Serum Anti-<italic>Saccharomyces cerevisiae</italic> Antibody Is Associated with Disease Severity in Patients with Primary Sclerosing Cholangitis.

UNLABELLED: <p>

Introduction

Primary sclerosing cholangitis (PSC) is a chronic liver disease accompanying inflammatory bowel disease (IBD). Anti-Saccharomyces cerevisiae antibody (ASCA) is a serological marker associated with aggressive IBD phenotype. Data on the association between ASCA and liver outcomes remain elusive. We aimed to explore whether ASCA seropositivity is associated with liver disease severity in people living with PSC-IBD.

METHODS

We conducted a retrospective study on adult patients with PSC-IBD at a tertiary center, between 2010 and 2023. Medical records were reviewed for demographics, clinical, and laboratory data. Severity of liver disease was assessed using the Amsterdam-Oxford prognostic model (AOM) and liver stiffness measurement (LSM), assessed by vibration-controlled transient elastography (FibroScan®).

RESULTS

The cohort comprised of 58 subjects with PSC-IBD and an available ASCA result. Thirty patients were diagnosed with ulcerative colitis (UC) and 28 with Crohn's disease (CD). Six of 30 (20%) patients with UC and 14 of 28 patients (50%) with CD had positive ASCA. In a univariate analysis, AOM (p = 0.021) and LSM (p = 0.018) were significantly higher in those positive for ASCA. In a multivariable model, ASCA positivity remained significantly associated with higher AOM score (p = 0.026) and a higher LSM (p = 0.036), even after adjustment for IBD subtype and disease duration.

CONCLUSION

In subjects with IBD with concomitant PSC, the presence of serum ASCA is associated with increased liver stiffness and AOM score, well-known markers for disease severity and reduced transplant-free survival. Further studies are warranted to validate these findings and to explore the biological mechanism underlying this association. </p>.