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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

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    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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Anti-Saccharomyces cerevisiae Antibody in Pediatric Crohn’s Disease Patients without Mucosal Healing Is a Useful Marker of Mucosal Damage

Mi Jin Kim1 , Eunsil Kim1 , Ben Kang2 , Yoon Lee3 , Eun-Suk Kang4 , and Yon Ho Choe1

1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 2Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, 3Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, and 4Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to:Yon Ho Choe
ORCID https://orcid.org/0000-0003-1525-7688
E-mail i101016@skku.edu

Received: July 8, 2020; Revised: September 24, 2020; Accepted: September 25, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut and Liver

Published online December 30, 2020

Copyright © Gut and Liver.

Abstract

Background/Aims: We evaluated whether anti-Saccharomyces cerevisiae antibody (ASCA) titers are associated with diagnostic findings, disease activity, Paris classification phenotypes, and persistence after infliximab (IFX) treatment in children with Crohn’s disease (CD). We also investigated the role of ASCA as a predictor of mucosal healing (MH) and clinical remission (CR).
Methods: This study included 61 CD patients aged 19 years or younger who were diagnosed and treated between September 2010 and January 2019 and followed for at least 1 year. ASCA was regularly measured at the diagnosis of CD and at least 1 year after IFX therapy.
Results: The average follow-up period was 3.8±3.4 years (range, 1.0 to 7.2 years). Regression analysis showed that the ASCA titer was the only factor associated with Simple Endoscopic Score for Crohn's Disease (SES-CD) or CR among all the parameters. In patients who had achieved MH (SES-CD=0), ASCA immunoglobulin G (IgG) was not associated with MH, but in patients without MH, ASCA IgG was associated with SES-CD (p=0.005) and CR (p<0.001). The cutoff value of ASCA IgG in patients with CR was 21.8 units. However, there was no difference in the relapse rate between the ASCA IgG-positive and -negative groups during the follow-up period.
Conclusions: In patients who have not achieved MH, ASCA IgG is closely related to mucosal damage and CR. Unlike western studies, ASCA IgG may be more helpful in predicting prognosis than IgA in Korean patients, but it is not an appropriate indicator to predict the relapse of CD.

Keywords: Crohn disease, Anti-Saccharomyces cerevisiae, Children, Marker, Mucosal healing


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Gut and Liver

Published online December 30, 2020

Copyright © Gut and Liver.

Anti-Saccharomyces cerevisiae Antibody in Pediatric Crohn’s Disease Patients without Mucosal Healing Is a Useful Marker of Mucosal Damage

Mi Jin Kim1 , Eunsil Kim1 , Ben Kang2 , Yoon Lee3 , Eun-Suk Kang4 , and Yon Ho Choe1

1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 2Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, 3Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, and 4Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to:Yon Ho Choe
ORCID https://orcid.org/0000-0003-1525-7688
E-mail i101016@skku.edu

Received: July 8, 2020; Revised: September 24, 2020; Accepted: September 25, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: We evaluated whether anti-Saccharomyces cerevisiae antibody (ASCA) titers are associated with diagnostic findings, disease activity, Paris classification phenotypes, and persistence after infliximab (IFX) treatment in children with Crohn’s disease (CD). We also investigated the role of ASCA as a predictor of mucosal healing (MH) and clinical remission (CR).
Methods: This study included 61 CD patients aged 19 years or younger who were diagnosed and treated between September 2010 and January 2019 and followed for at least 1 year. ASCA was regularly measured at the diagnosis of CD and at least 1 year after IFX therapy.
Results: The average follow-up period was 3.8±3.4 years (range, 1.0 to 7.2 years). Regression analysis showed that the ASCA titer was the only factor associated with Simple Endoscopic Score for Crohn's Disease (SES-CD) or CR among all the parameters. In patients who had achieved MH (SES-CD=0), ASCA immunoglobulin G (IgG) was not associated with MH, but in patients without MH, ASCA IgG was associated with SES-CD (p=0.005) and CR (p<0.001). The cutoff value of ASCA IgG in patients with CR was 21.8 units. However, there was no difference in the relapse rate between the ASCA IgG-positive and -negative groups during the follow-up period.
Conclusions: In patients who have not achieved MH, ASCA IgG is closely related to mucosal damage and CR. Unlike western studies, ASCA IgG may be more helpful in predicting prognosis than IgA in Korean patients, but it is not an appropriate indicator to predict the relapse of CD.

Keywords: Crohn disease, Anti-Saccharomyces cerevisiae, Children, Marker, Mucosal healing

Gut and Liver

Vol.15 No.3
May, 2021

pISSN 1976-2283
eISSN 2005-1212

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