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

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

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