IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case control study in the general population

Abstract

BackgroundPatients with Irritable Bowel Syndrome (IBS) often relate their symptoms to the intake of food and modify their diet. IgE-mediated food allergy is uncommon in IBS, but the role of IgG-mediated food hypersensitivity remains inconclusive. The primary aim of this study was to compare food- and yeast-specific IgG and IgG4 antibodies in subjects with and without IBS.MethodsThis was a case control study in the general population for which subjects completed questionnaires about abdominal complaints and their intake of common food items. Blood samples were collected, and food- and yeast-specific IgG and IgG4 antibodies were measured. Antibodies were measured in mg/L.ResultsWe included 269 subjects with IBS and 277 control subjects. After correction for subject characteristics and diet, there were no significant differences with regard to food- and yeast-specific IgG and IgG4 antibodies between subjects with IBS and controls. Lower values of IgG antibodies against egg (OR 0.99 (0.98 to 1.00), p = 0.002) and beef (OR 0.75 (0.60 to 0.94), p = 0.012) and higher values of IgG antibodies against chicken (OR 1.14 (1.03 to 1.27), p = 0.009) were associated with more severe symptoms.ConclusionsOur findings suggest that IgG-and IgG4-mediated food and yeast hypersensitivity in IBS is unlikely. IgG antibodies against food and yeast may reflect the diet.

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

“…16,17 Like atopic conditions, those observations suggest the possibility of a role of IgG4-related immune reaction in the pathophysiology of IBS. In a study from the United Kingdom, IBS patients had significantly higher IgG4 titers to wheat, beef, pork, and lamb compared to controls.…”

“…In a study from the United Kingdom, IBS patients had significantly higher IgG4 titers to wheat, beef, pork, and lamb compared to controls. 16 In contrast, a study from China showed that IBS patients had significantly higher levels of IgG antibody to crab, egg, shrimp, soybean, and wheat than controls. 17 In that study, patients with functional dyspepsia also had significantly higher titers of IgG antibody to egg and soybean, compared with controls.…”

“…16,17 The number of participants in each arm of this study was calculated to obtain results with an a of 0.05 and a power of 0.90. Therefore, we calculated that 54 subjects including 27 subjects and 27 controls were needed.…”

Current Dietary Approaches in Bowel Diseases: Low Fermentable Oligo-, Di- and Mono-Saccharides and Polyols (FODMAP) Diet: Review

“…Bunlardan en önemlisi; bireylerde aşırı duyarlılık gösteren besinlerin belirlenmesinde immünglo-bulin (IgG) veya IgE testleriyle ilgili tutarsızlıklar olduğudur. 23,24 Ligaarden ve ark., sağlıklı ve İBS tanısı alan hastalarda IgG testi pozitif olan besinlerin oranının benzer ve IgG testinin İBS tedavisinde kullanımının kısıtlı olduğu sonucuna varmışlardır. 23 Başka bir çalışmada ise IgG pozitif olan besinlerin kısıtlanmasıyla kontrol grubuna göre %10 daha iyi fayda sağlandığı görülmüştür.…”

“…23,24 Ligaarden ve ark., sağlıklı ve İBS tanısı alan hastalarda IgG testi pozitif olan besinlerin oranının benzer ve IgG testinin İBS tedavisinde kullanımının kısıtlı olduğu sonucuna varmışlardır. 23 Başka bir çalışmada ise IgG pozitif olan besinlerin kısıtlanmasıyla kontrol grubuna göre %10 daha iyi fayda sağlandığı görülmüştür. 24 İBS'de besin allerjisi varlığı ve İBS semptomlarında besin intoleransının da rol oynayacağına dair kesin bir kanıt mevcut değildir.…”