Correcting Leaky Gut Syndrome Lessens Relapse in Crohn’s Disease

December 21, 2011 By Leave a Comment

 

The Lancet

Volume 341, Issue 8858 5 June 1993, Pages 1437-1439

Originally published as Volume 1, Issue 8858

 

 

Intestinal permeability and the prediction of relapse in Crohn’s disease

 

J. Wyatt MS, H. Vogelsang MD, W. Hübl MD, T. Waldhoer PhD, H. Lochs MD

Abstract

To see whether intestinal permeability (IP) predicted relapse in Crohn’s disease, we measured IP in 72 patients with quiescent Crohn’s disease using the lactulose-mannitol test. The permeability index (lactulose/mannitol) was significantly higher in patients than in controls (0·046 [SEM 0·005] vs 0·018 [SEM 0·002], respectively). Patients were followed for 1 year after the test. 26 of the 37 patients with raised permeability, but only 6 of the 35 with normal permeability relapsed within 1 year after the test (p<0·001). The sensitivity of the permeability test as a predictor for relapse was 81 %. A significant correlation was found between the value of the permeability index and the probability of relapse (p<0·01). These results show that increases in intestinal permeability precede clinical relapses in Crohn’s disease and so are an indicator of subclinical disease. The measurement of intestinal permeability may lead to a better understanding of the pathogenesis of Crohn’s disease.

Filed Under: Allergy, Autoimmune Disease, Crohn's Disease, Diarrhea

Food Allergy and Irritable Bowel Syndrome

December 20, 2011 By Leave a Comment

Eswaran S. Tack J. Chey WD. Food: the forgotten factor in the irritable bowel syndrome. Gastroenterology Clinics of North America. 40(1):141-62, 2011.

There is a growing body of evidence to suggest that dietary constituents at least exacerbate symptoms and perhaps contribute to the development of the irritable bowel syndrome (IBS). While the evidence suggests that true food allergies are relatively uncommon, less clearly defined food intolerances may be an important contributor to symptoms in IBS patients. This article reviews the literature supporting a causal link between food and the symptoms of IBS as well as the evidence supporting dietary interventions as a way of managing IBS symptoms.

Filed Under: Allergy, Diarrhea, Irritable Bowel Syndrome, Leaky Gut

Connection Between Allergy and Eczema

December 14, 2011 By Leave a Comment

Connection Between Allergic Diseases And Autoimmune Diseases

ScienceDaily (Apr. 3, 2007) — A study by researchers at Children’s and the University of Washington (UW) identifies a connection between allergic diseases such as atopic dermatitis, also known as eczema, and autoimmune diseases. The study was published in the April 1 edition of Nature Immunology.

 

Approximately 75 percent of autoimmune diseases occur in women, most frequently during the childbearing years. These diseases also comprise a significant portion of chronic childhood disorders. Autoimmune disease refers to a group of more than 80 serious, chronic illnesses including diseases of the nervous, gastrointestinal, and endocrine systems as well as skin and other connective tissues, eyes, blood, and blood vessel. In all of these diseases, the underlying problem is similar—the body’s immune system (including B and/or T immune cells) becomes misdirected, attacking the very organs it was designed to protect.

“Our study implies that allergic and inflammatory diseases may actually trigger autoimmune diseases by relaxing the controls that normally eliminate newly produced, self-reactive B cells. This is important because many autoimmune diseases are caused by self-reactive antibodies produced by such B cells” said Dr. David Rawlings lead researcher and section head of Immunology at Children’s Hospital and the UW.

Researchers at Children’s are now trying to discover specifically where the “relaxation” in the control of B cell autoimmunity takes place. “In association with other UW laboratories, we also have begun to study drugs that can counter some of these effects. One such drug helps to prevent autoimmune kidney disease in a related animal model,” said Rawlings.

In addition to Dr. David Rawlings, other authors of the study included Alexander Astrakhan, Thuc Nguyen, MD and Shirly Becker-Herman, PhD.

