Jacques ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Steeman, C.
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Language :
English
Title :
Negative association between smoking and anti-saccharomyces cerevisiae antibodies in Crohn's disease
FIOCCHI C. Inflammatory bowel disease: etiology and pathogenesis. Gastroenterology. 1998, 115: 182-205.
HUGOT J.-P., CHAMAILLARD M., ZOUALI H., LESAGE S., CÉZARD J.-P., BELAÏCHE J., ALMER S., TYSK C., O'MORAIN C.A., GASSULL M., BINDER V., FINKEL Y., CORTOT A., MODIGLIANI R., LAURENT-PUIG P., GOWER-ROUSSEAU C., MACRY J., COLOMBEL J.-F., SAHBATOU M., THOMAS G. Association of NOD2 leucinerich repeat variants with susceptibility to Crohn's disease. Nature, 2001, 411: 599-603.
OGURA Y., BONEN D.K., INOHARA N., NICOLAE D.I., CHEN F.F., RAMOS R., BRITTON H., MORAN T., KARALIUSKAS R., DUERR R.H., ACHKAR J.P., BRANT S.R., BAYLESS T.M., KIRSCHNER B.S., HANAUER S.B., NUNEZ G., CHO J.H. A frameshift mutation in NOD2 associated with susceptibility to Crohn's disease. Nature, 2001, 411: 603-606.
HAMPE J., CUTHBERT A., CROUCHER P.J.P., MIRZA M.M., MASCHERETTI S., FISHER S., FRENZEL H., KING K., HASSELMEYER A., MACPHERSON A.J.S., BRIDGER S., VAN DEVENTER S., FORBERS A., NIKOLAUS S., LENNARD-JONES J.E., FOELSCH U.R., KRAWCZAK M., LEWIS C., SCHREIBER S., MATHEW C.G. Association between insertion mutation in NOD2 gene and Crohn's disease in German and British populations. Lancet, 2001, 357: 1925-1928.
SOMMERVILLE K.W., LOGAN R.F.A., EDMOND M., LANGMAN M.J.S. Smoking and Crohn's disease. BMJ 1984, 289: 954-6.
TIMMER A., SUTHERLAND L.R., MARTIN F. AND THE CANADIAN MESALAMINE FOR REMISSION OF CROHN'S DISEASE STUDY GROUP. Oral contraceptive use and smoking are risk factor for relapse in Crohn's disease. Gastroenterology, 1998, 114: 1143-1150.
DUFFY L.C., ZIELEZNY M.A., MARSHALL J.R., WEISER M.M., BYERS T.E., PHILLIPS J.F., OGRA P.L., GRAHAM S. Cigarette smoking and risk of clinical relapse in patients with Crohn's disease. Am. J. Prev. Med., 1990, 6 (3): 161-166.
SUTHERLAND L.R., RAMCHARAN S., BRYANT H., FICK G. Effect of cigarette smoking on recurrence of Crohn's disease. Gastroenterology, 1990, 98: 1123-1128.
LINDBERG E., JÄRNEROT G., HUITFELD B. Smoking in Crohn's disease: effect of location and clinical course. Gut, 1992, 33: 779-782.
COTTONE M., ROSSELLI M., ORLANDO A., OLIVA L., PULEO A., CAPPELLO M., TRAINA M., TONELLI F., PAGLIARO L. Smoking habits and recurrence in Crohn's disease. Gastroenterology, 1994, 106: 643-648.
BREUER-KATSCHINSKI B.D., HOLLANDER N., GOEBELL H. Effect of cigarette smoking on the course of Crohn's disease. Eur. J. Gastroenterol. Hepatol., 1996, 8 (3): 225-228.
COSNES J., CARBONNEL F., BEAUGERIE L., LE QUINTREC Y., GENDRE J.-P. Effects of Cigarette Smoking on the Long-term Course of Crohn's Disease. Gastroenterology, 1996, 110: 424-431.
PLEVY S.E., TARGAN S.R., YANG H., FERNANDEZ D., ROTTER J.I., TOYODA H. Tumor necrosis factor microsatellites define a Crohn's diseaseassociated haplotype on chromosome 6. Gastroenterology, 1996, 110: 1053-1060.
KINOUCHI Y., VAN HEEL D., CARDON L., LENCH N., JEWELL D.P. Transmission disequilibrium testing confirms the association of the TNFα 1031C allele with Crohn's disease. Gastroenterology, 2001, 120: A2321.
LOUIS E., PEETERS M., FRANCHIMONT D., SEIDEL L., FONTAINE F., DEMOLIN G., CROES F., DUPONT D., DAVIN L., OMRI S., RUTGEERTS P., BELAÏCHE J. Tumour necrosis factor (TNF) gene polymorphism in Crohn's disease (CD): influence on disease behaviour? Clin. Exp. Immunol., 2000, 119: 64-68.
REIF S., LAVY A., KETER D., FICH A., ELIAKIM R., HALAK A., BROIDE E., NIV Y., PATZ J., ODES S., VILLA Y., GILAT T. Lack of association between smoking and Crohn's disease but the usual association with ulcerative colitis in Jewish patients in Israel: a multicenter study. Am. J. Gastroenterol., 2000, 95: 474-478.
VASILIAUSKAS E.A., KAM L.Y., KARP L.C., GAIENNIE J., YANG H., TARGAN S.R. Marker antibody expression stratifies Crohn's disease into immunologically homogeneous subgroups with distinct clinical characteristics. Gut, 2000, 47 (4): 487-496.
MAIN J., MC KENZIE H., YEAMAN G.R., KERR M.A., ROBSON D., PENNINGTON G.R., PARRATT D. Antibody to Saccharomyces cerevisiae (baker's yeast) in Crohn's disease. BMJ 1988, 297: 1105-6.
