Colonoscopic allergen provocation (COLAP): a new diagnostic approach for gastrointestinal food allergy.

Bischoff, Stephan C.; Mayer, Julika; Wedemeyer, Jochen; Meier, P. N.; Zeck-Kapp, Gabriele; Wedi, Bettina; Kapp, Alexander; Cetin, Yalcin; Gebel, M.; Manns, Michael P.

doi:10.1136/gut.40.6.745

Cited by 136 publications

(106 citation statements)

References 27 publications

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“…Dietary-related IBS-like responses have been associated, both in patients and animal models, to local mechanisms of the colonic mucosa rather than a systemic reaction, more characteristic of food allergies. 4,6,7 In agreement with these observations, in this study, OVA-induced altered contractility in OVA-LPStreated rats was neither related to the presence of circulating specific IgEs (unpublished results) nor to the altered expression of pro-(IL-6 and IL-13) or anti-allergic (IL-12 and IL-10) cytokines. 26,27 However, these animals showed a specific up-regulation of IFN-1, similar to that observed in IBS-like states.…”

Section: Discussionsupporting

confidence: 75%

“…4,6 In this line, we have previously demonstrated that long-term exposure to oral ovalbumin (OVA), without adjuvants, results in a non-IgE mediated alteration of colonic motility in rats, an effect related to an excited-activated state of the tissue mucosal mast cells (MMCs). These OVA-mediated changes are reminiscent of those observed in IBS patients and in animal models of the disease.…”

Section: -5mentioning

confidence: 86%

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Lipopolysaccharides Facilitate Colonic Motor Alterations Associated to the Sensitization to a Luminal Antigen in Rats

Jardí

Aguilera

Vergara

et al. 2015

J Neurogastroenterol Motil

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Background/Aims Enteric dysbiosis is a risk factor for dietary proteins-associated intestinal alterations, contributing to the development of food allergies and the symptomatology of functional gastrointestinal disorders, mainly irritable bowel syndrome (IBS). We explored if a dysbiotic-like state, simulated by intraperitoneal administration of bacterial lipopolysaccharides (LPS), facilitates the sensitization to a luminal antigen, ovalbumin (OVA), in rats. Methods Rats were exposed to oral OVA for 1 week, alone or with LPS. Thereafter, colonic histology, goblet cell density, mucosal eosinophils and mucosal mast cell (MMC) and connective tissue mast cell (CTMC) were evaluated. Colonic expression (real-time quantitative polymerase chain reaction) of interleukins, IFN-α1 and integrins was assessed to determine local immune responses. Luminal and wall adhered microbiota were characterized by fluorescence in situ hybridization. Colonic contractility (in vitro) served to assess functional changes associated to OVA and/or LPS. Results Neither OVA nor LPS, alone or combined, lead to structural alterations, except for a reduced goblet cell density in OVA-LPS-treated rats. MMC density was unaffected, while CTMC counts increased within the submucosa of OVA-LPS-treated animals. Marginal immune activation (IFN-α1 up-regulation) was observed in OVA-LPS-treated rats. LPS induced a dysbiotic-like state characterized by decreased luminal bacterial counts, with a specific loss of clostridia. LPS facilitated Clostridium spp. wall adherence, an effect prevented by OVA. Colonic contractility was altered in OVA-LPS-treated animals, showing increased basal activity and enhanced motor responses to OVA. Conclusions Changes in gut microbiota and/or direct effects of LPS might enhance/facilitate local neuroimmune responses to food antigens leading to motor alterations similar to those observed in IBS.

