Document Detail

The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis.
MedLine Citation:
PMID:  16484508     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Patients with rheumatoid arthritis (RA) often feel there is an association between food intake and rheumatoid disease severity. To investigate a putative immunological link between gut immunity and RA, food antibodies were measured in serum and perfusion fluid from the jejunum of RA patients and healthy controls to determine the systemic and mucosal immune response.
METHODS: IgG, IgA, and IgM antibodies to dietary antigens were measured in serum and jejunal perfusion fluid from 14 RA patients and 20 healthy subjects. The antigens originated from cow's milk (alpha-lactalbumin, beta-lactoglobulin, casein), cereals, hen's egg (ovalbumin), cod fish, and pork meat.
RESULTS: In intestinal fluid of many RA patients, all three immunoglobulin classes showed increased food specific activities. Except for IgM activity against beta-lactoglobulin, all other IgM activities were significantly increased irrespective of the total IgM level. The RA associated serum IgM antibody responses were relatively much less pronounced. Compared with IgM, the intestinal IgA activities were less consistently raised, with no significant increase against gliadin and casein. Considerable cross reactivity of IgM and IgA antibodies was documented by absorption tests. Although intestinal IgG activity to food was quite low, it was nevertheless significantly increased against many antigens in RA patients. Three of the five RA patients treated with sulfasalazine for 16 weeks had initially raised levels of intestinal food antibodies; these became normalised after treatment, but clinical improvement was better reflected in a reduced erythrocyte sedimentation rate.
CONCLUSIONS: The production of cross reactive antibodies is strikingly increased in the gut of many RA patients. Their food related problems might reflect an adverse additive effect of multiple modest hypersensitivity reactions mediated, for instance, by immune complexes promoting autoimmune reactions in the joints.
M Hvatum; L Kanerud; R Hällgren; P Brandtzaeg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-16
Journal Detail:
Title:  Gut     Volume:  55     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-14     Completed Date:  2006-09-21     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  1240-7     Citation Subset:  AIM; IM    
Laboratory for Immunohistochemistry and Immunopathology (LIIPAT), Institute of Pathology, Rikshospitalet, N-0027 Oslo, Norway.
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MeSH Terms
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / drug therapy,  etiology,  immunology*
Cross Reactions
Dietary Proteins / immunology
Enzyme-Linked Immunosorbent Assay / methods
Food Hypersensitivity / complications,  immunology*
Immunity, Mucosal
Immunoglobulin A / analysis*
Immunoglobulin G / analysis*
Immunoglobulins / analysis
Intestinal Mucosa / immunology
Jejunum / immunology
Middle Aged
Sulfasalazine / therapeutic use
Reg. No./Substance:
0/Antirheumatic Agents; 0/Dietary Proteins; 0/Immunoglobulin A; 0/Immunoglobulin G; 0/Immunoglobulins; 599-79-1/Sulfasalazine

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