Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
Department of Radiology, Oncology and Pathology, Sapienza University of Rome, 00185 Rome, Italy.
Nutrients. 2023 May 17;15(10):2353. doi: 10.3390/nu15102353.
The clinical examination of patients often includes the observation of the existence of a close relationship between the ingestion of certain foods and the appearance of various symptoms. Until now, the occurrence of these events has been loosely defined as food intolerance. Instead, these conditions should be more properly defined as adverse food reactions (AFRs), which can consist of the presentation of a wide variety of symptoms which are commonly identified as irritable bowel syndrome (IBS). In addition, systemic manifestations such as neurological, dermatological, joint, and respiratory disorders may also occur in affected patients. Although the etiology and pathogenesis of some of them are already known, others, such as non-celiac gluten sensitivity and adverse reactions to nickel-containing foods, are not yet fully defined. The study aimed to evaluate the relationship between the ingestion of some foods and the appearance of some symptoms and clinical improvements and detectable immunohistochemical alterations after a specific exclusion diet. One hundred and six consecutive patients suffering from meteorism, dyspepsia, and nausea following the ingestion of foods containing gluten or nickel were subjected to the GSRS questionnaire which was modified according to the "Salerno experts' criteria". All patients underwent detection of IgA antibodies to tissue transglutaminase, oral mucosal patch tests with gluten and nickel (OMPT), and EGDS, including biopsies. Our data show that GSRS and OMPT, the use of APERIO CS2 software, and the endothelial marker CD34 could be suggested as useful tools in the diagnostic procedure of these new pathologies. Larger, multi-center clinical trials could be helpful in defining these emerging clinical problems.
临床检查中,患者常自述某些食物的摄入与各种症状的出现存在密切关系。直到现在,这些事件的发生一直被定义为食物不耐受。相反,这些情况应该更恰当地定义为不良食物反应(AFR),其表现为广泛的症状,通常被认为是肠易激综合征(IBS)。此外,受影响的患者还可能出现全身性表现,如神经、皮肤、关节和呼吸系统疾病。虽然其中一些的病因和发病机制已经明确,但其他如非麸质敏感性和对含镍食物的不良反应等尚未完全定义。本研究旨在评估某些食物的摄入与某些症状的出现之间的关系,以及在特定排除饮食后临床改善和可检测的免疫组织化学改变。106 例因摄入含麸质或镍的食物而出现气胀、消化不良和恶心的连续患者,根据“Salerno 专家标准”对 GSRS 问卷进行了修改,并接受了 IgA 组织转谷氨酰胺酶抗体、口腔黏膜贴斑试验(OMPT)与镍和 EGDS(包括活检)检测。我们的数据表明,GSRS 和 OMPT、APERIO CS2 软件的使用以及内皮标志物 CD34 可以作为这些新病理学诊断程序中的有用工具。更大规模的多中心临床试验可能有助于定义这些新兴的临床问题。
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