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Section: Discussionsupporting

confidence: 75%

Section: -5mentioning

confidence: 86%

Lipopolysaccharides Facilitate Colonic Motor Alterations Associated to the Sensitization to a Luminal Antigen in Rats

Jardí

Aguilera

Vergara

et al. 2015

J Neurogastroenterol Motil

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“…In our previous study, IgE was not a major antibody in milk-hypersensitive adults (Pelto et al, 1998). Similar results have been obtained by other groups (Bengtsson et al, 1996;Werfel et al, 1997;Bischoff et al, 1997). We measured serum reactivity to milk protein and milk-speci®c IgG 1 , IgG 2 , IgG 3 and IgA antibodies in serum and estimated the prevalence of milk hypersensitivity in young adults.…”

Section: Introductionsupporting

confidence: 84%

Milk hypersensitivity in young adults

et al. 1999

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Objective: To estimate the prevalence of milk hypersensitivity in Finnish adults. Design: Cross-sectional study. Subjects: Two hundred men and 206 women aged 27 y randomly recruited from the population register in southwestern Finland. Interventions: The subjects were interviewed about their dairy product consumption, abdominal discomfort after dairy product intake and lactose intolerance. From serum samples, serum reactivity to milk protein and milk-speci®c IgG 1 , IgG 2 , IgG 3 and IgA were measured. Results: About 20% of the subjects reported abdominal discomfort after dairy product intake, whereas only 6.4% had been diagnosed to have lactose intolerance. The amount of milk consumed correlated well with the serum assay results in subjects reporting abdominal discomfort but not in subjects who were free from these symptoms. Among subjects with no record of dairy product restriction or lactose intolerance, those experiencing abdominal discomfort after dairy product intake had signi®cantly higher serum reactivity to milk protein than those without such discomfort. The concentrations of serum milk-speci®c antibodies did not differ between these two groups. The prevalence of milk hypersensitivity in this population was estimated to be 3 ± 6%. Conclusions: Milk hypersensitivity may be as common in adults as in infants. The measurement of serum reactivity to milk protein may prove useful in screening milk hypersensitivity in subjects who have not restricted their dairy product consumption.

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“…Food intolerance, such as lactose intolerance, classically relates to a reaction to food components based on some metabolic deficiency. [33][34][35] Food allergy and hypersensitivity instead refer to undesirable immune-based reactions that cause symptoms. The most common food sensitivities have been related to proteins in nuts, wheat, and milk.…”

Section: Dietary Factors In Irritable Bowel Syndromementioning

confidence: 99%

Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten?

Volta

Sánchez

Boschetti

et al. 2016

J Neurogastroenterol Motil

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A tight link exists between dietary factors and irritable bowel syndrome (IBS), one of the most common functional syndromes, characterized by abdominal pain/discomfort, bloating and alternating bowel habits. Amongst the variety of foods potentially evoking "food sensitivity", gluten and other wheat proteins including amylase trypsin inhibitors represent the culprits that recently have drawn the attention of the scientific community. Therefore, a newly emerging condition termed non-celiac gluten sensitivity (NCGS) or nonceliac wheat sensitivity (NCWS) is now well established in the clinical practice. Notably, patients with NCGS/NCWS have symptoms that mimic those present in IBS. The mechanisms by which gluten or other wheat proteins trigger symptoms are poorly understood and the lack of specific biomarkers hampers diagnosis of this condition. The present review aimed at providing an update to physicians and scientists regarding the following main topics: the experimental and clinical evidence on the role of gluten/wheat in IBS; how to diagnose patients with functional symptoms attributable to gluten/wheat sensitivity; the importance of double-blind placebo controlled cross-over trials as confirmatory assays of gluten/wheat sensitivity; and finally, dietary measures for gluten/wheat sensitive patients. The analysis of current evidence proposes that gluten/wheat sensitivity can indeed represent a subset of the broad spectrum of patients with a clinical presentation of IBS. (J Neurogastroenterol Motil 2016;22:547-557)

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Colonoscopic allergen provocation (COLAP): a new diagnostic approach for gastrointestinal food allergy.

Abstract: (Gut 1997; 40: 745-753)

Cited by 136 publications

References 27 publications

Lipopolysaccharides Facilitate Colonic Motor Alterations Associated to the Sensitization to a Luminal Antigen in Rats

Lipopolysaccharides Facilitate Colonic Motor Alterations Associated to the Sensitization to a Luminal Antigen in Rats

Milk hypersensitivity in young adults

Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten?

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