Author:

Keywords:

Adolescent, inflammatory-bowel-disease, Adult, anti-saccharomyces-cerevisiae, Aged, antineutrophil cytoplasmic autoantibodies, Aged, 80 and over, mannan antibodies asca, Analysis of Variance, ulcerative-colitis, binding lectin, Antibodies, Fungal, Candida albicans, molecular characterization, intestinal permeability, Candidiasis, Case-Control Studies, antibiotic-therapy, controlled trial, Colony Count, Microbial, Crohn Disease, Enzyme-Linked Immunosorbent Assay, Female, France, Humans, Incidence, Logistic Models, Male, Middle Aged, Pedigree, Probability, Reference Values, Risk Assessment, Saccharomyces cerevisiae, Sensitivity and Specificity, Severity of Illness Index, Yeasts, Young Adult, Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, INFLAMMATORY-BOWEL-DISEASE, ANTI-SACCHAROMYCES-CEREVISIAE, ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES, MANNAN ANTIBODIES ASCA, ULCERATIVE-COLITIS, BINDING LECTIN, MOLECULAR CHARACTERIZATION, INTESTINAL PERMEABILITY, ANTIBIOTIC-THERAPY, CONTROLLED TRIAL, 1103 Clinical Sciences, 3202 Clinical sciences

Abstract:

OBJECTIVES: Anti-Saccharomyces cerevisiae antibodies (ASCAs) are present in 50-60% of patients with Crohn's disease (CD) and in 20-25% of their healthy relatives (HRs). The yeast, Candida albicans, has been shown to generate ASCAs, but the presence of C. albicans in the digestive tract of CD patients and their HRs has never been investigated. Therefore, we studied C. albicans carriage in familial CD and its correlation with ASCAs. METHODS: Study groups consisted of 41 CD families composed of 129 patients and 113 HRs, and 14 control families composed of 76 individuals. Mouth swabs and stool specimens were collected for isolation, identification, and quantification of yeasts. Serum samples were collected for detection of ASCAs and anti-C. albicans mannan antibodies (ACMAs). RESULTS: C. albicans was isolated significantly more frequently from stool samples from CD patients (44%) and their HRs (38%) than from controls (22%) (P<0.05). The prevalence of ACMAs was similar between CD patients, their HRs, and controls (22, 19, and 21%, respectively, P=0.845), whereas the prevalence of ASCAs was significantly increased in CD families (72 and 34% in CD and HRs, respectively, in contrast to 4% in controls, P<0.0001). AMCA levels correlated with C. albicans colonization in all populations. ASCA levels correlated with C. albicans colonization in HRs but not in CD patients. CONCLUSIONS: CD patients and their first-degree HRs are more frequently and more heavily colonized by C. albicans than are controls. ASCAs correlate with C. albicans colonization in HRs but not in CD. In HRs, ASCAs could result from an altered immune response to C. albicans. In CD, a subsequent alteration in sensing C. albicans colonization could occur with disease onset.