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Crohn's Disease Forum » Books, Multimedia, Research & News » Serum antibodies to Mycobacterium avium subspecies paratuberculosis combined with ant


08-04-2012, 08:59 PM   #1
kiny
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Serum antibodies to Mycobacterium avium subspecies paratuberculosis combined with ant

Checking for MAP antibody was as sensitive as ASCA test when determining if someone has crohn's disease. Together they were more sensitive than doing ASCA test alone (what most clinics do now)

But they find it in people with celiac too.



http://www.ncbi.nlm.nih.gov/pubmed/21221802

Serum antibodies to Mycobacterium avium subspecies paratuberculosis combined with anti-Saccharomyces cerevisiae antibodies in Crohn's disease patients: prevalence and diagnostic role.


Infectiologie Animale, Santé Publique, Tours, France.


BACKGROUND:

Because Mycobacterium avium subspecies paratuberculosis (MAP), the etiologic agent of Johne's disease in ruminant, has been identified in the mucosal layer and deeper bowel wall in CD patients, the seroactivity against MAP may define a distinct subset of patients requiring individual treatment. The aim of this study was to assess the performance of anti-MAP antibodies in the diagnostic strategy for CD.

METHODS:

Two hundred seventy-two individuals were included: 81 with CD, 36 with ulcerative colitis, 35 with coeliac diseases and 120 healthy blood donors. Anti-MAP were detected by ELISA using a purified protein derivative from MAP. Anti-Saccharomyces cerevisiae antibodies (ASCA) were detected by indirect immunofluorescence.

RESULTS:

The sensitivity and specificity of anti-MAP and ASCA for CD diagnosis were similar (sensitivity: 0.33 ± 0.10 and 0.31 ± 0.10; specificity: 0.96 ± 0.03 and 0.98 ± 0.02, respectively). A combination of these two tests enabled an increase in sensitivity (0.53 ± 0.10), although specificity remained unchanged (0.95 ± 0.04). No correlation was found between anti-MAP positivity and clinical features such as age at onset and the duration of CD, disease location, or intestinal complications. Conversely, extra-intestinal manifestations of CD were statistically associated with a positivity of anti-MAP (48% vs. 24%, P = 0.028), mostly with respect to arthritis (44.5% vs. 13%, P < 0.002). Interestingly, anti-MAP and ASCA were also found in an active form of coeliac disease.

CONCLUSION:

Our results suggest a complementary role of ASCA and anti-MAP for CD diagnosis and a possible common role of bacteria in small intestinal mucosal damage in CD and coeliac disease.

Last edited by kiny; 08-04-2012 at 10:03 PM.
08-05-2012, 02:29 AM   #2
SarahD
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Interesting results but I can't help but notice the low sensitivity, even with the two tests combined the chance of having a positive test result given that you have the disease is only around 50%. A 'good' test should generally have sensitivity closer to 70 or 80% or higher.
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