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Measurements of eosinophil activation before and after food challenges in adults with food hypersensitivity

Journal article
Authors Jenny Van Odijk
C. G. Peterson
S. Ahlstedt
Ulf Bengtsson
Magnus P. Borres
Lena Rossander-Hulthén
Jenny Magnusson
T. Hansson
Published in Int Arch Allergy Immunol
Volume 140
Issue 4
Pages 334-41
ISSN 1018-2438
Publication year 2006
Published at Institute of Medicine, Department of Rheumatology and Inflammation Research
Institute of Medicine, Department of Clinical Nutrition
Institute of Medicine, Department of Internal Medicine
Pages 334-41
Language en
Keywords Abdominal Pain/etiology/immunology, Adult, Aged, Chemokines, CC/blood, Double-Blind Method, Eating/*immunology, Eosinophil-Derived Neurotoxin/blood/urine, Eosinophils/*immunology, Feces/chemistry, Female, Food/adverse effects, Food Hypersensitivity/blood/*immunology/urine, Gastrointestinal Tract/chemistry/immunology, Humans, Leukotriene E4/urine, Male, Middle Aged, Single-Blind Method, Time Factors
Subject categories Internal medicine


BACKGROUND: Objective assessment of inflammatory reactions in the gastrointestinal tract could be useful in the diagnosis of food hypersensitivity. The aim of the present study was to investigate the involvement of eosinophils and mast cells in the inflammatory response of patients with food hypersensitivity before and after food challenges. METHODS: Eleven patients (4 with IgE-mediated allergy and 7 without) with food hypersensitivity and positive double-blind, placebo-controlled food challenge were subjected to food challenge in a single-blinded fashion. Four subjects with no known food hypersensitivity were recruited as controls. Placebo was given after a 1-week washout period followed by an active dose. Stool, urinary and serum samples were collected and symptoms were recorded in a diary. Fecal samples were analyzed for eosinophil protein X (F-EPX) and tryptase; urinary samples for EPX (U-EPX) and leukotriene E4 (U-LTE4) and serum samples were analyzed for eotaxin and food-specific IgE antibodies. RESULTS: Patients with IgE-mediated food allergy had increased levels of F-EPX compared to controls and tended to have lower serum levels of eotaxin compared to non-allergic patients and controls. U-LTE4 was significantly higher in allergic patients compared to non-allergic patients after challenge. Moreover, F-EPX correlated to U-LTE4 (p = 0.011). Reported symptoms, abdominal pain, distension, flatulence and nausea were similar in the allergic and non-allergic patients. CONCLUSION: The results strongly indicate that eosinophils are activated in the gastrointestinal tract of food-allergic patients but not in patients with non-allergic food hypersensitivity. Due to the inconsistent pattern of symptoms after placebo and active food challenge, it was not possible to relate the levels of inflammation markers to the recorded symptoms.

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