Clinical Relevance of IgG Antibodies against Food Antigens in Crohn’s Disease: A Double-Blind Cross-Over Diet Intervention Study

Abstract

Background: Environmental factors are thought to play an important role in the development of Crohn's disease (CD). Immune responses against auto-antigens or food antigens may be a reason for the perpetuation of inflammation. Methods: In a pilot study, 79 CD patients and 20 healthy controls were examined for food immunoglobulin G (IgG). Thereafter, the clinical relevance of these food IgG antibodies was assessed in a double-blind cross-over study with 40 patients. Based on the IgG antibodies, a nutritional intervention was planned. The interferon (IFN) secretion of T cells was measured. Eosinophilderived neurotoxin was quantified in stool. Results: The pilot study resulted in a significant difference of IgG antibodies in serum between CD patients and healthy controls. In 84 and 83% of the patients, respectively, IgG antibodies against processed cheese and yeast were detected. The daily stool frequency significantly decreased by 11% during a specific diet compared with a sham diet. Abdominal pain reduced and general well-being improved. IFN secretion of T cells increased. No difference for eosinophilderived neurotoxin in stool was detected. Conclusion: A nutritional intervention based on circulating IgG antibodies against food antigens showed effects with respect to stool frequency. The mechanisms by which IgG antibodies might contribute to disease activity remain to be elucidated. clusion: A nutritional intervention based on circulating IgG antibodies against food antigens showed effects with respect to stool frequency. The mechanisms by which IgG antibodies might contribute to disease activity remain to be elucidated.

Determination of the Effect of the Elimination Diet Applied for Overweight and Obese People with Food Intolerance on Body Composition and Biochemical Parameters

“…Moreover, considering that as dietary habit is a significant risk factor for yeast sensitivity, we may correlate this difference with the nature of Turkish diet which mainly bases on grain and excessive consumption of fermented foods and sugar. In a study, 84% and 83% of the patients showed highes intolerance to prossessed cheese and yeast, respectively [ 34 ].…”

Alterations of Food-specific Serum IgG4 Titers to Common Food Antigens in Patients With Irritable Bowel Syndrome

“…23 Similarly, high levels of the IgG4 food antibodies are also observed in patients with inflammatory bowel disease, where intestinal mucosal permeability is known to be increased. 24,25 Some studies have demonstrated that food-specific IgG4 antibody-guided exclusion diet may be effective in alleviating IBS symptoms. 26,27 The IgG4 antibody-guided exclusion diet affects various symptoms including abdominal pain or discomfort, stool shape, diarrhea frequency, and general feelings of distress.…”

The challenges of control groups, placebos and blinding in clinical trials of dietary interventions

“…There are at least seven sham-controlled dietary advice RCTs investigating the effect of 290 whole diet interventions reported in the literature (Table 2) (38)(39)(40)(41)(42)(43)(44)(45) . Most evaluate the effect of (40) , the patient's usual diet (41) , is relatively arbitrary (38,39,42,43) or excludes another 295 dietary component (44) .…”