Indications of 'atopic bowel' in patients with self-reported food hypersensitivity
Indications of 'atopic bowel' in patients with self-reported food hypersensitivity
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DOI：
10.1111/j.1365-2036.2010.04261.x
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发表时间：
2010-05-15
影响因子：
7.6
通讯作者：
Berstad, A.
中科院分区：
文献类型：
--
作者：
Lillestol, K.;Helgeland, L.;Berstad, A.
背景已提出特应性疾病与胃肠道主诉之间存在关联。目的探讨自我报告的食物过敏患者特应性疾病、胃肠道症状和可能的特应性疾病胃肠道表现之间的关联。方法记录了 71 名成年患者的症状、皮肤点刺试验、过敏血清标志物和肠道通透性。对十二指肠活检中的嗜酸性粒细胞、类胰蛋白酶和 IgE 阳性细胞进行计数。 结果 66 名患者 (93%) 患有肠易激综合征 (IBS)，43 名患者 (61%) 患有特应性疾病，主要是鼻结膜炎。所有 43 名受试者均对吸入性过敏原过敏，其中 29 名受试者（41%）对食物过敏原过敏，但食物挑战呈阴性。血清总 IgE 和十二指肠 IgE 阳性细胞计数显着相关（P < 0.0001），并且特应性患者的血清总 IgE 和十二指肠 IgE 阳性细胞计数均显着高于非特应性患者（分别为 P < 0.0001 和 P = 0.003）。 IgE 阳性细胞似乎是“武装”肥大细胞。与非特应性患者相比，特应性患者的肠道通透性显着升高（P = 0.02）。胃肠道症状以及类胰蛋白酶阳性肥大细胞和嗜酸性粒细胞的数量在各组之间没有差异。结论自我报告食物过敏的患者IBS和特应性疾病的患病率较高。与非特应性患者相比，特应性患者的肠道通透性和 IgE 承载细胞密度增加，但胃肠道症状在各组之间没有差异。
P>BackgroundAn association between atopic disease and gastrointestinal complaints has been suggested.AimTo explore the association between atopic disease, gastrointestinal symptoms, and possible gastrointestinal manifestations of atopic disease in patients with self-reported food hypersensitivity.MethodsSymptoms, skin prick tests, serum markers of allergy and intestinal permeability were recorded in 71 adult patients. Eosinophils, tryptase- and IgE-positive cells were counted in duodenal biopsies.ResultsSixty-six (93%) patients had irritable bowel syndrome (IBS) and 43 (61%) had atopic disease, predominantly rhinoconjunctivitis. All 43 were sensitized to inhalant allergens, 29 (41%) to food allergens, but food challenges were negative. Serum total IgE and duodenal IgE-positive cell counts were significantly correlated (P < 0.0001) and both were significantly higher in atopic than in non-atopic patients (P < 0.0001 and P = 0.003 respectively). IgE-positive cells appeared to be 'armed' mast cells. Intestinal permeability was significantly elevated in atopic compared with non-atopic patients (P = 0.02). Gastrointestinal symptoms and numbers of tryptase-positive mast cells and eosinophils did not differ between groups.ConclusionsPatients with self-reported food hypersensitivity had a high prevalence of IBS and atopic disease. Atopic patients had increased intestinal permeability and density of IgE-bearing cells compared with non-atopic patients, but gastrointestinal symptoms did not differ between groups.