Filed Under: Allergy, Autoimmune Disease, Eczema

Diet and Psoriasis:Experimental Data and Clinical Evidence

December 14, 2011 By Leave a Comment

Diet and Psoriasis: Experimental Data and Clinical Evidence

M. Wolters

The British Journal of Dermatology. 2005;153(4):706-714. © 2005 Blackwell Publishing

Summary and Introduction

Summary

Psoriasis is considered as a T-cell-mediated inflammatory skin disease which is characterized by hyperproliferation and poor differentiation of epidermal keratinocytes. While susceptibility to psoriasis is inherited, the disease is influenced by environmental factors such as infections and stress. Diet has been suggested to play a role in the aetiology and pathogenesis of psoriasis. Fasting periods, low-energy diets and vegetarian diets improved psoriasis symptoms in some studies, and diets rich in n-3 polyunsaturated fatty acids from fish oil also showed beneficial effects. All these diets modify the polyunsaturated fatty acid metabolism and influence the eicosanoid profile, so that inflammatory processes are suppressed. Some patients with psoriasis show an elevated sensitivity to gluten. In patients with IgA and/or IgG antigliadin antibodies the symptoms have been shown to improve on a gluten-free diet. The active form of vitamin D, 1,25-dihydroxyvitamin D3, exhibits antiproliferative and immunoregulatory effects via the vitamin D receptor, and thus is successfully used in the topical treatment of psoriasis. In this review, dietary factors which play a role in psoriasis are assessed and their potential benefit is evaluated. Furthermore, the risk of drug-nutrient interactions in psoriasis therapy is discussed.

Filed Under: Allergy, Psoriasis

Rheumatoid Arthritis and Food Allergy

December 1, 2011 By

Gut. 2006 Sep;55(9):1240-7. Epub 2006 Feb 16.

The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis.

Hvatum M, Kanerud L, Hällgren R, Brandtzaeg P.

Source

Laboratory for Immunohistochemistry and Immunopathology (LIIPAT), Institute of Pathology, Rikshospitalet, N-0027 Oslo, Norway.

Abstract

BACKGROUND AND AIMS:

Patients with rheumatoid arthritis (RA) often feel there is an association between food intake and rheumatoid disease severity. To investigate a putative immunological link between gut immunity and RA, food antibodies were measured in serum and perfusion fluid from the jejunum of RA patients and healthy controls to determine the systemic and mucosal immune response.

METHODS:

IgG, IgA, and IgM antibodies to dietary antigens were measured in serum and jejunal perfusion fluid from 14 RA patients and 20 healthy subjects. The antigens originated from cow’s milk (alpha-lactalbumin, beta-lactoglobulin, casein), cereals, hen’s egg (ovalbumin), cod fish, and pork meat.

RESULTS:

In intestinal fluid of many RA patients, all three immunoglobulin classes showed increased food specific activities. Except for IgM activity against beta-lactoglobulin, all other IgM activities were significantly increased irrespective of the total IgM level. The RA associated serum IgM antibody responses were relatively much less pronounced. Compared with IgM, the intestinal IgA activities were less consistently raised, with no significant increase against gliadin and casein. Considerable cross reactivity of IgM and IgA antibodies was documented by absorption tests. Although intestinal IgG activity to food was quite low, it was nevertheless significantly increased against many antigens in RA patients. Three of the five RA patients treated with sulfasalazine for 16 weeks had initially raised levels of intestinal food antibodies; these became normalised after treatment, but clinical improvement was better reflected in a reduced erythrocyte sedimentation rate.

CONCLUSIONS:

The production of cross reactive antibodies is strikingly increased in the gut of many RA patients. Their food related problems might reflect an adverse additive effect of multiple modest hypersensitivity reactions mediated, for instance, by immune complexes promoting autoimmune reactions in the joints.

