A kinetic study in adults with food hypersensitivity assessed as eosinophil activation in fecal samples.
BACKGROUND
Immune-mediated food hypersensitivity affecting the gut is difficult to evaluate, and objective tools to diagnose local gastrointestinal (GI) inflammatory reactions are lacking.


OBJECTIVE
To determine whether allergic manifestations in adults with a history of food-related GI symptoms could be assessed in feces during symptomatic and non-symptomatic periods, using the surrogate markers, eosinophil cationic protein (ECP), eosinophil protein X (EPX) and myeloperoxidase (MPO).


METHODS
Thirteen subjects with food hypersensitivity-related GI symptoms, confirmed by a positive double-blind placebo-controlled food challenge (DBPCFC), were subjected to an open kinetic food challenge design for 6 weeks. Symptoms were recorded and scored during the 3-week study period and stool samples were obtained every day. The surrogate markers ECP, EPX and MPO were measured in the supernatants from feces samples.


RESULTS
A significant increase in abdominal pain, distension and flatulence was observed during challenge, with a gradual decrease during elimination diet. Both between days and subjects, EPX levels were more frequently increased compared to ECP and MPO. Individuals with a history of a short duration of symptoms had significantly higher mean levels of EPX and MPO than those with a longer duration of symptoms.


CONCLUSIONS
An overall increase in levels of eosinophil markers, in particular EPX, was observed in feces from patients with food-related GI symptoms. However, rather than being a tool to differentiate symptomatic from non-symptomatic periods, EPX might be used for detecting an ongoing clinical or subclinical chronic inflammation, that may have an impact on the patient's clinical course of GI symptoms.
Magnusson
J
J
Asthma and Allergy Research Group, Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. jenny.magnusson@lungall.gu.se
Gellerstedt
M
M
Ahlstedt
S
S
Andersson
B
B
Bengtsson
U
U
Telemo
E
E
Hansson
T
T
Peterson
C G B
CG
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001798:Blood Proteins / Q000378:metabolism; D004311:Double-Blind Method; D047091:Eosinophil Granule Proteins; D047208:Eosinophil-Derived Neurotoxin; D004804:Eosinophils / Q000502:physiology*; D005243:Feces / Q000737:chemistry / Q000166:cytology*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D018836:Inflammation Mediators / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000378:metabolism; D012260:Ribonucleases / Q000378:metabolism; D012882:Skin Tests
D015415:Biomarkers; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D007073:Immunoglobulin E; D009195:Peroxidase; D047208:Eosinophil-Derived Neurotoxin; D012260:Ribonucleases