IBD Serology and Disease Outcomes in African Americans with Crohn's Disease

Madeline Bertha, Arthi Vasantharoopan, Archana Kumar, Beau B. Bruce, Jarod Prince, Tatyana Hofmekler, David Okou, Pankaj Chopra, Gabriel Wang, Cary Sauer, Carol J. Landers, Sunny Z. Hussain, Raymond K. Cross, Robert N. Baldassano, Michael D. Kappelman, Jeffrey Katz, Jonathan S. Alexander, Barbara S. Kirschner, Dedrick E. Moulton, Bankole O. OsuntokunAshish S Patel, Shehzad Saeed, Jan Michael A. Klapproth, Tanvi A. Dhere, Marla C. Dubinsky, Dermot McGovern, Subra Kugathasan

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Backgrounds: Recent studies have identified the role of serologic markers in characterizing disease phenotype, location, complications, and severity among Northern Europeans (NE) with Crohn's disease (CD). However, very little is known about the role of serology in CD among African Americans (AA). Our study explored the relationship between serology and disease phenotype in AA with CD, while controlling for genetic ancestry. Methods: AAs with CD were enrolled as participants through multicenter collaborative efforts. Serological levels of IgA anti-Saccharomyces cervisiae antibody (ASCA), IgG ASCA, E. coli outermembrane porin C, anti-CBir1, and ANCA were measured using enzyme-linked immunosorbent assays. Genotyping was performed using Illumina immunochip technology; an admixture rate was calculated for each subject. Multiple imputation by chained equations was performed to account for data missing at random. Logistic regression was used to calculate adjusted odds ratio (OR) for associations between serological markers and both complicated disease and disease requiring surgery. Results: A total of 358 patients were included in the analysis. The majority of our patients had inflammatory, noncomplicated disease (58.4%), perianal disease (55.7%), and documented colonic inflammation (86.8%). On multivariable analysis, both IgG ASCA and OmpC were associated with complicated disease (OR, 2.67; 95% CI, 1.67-4.28; OR, 2.23; 95% CI, 1.41-3.53, respectively) and disease requiring surgery (OR, 2.51; 95% CI, 1.49-4.22; OR, 3.57; 95% CI, 2.12-6.00). NE admixture to the African genome did not have any associations or interactions in relation to clinical outcome. Conclusions: Our study comprises the largest cohort of AAs with CD. The utility of serological markers for the prognosis of CD in NE applies equally to AA populations.

Original languageEnglish (US)
Pages (from-to)209-216
Number of pages8
JournalInflammatory Bowel Diseases
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • African Americans
  • Crohn's disease
  • inflammatory bowel disease
  • serology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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    Bertha, M., Vasantharoopan, A., Kumar, A., Bruce, B. B., Prince, J., Hofmekler, T., Okou, D., Chopra, P., Wang, G., Sauer, C., Landers, C. J., Hussain, S. Z., Cross, R. K., Baldassano, R. N., Kappelman, M. D., Katz, J., Alexander, J. S., Kirschner, B. S., Moulton, D. E., ... Kugathasan, S. (2018). IBD Serology and Disease Outcomes in African Americans with Crohn's Disease. Inflammatory Bowel Diseases, 24(1), 209-216. https://doi.org/10.1093/ibd/izx021