Measurements of Eosinophil Activation before and after Food Challenges in Adults with Food Hypersensitivity

Abstract

Background: Objective assessment of inflammatory reactions in the gastrointestinal tract could be useful in the diagnosis of food hypersensitivity. The aim of the present study was to investigate the involvement of eosinophils and mast cells in the inflammatory response of patients with food hypersensitivity before and after food challenges. Methods: Eleven patients (4 with IgE-mediated allergy and 7 without) with food hypersensitivity and positive double-blind, placebo-controlled food challenge were subjected to food challenge in a single-blinded fashion. Four subjects with no known food hypersensitivity were recruited as controls. Placebo was given after a 1-week washout period followed by an active dose. Stool, urinary and serum samples were collected and symptoms were recorded in a diary. Fecal samples were analyzed for eosinophil protein X (F-EPX) and tryptase; urinary samples for EPX (U-EPX) and leukotriene E₄ (U-LTE₄) and serum samples were analyzed for eotaxin and food-specific IgE antibodies. Results: Patients with IgE-mediated food allergy had increased levels of F-EPX compared to controls and tended to have lower serum levels of eotaxin compared to non-allergic patients and controls. U-LTE₄ was significantly higher in allergic patients compared to non-allergic patients after challenge. Moreover, F-EPX correlated to U-LTE₄ (p = 0.011). Reported symptoms, abdominal pain, distension, flatulence and nausea were similar in the allergic and non-allergic patients. Conclusion: The results strongly indicate that eosinophils are activated in the gastrointestinal tract of food-allergic patients but not in patients with non-allergic food hypersensitivity. Due to the inconsistent pattern of symptoms after placebo and active food challenge, it was not possible to relate the levels of inflammation markers to the recorded symptoms.

Inhibition of soluble epoxide hydrolase attenuates eosinophil recruitment and food allergen-induced gastrointestinal inflammation

“…4 Although the involvement of mast cells in food allergies is well recognized, 5 increasingly, several studies have indicated a role for eosinophils in promoting food allergen-induced inflammation. Experimental animal models of food antigen-driven GI inflammation [6][7][8] as well as studies in patients with food allergies [9][10][11] show that eosinophils are recruited to the intestinal mucosa in substantial numbers. Although present in the normal GI mucosa under homeostatic conditions, 12 eosinophils are known to contribute to inflammation when present in abnormal numbers.…”

Frequency of Abnormal Fecal Biomarkers in Irritable Bowel Syndrome

“…Inflammatory disorders such as inflammatory bowel disease may be discriminated from IBS with the use of the neutrophil-derived protein calprotectin in stool 14 – 17 . Food allergies, which have a reported prevalence rate of about 25% in IBS patients, 18 may be suggested by the presence of elevated fecal levels of eosinophil protein X, which may also be elevated in inflammatory bowel disorders and parasitic infections 19 – 25 . Pathogenic infections such as Clostridium difficile and parasites such as Giardia lamblia are reported in 5.7% and 6.5%, respectively, of people with symptoms attributable to IBS 26 , 27 and are readily detected on fecal specimens using established techniques such as culture and light microscopy.…”

“…[14][15][16][17] Food allergies, which have a reported prevalence rate of about 25% in IBS patients, 18 may be suggested by the presence of elevated fecal levels of eosinophil protein X, which may also be elevated in inflammatory bowel disorders and parasitic infections. [19][20][21][22][23][24][25] Pathogenic infections such as Clostridium difficile and parasites such as Giardia lamblia are reported in 5.7% and 6.5%, respectively, of people with symptoms attributable to IBS 26,27 and are readily detected on fecal specimens using established techniques such as culture and light microscopy. Blastocystis hominis, the most common human intestinal parasite, was long thought to be non-pathogenic.…”

Allura Red, Carmoisine and Indigo Carmine Inhibit Reactive Oxygen Species Production by Human Polymorphonuclear Leukocytesin Vitro

“…It is generally agreed that food additives in particular AFCs may cause non-IgE-mediated intolerance reactions in some predisposed individuals or sub populations causing asthma, rhinitis, urticaria, itchiness, and migraines in largely unidentified mechanisms (Orlatoniand Pastorello, 2006;Stevens et al, 2013). Studies, nevertheless, suggest hypersentivity reactions to food antigens could possibly be associated with inflammatory cells like eosinophils, neutrophils and mast cells (van Odijk et al, 2006;Stevens et al, 2013). Especially, neutrophils, of late are being identified, as playing critical role in allergic inflammatory processes giving rise to immense interest in these fascinating cells (Mocsai, 2013;Gunzer, 2014).…”