• food allergy
• irritable bowel syndrome
• pollen
• prevalence

• Aeroallergens
• Allergic diseases
• Irritable bowel syndrome

• IgE
• atopic disease
• irritable bowel syndrome
• self-perceived food intolerance

Food interaction, including food hypersensitivity, plays a key role in the pathogenesis of irritable bowel syndrome with diarrhea (IBS-D). Since only a few studies have been reported about the relationship between food hypersensitivity and IBS-D, we elucidate the prevalence of serological food hypersensitivity in patients with IBS-D and the characteristics of gastrointestinal symptoms and serum cytokine profiles in patients with IBS-D and serological food hypersensitivity.

Immunoglobulin E (Ig E)-mediated serological food hypersensitivity and serum cytokine levels were evaluated using the multiple allergen simultaneous test evaluating food allergen-specific serum IgE and Luminex Milliplex Panel containing multiple fluorescence-labeled beads. Class 2 or above was considered as IgE-mediated food hypersensitivity positive. The gastrointestinal symptom rating scale was used to evaluate symptoms.

We enrolled 92 subjects, including 60 with IBS-D and 32 healthy controls. The percentages of patients with IgE-mediated serological food hypersensitivity were not significantly different between the groups (controls = 28.1% and IBS-D = 33.3%). Serum IL-1β, IL-6, IL-8, macrophage inflammatory protein-1alpha, and TNF-α levels were higher in patients with IBS-D than in controls. Serum concentration of TNF-α (43.4 vs 21.8 pg/mL, P = 0.009) was higher in patients with IBS-D without IgE-mediated serological food hypersensitivity than those with food hypersensitivity.

One-third of Japanese patients with IBS-D showed IgE-mediated serological food hypersensitivity. The serum cytokine profile differed and was characterized by lower inflammatory cytokine levels in IBS-D with IgE-mediated serological food hypersensitivity. Serological test regarding IgE-mediated food hypersensitivity can detect a certain cluster of IBS-D.

• Cytokines
• Food hypersensitivity
• Inflammation
• Irritable bowel syndrome
• Tumor necrosis factor-alpha

Omalizumab is a humanized monoclonal antibody that binds to the high-affinity type-I IgE Fc receptors on mast cells (MCs) and basophils, inhibiting the IgE immune pathway. Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, and dysregulation of the immune system likely contributes to its etiology and/or symptomatology. Colonic biopsies from patients with IBS demonstrate considerable increase in the number of degranulating MCs releasing histamine in proximity to nerves, and this event may underlie the common IBS symptom of abdominal pain. Pharmacologic control of MC activation and mediator release is a current area of active interest in the field of IBS research. Recently, we and Pearson et al described 2 cases of patients with IBS with diarrhea (IBS-D) showing positive clinical response to omalizumab. In both cases, the female patients had severe, long-lasting IBS-D and achieved an almost complete resolution of IBS symptoms. Both patients were also able to discontinue all IBS medications after commencing the anti-IgE therapy. For both patients, the omalizumab treatment showed a relatively rapid onset of action, resembling the efficacy observed in and previously reported for patients with chronic spontaneous urticaria. In this Editorial, we discuss the possible biological mechanisms that may underlie the clinical efficacy of omalizumab in IBS. We suggest that there is a need for a well-designed prospective study to investigate the therapeutic effects of anti-IgE in IBS.

• IgE
• Omalizumab
• Irritable bowel syndrome
• Anti-inflammatory
• Irritable bowel syndrome with diarrhea

• Anti-Allergic Agents/therapeutic use
• Colon/drug effects
• Colon/immunology
• Colon/pathology
• Gastrointestinal Agents/therapeutic use
• Humans
• Immunoglobulin E/immunology
• Irritable Bowel Syndrome/diagnosis
• Irritable Bowel Syndrome/drug therapy
• Irritable Bowel Syndrome/immunology
• Omalizumab/therapeutic use
• Remission Induction
• Treatment Outcome

• Epidemiology
• Irritable bowel syndrome
• Pets

• Xolair
• atopy
• irritable bowel syndrome
• omalizumab

There is very few data available on the prevalence of food hypersensitivity among adults with asthma. The aim of this study was to explore the prevalence of self-reported adverse reactions and IgE sensitization to the different foods and to determine the spectrum and the prevalence of food-related gastrointestinal symptoms in adults with and with no asthma.

