Anti–Saccharomyces cerevisiae antibody explained

Antigen:Saccharomyces cerevisiae
Oneisoform:yes
Oneisoformspecialname:Mannans
Onesource:Saccharomyces cerevisiae
Onegene:pro
Oneorgan:Large Intestine
Onetissue:Epithelium
Onedisease:Colitis

Anti-Saccharomyces cerevisiae antibodies (ASCAs) are antibodies against antigens presented by the cell wall of the yeast Saccharomyces cerevisiae. These antibodies are directed against oligomannose sequences α-1,3 Man (α-1,2 Man α-1,2 Man)n (n = 1 or 2).[1] ASCAs and perinuclear antineutrophil cytoplasmic antibodies (pANCAs) are the two most useful and often discriminating biomarkers for colitis.[2] ASCA tends to recognize Crohn's disease more frequently, whereas pANCA tend to recognize ulcerative colitis.[3]

ASCA antibodies react to a yeast protein with mannans,[4] a 200-kDa glycoprotein.[5]

Diseases

Diseases in which ASCA are found include the following:

Intestinal yeast and ASCA positive

Intestinal yeast infections are seen in malabsorptive diseases like coeliac disease. In Crohn's disease and ulcerative colitis the presence of intestinal S. cerevisiae is rare, but the association with irritable bowel in coeliac disease remains unstudied.[14]

Anti-mannans

Mannan (oligomannan) is a component of the yeast cell wall. Antibodies to yeast mannans are found at increased frequency in Crohn's disease and ASCA positive Crohn's tend to have lower low levels of mannan-binding lectin.[15] Experimentally, antibodies to mannans from yeast can also crossreact to mannans of other types of yeast.[16] Study of the sugars indicated that a mannotetraose (4-mer) was responsible for highest response.[17] Studies of the 200 kDa glycoprotein antibodies found them commonly in healthy people, suggesting that the disease associated antibodies are to their carbohydrate moieties.[18] Mannans from other yeast, for example candida albicans, have found to cross react with ASCA which suggests that other yeast may induce ASCA associated diseases. ASCA are serological markers of candida albicans infections in humans and animals.[1]

Mannan-binding lectin (MBL) is a lectin produced by humans. In ASCA positive Crohn's disease the serum level of this protein is lower. Cellular response to mannan in ASCA positive peripheral blood lymphocytes could be inhibited by adding MBL, however, a high frequency of mutations in the MBL gene was found in ASCA positive patients.[19] Besides, MBL serum levels were inversely correlated with ASCA levels in Crohn's disease patients with severe clinical phenotypes.[20]

Crohn's disease

ASCA are consistently higher in frequency in Crohn's disease. Yeast cause a three-fold increase in lymphocyte proliferation relative to normal controls.[21] The ASCA antibodies are also more frequently found in familial Crohn's disease.[10] An altered humoral and cellular response to mannan is observed and may be due to a loss of yeast tolerance.[22] This alteration is marked by increased activation markers, CD25/CD69, upon proliferative stimulation of T-helper lymphocytes.

ASCA positive is a predictor for Crohn's disease with high specificity and positive predictive value (87% and 78% respectively). ASCA are associated with proximal (gastroduodenal and small bowel involvement) rather than purely colonic disease (P < 0.001) and with a more severe disease phenotype and requirement for surgery over a median follow-up time of 9 years (P < 0.0001). There is no association between genetic markers for Crohn's disease and NOD2 protein (also known as CARD15) or antibodies to mycoprotein antigen (IgA or IgG), indicating heterogeneous causes for Crohn's disease.[23] Experimental studies show that chemically induced colitis promotes opportunistic human fungal pathogen Candida albicans colonization. In turn, Candida albicans colonization generates ASCA.[24] According to another study, serum samples from patients with invasive candidiasis demonstrated that ASCA levels are significantly elevated compared to healthy controls, but the same, statistically, as of those with Crohn's disease.[25]

