This marker is usually part of a test called IBD Expanded Panel (IBD = Inflammatory Bowel Disease) and aids in the diagnosis of inflammatory bowel disease and the differential diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC); it is also a prognostic aid for clinical management of patients with CD.
What is IBD?
Inflammatory bowel disease is a chronic disorder of the lower gastrointestinal tract that may occur in three forms:
- Crohn’s disease (CD),
- Ulcerative colitis (UC),
- and Indeterminate colitis (IC).
How to diagnose IBD?
Its prevalence in the adult population approaches 0.3%. The differential diagnosis of the different forms of IBD is often difficult, time-consuming, and invasive. The gold standard for diagnosis is endoscopy with biopsies for histologic examination.
In recent years, however, a number of serological markers have been introduced. The most commonly employed serological markers of IBD are:
- anti-Saccharomyces cerevisiae antibody (ASCA) and
- atypical perinuclear antineutrophil cytoplasmic antibody (pANCA).
ASCA positivity is found predominantly in patients with Crohn’s disease (CD), while pANCA positivity is found predominantly in patients with Ulcerative colitis (UC).
A combination of ASCA and pANCA has a specificity of as high as 99% for differentiation of CD from UC. Nevertheless, there are a substantial number of patients with IBD who are negative for both. The addition of novel serological markers improves the sensitivity of the conventional ASCA/pANCA combination.
About two-thirds of patients with CD develop either a stricturing or penetrating disease course within 10 years after diagnosis. As many as 80% of all CD patients undergo surgery at least once during the course of their disease. Consequently, the identification of individuals susceptible to the development of more complicated disease behavior would allow for earlier and more aggressive treatment.
The IBD Expanded Panel test offers three novel markers:
- antichitobioside IgA (ACCA),
- antilaminaribioside IgG (ALCA),
- antimannobioside IgG (AMCA),
together with anti-Saccharomyces cerevisiae IgG (gASCA) and pANCA.
These markers provide additional diagnostic and prognostic information depending on the combination of results.
The antibodies included in the panel are:
- ASCA (anti-Saccharomyces cerevisiae antibodies),
- ALCA (antilaminaribioside carbohydrate antibodies),
- ACCA (antichitobioside carbohydrate antibodies),
- AMCA (antimannobioside carbohydrate antibodies).
Numerous studies of CD have demonstrated an association between ileal disease (ileal = last part of the small intestine) and the presence of ACCA, ALCA, AMCA, and ASCA. Among these antibodies, the association with localization to the small intestine increased with the number of positive antibodies and with the concentration of individual antibodies. A more aggressive or complicated disease course in CD (as indicated by stricturing or perforation of the intestine or need for surgery), has also been associated with the presence of ACCA, ALCA, AMCA, and ASCA. Among these antibodies, the association with complicated disease behavior or surgery increased with the number and concentration of antibodies.
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How to interpret your results:
###Please look at all markers of this report together###
When the only positive marker is pANCA, the interpretive comment on the report will read: "Suggestive of ulcerative colitis."
When only one of ACCA, ALCA, AMCA, or gASCA is positive and pANCA is negative, the interpretive comment will read: "Suggestive of Crohn's disease. Pattern is not conclusive for disease behavior risk stratification."
When only one of ACCA, ALCA, AMCA, or gASCA is positive and pANCA is positive, the interpretive comment will read: "Suggestive of inflammatory bowel disease. Pattern is not conclusive for any specific disease form."
When any two of ACCA, ALCA, AMCA, or gASCA are positive and pANCA is positive or negative, the interpretive comment will read: "Suggestive of Crohn's disease with high risk of aggressive disease behavior (development of strictures or fistulae)."
When any three or more of ACCA, ALCA, AMCA, or gASCA are positive and pANCA is positive or negative, the interpretive comment will read: "Suggestive of Crohn's disease with the very high risk of aggressive disease behavior (development of strictures or fistulae)."
When all markers are negative, the interpretive comment on the report will read: "Pattern is not suggestive of inflammatory bowel disease."
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Numerous studies of CD have demonstrated an association between ileal disease (ileal = last part of the small intestine) and the presence of ACCA, ALCA, AMCA, and ASCA. Among these antibodies, the association with localization to the small intestine increased with the number of positive antibodies and with the concentration of individual antibodies. A more aggressive or complicated disease course in CD (as indicated by stricturing or perforation of the intestine or need for surgery), has also been associated with the presence of ACCA, ALCA, AMCA, and ASCA. Among these antibodies, the association with complicated disease behavior or surgery increased with the number and concentration of antibodies.
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If gASCA levels are elevated in an IBD Expanded Panel, it may suggest a greater likelihood of Crohn's Disease. However, the presence of ASCA alone is not definitive for diagnosing Crohn's Disease. It's usually considered alongside other clinical findings, symptoms, and test results.
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More about Crohn's Disease:
Crohn's disease is a chronic inflammatory bowel disease (IBD) characterized by inflammation of the gastrointestinal (GI) tract. It can affect any part of the GI tract from the mouth to the anus, but most commonly it affects the end of the small intestine and the beginning of the large intestine. Symptoms can vary but often include abdominal pain, diarrhea, fatigue, weight loss, and malnutrition. The exact cause of Crohn's disease is unknown, but it is believed to result from an interaction of genetic, environmental, and immune factors. The inflammation caused by Crohn's disease can be painful and debilitating, and may lead to life-threatening complications. While there is no cure, treatments are available that can greatly reduce the symptoms and even bring about long-term remission. These treatments include medication, lifestyle changes, and sometimes surgery. Management of the disease requires a comprehensive approach and is often tailored to the individual patient's needs.
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It's important to understand that elevated gASCA levels are a biomarker and not a direct cause of symptoms or disease. Therefore, the treatment focuses on managing Crohn's disease itself rather than specifically targeting the elevated gASCA levels. Here are general approaches to treating Crohn's disease:
Medication:
Diet and Nutrition Management:
Lifestyle Changes:
Surgery:
Regular Monitoring:
Remember, treatment for Crohn's disease is highly individualized and depends on the severity and location of the disease, as well as the patient's overall health and response to treatment. It's crucial to work closely with a gastroenterologist to develop a tailored treatment plan. Additionally, ongoing research may continue to provide new insights and treatments for Crohn's disease, so staying informed about the latest developments is beneficial.
Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
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Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
How to interpret your results:
###Please look at all markers of this report together###
When the only positive marker is pANCA, the interpretive comment on the report will read: "Suggestive of ulcerative colitis."
When only one of ACCA, ALCA, AMCA, or gASCA is positive and pANCA is negative, the interpretive comment will read: "Suggestive of Crohn's disease. Pattern is not conclusive for disease behavior risk stratification."
When only one of ACCA, ALCA, AMCA, or gASCA is positive and pANCA is positive, the interpretive comment will read: "Suggestive of inflammatory bowel disease. Pattern is not conclusive for any specific disease form."
When any two of ACCA, ALCA, AMCA, or gASCA are positive and pANCA is positive or negative, the interpretive comment will read: "Suggestive of Crohn's disease with high risk of aggressive disease behavior (development of strictures or fistulae)."
When any three or more of ACCA, ALCA, AMCA, or gASCA are positive and pANCA is positive or negative, the interpretive comment will read: "Suggestive of Crohn's disease with the very high risk of aggressive disease behavior (development of strictures or fistulae)."
When all markers are negative, the interpretive comment on the report will read: "Pattern is not suggestive of inflammatory bowel disease."
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Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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We’ve crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
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