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Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study

The prevalence of patients with food intolerance (FI) has increased significantly. Immunoglobulin (Ig)E-mediated food allergies (FAs) are detected by determining IgE antibodies and skin prick test. Carbohydrate malabsorptions are clarified with breath tests. However, these diagnostic measures cannot...

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Autores principales: Dieterich, Walburga, Tietz, Esther, Kohl, Matthias, Konturek, Peter C., Rath, Timo, Neurath, Markus F., Zopf, Yurdagül
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889373/
https://www.ncbi.nlm.nih.gov/pubmed/33600102
http://dx.doi.org/10.14309/ctg.0000000000000312
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author Dieterich, Walburga
Tietz, Esther
Kohl, Matthias
Konturek, Peter C.
Rath, Timo
Neurath, Markus F.
Zopf, Yurdagül
author_facet Dieterich, Walburga
Tietz, Esther
Kohl, Matthias
Konturek, Peter C.
Rath, Timo
Neurath, Markus F.
Zopf, Yurdagül
author_sort Dieterich, Walburga
collection PubMed
description The prevalence of patients with food intolerance (FI) has increased significantly. Immunoglobulin (Ig)E-mediated food allergies (FAs) are detected by determining IgE antibodies and skin prick test. Carbohydrate malabsorptions are clarified with breath tests. However, these diagnostic measures cannot capture all intolerances and have limitations in case of gut-mediated FI. The aims of this pilot study were to evaluate different methods to determine intestinal mucosal IgE in patients with FA and to characterize the intestinal mucosa in patients with FI of unknown origin (FH). METHODS: Patients with FA and FH were compared with healthy controls. To determine the IgE antibodies and the cytokines tumor necrosis factor (TNF)-α and interferon (IFN)-γ of the intestinal mucosal, a lavage was performed as part of an ileocolonoscopy and samples were taken using the cytobrush and biopsy forceps. In a subgroup, mucosal samples were also taken from the duodenum. RESULTS: Data in homogenates of intestinal mucosal samples yielded the highest sensitivity for IgE antibody titers compared with lavage and cytobrush. Patients with FA presented increased intestinal TNF-α and low IFN-γ values. This was in contrast to FH patients, who showed low intestinal IgE antibodies and TNF-α levels, but increased IFN-γ values. DISCUSSION: The determination of IgE antibodies to diagnose intestinal IgE-mediated FA is most reliable in intestinal mucosal samples. Increased TNF-α and low IFN-γ levels in patients with FA characterize an allergic reaction. Decreased TNF-α and increased IFN-γ levels in patients with FH indicate an inflammation-related intolerance reaction (see Visual Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A520).
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spelling pubmed-78893732021-02-18 Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study Dieterich, Walburga Tietz, Esther Kohl, Matthias Konturek, Peter C. Rath, Timo Neurath, Markus F. Zopf, Yurdagül Clin Transl Gastroenterol Article The prevalence of patients with food intolerance (FI) has increased significantly. Immunoglobulin (Ig)E-mediated food allergies (FAs) are detected by determining IgE antibodies and skin prick test. Carbohydrate malabsorptions are clarified with breath tests. However, these diagnostic measures cannot capture all intolerances and have limitations in case of gut-mediated FI. The aims of this pilot study were to evaluate different methods to determine intestinal mucosal IgE in patients with FA and to characterize the intestinal mucosa in patients with FI of unknown origin (FH). METHODS: Patients with FA and FH were compared with healthy controls. To determine the IgE antibodies and the cytokines tumor necrosis factor (TNF)-α and interferon (IFN)-γ of the intestinal mucosal, a lavage was performed as part of an ileocolonoscopy and samples were taken using the cytobrush and biopsy forceps. In a subgroup, mucosal samples were also taken from the duodenum. RESULTS: Data in homogenates of intestinal mucosal samples yielded the highest sensitivity for IgE antibody titers compared with lavage and cytobrush. Patients with FA presented increased intestinal TNF-α and low IFN-γ values. This was in contrast to FH patients, who showed low intestinal IgE antibodies and TNF-α levels, but increased IFN-γ values. DISCUSSION: The determination of IgE antibodies to diagnose intestinal IgE-mediated FA is most reliable in intestinal mucosal samples. Increased TNF-α and low IFN-γ levels in patients with FA characterize an allergic reaction. Decreased TNF-α and increased IFN-γ levels in patients with FH indicate an inflammation-related intolerance reaction (see Visual Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A520). Wolters Kluwer 2021-02-17 /pmc/articles/PMC7889373/ /pubmed/33600102 http://dx.doi.org/10.14309/ctg.0000000000000312 Text en © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Dieterich, Walburga
Tietz, Esther
Kohl, Matthias
Konturek, Peter C.
Rath, Timo
Neurath, Markus F.
Zopf, Yurdagül
Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study
title Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study
title_full Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study
title_fullStr Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study
title_full_unstemmed Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study
title_short Food Intolerance of Unknown Origin: Caused by Mucosal Inflammation? A Pilot Study
title_sort food intolerance of unknown origin: caused by mucosal inflammation? a pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889373/
https://www.ncbi.nlm.nih.gov/pubmed/33600102
http://dx.doi.org/10.14309/ctg.0000000000000312
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