title: Measurements of eosinophil activation before and after food challenges in adults with food hypersensitivity.
abstract: BACKGROUND
  Objective assessment of inflammatory reactions in the gastrointestinal tract could be useful in the diagnosis of food hypersensitivity. The aim of the present study was to investigate the involvement of eosinophils and mast cells in the inflammatory response of patients with food hypersensitivity before and after food challenges.
  
  
  METHODS
  Eleven patients (4 with IgE-mediated allergy and 7 without) with food hypersensitivity and positive double-blind, placebo-controlled food challenge were subjected to food challenge in a single-blinded fashion. Four subjects with no known food hypersensitivity were recruited as controls. Placebo was given after a 1-week washout period followed by an active dose. Stool, urinary and serum samples were collected and symptoms were recorded in a diary. Fecal samples were analyzed for eosinophil protein X (F-EPX) and tryptase; urinary samples for EPX (U-EPX) and leukotriene E4 (U-LTE4) and serum samples were analyzed for eotaxin and food-specific IgE antibodies.
  
  
  RESULTS
  Patients with IgE-mediated food allergy had increased levels of F-EPX compared to controls and tended to have lower serum levels of eotaxin compared to non-allergic patients and controls. U-LTE4 was significantly higher in allergic patients compared to non-allergic patients after challenge. Moreover, F-EPX correlated to U-LTE4 (p = 0.011). Reported symptoms, abdominal pain, distension, flatulence and nausea were similar in the allergic and non-allergic patients.
  
  
  CONCLUSIONS
  The results strongly indicate that eosinophils are activated in the gastrointestinal tract of food-allergic patients but not in patients with non-allergic food hypersensitivity. Due to the inconsistent pattern of symptoms after placebo and active food challenge, it was not possible to relate the levels of inflammation markers to the recorded symptoms.
authors.affiliation: Department of Clinical Nutrition, Faculty of Medicine, Sahlgrenska Academy at Goteborg University, Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: van Odijk
authors.forename: C G B
authors.initials: CG
authors.lastname: Peterson
authors.forename: S
authors.initials: S
authors.lastname: Ahlstedt
authors.forename: U
authors.initials: U
authors.lastname: Bengtsson
authors.forename: M P
authors.initials: MP
authors.lastname: Borres
authors.forename: L
authors.initials: L
authors.lastname: Hulthén
authors.forename: J
authors.initials: J
authors.lastname: Magnusson
authors.forename: T
authors.initials: T
authors.lastname: Hansson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000276:immunology; D000328:Adult; D000368:Aged; D054413:Chemokine CCL11; D019742:Chemokines, CC / Q000097:blood; D004311:Double-Blind Method; D004435:Eating / Q000276:immunology*; D047208:Eosinophil-Derived Neurotoxin / Q000097:blood / Q000652:urine; D004804:Eosinophils / Q000276:immunology*; D005243:Feces / Q000737:chemistry; D005260:Female; D005502:Food / Q000009:adverse effects; D005512:Food Hypersensitivity / Q000097:blood / Q000276:immunology* / Q000652:urine; D041981:Gastrointestinal Tract / Q000737:chemistry / Q000276:immunology; D006801:Humans; D017999:Leukotriene E4 / Q000652:urine; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: C515456:CCL11 protein, human; D054413:Chemokine CCL11; D019742:Chemokines, CC; D017999:Leukotriene E4; D047208:Eosinophil-Derived Neurotoxin