MEASLES IGM IMMUNOREACTIVITY IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE

Aim. The purpose of our study was to examine measles IgM immunoreactiv ity in patients with inflammatory bowel disease. Patients and methods. In an International collaborative study, serum measles IgM immunoreac tivity was assayed in consecutive outpatients with Crohn's disease (n= 95), ulcerative colitis (n=79), viral hepatitis (n=63) and blood donor s (n=30). Two commercial measles assays - enzyme linked immunosorbent assay and indirect fluorescence assay - and a Public Health Laboratory Service (PHLS) ''in house'' antibody capture radioimmunoassay were us ed. Results were compared with serum rubella and Epstein-Barr virus-sp ecific IgM immunoreactivity, total serum IgM, and measles IgG immunore activity. Twenty patients with inflammatory bowel disease were studied serially over a 4-month period. Results. By enzyme linked immunosorbe nt assay, the prevalence of raised serum measles IgM immunoreactivity was significantly greater in patients with Crohn's disease 23/95 (24%) and ulcerative colitis 20/79 (27%) compared with hepatitis patients 2 /63 (3%) and normal controls 0/30 (0%) (p<0.001). Indirect fluorescenc e assay produced significantly more positive results than enzyme linke d immunosorbent assay in both Crohn's disease (50/87; 57%) and ulcerat ive colitis (35/68; 51%) but not in controls (0%) (p<0.001). In contra st, not sera were positive using MCRIA. In the enzyme linked immunosor bent assay measles IgM immunoreactivity did not correlate with either total IgM, rubella or Epstein-Barr virus IgM immunoreactivities - whic h were no raised - measles Ige immunoreactivity or disease activity Pa tients not receiving steroids were more likely to have raised measles IgM immunoreactivity (p<0.5). All sera tested for Rheumatoid factor we re negative. Of 20 patients with inflammatory bowel disease studied by ELISA over a 4-month period, 50% showed raised measles IgM immunoreac tivity at some stage. Conclusion. The data suggest a specific and fluc tuating immune response to measles virus in patients with Crohn's dise ase and ulcerative colitis, that may be modified by corticosteroid the rapy.