School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia.
Priority Research Centre for Digestive Health and Neurogastroenterology, University of Newcastle, Newcastle, NSW, Australia.
Curr Gastroenterol Rep. 2020 Aug 14;22(10):51. doi: 10.1007/s11894-020-00789-9.
PURPOSE OF REVIEW: Functional dyspepsia (FD) is a chronic functional gastrointestinal disorder characterised by upper gastrointestinal symptoms. Here, we aimed to examine the evidence for immune responses to food in FD and overlap with food hypersensitivity conditions. RECENT FINDINGS: A feature of FD in a subset of patients is an increase in mucosal eosinophils, mast cells, intraepithelial cytotoxic T cells and systemic gut-homing T cells in the duodenum, suggesting that immune dysfunction is characteristic of this disease. Rates of self-reported non-celiac wheat/gluten sensitivity (NCW/GS) are higher in FD patients. FD patients commonly report worsening symptoms following consumption of wheat, fermentable oligosaccharides, disaccharides, monosaccharides, or polyols (FODMAPs), high-fat foods and spicy foods containing capsaicin. Particularly, wheat proteins and fructan in wheat may drive symptoms. Immune mechanisms that drive responses to food in FD are still poorly characterised but share key effector cells to common food hypersensitivities including non-IgE-mediated food allergy and eosinophilic oesophagitis.
目的综述:功能性消化不良(FD)是一种以胃肠道症状为特征的慢性功能性胃肠道疾病。在这里,我们旨在研究 FD 中对食物的免疫反应证据及其与食物过敏状态的重叠。
最新发现:在 FD 的一部分患者中,十二指肠黏膜中嗜酸性粒细胞、肥大细胞、上皮内细胞毒性 T 细胞和肠道归巢 T 细胞增加,表明免疫功能障碍是这种疾病的特征。FD 患者自我报告的非乳糜泻小麦/麸质敏感性(NCW/GS)发生率更高。FD 患者常报告在食用小麦、可发酵寡糖、双糖、单糖或多元醇(FODMAP)、高脂肪食物和含有辣椒素的辛辣食物后症状加重。特别是小麦蛋白和小麦中的果糖可能会引起症状。FD 中驱动食物反应的免疫机制仍未得到很好的描述,但与常见食物过敏反应(包括非 IgE 介导的食物过敏和嗜酸性食管炎)共享关键效应细胞。
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