Anti-proteinase 3 antineutrophil cytoplasmic antibody reflects disease activity and predicts the response to steroid therapy in ulcerative colitis View Full Text


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Article Info

DATE

2021-08-23

AUTHORS

Yuki Aoyama, Tomoki Inaba, Sakuma Takahashi, Hisae Yasuhara, Sakiko Hiraoka, Takeshi Morimoto, Hugh Shunsuke Colvin, Masaki Wato, Midori Ando, Satoko Nakamura, Koichi Mizobuchi, Hiroyuki Okada

ABSTRACT

BackgroundSerum anti-proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA) is a disease-specific antibody against granulomatosis with polyangiitis. PR3-ANCA is a useful serological marker for disease severity in ulcerative colitis (UC). The purpose of this study was to investigate whether PR3-ANCA levels could also predict the success of induction therapy and to compare its performance against other markers, including serum CRP and fecal hemoglobin.MethodsThis was a multicenter retrospective study. In total, 159 patients with active-phase UC underwent colonoscopy. Disease activity was measured using the Mayo endoscopic subscore (MES). PR3-ANCA positivity and the response to induction therapy, either 5-aminosalicylic acid or steroid, were assessed. PR3-ANCA, CRP, and fecal hemoglobin were measured during the active phase, and during clinical remission.ResultsEighty-five (53.5%) of 159 patients with active UC were positive for PR3-ANCA. PR3-ANCA titers were significantly higher in the group of patients with MES 3 compared to patients with MES 1 (P = 0.002) or MES 2 (P = 0.035). Steroid therapy was administered to 56 patients with a median partial Mayo score of 7 (5–9), which is equivalent to moderate-to-severe disease activity. PR3-ANCA positivity of non-responders to steroid therapy was significantly higher than that of responders (71.9% vs, 41.7%, P = 0.030), whereas CRP and fecal hemoglobin were not predictive of steroid response. Multivariate analysis demonstrated that PR3-ANCA positivity was associated with non-response to steroid therapy (odds ratio 5.19; 95% confidence interval, 1.54–17.5; P = 0.008). Of the 37 patients treated to clinical remission who were also positive for PR3-ANCA during the active phase, 27 had an MES of ≥ 1, and 10 patients had an MES of 0. In clinical remission, the proportion of patients with MES 0 in 17 patients whose PR3-ANCA became negative was significantly higher than that in 20 patients whose PR3-ANCA remained positive (47.1% vs. 10.0%, P = 0.023).ConclusionsPR3-ANCA not only serves as a marker of disease activity, but also predicts the failure of steroid therapy in moderate-to-severe UC.Trial registration: This study was retrospectively registered in the UMIN Clinical Trials Registry System (000039174) on January 16, 2020. More... »

PAGES

325

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12876-021-01903-5

DOI

http://dx.doi.org/10.1186/s12876-021-01903-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1140585905

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34425765


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23 CRP
24 MES 0
25 MES-1
26 MES-2
27 MES-3
28 Mayo endoscopic subscore
29 Mayo score
30 MethodsThis
31 PR3-ANCA
32 PR3-ANCA levels
33 PR3-ANCA positivity
34 PR3-ANCA titers
35 ResultsEighty-five
36 UMIN Clinical Trials Registry System
37 acid
38 active phase
39 active ulcerative colitis
40 activity
41 analysis
42 antibodies
43 antineutrophil cytoplasmic antibody
44 clinical remission
45 colitis
46 colonoscopy
47 cytoplasmic antibodies
48 disease activity
49 disease severity
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51 endoscopic subscore
52 faecal haemoglobin
53 failure
54 granulomatosis
55 group
56 group of patients
57 hemoglobin
58 induction therapy
59 levels
60 markers
61 median partial Mayo score
62 multicenter retrospective study
63 multivariate analysis
64 partial Mayo score
65 patients
66 performance
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68 polyangiitis
69 positivity
70 proportion
71 proportion of patients
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73 registry system
74 remission
75 responders
76 response
77 retrospective study
78 scores
79 serological markers
80 serum CRP
81 severe disease activity
82 severe ulcerative colitis
83 severity
84 steroid response
85 steroid therapy
86 steroids
87 study
88 subscores
89 success
90 system
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92 titers
93 ulcerative colitis
94 underwent colonoscopy
95 useful serological marker
96 schema:name Anti-proteinase 3 antineutrophil cytoplasmic antibody reflects disease activity and predicts the response to steroid therapy in ulcerative colitis
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