Inflammatory Bowel Diseases

Skip Navigation LinksHome > July 2013 - Volume 19 - Issue 8 > Granulocyte–Macrophage Colony-Stimulating Factor Autoantibod...
Inflammatory Bowel Diseases:
doi: 10.1097/MIB.0b013e318281f506
Original Clinical Articles

Granulocyte–Macrophage Colony-Stimulating Factor Autoantibodies: A Marker of Aggressive Crohn's Disease

Gathungu, Grace MD*; Kim, Mi-Ok PhD; Ferguson, John P. PhD; Sharma, Yashoda PhD; Zhang, Wei MD, PhD; Ng, Sok Meng E. BS; Bonkowski, Erin MD§; Ning, Kaida MS; Simms, Lisa A. BSc‖,¶; Croft, Anthony R. MBBS; Stempak, Joanne M. MSc**; Walker, Nicole BMed; Huang, Ning MAppScl; Xiao, Yang PhD††; Silverberg, Mark S. MD, PhD**; Trapnell, Bruce MD‡‡; Cho, Judy H. MD‡,§§; Radford-Smith, Graham L. MB, BCh, PhD‖,¶; Denson, Lee A. MD§

Supplemental Author Material
Collapse Box


Background: Neutralizing autoantibodies (Abs) against granulocyte–macrophage colony-stimulating factor (GM-CSF Ab) have been associated with stricturing ileal Crohn's disease (CD) in a largely pediatric patient cohort (total 394, adult CD 57). The aim of this study was to examine this association in 2 independent predominantly adult inflammatory bowel disease patient cohorts.

Methods: Serum samples from 742 subjects from the NIDDK IBD Genetics Consortium and 736 subjects from Australia were analyzed for GM-CSF Ab and genetic markers. We conducted multiple regression analysis with backward elimination to assess the contribution of GM-CSF Ab levels and established CD risk alleles and smoking on ileal disease location in the 477 combined CD subjects from both cohorts. We also determined associations of GM-CSF Ab levels with complications requiring surgical intervention in combined CD subjects in both cohorts.

Results: Serum samples from patients with CD expressed significantly higher concentrations of GM-CSF Ab when compared with ulcerative colitis or controls in each cohort. Nonsmokers with ileal CD expressed significantly higher GM-CSF Ab concentrations in the Australian cohort (P = 0.002). Elevated GM-CSF Ab, ileal disease location, and disease duration more than 3 years were independently associated with stricturing/penetrating behavior and intestinal resection for CD.

Conclusions: The expression of high GM-CSF Ab is a risk marker for aggressive CD behavior and complications including surgery. Modifying factors include environmental exposure to smoking and genetic risk markers.

© Crohn's & Colitis Foundation of America, Inc.

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.