Assessment of Anti-vinculin and Anti-cytolethal Distending Toxin B Antibodies in Subtypes of Irritable Bowel Syndrome

Dig Dis Sci. 2017 Jun;62(6):1480-1485. doi: 10.1007/s10620-017-4585-z. Epub 2017 Apr 27.


Background: Antibodies to cytolethal distending toxin B (CdtB) and vinculin are novel biomarkers that rule-in and differentiate irritable bowel syndrome with diarrhea (IBS-D) from other causes of diarrhea and healthy controls.

Aim: To determine whether these antibodies can also diagnose and differentiate other IBS subtypes.

Methods: Subjects with IBS-D based on Rome III criteria (n = 2375) were recruited from a large-scale multicenter clinical trial (TARGET 3). Healthy subjects without gastrointestinal (GI) diseases or symptoms (n = 43) and subjects with mixed IBS (IBS-M) (n = 25) or IBS with constipation (IBS-C) (n = 30) were recruited from two major medical centers. Plasma levels of anti-CdtB and anti-vinculin antibodies in all subjects were determined by enzyme-linked immunosorbent assay. Optical densities of ≥1.68 and ≥2.80 were considered positive for anti-vinculin and anti-CdtB, respectively. Plasma levels of anti-CdtB and anti-vinculin antibodies were highest in IBS-D and lowest in IBS-C and healthy controls (P < 0.001). Levels in IBS-C subjects were not statistically different from controls (P > 0.1). Positivity for anti-CdtB or anti-vinculin resulted in a statistically significant negative gradient from IBS-D (58.1%) to IBS-M (44.0%), IBS-C (26.7%), and controls (16.3%) (P < 0.001).

Conclusions: Anti-CdtB and anti-vinculin titers and positivity rates differ in IBS subtypes, with higher antibody levels and positivity rates in IBS-D and IBS-M, and lower levels in IBS-C subjects that are similar to those in healthy controls. These antibodies appear useful in the diagnosis of IBS-M and IBS-D, but not IBS-C. Furthermore, these findings suggest that IBS-C is pathophysiologically distinct from subtypes with diarrheal components (i.e., IBS-M and IBS-D).

Keywords: Biomarker; Constipation; Cytolethal distending toxin; Diarrhea; Irritable bowel syndrome; Vinculin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies / blood*
  • Bacterial Toxins / immunology*
  • Biomarkers / blood
  • Case-Control Studies
  • Constipation / blood
  • Constipation / diagnosis*
  • Constipation / etiology
  • Diagnosis, Differential
  • Diarrhea / blood
  • Diarrhea / diagnosis*
  • Diarrhea / etiology
  • Female
  • Humans
  • Irritable Bowel Syndrome / blood*
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / diagnosis
  • Male
  • Middle Aged
  • Vinculin / immunology*
  • Young Adult


  • Antibodies
  • Bacterial Toxins
  • Biomarkers
  • cytolethal distending toxin
  • Vinculin