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Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis

Crohn’s disease (CD) is a chronic intestinal disorder characterized by refractory gastrointestinal ulcerations. Intestinal tuberculosis (ITB) is one common intestinal disease in east Asia. The two diseases share similar clinical manifestations and endoscopic characteristics. Thus, it is difficult to...

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Autores principales: Jiang, Mingshan, Zeng, Zhen, Chen, Kexin, Dang, Yuan, Li, Lili, Ma, Chunxiang, Cheng, Rui, Hu, Kehan, Li, Xi, Zhang, Hu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966387/
https://www.ncbi.nlm.nih.gov/pubmed/35371004
http://dx.doi.org/10.3389/fimmu.2022.820891
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author Jiang, Mingshan
Zeng, Zhen
Chen, Kexin
Dang, Yuan
Li, Lili
Ma, Chunxiang
Cheng, Rui
Hu, Kehan
Li, Xi
Zhang, Hu
author_facet Jiang, Mingshan
Zeng, Zhen
Chen, Kexin
Dang, Yuan
Li, Lili
Ma, Chunxiang
Cheng, Rui
Hu, Kehan
Li, Xi
Zhang, Hu
author_sort Jiang, Mingshan
collection PubMed
description Crohn’s disease (CD) is a chronic intestinal disorder characterized by refractory gastrointestinal ulcerations. Intestinal tuberculosis (ITB) is one common intestinal disease in east Asia. The two diseases share similar clinical manifestations and endoscopic characteristics. Thus, it is difficult to establish a definite diagnosis of CD, CD concomitant with ITB (CD-ITB), and ITB in practice. Some enterogeneous microbiotic markers have been applied to differentiate CD and ITB, but it remains unknown how they work for the three groups of patients. The aim of our study was to explore the diagnostic values of these enterogeneous microbiotic markers (ASCA IgG, ASCA IgA, ACCA, Anti-I2 and AMCA) among CD, CD-ITB, and ITB patients. A total of 124 individuals were retrospectively enrolled in this study, namely, 103 CD patients, 10 CD-ITB patients, 9 ITB patients, and 68 healthy controls. The demographic and clinical characteristics of these patients were collected and analyzed. The values of these individual or combined enterogeneous microbiotic markers in diagnosis and classification were assessed in CD, CD-ITB, and ITB patients. ASCA IgG, ASCA IgA, and AMCA could accurately differentiate CD patients from healthy controls with an area under curve (AUC) of 0.688, 0.601, and 0.638, respectively. ASCA IgG was significantly higher in CD patients than in CD-ITB patients (P = 0.0003). The Anti-I2 antibody was appropriate for distinguishing CD-ITB from ITB patients (P = 0.039). In CD patients, ASCA IgG was higher in severe patients than in mild (P <0.0001) and inactive patients (P <0.0001), respectively. AMCA was significantly elevated in severe and moderate patients compared to inactive patients (P = 0.001, P = 0.003, respectively). AMCA was associated with a higher risk of CD-related surgery with a significant P-value of 0.0038. In our cohort, ASCAs and AMCA could accurately distinguish CD from healthy controls with an acceptable AUC. A combination of elevated ASCA IgG and AMCA antibodies established a higher sensitivity in differentiating CD from healthy controls. Elevated ASCA IgG demonstrated a differential diagnostic value between CD and CD-ITB. Anti-I2 could also distinguish CD-ITB from ITB. The level of AMCA was associated with both disease severity and CD-related surgery. Likewise, the level of ASCA IgG was also related to disease severity.
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spelling pubmed-89663872022-03-31 Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis Jiang, Mingshan Zeng, Zhen Chen, Kexin Dang, Yuan Li, Lili Ma, Chunxiang Cheng, Rui Hu, Kehan Li, Xi Zhang, Hu Front Immunol Immunology Crohn’s disease (CD) is a chronic intestinal disorder characterized by refractory gastrointestinal ulcerations. Intestinal tuberculosis (ITB) is one common intestinal disease in east Asia. The two diseases share similar clinical manifestations and endoscopic characteristics. Thus, it is difficult to establish a definite diagnosis of CD, CD concomitant with ITB (CD-ITB), and ITB in practice. Some enterogeneous microbiotic markers have been applied to differentiate CD and ITB, but it remains unknown how they work for the three groups of patients. The aim of our study was to explore the diagnostic values of these enterogeneous microbiotic markers (ASCA IgG, ASCA IgA, ACCA, Anti-I2 and AMCA) among CD, CD-ITB, and ITB patients. A total of 124 individuals were retrospectively enrolled in this study, namely, 103 CD patients, 10 CD-ITB patients, 9 ITB patients, and 68 healthy controls. The demographic and clinical characteristics of these patients were collected and analyzed. The values of these individual or combined enterogeneous microbiotic markers in diagnosis and classification were assessed in CD, CD-ITB, and ITB patients. ASCA IgG, ASCA IgA, and AMCA could accurately differentiate CD patients from healthy controls with an area under curve (AUC) of 0.688, 0.601, and 0.638, respectively. ASCA IgG was significantly higher in CD patients than in CD-ITB patients (P = 0.0003). The Anti-I2 antibody was appropriate for distinguishing CD-ITB from ITB patients (P = 0.039). In CD patients, ASCA IgG was higher in severe patients than in mild (P <0.0001) and inactive patients (P <0.0001), respectively. AMCA was significantly elevated in severe and moderate patients compared to inactive patients (P = 0.001, P = 0.003, respectively). AMCA was associated with a higher risk of CD-related surgery with a significant P-value of 0.0038. In our cohort, ASCAs and AMCA could accurately distinguish CD from healthy controls with an acceptable AUC. A combination of elevated ASCA IgG and AMCA antibodies established a higher sensitivity in differentiating CD from healthy controls. Elevated ASCA IgG demonstrated a differential diagnostic value between CD and CD-ITB. Anti-I2 could also distinguish CD-ITB from ITB. The level of AMCA was associated with both disease severity and CD-related surgery. Likewise, the level of ASCA IgG was also related to disease severity. Frontiers Media S.A. 2022-03-16 /pmc/articles/PMC8966387/ /pubmed/35371004 http://dx.doi.org/10.3389/fimmu.2022.820891 Text en Copyright © 2022 Jiang, Zeng, Chen, Dang, Li, Ma, Cheng, Hu, Li and Zhang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Jiang, Mingshan
Zeng, Zhen
Chen, Kexin
Dang, Yuan
Li, Lili
Ma, Chunxiang
Cheng, Rui
Hu, Kehan
Li, Xi
Zhang, Hu
Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis
title Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis
title_full Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis
title_fullStr Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis
title_full_unstemmed Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis
title_short Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn’s Disease and Intestinal Tuberculosis
title_sort enterogenous microbiotic markers in the differential diagnosis of crohn’s disease and intestinal tuberculosis
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966387/
https://www.ncbi.nlm.nih.gov/pubmed/35371004
http://dx.doi.org/10.3389/fimmu.2022.820891
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