New-Onset of Crohn’s Disease Is Associated with Antistreptolysin O Positive Titers
Received 14 January 2020
Accepted for publication 7 April 2020
Published 11 May 2020 Volume 2020:13 Pages 187—191
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Everson L.A. Artifon
Anton Bermont,1 Efrat Broide,1 Shay Matalon,1 Vered Richter,1 Tsilia Lazarovitch,2 Haggai Bar-Yoseph,3 Haim Shirin1
1The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Tel Aviv University, Tel Aviv, Israel; 2The Microbiology Laboratory, Shamir (Assaf Harofeh) Medical Center, Tel Aviv University, Tel Aviv, Israel; 3Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, Israel
Correspondence: Haim Shirin
The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin 7033001, Israel
Objective: Different infectious agents have been presumed to be candidates acting as an etiologic factor or trigger of Crohn’s disease (CD). Group A Streptococcus (GAS) is a common human infection agent that can also trigger post-infectious immune-mediated conditions. The current study aimed to examine whether the immunogenic activity induced by GAS may trigger new-onset of CD.
Methods: Data for antistreptolysin O (ASO) level, throat culture for GAS, and history of streptococcal infection were collected from 91 patients with CD that were divided into three groups including; new-onset CD, CD in remission and active CD. The data were compared with the control group.
Results: All participants had negative results of throat culture for GAS and had no history of documented streptococcal infection in the past year. Our results indicate that new-onset CD, but not CD in remission or active CD, is associated with significantly increased positive ASO compared to controls. Half of the patients in the new-onset CD group were ASO positive, which was significantly higher compared to the control group in a univariant (OR: 4.00; 95% CI 1.27– 12.58; P=0.02) and multivariant analysis (OR: 4.41; 95% CI 1.35– 14.37; P=0.014).
Conclusion: Our study is the first to focus on ASO levels in patients with CD and to demonstrate a significant association between ASO and new-onset of CD. Large prospective randomized controlled studies are needed to confirm the validity of this data and to further clarify the clinical significance of our findings.
Keywords: inflammatory bowel disease, IBD, Crohn’s disease, new-onset, group A Streptococcus, antistreptolysin O, ASO
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