食物特异性 IgG4 引导的排除饮食可改善克罗恩病的症状：一项初步研究。

Food-specific IgG4-guided exclusion diets improve symptoms in Crohn's disease: a pilot study.

机构信息

St George's Hospital, London, UK.

出版信息

Colorectal Dis. 2011 Sep;13(9):1009-13. doi: 10.1111/j.1463-1318.2010.02373.x. Epub 2010 Jul 7.

DOI:10.1111/j.1463-1318.2010.02373.x

PMID:20626437

Abstract

AIM

Exclusion diets have been shown to prolong remission in Crohn's disease (CD). We assessed IgG4-targeted exclusion diets in patients with CD.

METHOD

Forty patients with symptomatic CD were recruited. Their sera were tested for IgG4 antibodies to 14 specific food antigens and each subject's four most reactive foods were excluded for 4 weeks. Disease activity was assessed using a modified CD activity index (mCDAI). Questionnaire and inflammatory markers were measured before and on completion of the exclusion diet.

RESULTS

Eleven patients did not complete the study, leaving 29 for analysis. Of these, 26 (90%) reported symptomatic improvement with a reduction in mCDAI from a mean of 171-97.5 (P = 0.0001). The ESR fell from 23 to 17 mm/h (P = 0.021) and the IgG4 titres for the excluded foods fell from a mean of 3015-2306 mcgA/l (P = 0.003).

CONCLUSION

IgG4-guided exclusion diets resulted in significant symptomatic improvement with an objective fall in an inflammatory marker. This approach may be useful in clinical practice.

摘要

目的

排除饮食已被证明可延长克罗恩病（CD）的缓解期。我们评估了针对 IgG4 的排除饮食在 CD 患者中的作用。

方法

招募了 40 名有症状的 CD 患者。检测其血清中针对 14 种特定食物抗原的 IgG4 抗体，将每位患者的四种反应最强烈的食物排除在外 4 周。使用改良的 CD 活动指数（mCDAI）评估疾病活动度。在开始排除饮食前和完成后测量问卷和炎症标志物。

结果

11 名患者未完成研究，29 名患者进行了分析。其中，26 名（90%）报告症状改善，mCDAI 从平均 171-97.5 降低（P=0.0001）。ESR 从 23 降至 17 mm/h（P=0.021），排除食物的 IgG4 滴度从平均 3015-2306 mcgA/l 降低（P=0.003）。