Increased intestinal sugar permeability after challenge in children with cow's milk allergy or intolerance

Troncone, Riccardo; Caputo, N; Florio, Giovanni; Finelli, E

doi:10.1111/j.1398-9995.1994.tb00816.x

Cited by 30 publications

(22 citation statements)

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“…A statistically significant association has been demonstrated between the severity of referred clinical symptoms and the increase in the intestinal permeability index [102,103]. In patients with cow's milk allergy or intolerance, cellobiose/mannitol sugar permeability test, performed before and after cow's milk challenge, showed alteration of intestinal permeability induced by milk, suggesting the usefulness of the sugar permeability test, in addition to clinical observation, as an aid in the evaluation of challenge tests in infants with suspected cow's milk allergy or intolerance [104,105].…”

Section: Non-celiac Gluten Sensitivitymentioning

confidence: 99%

Non-Celiac Gluten Sensitivity: Literature Review

Mansueto

Seidita

D’Alcamo

et al. 2014

Journal of the American College of Nutrition

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Key words: non-celiac gluten sensitivity, celiac disease, wheat allergy, food allergy, HLA, flow cytometric basophil activation test, innate immune response Background: A significant percentage of the general population report problems caused by wheat and/or gluten ingestion, even though they do not have celiac disease (CD) or wheat allergy (WA), because they test negative both for CD-specific serology and histopathology and for immunoglobulin E (IgE)-mediated assays. Most patients report both gastrointestinal and nongastrointestinal symptoms, and all report improvement of symptoms on a gluten-free diet. This clinical condition has been named non-celiac gluten sensitivity (NCGS).Aim: We attempt to define the current pathogenic, clinical, and diagnostic criteria of this "new" disease, to provide a practical view that might be useful to evaluate, diagnose, and manage NCGS patients.Methods: We reviewed the international literature through PubMed and Medline, using the search terms "wheat (hyper)sensitivity," "wheat allergy," "wheat intolerance," "gluten (hyper)sensitivity," and "gluten intolerance," and we discuss current knowledge about NCGS.Results: It has been demonstrated that patients suffering from NCGS are a heterogeneous group, composed of several subgroups, each characterized by different pathogenesis, clinical history, and, probably, clinical course. NCGS diagnosis can be reached only by excluding CD and WA. Recent evidence shows that a personal history of food allergy in infancy, coexistent atopy, positive for immunoglobulin G (IgG) antigliadin antibodies and flow cytometric basophil activation test, with wheat and duodenal and/or ileum-colon intraepithelial and lamina propria eosinophil counts, could be useful to identify NCGS patients.Conclusions: Future research should aim to identify reliable biomarkers for NCGS diagnosis and to better define the different NCGS subgroups. Key teaching points:• Most patients report both gastrointestinal and nongastrointestinal symptoms, and all agree that there is an improvement of symptoms on a gluten-free diet.• NCGS diagnosis can be reached only by excluding celiac disease and wheat allergy.• Patients suffering from NCGS are a heterogeneous group, composed of several subgroups, each characterized by different pathogenesis, clinical history, and, probably, clinical course.• A personal history of food allergy in infancy, coexistent atopy, positive IgG antigliadin antibodies (AGA) and flow cytometric basophil activation test, with wheat and duodenal and/or ileum-colon intraepithelial and lamina propria eosinophil counts, could be useful to identify NCGS patients.• Future research should aim to identify reliable biomarkers for NCGS diagnosis and to better define the different NCGS subgroup. Abbreviations: CD = celiac disease, WA = wheat allergy, NCGS = non-celiac gluten sensitivity, GFD = gluten-free diet, IBS = irritable bowel syndrome, HLA = human leukocyte antigen, tTg = antitissue transglutaminase, AGA = antigliadin antibodies, EMA = endomysial antigen, DGP = deami...

