Anti-OmpC Antibodies in Crohn’s Disease and Ulcerative Colitis: Evidence from a Systematic Review and Meta-Analysis

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ID: 317249
2026
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Abstract
Abstract Objective Anti-OmpC antibodies target the Escherichia coli outer membrane porin C. Their diagnostic and prognostic roles in inflammatory bowel disease (IBD) remain uncertain. We systematically assessed their prevalence, diagnostic accuracy, and clinical associations in Crohn’s disease (CD) and ulcerative colitis (UC). Methods We performed a systematic review and meta-analysis (PROSPERO CRD420251066959) of 31 studies including ∼11,000 participants with CD, UC, and controls. Random-effects models estimated pooled prevalence, odds ratios (OR), sensitivity, specificity, diagnostic odds ratios (DOR), and summary receiver operating characteristic (SROC) curves. Subgroup and sensitivity analyses were performed by assay cutoff, and publication bias was evaluated with funnel plots, Egger’s regression, and trim-and-fill. Results For CD, 11 studies compared patients with controls; eight using standardized ELISA cutoffs showed a strong association (OR = 6.99, 95% CI 3.99–12.23; I2 = 58%). For UC, 11 studies yielded OR = 4.75 (95% CI 2.82–7.99; I2 = 37%). Pooled prevalence was 36.9% in CD and 26.8% in UC. Diagnostic accuracy showed modest sensitivity (CD 0.39; UC 0.30) but high specificity (CD 0.89; UC 0.88), with AUCs of 0.76 and 0.77. In CD, OmpC positivity was associated with complicated phenotype (OR = 2.77) and surgery (OR = 2.41), but not with location, activity, or extra-intestinal manifestations. Conclusions Anti-OmpC antibodies are strongly associated with CD and show a supportive but less consistent association in ulcerative colitis., with high specificity but limited sensitivity. In Crohn’s disease, OmpC positivity is associated with complicated disease behavior and increased odds of surgery, although these findings should be interpreted cautiously given the observational nature of the included studies. Incorporation into multi-marker serological panels may enhance diagnostic confidence and risk stratification.
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Authors Ramy Sekla, Aleena Sammar, Amil Shah, Funmilayo Oludiran, Muhammad Sohaib, Mena Tawfik
Journal Crohn s & Colitis 360
Year 2026
DOI
10.1093/crocol/otag056
URL
https://doi.org/10.1093/crocol/otag056
Keywords Keywords not found

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