Laboratory for Intestinal Neuroimmune Interactions, Translational Research Center for Gastrointestinal Disorders, KU Leuven Department of Chronic Diseases, Metabolism and Ageing, Leuven, Belgium.
Laboratory for Mucosal Immunology, Translational Research Center for Gastrointestinal Disorders, KU Leuven Department of Chronic Diseases, Metabolism and Ageing, Leuven, Belgium.
Nature. 2021 Feb;590(7844):151-156. doi: 10.1038/s41586-020-03118-2. Epub 2021 Jan 13.
Up to 20% of people worldwide develop gastrointestinal symptoms following a meal, leading to decreased quality of life, substantial morbidity and high medical costs. Although the interest of both the scientific and lay communities in this issue has increased markedly in recent years, with the worldwide introduction of gluten-free and other diets, the underlying mechanisms of food-induced abdominal complaints remain largely unknown. Here we show that a bacterial infection and bacterial toxins can trigger an immune response that leads to the production of dietary-antigen-specific IgE antibodies in mice, which are limited to the intestine. Following subsequent oral ingestion of the respective dietary antigen, an IgE- and mast-cell-dependent mechanism induced increased visceral pain. This aberrant pain signalling resulted from histamine receptor H-mediated sensitization of visceral afferents. Moreover, injection of food antigens (gluten, wheat, soy and milk) into the rectosigmoid mucosa of patients with irritable bowel syndrome induced local oedema and mast cell activation. Our results identify and characterize a peripheral mechanism that underlies food-induced abdominal pain, thereby creating new possibilities for the treatment of irritable bowel syndrome and related abdominal pain disorders.
全球多达 20%的人在进食后会出现胃肠道症状,导致生活质量下降、发病率高和医疗费用高。尽管近年来科学界和普通大众对这一问题的兴趣显著增加,随着无麸质和其他饮食的全球普及,食物引起的腹部不适的潜在机制在很大程度上仍然未知。在这里,我们表明细菌感染和细菌毒素可以引发免疫反应,导致小鼠肠道中产生特定于饮食抗原的 IgE 抗体。随后口服摄入相应的饮食抗原,会引发 IgE 和肥大细胞依赖性机制,导致内脏疼痛增加。这种异常的疼痛信号传导源于组胺受体 H 介导的内脏传入神经敏化。此外,将食物抗原( gluten、wheat、soy 和 milk)注入肠易激综合征患者的直肠乙状结肠黏膜会引起局部水肿和肥大细胞激活。我们的研究结果确定并描述了一种潜在的外周机制,该机制是食物引起的腹痛的基础,从而为治疗肠易激综合征和相关腹痛疾病提供了新的可能性。
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