MC KENZIE H., MAIN J., PENNINGTON C.R., PARRATT D. Antibody to selected strains of Saccaharomyces cerevisiae (baker's and brewer's yeast) and Candida albicans in Crohn's disease. Gut, 1990, 31: 536-538.
LINDBERG E., MAGNUSSON K.-E., TYSK C., JÄRNEROT G. Antibody (IgG, IgA and IgM) to baker's yeast (Saccahromyces cerevisiae), yeast mannan, gliadin, ovalbumin and betalactoglobulin in monozygotic twins with inflammatory bowel disease. Gut. 1992, 33: 909-913.
GIAFFER M.H., CLARK A., HOLDSWORTH C.D. Antibodies to Saccharomyces cerevisiae in patients with Crohn's disease and their possible pathogenic importance. Gut, 1992, 33: 1071-1075.
BARCLAY G.R., MC KENZIE H., PENNINGTON J., PARRATT D., PENNINGTON C.R. The Effect of Dietary Yeast on the Activity of Stable Chronic Crohn's disease. Scand. J. Gastroenterol, 1992, 27: 196-200.
QUINTON J.F., SENDID B., REUMAUX D., DUTHILLEUL P., CORTOT A., GRANDBASTIEN B., CHARRIER G., TARGAN S.R., COLOMBEL J.F., POULAIN D. Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role. Gut, 1998, 42 (6): 778-791.
SENDID B., QUINTON J.F., CHARRIER G., GOULET O., CORTOT A., GRANDBASTIEN B., POULAIN D., COLOMBEL J.F. Anti-Saccahromyces cerevisiae mannan antibodies in familial Crohn's disease. Am. J. Gastroenterol., 1998, 93 (8): 1306-1310.
RUEMMELE F.M., TARGAN S.R., LEVY G., DUBINSKY M., BRAUN J., SEIDMAN E.G. Diagnostic Accuracy of Serological Assays in Pediatric Inflammatory Bowel Disease. Gastroenterology, 1998, 115: 822-829.
SUTTON C.L., YANG H., LI Z., ROTTER J.I., TARGAN S.R., BRAUN J. Familial expression of anti-Saccharomyces cerevisiae mannan antibodies in affected and unaffected relatives of patients with Crohn's disease. Gut, 2000, 46 (): 58-63.
BARNES R.M.R., ALLAN S., TAYLOR-ROBINSON CH., FINN R., JOHNSON P.M. Serum Antibodies Reactive with Saccharomyces cerevisiae in Inflammatory Bowel Disease: Is IgA Antibody a Marker for Crohn's Disease? Int. Arch. Allergy Appl. Immunol., 1990, 92: 9-15.
GASCHE C., SCHÖLMERICH J., BRYNSKOV J., D'HAENS G., HANAUER S.B., IRVINE E.J., JEWELL D.P., RACHMILEWITZ D., SACHAR D.B., SANDBORN W.J., SUTHERLAND L.R. A simple classification of Crohn's disease: report of the Working Party for the World Congresses of Gastroenterology, Inflammatory Bowel Disease, 2000 Feb, 6 (1): 8-15.
LOUIS E., COLARD A., OGER A.F., DEGROOTE E., ABOUL NASER EL YAFI F., BELAÏCHE J. Behavior of Crohn's disease according to Vienna classification: changing pattern over the course of the disease. Gut in press.
VERMEIRE S., JOOSENS S., PEETERS M., MONSUUR F., MARIEN G., BOSSUYT X., GROENEN P., VLIETINCK R., RUTGEERTS P. Comparative Study of ASCA (anti-Saccharomyces cerevisiae antibody) assays in Inflammatory Bowel Disease. Gastroenterology, 2001, 120: 827-833.
TAYLOR K.D., LI Z., BARRY M., FISCHEL-GHODSIAN N., PLEVY S.E., ROTTER J.I., TARGAN S.R., YANG H. Tumor necrosis factor microsatellite haplotype a11b4cd3e3 is associated with anti-Saccharomyces Cerevisiae antibody (ASCA) across clinical forms of Inflammatory Bowel Disease. Gastroenterology 114,4, A098 AGA abstracts, G4492.
WILSON A.G., SYMONS J.A., MC DOWEL T.L., MC DEVITT H.O., DUFF G.W. Effect of a polymorphism in the human tumor necrosis factor promoter on transcriptional activation. Proc. Natl. Acad. Sci. USA, 1997, 94: 3195-9.
BOUMA G., CRUSIUS J.B.A., OUDKERK POOL M. et al. Secretion of tumor necrosis factor α and lymphotoxin α in relation to polymorphisms in the TNF genes and HLA-DR alleles. Relevance for inflammatory bowel disease. Scand. J. Immunol., 1996, 43: 456-463.
LOUIS E., FRANCHIMONT D., PIRON A. et al. Tumor necrosis factor gene polymorphism influence tumor necrosis factor α production in LPS-stimulated whole blood cell culture in healthy humans. Clin. Exp. Immunol., 1998, 113: 401-406.
SOSTEGNI R., DAPERNO M., ERCOLE E., RIGAZIO C., BRESSO F., MASOERO G., CASTELLINO F., ZAFFINO C., ROCCA R. MOLINARO G.C., ROCCA G., ASTEGIANO M., PERA A. Detection of anti-Saccharomyces cerevisiae antibodies in Crohn's disease: is it a reliable diagnostic and prognostic marker? Dig. Liver Dis., 2001, 33: 755-761.
BARTON J.R., RIED M.A., GAZE M.N., MARAN A.G.D., FERGUSON A. Mucosal immunodeficiency in smokers and in patients with epithelial head and neck tumors. Gut, 1990, 31: 378-382.
