Intestinal permeability in patients with adverse reactions to food

Abstract

Background An abnormal intestinal permeability could contribute to establish an altered sensitivity to food-allergen. Aim To evaluate the intestinal permeability in subjects with adverse reactions to food on allergen-free diet. Subjects 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. Methods Intestinal permeability was evaluated by Lactulose/Mannitol ratio urinary detection determined by anion-exchange chromatography. Results 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. Conclusions 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.