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Candida albicans Colonization and ASCA in Familial Crohn's Disease

2009; Lippincott Williams & Wilkins; Volume: 104; Issue: 7 Linguagem: Inglês

10.1038/ajg.2009.225

1572-0241

Annie Standaert–Vitse, Boualem Sendid, Marie Joossens, Nadine François, Peggy Vandewalle-El Khoury, Julien Branche, Herbert Van Kruiningen, Thierry Jouault, Paul Rutgeerts, Corinne Gower–Rousseau, Christian Libersa, Christel Neut, Franck Broly, Mathias Chamaillard, Séverine Vermeire, Daniel Poulain, Jean‐Frédéric Colombel,

Microscopic Colitis

OBJECTIVES: Anti-Saccharomyces cerevisiaeantibodies (ASCAs) are present in 50-60% of patients with Crohn's disease (CD) and in 20-25% of their healthy relatives (HRs). The yeast,Candida albicans,has been shown to generate ASCAs, but the presence ofC. albicansin the digestive tract of CD patients and their HRs has never been investigated. Therefore, we studiedC. albicanscarriage in familial CD and its correlation with ASCAs. METHODS: Study groups consisted of 41 CD families composed of 129 patients and 113 HRs, and 14 control families composed of 76 individuals. Mouth swabs and stool specimens were collected for isolation, identification, and quantification of yeasts. Serum samples were collected for detection of ASCAs and anti-C. albicansmannan antibodies (ACMAs). RESULTS: C. albicanswas isolated significantly more frequently from stool samples from CD patients (44%) and their HRs (38%) than from controls (22%) (P<0.05). The prevalence of ACMAs was similar between CD patients, their HRs, and controls (22, 19, and 21%, respectively,P= 0.845), whereas the prevalence of ASCAs was significantly increased in CD families (72 and 34% in CD and HRs, respectively, in contrast to 4% in controls,P<0.0001). AMCA levels correlated withC. albicanscolonization in all populations. ASCA levels correlated withC. albicanscolonization in HRs but not in CD patients. CONCLUSIONS: CD patients and their first-degree HRs are more frequently and more heavily colonized byC. albicansthan are controls. ASCAs correlate withC. albicanscolonization in HRs but not in CD. In HRs, ASCAs could result from an altered immune response toC. albicans.In CD, a subsequent alteration in sensingC. albicanscolonization could occur with disease onset.