Anti-Neutrophilic Cytoplasmatic Antibodies as a Marker of Inflammatory Intestinal Diseases

The incidence of inflammatory bowel diseases (IBD), which are represented by two main nosological forms: ulcerative colitis (UC) and Crohn’s disease (CD), is increasing worldwide. UC usually affects the large intestine, whereas CD can cover the entire gastrointestinal tract (GI tract), from the mouth to the anus. Although the etiology of IBD is not fully understood, it is considered an immunologically mediated disease in genetically susceptible patients. In order to improve the early diagnosis of inflammatory bowel diseases, an active search for new immunological markers is underway. This is due to the fact that the development of IBD is based on a violation of the immune response to endogenous antigens or microorganisms in genetically predisposed individuals, which makes immunological markers a promising direction for improving diagnosis. The study included 150 patients. Of these, the main group consisted of 100 coloproctology department patients with IBD: 65 patients with UC, including 42 (65%) men and 23 (35%) women, with an average age of 43.20±13.21 years; 35 patients with acute CD, including 26 (74%) men and 9 (26%) women, their average age was 38.34±12.13 years; 50 patients were in the control group, including 27 (54%) men and 23 (46%) women, their average age was 51.42±14.29 years. All patients lived in the Samara region at the time of the examination. The diagnosis of UC or CD was established on the basis of clinical, laboratory, endoscopic and histopathological results in accordance with the diagnostic criteria of IBD. A panel of antineutrophil cytoplasmic antibodies was analyzed. In patients with UC, a statistically significant positive ANCA result was obtained for elastase (p<0.001), lactoferrin (p<0.001), cathepsin G (p<0.001), myeloperoxidase (p<0.001), lysozyme (p<0.001), BPI (p<0.001), proteinase 3 (p<0.001). Based on the data we have obtained, panels, including the determination of multiple antibodies, seem to be a promising tool for the differential diagnosis of Crohn’s disease and ulcerative colitis. In addition, they can be useful for stratifying patients, allowing them to be classified according to the severity of the disease and assess the risk of complications.