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Humoral response to Clostridium difficile in inflammatory bowel disease, including correlation with immunomodulatory treatment

Henriksson, Gunnel LU ; Bredberg, Johan; Wullt, Marlene LU ; Lyrenäs, Ebbe; Hindorf, Ulf LU ; Ohlsson, Björn LU and Grip, Olof LU (2019) In BMJ Open 3(2). p.154-158
Abstract

Background and Aim: An abnormal immune response to intestinal bacteria has been observed in Crohn's disease (CD). Clostridium difficile infection incidence and severity are increased in CD, but reports on the humoral response have provided conflicting results. We aimed to shed light on the possible role of C. difficile in CD pathogenesis by paying attention to the influence of immunomodulatory treatment on the humoral response.

Methods: A total of 71 consecutive outpatients with CD, 67 with ulcerative colitis (UC), and 121 healthy controls were analyzed for serum IgA and IgG to C. difficile toxins A and B.

Results: IgA levels were similar in all study groups. IgG to toxin A was increased similarly in CD and UC (P = 0.02 for... (More)

Background and Aim: An abnormal immune response to intestinal bacteria has been observed in Crohn's disease (CD). Clostridium difficile infection incidence and severity are increased in CD, but reports on the humoral response have provided conflicting results. We aimed to shed light on the possible role of C. difficile in CD pathogenesis by paying attention to the influence of immunomodulatory treatment on the humoral response.

Methods: A total of 71 consecutive outpatients with CD, 67 with ulcerative colitis (UC), and 121 healthy controls were analyzed for serum IgA and IgG to C. difficile toxins A and B.

Results: IgA levels were similar in all study groups. IgG to toxin A was increased similarly in CD and UC (P = 0.02 for both). In contrast, IgG to toxin B was elevated only in CD patients not receiving disease-modifying anti-inflammatory bowel disease drugs (DMAID) (n = 16) (P = 0.0001), while the CD medication subgroup (n = 47) had a level similar to healthy controls. The UC results were not influenced by DMAID treatment.

Conclusion: Our findings add support to the idea of a disturbed interaction between intestinal cells and the microbiota being part of the CD disease mechanism. An abnormal immune response to C. difficile toxin B may be a critical component of this interaction.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ Open
volume
3
issue
2
pages
5 pages
publisher
British Medical Journal Publishing Group
ISSN
2044-6055
DOI
10.1002/jgh3.12122
language
English
LU publication?
yes
id
57a47c96-cbac-463b-8354-360d194dc224
date added to LUP
2019-08-07 13:32:33
date last changed
2019-08-08 12:08:57
@article{57a47c96-cbac-463b-8354-360d194dc224,
  abstract     = {<p>Background and Aim: An abnormal immune response to intestinal bacteria has been observed in Crohn's disease (CD). Clostridium difficile infection incidence and severity are increased in CD, but reports on the humoral response have provided conflicting results. We aimed to shed light on the possible role of C. difficile in CD pathogenesis by paying attention to the influence of immunomodulatory treatment on the humoral response.</p><p>Methods: A total of 71 consecutive outpatients with CD, 67 with ulcerative colitis (UC), and 121 healthy controls were analyzed for serum IgA and IgG to C. difficile toxins A and B.</p><p>Results: IgA levels were similar in all study groups. IgG to toxin A was increased similarly in CD and UC (P = 0.02 for both). In contrast, IgG to toxin B was elevated only in CD patients not receiving disease-modifying anti-inflammatory bowel disease drugs (DMAID) (n = 16) (P = 0.0001), while the CD medication subgroup (n = 47) had a level similar to healthy controls. The UC results were not influenced by DMAID treatment.</p><p>Conclusion: Our findings add support to the idea of a disturbed interaction between intestinal cells and the microbiota being part of the CD disease mechanism. An abnormal immune response to C. difficile toxin B may be a critical component of this interaction.</p>},
  author       = {Henriksson, Gunnel and Bredberg, Johan and Wullt, Marlene and Lyrenäs, Ebbe and Hindorf, Ulf and Ohlsson, Björn and Grip, Olof},
  issn         = {2044-6055},
  language     = {eng},
  number       = {2},
  pages        = {154--158},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Humoral response to Clostridium difficile in inflammatory bowel disease, including correlation with immunomodulatory treatment},
  url          = {http://dx.doi.org/10.1002/jgh3.12122},
  volume       = {3},
  year         = {2019},
}