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Dietary antigens in Crohn's disease: Antibodies to porcine pancreatic amylase

American Journal of Gastroenterology, ISSN: 0002-9270, Vol: 103, Issue: 3, Page: 656-664
2008
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Article Description

OBJECTIVES: There is no clear evidence that dietary proteins aggravate Crohn's disease (CD). We aimed to clarify the antibody response to dietary proteins in CD. METHODS: Antibody to porcine pancreatic amylase (PPA) a protease-resistant dietary protein (anti-PPA), was examined in CD patients (N = 104), ulcerative colitis (UC) patients (N = 85), and healthy controls (N = 83), and its relationship with the clinical characteristics of CD was investigated. Antibodies to casein and ovalbumin, anti-Saccharomyces cerevisiae antibodies (ASCA), and antibodies to I2 from Pseudomonas fluorescens (anti-I2) were also examined. RESULTS: Thirty-eight percent (39/104) of the CD patients expressed anti-PPA antibodies, and this percentage was significantly higher as compared with the control group (5%, 4/83) and the UC group (9%, 8/85) (P < 0.001). A significantly higher level of anti-PPA antibodies was detected in patients with "small bowel disease-dominant" CD than in those with "colitis-dominant" CD (P < 0.05). Antibodies to casein and ovalbumin were not specifically expressed in CD patients. As ASCA was detected in 33% and anti-I2 in 46% of the CD patients, 72% of the CD patients were found positive for at least one of the three antibodies including anti-PPA antibodies. CONCLUSIONS: CD patients showed a specific antibody response to PPA, as compared with UC patients and controls. There was a significantly higher level of anti-PPA antibody in patients with "small bowel disease-dominant" CD, suggesting that dietary proteins could play a role in the inflammatory response in CD patients with small bowel disease. Anti-PPA antibodies combined with ASCA/anti-I2 may be useful for the diagnosis of CD. © 2008 by Am. Coll. of Gastroenterology.

Bibliographic Details

Suzuki, Hideki; Fukuda, Yoshihiro; Koizuka, Hiromasa; Tomita, Toshihiko; Hori, Kazutoshi; Suzuki, Manabu; O'Morain, Colm

Ovid Technologies (Wolters Kluwer Health)

Medicine

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