Specific Antibodies May Be Marker of Ulcerative Colitis in Young Patients, Study Suggests

Specific Antibodies May Be Marker of Ulcerative Colitis in Young Patients, Study Suggests
A positive test for the proteinase 3-anti-neutrophil cytoplasmic antibodies (PR3-ANCA) may differentiate ulcerative colitis (UC) from Crohn's disease (CD) in children and adolescents with inflammatory bowel disease (IBD), a study suggests. The study, “PR3-ANCA and panel diagnostics in pediatric inflammatory bowel disease to distinguish ulcerative colitis from Crohn's disease,” was published in the journal PLOS ONE. Establishing a correct IBD diagnosis can be challenging due to atypical presentations of both CD and UC, which complicates disease management. According to the revised Porto criteria, antibody testing may help distinguish between CD and UC in children and adolescents, although the existence of fewer markers of UC than those of CD is a limitation. ANCAs are one of the most investigated antibodies in IBD. They can be subdivided into specific subtypes based on distinct tissue and cell staining patterns, as assessed by a technique called immunofluorescence. PR3-ANCA is a hallmark of granulomatosis with polyangiitis, a subset of ANCA-associated vasculitis (AAV). It has also been associated with UC in adults, including a link to more extended disease. In this study, researchers from the University Children's Hospital Bern and the Children’s Hospital Lucerne, in Switzerland, explored PR3-ANCA testing as a tool for UC diagnosis in children and adolescents with IBD. The investigators also conducted an extensive antibody profiling to obtain an optimal antibody panel to differentiate CD and UC. For this purpose, they determined the prevalence of PR3-ANCA; myeloperoxidase (MPO)-ANCA, a marker for the AAV type microscopic polyangiitis; pANCA, cANCA, and xANCA (different cell staining patterns of ANCAs); anti-Saccharomyces cerevisiae antibodies (A
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