دورية أكاديمية
Outcomes of Serum Food-Specific Immunoglobulin G 4 to Guide Elimination Diet in Patients With Eosinophilic Esophagitis.
| العنوان: | Outcomes of Serum Food-Specific Immunoglobulin G 4 to Guide Elimination Diet in Patients With Eosinophilic Esophagitis. |
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| المؤلفون: | Lim AHW; Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia.; Adelaide Medical School, University of Adelaide, Adelaide, Australia., Ngoi B; Adelaide Medical School, University of Adelaide, Adelaide, Australia., Perkins GB; Adelaide Medical School, University of Adelaide, Adelaide, Australia.; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia., Wong S; Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia.; Adelaide Medical School, University of Adelaide, Adelaide, Australia., Whitelock G; Nutrition and Dietetics, Royal Adelaide Hospital, Adelaide, Australia., Hurtado P; Adelaide Medical School, University of Adelaide, Adelaide, Australia.; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia., Ruszkiewicz A; Adelaide Medical School, University of Adelaide, Adelaide, Australia.; Department of Surgical Pathology, SA Pathology, Adelaide, Australia.; Centre of Cancer Biology, University of South Australia, Adelaide, Australia., Le TA; Department of Immunology, Royal Adelaide Hospital, Adelaide, Australia ., Hissaria P; Adelaide Medical School, University of Adelaide, Adelaide, Australia.; Department of Immunology, Royal Adelaide Hospital, Adelaide, Australia ., Nguyen NQ; Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia.; Adelaide Medical School, University of Adelaide, Adelaide, Australia. |
| المصدر: | The American journal of gastroenterology [Am J Gastroenterol] 2024 Jun 01; Vol. 119 (6), pp. 1066-1073. Date of Electronic Publication: 2024 Feb 01. |
| نوع المنشور: | Journal Article; Controlled Clinical Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 0421030 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1572-0241 (Electronic) Linking ISSN: 00029270 NLM ISO Abbreviation: Am J Gastroenterol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2019-> : [Philadelphia, PA] : Wolters Kluwer Health Original Publication: New York, Elsevier Science, -2003. |
| مواضيع طبية MeSH: | Eosinophilic Esophagitis*/diet therapy , Eosinophilic Esophagitis*/immunology , Eosinophilic Esophagitis*/blood , Immunoglobulin G*/blood, Humans ; Female ; Male ; Adult ; Prospective Studies ; Middle Aged ; Food Hypersensitivity/diet therapy ; Food Hypersensitivity/complications ; Food Hypersensitivity/immunology ; Food Hypersensitivity/blood ; Deglutition Disorders/etiology ; Deglutition Disorders/diet therapy ; Esophagoscopy ; Eosinophils/immunology ; Young Adult ; Elimination Diets |
| مستخلص: | Introduction: Eosinophilic esophagitis (EoE) is associated with atopy; however, recent studies have identified an association with food-specific immunoglobulin G 4 (FS-IgG 4 ) rather than immunoglobulin E antibodies. This study aimed to evaluate the role of serum FS-IgG 4 in guiding an elimination diet and its outcomes. Methods: Patients with and without EoE were enrolled in a prospective, controlled, single tertiary center trial. Serum FS-IgG 4 titers, esophageal eosinophil counts, and dysphagia symptom questionnaire scores were assessed, and participants with elevated FS-IgG 4 (ImmunoCAP, cutoff of 10 mgA/L) commenced 6-week targeted elimination diet. Repeat serum FS-IgG 4 and endoscopic and histologic examination were performed at 6-week follow-up. Results: Twenty-two patients with active EoE and 13 controls were recruited. Serum FS-IgG 4 to milk, wheat, soy, eggs, and nuts was significantly higher in EoE ( P = 0.0002, P = 0.002, P = 0.003, P = 0.012, and P < 0.001, respectively). Elevated serum FS-IgG 4 to 1 or more food groups (median 2) was identified in 21/22 (95.4%) patients with EoE; 20/21 underwent 6-week dietary elimination. Median reductions in dysphagia symptom questionnaire score and EoE endoscopic reference score after elimination were 8 ( P = 0.0007) and 1 ( P = 0.002), respectively. Nine (45%) patients had histological remission (<15 eosinophils per high-power field). Fall in median esophageal eosinophil count was not statistically significant (50 vs 23; P = 0.068). Serum FS-IgG 4 did not decline by 6-week follow-up. Discussion: Serum FS-IgG 4 to milk, wheat, soy, egg, and nuts was present at higher levels in EoE, with targeted elimination resulting in 45% histologic remission rate. Serum FS-IgG 4 has potential as a noninvasive biomarker in EoE. When successful, FS-IgG 4 -led elimination diet can negate need for medications and be viewed more favorably by patients because of its smaller endoscopic burden compared with empirical elimination diets. (Copyright © 2024 by The American College of Gastroenterology.) |
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| المشرفين على المادة: | 0 (Immunoglobulin G) |
| تواريخ الأحداث: | Date Created: 20240201 Date Completed: 20240604 Latest Revision: 20240725 |
| رمز التحديث: | 20240726 |
| DOI: | 10.14309/ajg.0000000000002678 |
| PMID: | 38299582 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1572-0241 |
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| DOI: | 10.14309/ajg.0000000000002678 |