Uzunısmaıl Hülya, Cengız Mahir, Uzun Hafize, Ozbakir Fatma, Göksel Süha, Demırdağ Filiz, Can Günay, Balci Huriye
Department of Gastroenterology, İstanbul University Cerrahpaşa Medical School İstanbul/Turkey.
Turk J Gastroenterol. 2012 Feb;23(1):19-27. doi: 10.4318/tjg.2012.0332.
BACKGROUND/AIMS: This study was designed to assess the role of foods with raised IgG antibodies and additives on the symptoms and inflammation of Crohn's disease.
Eight patients with Crohn's disease in remission were studied. They followed a strict diet during phase I. Then, provocations with two, three-day periods (phases II and III) followed: in phase II, pure forms of foods with high IgG antibodies and in phase III, off-the-shelf forms of those foods were added. Stool samples were collected for fecal calprotectin assay. Blood samples were taken on the 11th and 17th days for highly sensitive C-reactive protein, ferritin, erythrocyte sedimentation rate, white blood cells, and platelets. Patients kept a diet-symptom diary.
Increased Crohn's disease activity index scores were found statistically significant (p=0.012) between pre- and during the provocation weeks. There were significant increases according to Harvey-Bradshaw Index when the highest values during the phases I, II (p=0.027) and I, III (p=0.027) were compared. The increases in highly sensitive C-reactive protein (p=0.025) and white blood cells (p= 0.036) were found statistically significant. Fecal calprotectin levels showed day-to-day variability. When compared, the levels of fecal calprotectin increased in all patients on the last day of the restriction (10th day) and the first day of the provocation (11th day) with the exception of one patient.
Foods with raised IgG antibody levels and food additives can provoke the symptoms and may stimulate the inflammation in patients with Crohn's disease. Addition of a proper diet with restriction of those foods may be beneficial in the medical treatment.
背景/目的：本研究旨在评估具有升高IgG抗体的食物及添加剂在克罗恩病症状和炎症中的作用。
对8例处于缓解期的克罗恩病患者进行研究。他们在第一阶段遵循严格的饮食。然后，进行两个为期三天的激发试验（第二阶段和第三阶段）：在第二阶段，使用具有高IgG抗体的纯净形式食物，在第三阶段，添加那些食物的市售形式。收集粪便样本进行粪便钙卫蛋白检测。在第11天和第17天采集血液样本检测高敏C反应蛋白、铁蛋白、红细胞沉降率、白细胞和血小板。患者记录饮食-症状日记。
在激发试验前和试验期间，克罗恩病活动指数评分增加具有统计学意义（p=0.012）。当比较第一阶段、第二阶段（p=0.027）和第一阶段、第三阶段（p=0.027）的最高值时，根据哈维-布拉德肖指数有显著增加。高敏C反应蛋白（p=0.025）和白细胞（p=0.036）的增加具有统计学意义。粪便钙卫蛋白水平显示出每日变化。相比之下，除一名患者外，所有患者在限制期最后一天（第10天）和激发试验第一天（第11天）的粪便钙卫蛋白水平均升高。
具有升高IgG抗体水平的食物和食品添加剂可引发克罗恩病患者的症状并可能刺激炎症。限制这些食物并添加适当饮食可能对医疗有益。
