Abstract
There is an increasing amount of evidence which links the pathogenesis of irritable bowel syndrome (IBS) with food IgG hyperreactivity. Some authors have suggested that food IgG hyperreactivity could be also involved in the pathophysiology of major depressive disorder (MDD). The aim of this study was to compare levels of serum IgG against 39 selected food antigens between three groups of participants: patients with MDD (MDD group), patients with IBS (IBS group) and healthy controls (HC group). The study included 65 participants (22 in the MDD group, 22 in the IBS group and 21 in the HC group). Serum IgG levels were examined using enzyme-linked immunosorbent assay (ELISA). Medical records, clinical data and laboratory results were collected for the analysis. IgG food hyperreactivity (interpreted as an average of levels of IgG antibodies above 7.5 µg/mL) was detected in 28 (43%) participants, including 14 (64%) from the MDD group, ten (46%) from the IBS group and four (19%) from the HC group. We found differences between extreme IgG levels in MDD versus HC groups and in IBS versus HC groups. Patients with MDD had significantly higher serum levels of total IgG antibodies and IgG against celery, garlic and gluten compared with healthy controls. The MDD group also had higher serum IgG levels against gluten compared with the IBS group. Our results suggest dissimilarity in immune responses against food proteins between the examined groups, with the highest immunoreactivity in the MDD group. Further studies are needed to repeat and confirm these results in bigger cohorts and also examine clinical utility of IgG-based elimination diet in patients with MDD and IBS.
Highlights
Depression is an etiologically and clinically heterogeneous psychiatric disorder [1] which affects more than 300 million people worldwide [2]
The major depressive disorder (MDD) group had higher Body Mass Index (BMI) and lower levels of physical activity compared with the irritable bowel syndrome (IBS) group
Our findings suggest more common food-specific serum IgG hyperreactivity among patients with
Summary
Depression is an etiologically and clinically heterogeneous psychiatric disorder [1] which affects more than 300 million people worldwide [2]. In 1991, Smith formulated the macrophage theory of depression which suggested that mechanisms involved in the pathogenesis of the disease are macrophage activation and excessive secretion of pro-inflammatory cytokines. There is a vast body of evidence in support of this theory: (1) the imbalance of pro-inflammatory and anti-inflammatory mediators is observed before the onset of the illness [6]; (2) significantly higher levels of pro-inflammatory cytokines are observed in the acute phase of depression [7]; (3) higher levels of inflammation markers are linked to a higher risk of recurrence of the depressive episode [8]; (4) higher concentrations of markers of inflammation are connected with progression of the illness [9]; (5) a wide range of anti-inflammatory agents have been successfully tested in patients suffering from major depressive disorder (MDD) [10].
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