Age of diagnosis influences serologic responses in children with Crohn's disease

A possible clue to etiology?

James Markowirz, Subra Kugathasan, Marla Dubinsky, Ling Mei, Wallace Crandall, Neal LeLeiko, Maria Oliva-Hemker, Joel Rosh, Jonathan Evans, David Mack, Anthony Otley, Marian Pfefferkorn, Ron Bahar, Eric Vasiliauskas, Ghassan Wahbeh, Gary Silber, J. Antonio Quiros, Iwona Wrobel, Justin Nebel, Carol Landers & 4 others Yoanna Picornell, Stephan Targan, Trudy Lerer, Jeffrey Hyams

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: Crohn's disease (CD) is often associated with antibodies to microbial antigens. Differences in immune response may offer clues to the pathogenesis of the disease. The aim was to examine the influence of age at diagnosis on the serologic response in children with CD. Methods: Data were drawn from 3 North American multicenter pediatric inflammatory bowel disease (IBD) research consortia. At or shortly after diagnosis, pANCA, ASCA IgA, ASCA IgG, anti-ompC, and anti-CBir1 were assayed. The results were compared as a function of age at CD diagnosis (0-7 years versus 8-15 years). Results: In all, 705 children (79 <8 years of age at diagnosis, 626 ≥8 years) were studied. Small bowel CD was less frequent in the younger group (48.7% versus 72.6%; P < 0.0001), while colonic involvement was comparable (91.0% versus 86.5%). ASCA IgA and IgG were seen in <20% of those 0-7 years old compared to nearly 40% of those 8-15 years old (P < 0.001), while anti-CBir1 was more frequent in the younger children (66% versus 54%, P < 0.05). Anti-CBir1 detected a significant number of children in both age groups who otherwise were serologically negative. Both age at diagnosis and site of CD involvement were independently associated with expression of ASCA and anti-CBir1. Conclusions: Compared to children 8-15 years of age at diagnosis, those 0-7 years are more likely to express anti-CBir1 but only half as likely to express ASCA. These age-associated differences in antimicrobial seropositivity suggest that there may be different, and as yet unrecognized, genetic, immunologic, and/or microbial factors leading to CD in the youngest children.

Original languageEnglish
Pages (from-to)714-719
Number of pages6
JournalInflammatory Bowel Diseases
Volume15
Issue number5
DOIs
StatePublished - 2009

Fingerprint

Crohn Disease
Immunoglobulin A
Inflammatory Bowel Diseases
Age Groups
Immunoglobulin G
Pediatrics
Antigens
Antibodies
Research

Keywords

  • Children
  • Crohn's disease
  • Serologic responses

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Markowirz, J., Kugathasan, S., Dubinsky, M., Mei, L., Crandall, W., LeLeiko, N., ... Hyams, J. (2009). Age of diagnosis influences serologic responses in children with Crohn's disease: A possible clue to etiology? Inflammatory Bowel Diseases, 15(5), 714-719. https://doi.org/10.1002/ibd.20831

Age of diagnosis influences serologic responses in children with Crohn's disease : A possible clue to etiology? / Markowirz, James; Kugathasan, Subra; Dubinsky, Marla; Mei, Ling; Crandall, Wallace; LeLeiko, Neal; Oliva-Hemker, Maria; Rosh, Joel; Evans, Jonathan; Mack, David; Otley, Anthony; Pfefferkorn, Marian; Bahar, Ron; Vasiliauskas, Eric; Wahbeh, Ghassan; Silber, Gary; Quiros, J. Antonio; Wrobel, Iwona; Nebel, Justin; Landers, Carol; Picornell, Yoanna; Targan, Stephan; Lerer, Trudy; Hyams, Jeffrey.

In: Inflammatory Bowel Diseases, Vol. 15, No. 5, 2009, p. 714-719.