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Section: Non-celiac Gluten Sensitivitymentioning

confidence: 99%

Non-Celiac Gluten Sensitivity: Literature Review

Mansueto

Seidita

D’Alcamo

et al. 2014

Journal of the American College of Nutrition

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“…Although some antigenic proteins are endocytosed into enterocytes and transported across the epithelium via the transcellular pathway, most proteins are degraded by intracellular enzymes, thus eliminating their antigenic properties (22). However, increased intestinal permeability has been documented in vivo in patients with food allergy (4,19), as well as in biopsy specimens (12) and in animal models of food hypersensitivity (3,10,17,21,24). It is clear that in sensitized individuals intact antigen does penetrate the epithelium to induce both immediate hypersensitivity and late-phase allergic reactions.…”

mentioning

confidence: 99%

Glucagon-like peptide-2-enhanced barrier function reduces pathophysiology in a model of food allergy

Cameron

Yang

Perdue

2003

American Journal of Physiology-Gastrointestinal and Liver Physi

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. Glucagon-like peptide-2-enhanced barrier function reduces pathophysiology in a model of food allergy. Am J Physiol Gastrointest Liver Physiol 284: G905-G912, 2003. First published January 29, 2003 10.1152/ajpgi.00231. 2002.-Penetration of the gut epithelial barrier by intact luminal antigen is necessary for immunologically mediated pathophysiology in the context of food allergy. We investigated if glucagon-like peptide-2 (GLP-2) could affect immediate hypersensitivity and late-phase allergic inflammation in a murine model. Mice were sensitized to horseradish peroxidase (HRP); studies were conducted 14 days later. Mice were treated with 5 g GLP-2 subcutaneously 4 h before antigen challenge. For immediate hypersensitivity, jejunal segments in Ussing chambers were challenged by luminal HRP antigen. GLP-2 treatment reduced the uptake of HRP and the antigen-induced secretory response after luminal challenge. GLP-2 appears to reduce macromolecular uptake independent of the CD23-mediated enhanced antigen uptake pathway. For the late phase, mice were gavaged with antigen, and 48 h later the function and histology of the jejunum were examined. GLP-2 prevented the usual prolonged permeability defect and reduced the number of inflammatory cells in the mucosa. Our studies demonstrate that a single treatment of sensitized mice with GLP diminishes both immediate and late-phase hypersensitivity reactions characteristic of food allergy by inhibiting transepithelial uptake of antigen. food allergy; transcellular and paracellular permeability; epithelial barrier function GLUCAGON-LIKE PEPTIDE-2 (GLP-2) is a 33-amino acid peptide secreted by the enteroendocrine L cells of the intestinal epithelium (16). The biological activities of GLP-2 include augmented growth of the gut mucosa [by both increased crypt cell proliferation and decreased enterocyte apoptosis (20)], stimulation of nutrient absorption (7), and enhanced barrier function (2). Such changes may account for the beneficial effects of GLP-2 in models of massive small bowel resection (18), total parenteral nutrition (8), and intestinal inflammation (6, 11). Specifically, improved barrier function may prevent the uptake of luminal antigens, bacterial products, and other proinflammatory material into the mucosa where they can provoke immune/inflammatory reactions, although this hypothesis has not yet been tested precisely. However, our previous study (2) in mice demonstrated that GLP-2 was able to reduce penetration of the epithelium by both small and large molecules; this effect was documented within 4 h after a single subcutaneous injection.Food allergy is a condition in which ingested food antigens rapidly provoke gastrointestinal symptoms in sensitized individuals (in humans or rodent models; reviewed in Ref. 9). Food allergic reactions are caused by antigen cross-linking of IgE bound to mucosal mast cells in the subepithelial compartment. Released mast cell mediators then act on cell receptors to induce intestinal anaphylaxis involving ion secretion, the driving force...

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“…Показано, что у детей с аллергией к белкам коровьего молока кишечная проницаемость повышается, причем не до, а после контакта с аллергеном [49].…”

Section: дефекты эпителиального барьера при пищевой аллергииunclassified

Role of the Barrier Dysfunction of the Intestines in the Development of Alimentary Allergy in Children

Боровик¹,

Макарова²,

Яцык³

et al. 2013

Vopr. sovr. pediatr.

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Increased intestinal sugar permeability after challenge in children with cow's milk allergy or intolerance

Cited by 30 publications

References 10 publications

Non-Celiac Gluten Sensitivity: Literature Review

Non-Celiac Gluten Sensitivity: Literature Review

Glucagon-like peptide-2-enhanced barrier function reduces pathophysiology in a model of food allergy

Role of the Barrier Dysfunction of the Intestines in the Development of Alimentary Allergy in Children

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