Does food intolerance have any role in the aetiology and management of rheumatoid disease?

Intestinal Permeability and Antigen Absorption in Rheumatoid Arthritis

“…Since macromolecules capable of eliciting an immune re sponse have been implicated in food allergy, we used immunoreactive BLG as a probe for gut absorption. It is, however, not surprising that our findings are largely in agreement with those of other studies [15][16][17][18][19], It has been difficult to reconcile these results with the clinical effects of restricted diets in RA [2]. Manip ulation of the diet suggested that individual patients may benefit from withdrawal of specific foods [2,4,5,20] or fasting [7], Changes in fatty acid composition in the diet and EPA-rich fish oil seemed also to amelio rate symptoms in some of the cases [21].…”

“…It is, however, not surprising that our findings are largely in agreement with those of other studies [15][16][17][18][19], It has been difficult to reconcile these results with the clinical effects of restricted diets in RA [2]. Manip ulation of the diet suggested that individual patients may benefit from withdrawal of specific foods [2,4,5,20] or fasting [7], Changes in fatty acid composition in the diet and EPA-rich fish oil seemed also to amelio rate symptoms in some of the cases [21]. Aberrant im mune responses to cow's milk has been reported in 1 patient by Panush et al [5], but only occasionally has IgE-mediated hypersensitivity to foods been observed [6] and quite certainly unrelated to RA.…”

“…It has been postulated that some rheumatic disorders may arise from food allergy and/or intolerance [1,2] or alternatively that food-derived antigens may per petuate inflammation so that dietary manipulation would affect clinical manifestations [3][4][5]. Prevalence of atopy in RA has been found to be similar to that observed in the general population, with levels of IgE within the normal range [6].…”

“…The patients' diet may be one such co-factor, with dramatic improvement in some cases after elimination of certain foods or dietary restric tion [2,5,7,20], We propose that prolonged treatment with anti-in flammatory agents induces a continuous increase of gut permeability, resulting in secondary damage with clinical effects. The roles of gastrointestinal lesions and local or systemic prostaglandin inhibition cannot be distinguished from our data, but the latter possibil ity is favored [17] and also suggested by our findings in normal subjects.…”