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Beyond a defective innate immune response in inflammatory bowel disease (IBD), an increased immunological response toward microbial and self antigens has been intrinsically linked to the pathogenesis of such common immunopathologies of the gut. Mounting evidence indicates that increased seroreactivity toward certain antigens are a predictive and quantitative heritable trait, including the anti-Saccharomyces cerevisiae antibody (ASCA). Consistently, Candida albicans and Crohn's disease-associated NOD2 mutations have been recently identified as immunogen and genetic determinants for ASCA, respectively. In clinical practice, current panels of serological markers are not recommended for diagnosis, stratifying, and monitoring IBD. Therefore, prospective studies and highly sensitive serological panels of markers are eagerly awaited before guiding clinical decisions. Better understanding of the serological response in IBD might also provide new insights into their epidemiology and pathophysiology.
Peyrin‐Biroulet et al. (Mon,) studied this question.
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