Characterisation of immune mediator release during the immediate response to segmental mucosal challenge in the jejunum of patients with food allergy

J Santos, C Bayarri, E Saperas, C Nogueiras, M Antolin… - Gut, 1999 - gut.bmj.com
J Santos, C Bayarri, E Saperas, C Nogueiras, M Antolin, M Mourelle, A Cadahia…
Gut, 1999gut.bmj.com
BACKGROUND Food allergy is a common complaint among patients with a broad spectrum
of abdominal and extra-abdominal symptoms that must be distinguished from other more
common non-immunological food intolerances. AIMS To investigate whether human
intestinal hypersensitivity reactions are associated with detectable release of inflammatory
mediators from activated cells, which may serve as a biological marker of true allergic
reactions. PATIENTS/METHODS In eight patients with food allergy and seven healthy …
BACKGROUND
Food allergy is a common complaint among patients with a broad spectrum of abdominal and extra-abdominal symptoms that must be distinguished from other more common non-immunological food intolerances.
AIMS
To investigate whether human intestinal hypersensitivity reactions are associated with detectable release of inflammatory mediators from activated cells, which may serve as a biological marker of true allergic reactions.
PATIENTS/METHODS
In eight patients with food allergy and seven healthy volunteers, a closed-segment perfusion technique was used to investigate the effects of jejunal food challenge on luminal release of tryptase, histamine, prostaglandin D2, eosinophil cationic protein, peroxidase activity, and water flux.
RESULTS
Intraluminal administration of food antigens induced a rapid increase in intestinal release of tryptase, histamine, prostaglandin D2, and peroxidase activity (p<0.05 v basal period) but not eosinophil cationic protein. The increased release of these mediators was associated with a notable water secretory response.
CONCLUSIONS
These results suggest that human intestinal hypersensitivity reactions are characterised by prompt activation of mast cells and other immune cells, with notable and immediate secretion of water and inflammatory mediators into the intestinal lumen. Analysis of the profile of markers released into the jejunum after food provocation may be useful for the objective diagnosis of food allergy.
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