Vojdani Aristo, Lambert Jama
Immunosciences Lab., Inc., 822 S. Robertson Boulevard, Suite 312, Los Angeles, CA 90035, USA.
Case Rep Gastrointest Med. 2012;2012:265052. doi: 10.1155/2012/265052. Epub 2012 Sep 12.
Enhanced intestinal permeability and food sensitivity are two of the many proven causes of gastrointestinal disorders. This present report describes a woman with no previous gastrointestinal (GI) complaints, who underwent dental root canal, bone graft, and implant procedures. Postsurgery she experienced an allergic reaction to the combined medications. In the weeks that followed, she presented with multiple food intolerances. Four weeks after the final dental procedure, she was assessed serologically for mucosal immune function, salivary, and blood-gluten reactivity, intestinal permeability, and other food sensitivities. Compared to her test reports from two months prior to her first dental procedure, the patient's results showed high total secretory IgA (SIgA) and elevated salivary antibodies to alpha-gliadin, indicating abnormal mucosal immunity and loss of tolerance to gluten. Her serologic assessments revealed immunoglobulin G (IgG) and IgA antibodies to a range of wheat/gluten proteins and peptides, gut bacterial endotoxins and tight junction proteins. These test results indicate gut dysbiosis, enhanced intestinal permeability, systemic gluten-reactivity, and immune response to other dietary macromolecules. The present case suggests that patients who experience severe allergic or pseudoallergic reactions to medication should be assessed and monitored for gut dysfunction. If left untreated this could lead to autoimmune reactions to self tissues.
肠道通透性增强和食物敏感性是已被证实的众多胃肠道疾病病因中的两个。本报告描述了一名既往无胃肠道不适的女性，她接受了牙根管治疗、骨移植和种植牙手术。术后她对联合用药出现了过敏反应。在接下来的几周里，她出现了多种食物不耐受。在最后一次牙科手术后四周，对她进行了血清学评估，以检测黏膜免疫功能、唾液和血液中麸质反应性、肠道通透性及其他食物敏感性。与首次牙科手术前两个月的检测报告相比，患者的检测结果显示总分泌型IgA（SIgA）水平较高，唾液中抗α-麦醇溶蛋白抗体升高，表明黏膜免疫异常且对麸质耐受性丧失。她的血清学评估显示存在针对一系列小麦/麸质蛋白和肽、肠道细菌内毒素和紧密连接蛋白的免疫球蛋白G（IgG）和IgA抗体。这些检测结果表明肠道生态失调、肠道通透性增强、全身性麸质反应性以及对其他饮食大分子的免疫反应。本病例表明，对药物发生严重过敏或类过敏反应的患者应评估和监测肠道功能障碍。若不治疗，这可能导致对自身组织的自身免疫反应。
