Document Detail

Local allergic reaction in food-hypersensitive adults despite a lack of systemic food-specific IgE.
MedLine Citation:
PMID:  11994715     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Objective tools are lacking for the diagnosis of local gastrointestinal inflammatory reactions in skin prick test (SPT)-negative and serum IgE antibody (s-IgE Ab)-negative patients with suspected food allergy. OBJECTIVE: The purpose of this investigation was to evaluate the presence of eosinophils, T cells, local IgE-bearing cells, IL-4, and IFN-gamma in small intestinal biopsy specimens from adult SPT-negative/s-IgE Ab-negative patients with food allergy during symptomatic and nonsymptomatic periods. METHODS: Fourteen patients with food allergy-related gastrointestinal symptoms confirmed by double-blinded, placebo-controlled food challenge (DBPCFC) were investigated. Eleven of the patients were SPT-negative and s-IgE Ab-negative. Sex- and age-matched healthy volunteers were used as controls. Duodenal biopsies were studied with immunostaining through use of a panel of mouse monoclonal antibodies specific for eosinophils, CD3, CD4, CD8, IgE, IL-4, and IFN-gamma. RESULTS: Significant increases in numbers of MBP+ eosinophils, IgE-bearing cells, and T cells were found in the duodenal mucosa of the patients when they were symptomatic in comparison with when they were asymptomatic and in comparison with healthy controls. Numbers of IL-4+ cells were increased and numbers of IFN-gamma+ cells were reduced in the patients when they were symptomatic in comparison with when they were asymptomatic and in comparison with the controls. There were no differences in total s-IgE levels between any of the groups. CONCLUSION: A significant correlation was found between the appearance of symptoms of food hypersensitivity and the duodenal presence of IgE-bearing cells, activated eosinophils, and T cells in patients with negative SPT results and negative s-IgE Ab to the offending food. We suggest that a localized IgE-mediated response caused the gastrointestinal symptoms seen in these patients.
Xiao Ping Lin; Jenny Magnusson; Staffan Ahlstedt; Anna Dahlman-Höglund; Lars A Hanson L; Olle Magnusson; Ulf Bengtsson; Esbjörn Telemo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  109     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-07     Completed Date:  2002-06-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  879-87     Citation Subset:  AIM; IM    
Department of Clinical Immunology, Sahlgrenska University Hospital, Göteborg, Sweden.
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MeSH Terms
Antigens, CD3 / metabolism
CD4-Positive T-Lymphocytes / pathology
CD8-Positive T-Lymphocytes / pathology
Duodenum / metabolism,  pathology
Eosinophils / pathology
Food Hypersensitivity / metabolism*,  pathology*
Immunoglobulin E / analysis*,  blood,  immunology,  metabolism
Interferon-gamma / blood,  metabolism
Interleukin-4 / blood,  metabolism
Intestinal Mucosa / metabolism,  pathology
Intestine, Small / metabolism*,  pathology*
Leukocyte Count
Middle Aged
Reg. No./Substance:
0/Antigens, CD3; 0/Epitopes; 207137-56-2/Interleukin-4; 37341-29-0/Immunoglobulin E; 82115-62-6/Interferon-gamma

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