Research output: Contribution to journalArticle

Markowirz, J, Kugathasan, S, Dubinsky, M, Mei, L, Crandall, W, LeLeiko, N, Oliva-Hemker, M, Rosh, J, Evans, J, Mack, D, Otley, A, Pfefferkorn, M, Bahar, R, Vasiliauskas, E, Wahbeh, G, Silber, G, Quiros, JA, Wrobel, I, Nebel, J, Landers, C, Picornell, Y, Targan, S, Lerer, T & Hyams, J 2009, 'Age of diagnosis influences serologic responses in children with Crohn's disease: A possible clue to etiology?', Inflammatory Bowel Diseases, vol. 15, no. 5, pp. 714-719. https://doi.org/10.1002/ibd.20831
Markowirz, James ; Kugathasan, Subra ; Dubinsky, Marla ; Mei, Ling ; Crandall, Wallace ; LeLeiko, Neal ; Oliva-Hemker, Maria ; Rosh, Joel ; Evans, Jonathan ; Mack, David ; Otley, Anthony ; Pfefferkorn, Marian ; Bahar, Ron ; Vasiliauskas, Eric ; Wahbeh, Ghassan ; Silber, Gary ; Quiros, J. Antonio ; Wrobel, Iwona ; Nebel, Justin ; Landers, Carol ; Picornell, Yoanna ; Targan, Stephan ; Lerer, Trudy ; Hyams, Jeffrey. / Age of diagnosis influences serologic responses in children with Crohn's disease : A possible clue to etiology?. In: Inflammatory Bowel Diseases. 2009 ; Vol. 15, No. 5. pp. 714-719.
@article{b93dae4eb45243af95d1648b650cc6b2,
title = "Age of diagnosis influences serologic responses in children with Crohn's disease: A possible clue to etiology?",
abstract = "Background: Crohn's disease (CD) is often associated with antibodies to microbial antigens. Differences in immune response may offer clues to the pathogenesis of the disease. The aim was to examine the influence of age at diagnosis on the serologic response in children with CD. Methods: Data were drawn from 3 North American multicenter pediatric inflammatory bowel disease (IBD) research consortia. At or shortly after diagnosis, pANCA, ASCA IgA, ASCA IgG, anti-ompC, and anti-CBir1 were assayed. The results were compared as a function of age at CD diagnosis (0-7 years versus 8-15 years). Results: In all, 705 children (79 <8 years of age at diagnosis, 626 ≥8 years) were studied. Small bowel CD was less frequent in the younger group (48.7{\%} versus 72.6{\%}; P < 0.0001), while colonic involvement was comparable (91.0{\%} versus 86.5{\%}). ASCA IgA and IgG were seen in <20{\%} of those 0-7 years old compared to nearly 40{\%} of those 8-15 years old (P < 0.001), while anti-CBir1 was more frequent in the younger children (66{\%} versus 54{\%}, P < 0.05). Anti-CBir1 detected a significant number of children in both age groups who otherwise were serologically negative. Both age at diagnosis and site of CD involvement were independently associated with expression of ASCA and anti-CBir1. Conclusions: Compared to children 8-15 years of age at diagnosis, those 0-7 years are more likely to express anti-CBir1 but only half as likely to express ASCA. These age-associated differences in antimicrobial seropositivity suggest that there may be different, and as yet unrecognized, genetic, immunologic, and/or microbial factors leading to CD in the youngest children.",
keywords = "Children, Crohn's disease, Serologic responses",
author = "James Markowirz and Subra Kugathasan and Marla Dubinsky and Ling Mei and Wallace Crandall and Neal LeLeiko and Maria Oliva-Hemker and Joel Rosh and Jonathan Evans and David Mack and Anthony Otley and Marian Pfefferkorn and Ron Bahar and Eric Vasiliauskas and Ghassan Wahbeh and Gary Silber and Quiros, {J. Antonio} and Iwona Wrobel and Justin Nebel and Carol Landers and Yoanna Picornell and Stephan Targan and Trudy Lerer and Jeffrey Hyams",
year = "2009",
doi = "10.1002/ibd.20831",
language = "English",
volume = "15",
pages = "714--719",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "5",

}

TY - JOUR

T1 - Age of diagnosis influences serologic responses in children with Crohn's disease

T2 - A possible clue to etiology?

