Institute of Medicine, University of Bergen, Norway.
Aliment Pharmacol Ther. 2010 May;31(10):1112-22. doi: 10.1111/j.1365-2036.2010.04261.x. Epub 2010 Feb 16.
An association between atopic disease and gastrointestinal complaints has been suggested.
To explore the association between atopic disease, gastrointestinal symptoms, and possible gastrointestinal manifestations of atopic disease in patients with self-reported food hypersensitivity.
Symptoms, skin prick tests, serum markers of allergy and intestinal permeability were recorded in 71 adult patients. Eosinophils, tryptase- and IgE-positive cells were counted in duodenal biopsies.
Sixty-six (93%) patients had irritable bowel syndrome (IBS) and 43 (61%) had atopic disease, predominantly rhinoconjunctivitis. All 43 were sensitized to inhalant allergens, 29 (41%) to food allergens, but food challenges were negative. Serum total IgE and duodenal IgE-positive cell counts were significantly correlated (P < 0.0001) and both were significantly higher in atopic than in non-atopic patients (P < 0.0001 and P = 0.003 respectively). IgE-positive cells appeared to be 'armed' mast cells. Intestinal permeability was significantly elevated in atopic compared with non-atopic patients (P = 0.02). Gastrointestinal symptoms and numbers of tryptase-positive mast cells and eosinophils did not differ between groups.
Patients with self-reported food hypersensitivity had a high prevalence of IBS and atopic disease. Atopic patients had increased intestinal permeability and density of IgE-bearing cells compared with non-atopic patients, but gastrointestinal symptoms did not differ between groups.
有人提出特应性疾病与胃肠道症状之间存在关联。
探讨有食物过敏自述史的患者中特应性疾病、胃肠道症状与特应性疾病可能的胃肠道表现之间的关系。
记录 71 例成年患者的症状、皮肤点刺试验、过敏血清标志物和肠道通透性。在十二指肠活检中计算嗜酸性粒细胞、类胰蛋白酶和 IgE 阳性细胞的数量。
66 例（93%）患者患有肠易激综合征（IBS），43 例（61%）患有特应性疾病，主要为鼻结膜炎。43 例均对吸入性过敏原敏感，29 例（41%）对食物过敏原敏感，但食物激发试验均为阴性。血清总 IgE 和十二指肠 IgE 阳性细胞计数呈显著正相关（P < 0.0001），且特应性患者的上述两项指标均显著高于非特应性患者（P < 0.0001 和 P = 0.003）。IgE 阳性细胞似乎是“武装”的肥大细胞。与非特应性患者相比，特应性患者的肠道通透性明显升高（P = 0.02）。两组间胃肠道症状以及类胰蛋白酶阳性肥大细胞和嗜酸性粒细胞数量无差异。
有食物过敏自述史的患者 IBS 和特应性疾病的患病率较高。与非特应性患者相比，特应性患者的肠道通透性和 IgE 阳性细胞密度增加，但两组间胃肠道症状无差异。