A cross sectional study based on interviews and questionnaire responses from 1527 subjects, aged 18–75 years of age, from Västra Götaland in Sweden, as part of the larger West Sweden Asthma Study. IgE analyses were performed in sera from all subjects.

Fifty three percent of adults with asthma reported adverse reactions to foods compared to 30 % of non-asthmatics. Most asthmatics reported symptoms from eating hazelnut, followed by other nuts, birch-related foods, milk, peanut and shellfish. Furthermore, adults with asthma experienced significantly more often gastrointestinal symptoms from hazelnut, apple and milk and were found to significantly more often be sensitized to the most common foods compared to the non-asthmatic subjects. The asthmatics showed a significant correlation between IgE to both hazelnut and birch and self-reported symptoms after ingestion of hazelnut and to a lesser extent to almonds.

The prevalence of self-reported adverse reactions and sensitization to the most common foods was much higher among the asthmatic subjects. Hazelnut was the food that asthmatics most frequently experienced adverse reactions from, and the strong correlation between IgE to hazelnut and birch indicate that the observed adverse reactions are partly due to sensitization to allergens from the PR-10 family.

The online version of this article (doi:10.1186/s13601-015-0067-6) contains supplementary material, which is available to authorized users.

• Asthma
• Epidemiology
• Food allergy

• Asthma
• Atopy
• Elimination diet
• Food allergy
• Food intolerance
• Irritable bowel syndrome
• Non-celiac wheat sensitivity

• Celiac Disease/classification
• Celiac Disease/diagnosis
• Celiac Disease/diet therapy
• Celiac Disease/epidemiology
• Diet/adverse effects
• Diet, Gluten-Free
• Humans
• Irritable Bowel Syndrome/diagnosis
• Irritable Bowel Syndrome/drug therapy
• Irritable Bowel Syndrome/epidemiology
• Irritable Bowel Syndrome/immunology
• Prevalence
• Risk Factors
• Treatment Outcome
• Wheat Hypersensitivity/complications
• Wheat Hypersensitivity/diagnosis
• Wheat Hypersensitivity/diet therapy
• Wheat Hypersensitivity/epidemiology
• Wheat Hypersensitivity/immunology

• Allergen components
• Allergic inflammation
• Biopsies
• Birch-pollen
• Gastrointestinal symptoms
• Gastroscopy

• fatigue
• food hypersensitivity
• irritable bowel syndrome
• quality of life

• chromogranin A
• food hypersensitivity
• gut lavage fluid
• liquid chromatography
• serotonin

Self-reported hypersensitivity to food is a common condition and many of these patients have indications of intestinal immune activation. Dendritic cells (DCs) are recognized as the most potent antigen-presenting cells involved in both initiating immune responses and maintaining tolerance. The aims of this study were to evaluate the DC populations with their phenotype and T cell stimulatory capacity in patients with food hypersensitivity and to study its relationship with atopic disease. Blood samples from 10 patients with self-reported food hypersensitivity, divided into atopic and nonatopic subgroups, and 10 gender- and age-matched healthy controls were analyzed by flow cytometry using the Miltenyi Blood Dendritic cells kit. Monocyte-derived DCs (moDCs) were evaluated concerning their phenotype and T cell stimulatory capacity. DC populations and cell surface markers were not significantly different between patients and healthy controls, but moDCs from atopic patients expressed significantly more CD38 compared to moDCs from nonatopic patients. Moreover, lipopolysaccharide stimulated moDCs from atopic patients produced significantly more interleukin-10 compared to nonatopic patients. CD38 expression was correlated to total serum immunoglobulin E levels. These findings support the notion of immune activation in some patients with self-reported food hypersensitivity. They need to be confirmed in a larger cohort.

• CD38
• atopy
• dendritic cells
• food hypersensitivity

• butyrate
• dysbiosis
• gut microbiota
• irritable bowel syndrome
• short-chain fatty acids