New-Onset of Crohn’s Disease Is Associated with Antistreptolysin O Positive Titers

Abstract

Anton Bermont,1 Efrat Broide,1 Shay Matalon,1 Vered Richter,1 Tsilia Lazarovitch,2 Haggai Bar-Yoseph,3 Haim Shirin1 1The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Tel Aviv University, Tel Aviv, Israel; 2The Microbiology Laboratory, Shamir (Assaf Harofeh) Medical Center, Tel Aviv University, Tel Aviv, Israel; 3Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, IsraelCorrespondence: Haim ShirinThe Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 7033001, IsraelTel [phone]Fax [phone]Email [email protected]: Different infectious agents have been presumed to be candidates acting as an etiologic factor or trigger of Crohn’s disease (CD). Group A Streptococcus (GAS) is a common human infection agent that can also trigger post-infectious immune-mediated conditions. The current study aimed to examine whether the immunogenic activity induced by GAS may trigger new-onset of CD.Methods: Data for antistreptolysin O (ASO) level, throat culture for GAS, and history of streptococcal infection were collected from 91 patients with CD that were divided into three groups including; new-onset CD, CD in remission and active CD. The data were compared with the control group.Results: All participants had negative results of throat culture for GAS and had no history of documented streptococcal infection in the past year. Our results indicate that new-onset CD, but not CD in remission or active CD, is associated with significantly increased positive ASO compared to controls. Half of the patients in the new-onset CD group were ASO positive, which was significantly higher compared to the control group in a univariant (OR: 4.00; 95% CI 1.27– 12.58; P=0.02) and multivariant analysis (OR: 4.41; 95% CI 1.35– 14.37; P=0.014).Conclusion: Our study is the first to focus on ASO levels in patients with CD and to demonstrate a significant association between ASO and new-onset of CD. Large prospective randomized controlled studies are needed to confirm the validity of this data and to further clarify the clinical significance of our findings.Keywords: inflammatory bowel disease, IBD, Crohn’s disease, new-onset, group A Streptococcus, antistreptolysin O, ASO

Keywords

• inflammatory bowel disease
• ibd
• crohn’s disease
• new-onset
• group a streptococcus
• antistreptolysin o
• aso