PMID: 16484508 [PubMed - indexed for MEDLINE] PMCID: PMC1860040

Filed Under: Allergy, Arthritis, Autoimmune Disease

Food Allergy and Arthritis

December 1, 2011 By

Clin Rheumatol. 1991 Dec;10(4):401-7.

Diet and disease symptoms in rheumatic diseases–results of a questionnaire based survey.

Haugen M, Kjeldsen-Kragh J, Nordvåg BY, Førre O.

Source

Department of General Practice, University of Oslo, Norway.

Abstract

Experiences with food intake, diet manipulations and fast were registered in rheumatic patients. The study was a questionnaire-based survey in which 742 patients participated. It comprised 290 patients with rheumatoid arthritis, 51 patients with juvenile rheumatoid arthritis, 87 patients with ankylosing spondylitis, 51 patients with psoriatic arthropathy, 65 patients with primary fibromyalgia and 34 patients with osteoarthritis. One third of the patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthropathy reported aggravation of disease symptoms after intake of certain foods while 43% of the patients with juvenile rheumatoid arthritis and 42% of the patients with primary fibromyalgia stated the same. Twenty-six percent of the patients with juvenile rheumatoid arthritis and 23% of the patients with rheumatoid arthritis, ankylosing spondylitis and primary fibromyalgia had previously tried certain diets in the attempt to alleviate disease symptoms, whereas 13% of the patients with psoriatic arthropathy and 10% with osteoarthritis had tried diet therapy. Less pain and stiffness were reported by 46% of the patients and 36% reported reduced joint swelling. Similar beneficial effects of diet were also reported in other rheumatic disease groups. Fifteen percent of the patients with rheumatoid arthritis and ankylosing spondylitis had been through a fasting period. Less pain and stiffness were reported by 2/3 of the patients in both groups and half of the patients in both groups reported a reduced number of swollen joints.

PMID: 1802495 [PubMed - indexed for MEDLINE]

Filed Under: Allergy, Arthritis, Autoimmune Disease

Hidden Allergies May Be Cause of Fatigue & Depression

December 1, 2011 By

By Rick Ansorge, Eric Metcalf and the editors of Prevention Health Books

 

People with allergies know that their sniffling and sneezing is allergen-induced, but allergies don’t always present themselves with such typical symptoms. Sometimes allergic reactions can cause fatigue, headaches — or even depression.

Chronic fatigue syndrome
If you’ve been experiencing extreme exhaustion for 6 months or more and your doctor hasn’t been able to identify the cause, you might have chronic fatigue syndrome (CFS). And if you do have CFS, allergies could be playing an important role, says Leo Galland, MD, director of the Foundation for Integrated Medicine in New York City and author of “Power Healing.”

Though no one knows exactly what causes CFS, researchers have found that more than half of the people with CFS they’ve studied also have allergies. “I believe that being an allergic individual predisposes you to chronic fatigue syndrome,” says Galland. “Chronic fatigue syndrome seems to be associated with an over-reactivity of certain parts of the immune system, which is similar to what we see in people with allergies.”

And when allergies are part of the cause, treating the allergies can be a part of the cure. “I’ve found that close to three-fourths of my patients will find their fatigue improves when their allergies improve,” Galland notes. This improvement varies widely, but sometimes it can be dramatic. “There have been some patients in whom disabling chronic fatigue totally goes away when their food allergies were treated,” he reports.

Depression
Scientists acknowledge that allergens can contribute to mood alterations. In a 3-year study of 36 people with allergies, Paul S. Marshall, PhD, a psychologist at Hennepin County Medical Center in Minneapolis, found that 69 percent reported feeling more irritable when their allergies flared up; 63 percent reported more fatigue; 41 percent said that they had difficulty staying awake; and 31 percent reported feeling “sad.” So the idea that allergies might exacerbate mild depression in a few people who have other allergic symptoms isn’t that far-fetched to some researchers.

