Role of Serum Proteinase 3 Antineutrophil Cytoplasmic Antibodies in the Diagnosis, Evaluation of Disease Severity, and Clinical Course of Ulcerative Colitis
So Imakiire,
Hidetoshi Takedatsu,
Keiichi Mitsuyama,
Hideto Sakisaka,
Kozo Tsuruta,
Masaru Morita,
Nobuaki Kuno,
Koichi Abe,
Sadahiro Funakoshi,
Hideki Ishibashi,
Shinichiro Yoshioka,
Takuji Torimura,
Fumihito Hirai
Affiliations
So Imakiire
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Hidetoshi Takedatsu
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
Keiichi Mitsuyama
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
Hideto Sakisaka
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Kozo Tsuruta
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
Masaru Morita
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
Nobuaki Kuno
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Koichi Abe
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Sadahiro Funakoshi
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Hideki Ishibashi
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Shinichiro Yoshioka
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
Takuji Torimura
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
Fumihito Hirai
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Background/Aims: Proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA) is a serologic marker for granulomatosis with polyangiitis. However, recent studies have also shown their role as diagnostic markers for ulcerative colitis (UC). This study was performed to investigate the clinical roles of PR3-ANCAs in the disease severity, disease extension, and clinical course of UC. Methods: Serum PR3-ANCAs were measured in 173 UC patients including 77 patients with new-onset patients UC diagnosed within 1 month, 110 patients with Crohn’s disease, 48 patients with other intestinal diseases, and 71 healthy controls. Associations between the PR3-ANCA titer and clinical data, such as disease severity, disease extension, and clinical course, were assessed. The clinical utility of PR3-ANCA measurement was evaluated by receiver operating characteristic (ROC) analysis. Results: PR3-ANCA ≥3.5 U/mL demonstrated 44.5% sensitivity and 95.6% specificity for the diagnosis of UC in all patients. PR3-ANCA positivity was more prevalent in the 77 new-onset UC patients (58.4%). In this group, the disease severity and extension were more severe in PR3-ANCA positive patients than in PR3-ANCA negative group (p<0.001). After treatment, the partial Mayo scores were significantly decreased with the PR3-ANCA titers. The proportion of patients who required steroids for induction therapy was significantly higher among PR3-ANCA positive than negative group. ROC analysis revealed that PR3-ANCA ≥3.5 U/mL had 75% sensitivity and 69.0% specificity for steroid requirement in new-onset UC patients. Conclusions: Our results indicate that PR3-ANCA measurement is useful not only for diagnosing UC but also for evaluating disease severity and extension and predicting the clinical course.
