Both Preoperative Perinuclear Antineutrophil Cytoplasmic Antibody and Anti-CBir1 Expression in Ulcerative Colitis Patients Influence Pouchitis Development After Ileal Pouch–Anal Anastomosis  Phillip Fleshner, Andrew Ippoliti, Marla Dubinsky, Eric Vasiliauskas, Ling Mei, Konstantinos A. Papadakis, Jerome I. Rotter, Carol Landers, Stephan Targan  Clinical Gastroenterology and Hepatology  Volume 6, Issue 5, Pages 561-568 (May 2008) DOI: 10.1016/j.cgh.2008.01.002 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 Anti-CBir1 was expressed in 19% of patients. Lines indicate the median level for each group. The percentage of positive samples defined as greater than 2 SD above the mean of the normal controls for each group is shown. Clinical Gastroenterology and Hepatology 2008 6, 561-568DOI: (10.1016/j.cgh.2008.01.002) Copyright © 2008 AGA Institute Terms and Conditions

Figure 2 Relationship between pANCA and anti-CBir1 seroreactivity and the overall incidence of pouchitis. There was a significantly higher incidence of pouchitis noted in pANCA+ patients versus pANCA− patients (*P = .005). Anti-CBir1 expression also was associated with overall pouchitis development (**P = .02). Clinical Gastroenterology and Hepatology 2008 6, 561-568DOI: (10.1016/j.cgh.2008.01.002) Copyright © 2008 AGA Institute Terms and Conditions

Figure 3 Association between pANCA/anti-CBir1 positivity and the incidence of pouchitis. The overall incidence of pouchitis (■) increased significantly with increased seromarker positivity (P trend = .0003). There was also a significant direct association between AP (▩) development (P trend = .007), but not CP (☐) development (P trend = .05), with increasing seromarker positivity. Zero, 1, or 2 represents the number of seromarkers expressed. Patient numbers shown along the x-axis. Clinical Gastroenterology and Hepatology 2008 6, 561-568DOI: (10.1016/j.cgh.2008.01.002) Copyright © 2008 AGA Institute Terms and Conditions

Figure 4 Relationship between pANCA level and pouchitis. There was a higher incidence of CP in patients with HL-pANCA (n = 21) expression (>100 ELISA U/mL) compared with LL-pANCA (n = 217) expression (*P = .03). Clinical Gastroenterology and Hepatology 2008 6, 561-568DOI: (10.1016/j.cgh.2008.01.002) Copyright © 2008 AGA Institute Terms and Conditions

Figure 5 Effect of anti-CBir1 expression and pANCA level on the cumulative incidence of AP. The risk of developing AP after IPAA among patients with LL-pANCA+ was significantly (P = .04) higher in patients who also were anti-CBir1+(●) versus patients who also were anti-CBir1− (○). There was no effect of anti-CBir1 on the incidence of AP in patients with HL-pANCA+ expression. Clinical Gastroenterology and Hepatology 2008 6, 561-568DOI: (10.1016/j.cgh.2008.01.002) Copyright © 2008 AGA Institute Terms and Conditions

Figure 6 Effect of anti-CBir1 expression and pANCA level on the cumulative incidence of CP. The risk of developing CP after IPAA among patients with HL-pANCA+ was significantly (P = .04) higher in patients who also were anti-CBir1+ (●) versus patients who also were anti-CBir1− (○). There was no effect of anti-CBir1 on the incidence of CP in patients with LL-pANCA+ expression. Clinical Gastroenterology and Hepatology 2008 6, 561-568DOI: (10.1016/j.cgh.2008.01.002) Copyright © 2008 AGA Institute Terms and Conditions