Filed Under: Allergy, Depression, Fatigue

Tackling Allergies Can Ease Asthma Suffering

November 25, 2011 By

How Tackling Allergies Can Ease Asthma Suffering

by JOANNE SILBERNER (NPR)

While they’re pretty, but flowers — as well as trees and grasses — release huge amounts of pollen, which isn’t great news for pollen-allergy sufferers. For asthmatic kids, these allergies may further aggravate symptoms such as wheezing.
April 12, 2010

About 4 million to 5 million American children have persistent asthma, and about 90 percent of them also have allergies. Studies have found that treating the allergies can not only make asthmatic children more comfortable, but it can even keep them out of the emergency room.

“For the vast majority of children with asthma, allergies are a very important, if not the most important factor in causing symptoms and determining risk for hospitalizations and emergency room visits,” says asthma expert Dr. William Busse of the University of Wisconsin.

And federal guidelines for treating asthma say children with persistent asthma should be checked for allergies. Still, there are many asthmatic children whose allergies go undiagnosed and untreated. Dr. Karen DeMuth sees it every day at her clinic at Emory University. “I don’t know if anyone has been keeping data,” she says, “but there definitely is a lot of undermanaged asthma.”

She points to 4-year-old Abbie Denham, who came to her office in February. Before Abbie saw DeMuth, she had drugs for asthma flare-ups and medicine for her skin allergy, eczema. But no one had even diagnosed her respiratory allergies.

Abbie’s mother, Carla Denham, said that despite asthma medication, her daughter wheezed at night, and couldn’t run or play without running out of breath. When DeMuth checked Abbie for allergies, she found that the girl was pretty much allergic to everything: all sorts of pollens, molds, cats, dogs, dust mites and cockroaches. DeMuth counseled the mother on avoiding allergens, kept Abbie on asthma medication, and gave her nasal sprays for the allergies.

David McNew/Getty ImagesAsthmatics have trouble breathing when their airways become inflamed and constricted (left; at right is what a normal airway looks like). The yellow stuff inside the airway is mucus; studies have found that many asthmatics have increased mucus-producing cells.

“She’s keeping up with everybody, and she’s sleeping wonderfully — she’s a different child at night,” says Denham.

That experience is evidently pretty common. Busse estimates that 30 or 40 percent of children with allergic asthma never have their allergies diagnosed.

Dr. Stephen Teach of Children’s National Medical Center says that among the inner-city kids he sees, it’s a lot more. “The vast majority of inner-city children have not had a comprehensive evaluation for allergies,” he says.

Tackling Allergies Is Tricky Business

One reason is that allergies are a challenge to diagnose. Doctors need to have a thorough understanding of what a child is exposed to. There are blood and skin tests, but they can be difficult to read. And once doctors identify a problem, allergies are a challenge to treat. Allergy shots offer relief to some, but patients need to continue to get a shot about once a month for three to five years to attain immunity. Allergy drugs have side effects, and can’t be taken with certain other drugs. Avoiding allergens like pollen, dust or animal dander can also be hard.

There is, however, compelling evidence that avoidance helps with asthma. One such study appeared in the New England Journal of Medicine in 2004. Researchers trained parents of about 500 kids with asthma on how to protect their children from exposure to allergens like dust, cockroaches, mold and animals, as well as tobacco smoke. Compared to a similar group, the kids in the treatment group had an average of 21 fewer days of wheezing. A study last year in theAmerican Journal of Public Health showed that when parents were trained in how to protect their kids from allergens and tobacco smoke, emergency room visits went down by 30 percent.

Teach says allergen avoidance is a good approach, but it takes a lot of effort. “In order to educate a family, you have to talk about a lot of different things,” he says. “And primary care doctors have a limited amount of time.” He estimates that it takes an hour to an hour and a half to fully educate parents on allergens and other things that can spark asthma. Most insurers don’t pay doctors for that kind of time.

Filed Under: Allergy, Asthma