Open AccessAge of diagnosis influences serologic responses in children with Crohn's disease: A possible clue to etiology?
Author(s) -
Markowitz James,
Kugathasan Subra,
Dubinsky Marla,
Mei Ling,
Crandall Wallace,
LeLeiko Neal,
OlivaHemker Maria,
Rosh Joel,
Evans Jonathan,
Mack David,
Otley Anthony,
Pfefferkorn Marian,
Bahar Ron,
Vasiliauskas Eric,
Wahbeh Ghassan,
Silber Gary,
Quiros J. Antonio,
Wrobel Iwona,
Nebel Justin,
Landers Carol,
Picornell Yoanna,
Targan Stephan,
Lerer Trudy,
Hyams Jeffrey
Publication year - 2009
Publication title -
inflammatory bowel diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.932
H-Index - 146
eISSN - 1536-4844
pISSN - 1078-0998
DOI - 10.1002/ibd.20831
Subject(s) - serology , medicine , etiology , inflammatory bowel disease , disease , crohn's disease , immunology , panca , gastroenterology , pathogenesis , antibody , anti neutrophil cytoplasmic antibody , vasculitis
Background: Crohn's disease (CD) is often associated with antibodies to microbial antigens. Differences in immune response may offer clues to the pathogenesis of the disease. The aim was to examine the influence of age at diagnosis on the serologic response in children with CD. Methods: Data were drawn from 3 North American multicenter pediatric inflammatory bowel disease (IBD) research consortia. At or shortly after diagnosis, pANCA, ASCA IgA, ASCA IgG, anti‐ompC, and anti‐CBir1 were assayed. The results were compared as a function of age at CD diagnosis (0–7 years versus 8–15 years). Results: In all, 705 children (79 <8 years of age at diagnosis, 626 ≥8 years) were studied. Small bowel CD was less frequent in the younger group (48.7% versus 72.6%; P < 0.0001), while colonic involvement was comparable (91.0% versus 86.5%). ASCA IgA and IgG were seen in <20% of those 0–7 years old compared to nearly 40% of those 8–15 years old ( P < 0.001), while anti‐CBir1 was more frequent in the younger children (66% versus 54%, P < 0.05). Anti‐CBir1 detected a significant number of children in both age groups who otherwise were serologically negative. Both age at diagnosis and site of CD involvement were independently associated with expression of ASCA and anti‐CBir1. Conclusions: Compared to children 8–15 years of age at diagnosis, those 0–7 years are more likely to express anti‐CBir1 but only half as likely to express ASCA. These age‐associated differences in antimicrobial seropositivity suggest that there may be different, and as yet unrecognized, genetic, immunologic, and/or microbial factors leading to CD in the youngest children. (Inflamm Bowel Dis 2008)