食物抗原特异性IgG和IgE在功能性胃肠病发病中的作用

背景：许多功能性胃肠病患者于进食某些食物后出现症状加重。目的：测定肠易激综合征（IBS）和功能性消化不良（FD）患者的血清食物抗原特异性IgG和IgE，探讨食物过敏在功能性胃肠病发病中的作用。方法：符合罗马Ⅱ标准的37例IBS患者、28例FD患者以及20例健康志愿者纳入本研究。以酶联免疫吸附测定（ELISA）检测受试者血清中14种食物抗原特异性IgG和IgE，同时测定血清总IgE水平。通过问卷调查行症状评分，分析血清食物抗原特异性IgG水平与症状总评分的相关性。结果：与健康对照组相比，IBS组血清中螃蟹、鸡蛋、河虾、大豆和小麦抗原特异性IgG水平显著升高（P〈0．05），FD组血清中鸡蛋和大豆抗原特异性IgG水平显著升高（P〈0．05）。三组间血清总IgE水平和食物抗原特异性IgE阳性率差异无统计学意义。IBS组和FD组血清食物抗原特异性IgG水平与症状总评分之间无明显相关性。结论：IBS和FD患者血清中部分食物抗原特异性IgG水平显著升高．提示IgG介导的食物过敏可能是功能性胃肠病潜在的发病机制之一。

Role of Food Antigen-specific IgG and IgE in the Pathogenesis of Functional Gastrointestinal Disorders

Background： Postprandial worsening of symptoms after taking certain foods are commonly seen in patients with functional gastrointestinal disorders. Aims： To assess the serum food antigen-specific IgG and IgE in patients with irritable bowel syndrome （IBS） and functional dyspepsia （FD）, so as to investigate the role of food allergy in the development of functional gastrointestinal disorders. Methods： Thirty-seven IBS patients and 28 FD patients fulfilling Rome lI criteria and 20 healthy volunteers were enrolled in this study. Serum IgG and IgE to 14 common foods were determined by enzyme-linked immunosorbent assay （ELISA）. Serum total IgE was also measured. Symptoms were assessed by questionnaire. The correlation of serum food antigen-specific IgG and score of symptoms was analyzed. Results： IBS patients had significantly higher titers of IgG antibody to crab, egg, shrimp, soybean and wheat, while FD patients had significantly higher titers of IgG antibody to egg and soybean as compared with the healthy controls （P〈0.05）. The percentage of individuals with detectable positive food antigen-specific IgE antibody did not show any significant differences between the three groups, so did the serum total IgE antibody titers. No significant correlation was seen between serum food antigen-specific IgG antibody titers and score of symptoms both in IBS and FD patients. Conclusions： Serum IgG antibody titers to some foods increase significantly in IBS and FD patients. Food allergy mediated by IgG might be one of the potential mechanisms in the development of functional gastrointestinal disorders.