Investigation of Yeast or Candida Colonization with ASCA, pANCA in Chronic Inflammatory Bowel Patients

Inflammatory bowel disease (IBD) is a chronic disease with inflammation and involvement in various parts of the gastrointestinal tract. The most common types of inflammation are, Ulcerative colitis (UC) and Crohn's disease (CD). Another less common type of IBD is indetermine colitis (IC). Accurate diagnosis of IBD; in particular, it is very important for the differentiation, treatment and prognosis of Crohn's disease and ulcerative colitis. Anti-Saccharomyces cereviciae antibody (ASCA) and perinuclear anti-neutrophilic cytoplasmic antibody (pANCA) serological markers are used together for the differentiation of these species and detection of IC. In addition, especially in the development of CH with yeast and Candida colonization is common. In the human gastrointestinal tract, Candida albicans (C.albicans) is the most isolated species. This is followed by Candida tropicalis (C.tropicalis) and Candida glabrata (C.glabrata). The aim of this study was to investigate the presence of ASCA and p-ANCA antibodies in serum, Candida spp. colonization in feces, detection of chronic inflammatory bowel patients and correlation. In our study, 120 patients diagnosed with IBD in gastroenterology clinic and outpatient clinic and 30 healthy controls in the same age range, ASCA and pANCA antibodies by indirect immunofluorescence (IIFA) method, mycological diagnostic methods from stool samples and Candida spp. colonization were determined. In our study, the pANCA positivity rate was %51.9 in patients with UC and the ASCA positivity rate was %60 in CH (p<0.05). Candida species grew in 76 (63.3%) of stool samples taken from 120 patients with IBD and 16 (53.3%) of stool samples taken from 30 control groups. However, the culture of 49 IBD and 9 healthy individuals with 5 or more coloni numbers was evaluated, with yeast and Candida species were identified. Of the 49 IBD, 24(%20.0) C.albicans, 7(%5.8) C.glabrata, 4(%3.3) Saccharomyces cerevisiae (S.cerevisiae), 4(%3.3) Candida kefyr (C.kefyr), 3(%2.5) Candida firmetaria (C.firmetaria), 3(%2.5) Candida krusei (C.krusei), 3(%2.5) Candida dubliniensis (C.dubliniensis) and 1(%0.8) Candida melibiosica (C.melibiosica) of defined. 4(%13.3) C.albicans, 2(%6.7) C.glabrata, 2(%6.7) C.krusei and 1(%3.3) C.kefyr were identified in 9 healthy individuals. Yeast and Candida species were found to be statistically significant in IBD and control groups (p <0.05). Stool culture of both groups; similar species were produced and C.albicans was the most reproduced species. There was no significant result between ASCA and pANCA antibody and Candida species. However, in ASCA and pANCA positivity, with yeast and Candida colonization was more common than negativity. In addition, a statistically significant correlation was found between ASCA and pANCA fluorescence intensity and yeast or Candida spp. colonies. (p <0.05). Currently, there are no tests in IBD that will definitively differentiate between UC and CH and make a diagnosis. However, ASCA and pANCA serological tests may be helpful in differentiation and diagnosis of the disease; investigation of autoantibodies and cross-reacting infectious agents, especially yeasts, in these tests may increase the specificity and importance of these serological tests. Key Words: Inflammatory Bowel Disease, Ulcerative Colitis, Crohn, Anti-Saccharomyces cereviciae (ASCA), pANCA, Candida spp.