Notes and References

  1. 16697740. 2006. Standaert-Vitse. A.. Jouault. T.. Vandewalle. P.. Mille. C.. Seddik. M.. Sendid. B.. Mallet. J. M.. Colombel. J. F.. Poulain. D.. Candida albicans is an immunogen for anti-Saccharomyces cerevisiae antibody markers of Crohn's disease. Gastroenterology. 130. 6. 1764–75. 10.1053/j.gastro.2006.02.009. free. vanc.
  2. Desplat-Jégo S . Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: results of a multicenter study . World J. Gastroenterol. . 13 . 16 . 2312–8 . 2007 . 17511029 . 4147139 . 10.3748/wjg.v13.i16.2312. vanc . Johanet C . Escande A . 3 . Goetz . J . Fabien . N . Olsson . N . Ballot . E . Sarles . J . Baudon . JJ . free .
  3. Joossens S . The value of serologic markers in indeterminate colitis: a prospective follow-up study . Gastroenterology . 122 . 5 . 1242–1247 . 2002 . 11984510 . 10.1053/gast.2002.32980 . vanc . Reinisch W . Vermeire S . 3 . Sendid . B . Poulain . D . Peeters . M . Geboes . K . Bossuyt . X . Vandewalle . P . free .
  4. Lindberg E, Magnusson KE, Tysk C, Järnerot G . Antibody (IgG, IgA, and IgM) to baker's yeast (Saccharomyces cerevisiae), yeast mannan, gliadin, ovalbumin and betalactoglobulin in monozygotic twins with inflammatory bowel disease . Gut . 33 . 7 . 909–913 . 1992 . 1644330 . 10.1136/gut.33.7.909 . 1379403 .
  5. Heelan BT, Allan S, Barnes RM . Identification of a 200-kDa glycoprotein antigen of Saccharomyces cerevisiae . Immunol. Lett. . 28 . 3 . 181–185 . 1991 . 1885214 . 10.1016/0165-2478(91)90001-Q .
  6. Monselise A, Weinberger A, Monselise Y, Fraser A, Sulkes J, Krause I . Anti-Saccharomyces cerevisiae antibodies in Behçet's disease--a familial study . Clin. Exp. Rheumatol. . 24 . 5 Suppl 42 . S87–90 . 2006 . 17067434 .
  7. Fresko I . Anti-Saccharomyces cerevisiae antibodies (ASCA) in Behçet's syndrome . Clin. Exp. Rheumatol. . 23 . 4 Suppl 38 . S67–70 . 2005 . 16273768 . vanc . Ugurlu S . Ozbakir F . 3 . Celik . A . Yurdakul . S . Hamuryudan . V . Yazici . H .
  8. Giaffer MH, Clark A, Holdsworth CD . Antibodies to Saccharomyces cerevisiae in patients with Crohn's disease and their possible pathogenic importance . Gut . 33 . 8 . 1071–1075 . 1992 . 1398231 . 10.1136/gut.33.8.1071 . 1379444 .
  9. Toumi D, Mankaï A, Belhadj R, Ghedira-Besbes L, Jeddi M, Ghedira I . 22067865 . Anti-Saccharomyces cerevisiae antibodies in coeliac disease . Scand. J. Gastroenterol. . 42 . 7 . 821–826 . 2007 . 17558905 . 10.1080/00365520601154996.
  10. vanc . Annese . V . Andreoli . A . Andriulli . A . Dinca . R . Gionchetti . P . Latiano . A . Lombardi . G . Piepoli . A . Poulain . D . Sendid . B . Colombel . JF . Familial expression of anti-Saccharomyces cerevisiae Mannan antibodies in Crohn's disease and ulcerative colitis: a GISC study . The American Journal of Gastroenterology . August 2001 . 96 . 8 . 2407–12 . 10.1111/j.1572-0241.2001.04043.x . 11513182 . 24310666 .
  11. Holstein A, Burmeister J, Plaschke A, Rosemeier D, Widjaja A, Egberts EH . Autoantibody profiles in microscopic colitis . J. Gastroenterol. Hepatol. . 21 . 6 . 1016–1020 . 2006 . 16724988 . 10.1111/j.1440-1746.2005.04027.x. 41526612 .