AU - Markowirz, James

AU - Kugathasan, Subra

AU - Dubinsky, Marla

AU - Mei, Ling

AU - Crandall, Wallace

AU - LeLeiko, Neal

AU - Oliva-Hemker, Maria

AU - Rosh, Joel

AU - Evans, Jonathan

AU - Mack, David

AU - Otley, Anthony

AU - Pfefferkorn, Marian

AU - Bahar, Ron

AU - Vasiliauskas, Eric

AU - Wahbeh, Ghassan

AU - Silber, Gary

AU - Quiros, J. Antonio

AU - Wrobel, Iwona

AU - Nebel, Justin

AU - Landers, Carol

AU - Picornell, Yoanna

AU - Targan, Stephan

AU - Lerer, Trudy

AU - Hyams, Jeffrey

PY - 2009

Y1 - 2009

N2 - Background: Crohn's disease (CD) is often associated with antibodies to microbial antigens. Differences in immune response may offer clues to the pathogenesis of the disease. The aim was to examine the influence of age at diagnosis on the serologic response in children with CD. Methods: Data were drawn from 3 North American multicenter pediatric inflammatory bowel disease (IBD) research consortia. At or shortly after diagnosis, pANCA, ASCA IgA, ASCA IgG, anti-ompC, and anti-CBir1 were assayed. The results were compared as a function of age at CD diagnosis (0-7 years versus 8-15 years). Results: In all, 705 children (79 <8 years of age at diagnosis, 626 ≥8 years) were studied. Small bowel CD was less frequent in the younger group (48.7% versus 72.6%; P < 0.0001), while colonic involvement was comparable (91.0% versus 86.5%). ASCA IgA and IgG were seen in <20% of those 0-7 years old compared to nearly 40% of those 8-15 years old (P < 0.001), while anti-CBir1 was more frequent in the younger children (66% versus 54%, P < 0.05). Anti-CBir1 detected a significant number of children in both age groups who otherwise were serologically negative. Both age at diagnosis and site of CD involvement were independently associated with expression of ASCA and anti-CBir1. Conclusions: Compared to children 8-15 years of age at diagnosis, those 0-7 years are more likely to express anti-CBir1 but only half as likely to express ASCA. These age-associated differences in antimicrobial seropositivity suggest that there may be different, and as yet unrecognized, genetic, immunologic, and/or microbial factors leading to CD in the youngest children.

AB - Background: Crohn's disease (CD) is often associated with antibodies to microbial antigens. Differences in immune response may offer clues to the pathogenesis of the disease. The aim was to examine the influence of age at diagnosis on the serologic response in children with CD. Methods: Data were drawn from 3 North American multicenter pediatric inflammatory bowel disease (IBD) research consortia. At or shortly after diagnosis, pANCA, ASCA IgA, ASCA IgG, anti-ompC, and anti-CBir1 were assayed. The results were compared as a function of age at CD diagnosis (0-7 years versus 8-15 years). Results: In all, 705 children (79 <8 years of age at diagnosis, 626 ≥8 years) were studied. Small bowel CD was less frequent in the younger group (48.7% versus 72.6%; P < 0.0001), while colonic involvement was comparable (91.0% versus 86.5%). ASCA IgA and IgG were seen in <20% of those 0-7 years old compared to nearly 40% of those 8-15 years old (P < 0.001), while anti-CBir1 was more frequent in the younger children (66% versus 54%, P < 0.05). Anti-CBir1 detected a significant number of children in both age groups who otherwise were serologically negative. Both age at diagnosis and site of CD involvement were independently associated with expression of ASCA and anti-CBir1. Conclusions: Compared to children 8-15 years of age at diagnosis, those 0-7 years are more likely to express anti-CBir1 but only half as likely to express ASCA. These age-associated differences in antimicrobial seropositivity suggest that there may be different, and as yet unrecognized, genetic, immunologic, and/or microbial factors leading to CD in the youngest children.

KW - Children

KW - Crohn's disease

KW - Serologic responses

UR - http://www.scopus.com/inward/record.url?scp=67650302082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650302082&partnerID=8YFLogxK

U2 - 10.1002/ibd.20831

DO - 10.1002/ibd.20831

M3 - Article

VL - 15

SP - 714

EP - 719

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 5

ER -