[Show abstract][Hide abstract] ABSTRACT: Anisakis simplex is a parasite that, if present in uncooked and contaminated saltwater fish, can invade the human gut. Two different clinical situations are recognized: the first, known as a gastrointestinal disease, varying from an asymptomatic episode to vomiting and diarrhea, and the second, classified as an adverse reaction to food, characterized by a wide spectrum of allergic reactions like rhinitis, conjunctivitis, or even anaphylaxis causing hypotension and/or shock. The intestinal epithelium, the major defense system against external molecules, represents an open gate for toxins and allergens if its protective function is compromised. Previous data have demonstrated a strict relationship between an altered intestinal permeability (I.P.) and worsening of the clinical manifestations in patients with adverse reactions to the food. In this article we evaluated the sensitization to A. simplex among patients who referred clinical symptoms of allergy. All subjects underwent commonly used alimentary skin prick test for food allergens, to which Ani s1, an A. simplex allergen, was added. In addition, in A. simplex-sensitized subjects, I.P. was determined upon their enrolment to the study (time 0) and after 6 months of consuming a raw fish-free diet (time 6). Five hundred and forty subjects were screened, and 170 had a positive skin prick test, 87 (51.2%) of whom were positive to Ani s1. Increased I.P. was evidenced in A. simplex-sensitized subjects with worse clinical symptoms, which receded after 6 months' elimination of raw seafood. With our data we demonstrated that the alimentary habit to eat raw fish represents a high risk for the integrity of the intestinal mucosa, and we suggest that this pathological situation may constitute an ideal, under-estimated, open gate for molecules that predispose to other, more important pathologies.
[Show abstract][Hide abstract] ABSTRACT: An abnormal intestinal permeability could contribute to establish an altered sensitivity to food-allergen.
To evaluate the intestinal permeability in subjects with adverse reactions to food on allergen-free diet.
Twenty-one patients with food allergy and 20 with food hypersensitivity on allergen-free diet were enrolled and divided in four groups according to the seriousness of their referred clinical symptoms when they were on a free diet.
Intestinal permeability was evaluated by Lactulose/Mannitol ratio urinary detection determined by anion-exchange chromatography.
Statistically significant different Lactulose/Mannitol ratio was evidenced in subjects with food allergy (p=0.003) or hypersensitivity (p=0.0008) compared to control patients. The correlation between Lactulose/Mannitol ratio and the seriousness of clinical symptoms, by using Spearman test, was statistically significant for food allergy (p=0.0195) and hypersensitivity (p=0.005) patients.
The present data demonstrate that impaired intestinal permeability, measured in our conditions, is present in all subjects with adverse reactions to food. In addition, for the first time, we report a statistically significant association between the severity of referred clinical symptoms and the increasing of Intestinal Permeability Index. These data reveal that intestinal permeability is not strictly dependent on IgE-mediated processes but could better be related to other mechanisms involved in early food sensitisation, as breast-feeding, or microbial environment that influence the development of oral tolerance in early infancy.
[Show abstract][Hide abstract] ABSTRACT: At present no data are available on the effects of unconjugated bilirubin (UCB) on the gut of the preterm. We evaluated 25 jaundiced preterm (12 male, GA 35.0±1.0 wks, BW 2152.2±301.3 g, serum bilirubin201.7millimol/L (range 97.4 - 265). Gastric electrical activity was recorded by cutaneous electrogastrography (EGG module UPS 2020 - MMS) for 30 minutes before and one hour after formula feed and the following parameters evaluated: gastric frequency and power, instability coefficient of frequency and power, percentage of normal slow wave, bradygastria and tachygastria. The urinary lactulose/mannitol ratio (La/Ma ratio) was measured after oral ingestion of a solution containing 8.6 g of lactulose and 140 mg of mannitol per 100 ml water at a dose of 2 ml/kg. Urine was then collected for five hours; lactulose and mannitol concentrations were measured by HPLC (high liquid phase chromatography) (mg/l) and La/Ma ratio calculated. Fecal calprotectin (FC) was measured by an ELISA kit (Calprest) and the stool samples were treated following the manufacturer s instructions. In the preprandial period, serum bilirubin correlates positively with the percentage of normal slow waves (r=0.60; p< 0.001) and negatively with percentage of tachygastria (r-0.42; p< 0.03). Correlations were lost in the postprandial period. A multiple linear regression model showed that intestinal permeability (La/Ma ratio) (mean 0.25 ± 0.15) is influenced by both UCB and FC (mean 319.8± 4.5) (r=051; p=0.03). These data show that UCB affects IP, gastric motility and gut inflammation. We believe that UCB represents a condition of increased risk for preterms due to a complex involvment of the whole intestinal apparatus that has never been hypothesised before.
Pediatric Research 08/2005; 58(2). DOI:10.1203/00006450-200508000-00148 · 2.31 Impact Factor