  12. Main J . Antibody to Saccharomyces cerevisiae (bakers' yeast) in Crohn's disease . BMJ . 297 . 6656 . 1105–1106 . 1988 . 3143445 . 10.1136/bmj.297.6656.1105 . 1834894 . vanc . McKenzie H . Yeaman GR . 3 . Kerr . M. A. . Robson . D. . Pennington . C. R. . Parratt . D. .
  13. Barnes RM, Allan S, Taylor-Robinson CH, Finn R, Johnson PM . Serum antibodies reactive with Saccharomyces cerevisiae in inflammatory bowel disease: is IgA antibody a marker for Crohn's disease? . Int. Arch. Allergy Appl. Immunol. . 92 . 1 . 9–15 . 1990 . 2246081 . 10.1159/000235217 .
  14. Mallant-Hent RC, Mooij M, von Blomberg BM, Linskens RK, van Bodegraven AA, Savelkoul PH . Correlation between Saccharomyces cerevisiae DNA in intestinal mucosal samples and anti-Saccharomyces cerevisiae antibodies in serum of patients with IBD . World J. Gastroenterol. . 12 . 2 . 292–7 . 2006 . 16482632 . 4066041 . 10.3748/wjg.v12.i2.292 . free .
  15. Seibold F . Association of deficiency for mannan-binding lectin with anti-mannan antibodies in Crohn's disease: A family study . Inflamm. Bowel Dis. . 13 . 9 . 1077–1082 . 2007 . 17480019 . 10.1002/ibd.20156 . vanc . Boldt AB . Seibold-Schmid B . 3 . Schoepfer . Alain M. . Flogerzi . Beatrice . Müller . Stefan . Kun . Jürgen F.J.. 12544070 .
  16. Schaffer T, Müller S, Flogerzi B, Seibold-Schmid B, Schoepfer AM, Seibold F . 39103743 . Anti-Saccharomyces cerevisiae mannan antibodies (ASCA) of Crohn's patients crossreact with mannan from other yeast strains, and murine ASCA IgM can be experimentally induced with Candida albicans . Inflammatory Bowel Diseases. 13. 11. 1339–1346. 2007 . 17636567 . 10.1002/ibd.20228.
  17. Sendid B . Specific antibody response to oligomannosidic epitopes in Crohn's disease . Clin. Diagn. Lab. Immunol. . 3 . 2 . 219–26 . 1996 . 8991640 . 10.1128/CDLI.3.2.219-226.1996. 170283 . vanc . Colombel JF . Jacquinot PM . 3 . Faille . C . Fruit . J . Cortot . A . Lucidarme . D . Camus . D . Poulain . D .
  18. Sander U, Kunze I, Bröker M, Kunze G . Humoral immune response to a 200-kDa glycoprotein antigen of Saccharomyces cerevisiae is common in man . Immunol. Lett. . 61 . 2–3 . 113–117 . 1998 . 9657263 . 10.1016/S0165-2478(98)00003-0 .
  19. Seibold F . Genetic variants of the mannan-binding lectin are associated with immune reactivity to mannans in Crohn's disease . Gastroenterology . 127 . 4 . 1076–1084 . 2004 . 15480986 . 10.1053/j.gastro.2004.07.056 . vanc . Konrad A . Flogerzi B . 3 . Seibold-Schmid . Beatrice . Arni . Stephan . Jüliger . Simone . Kun . Jürgen F.J. . free .
  20. Choteau. Laura. Vasseur. Francis. Lepretre. Frederic. Figeac. Martin . Gower-Rousseau. Corine. Dubuquoy. Laurent. Poulain. Daniel. Colombel. Jean-Frederic . Sendid. Boualem. Jawhara. Samir. vanc. Polymorphisms in the Mannose-Binding Lectin Gene are Associated with Defective Mannose-Binding Lectin Functional Activity in Crohn's Disease Patients . Scientific Reports . 2016 . 6 . 1 . 29636 . 10.1038/srep29636 . 27404661 . 4940739 . 2016NatSR...629636C .
  21. Young CA, Sonnenberg A, Burns EA . Lymphocyte proliferation response to baker's yeast in Crohn's disease . Digestion . 55 . 1 . 40–43 . 1994 . 8112496 . 10.1159/000201121 .
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