These foods include wheat, milk products, egg, peanut, soy, sesame, tree nuts, shellfish, spicy foods, coffee, vegetables, fatty foods and alcohol.7,16,17 Actually, IBS patients tend to think that specific foods are triggers.18 Although many IBS patients mention that they avoid certain foods, this does not seem to significantly affect their intake of nutrients. IgG4 titers to wheat, leek and taro compared to those of controls. Serum Rimantadine Hydrochloride IgG4 titers to ginger, cocoa, walnut, white radish, onion, and lettuce in IBS patients tended to be higher than controls. IgG4 titers to wheat, gluten and gliadin in the diarrhea subgroup, and lettuce, leek and taro in the non-diarrhea subgroup tended to be higher compared with controls. The number of subjects with positivity to apple, orange, lettuce, and leek was significantly higher in IBS patients than controls. The number of subjects with positivity to apple, orange, gluten, and gliadin in the diarrhea subgroup, Rimantadine Hydrochloride and egg white, pineapple, soybean, lettuce, and leek in the non-diarrhea subgroup was significantly higher compared with controls. Conclusions Serum IgG4 antibody levels to some common foods are abnormally elevated in IBS patients. The type of foods with abnormally elevated serum IgG4 titers in the diarrhea subgroup may be different from that in the non-diarrhea subgroup. test. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A = 0.043), leek (0.13 0.22 U/mL vs 0.03 0.10; = 0.026), taro (1.00 2.17 U/mL vs 0.11 0.26; = 0.029), compared with healthy controls. Serum IgG4 titers to ginger, cocoa, walnut, white radish, onion, and lettuce in IBS patients tended to be higher than those in controls. IgG4 titers to wheat, gluten and gliadin in the diarrhea subgroup tended to be higher than those in controls. Patients in the non-diarrhea subgroup tended to have higher IgG4 levels to lettuce, leek and taro, compared with healthy controls (Table 3). Table 3 Food Antigens Showing Differences in IgG4 Titers (U/mL) Between Patients and Controls 0.1 was shown in the table. The Number of Subjects With Positivity for Serum Food IgG4 Titers The number of subjects with positivity for serum food IgG4 titers to apple, orange, lettuce, and leek was significantly higher in IBS patients than that in healthy controls. The number of subjects with positivity to apple, orange, gluten, and gliadin in the diarrhea subgroup, and egg white, pineapple, soybean, lettuce, and leek in Rimantadine Hydrochloride the non-diarrhea subgroup was significantly higher, compared with controls (Table 4). Table 4 The Number of Subjects with a Positive Antigen Defined as Its IgG4 Titer 0. 7 U/mL in Irritable Bowel Syndrome Patients and Healthy Controls 0.1 was shown in the table. Discussion In the ELF3 present study, we exhibited that serum IgG4 antibody levels to some foods were abnormally elevated in IBS patients. Furthermore, the type of foods with abnormally elevated IgG4 titers compared to normal controls in the diarrhea subgroup was different Rimantadine Hydrochloride from that in the non-diarrhea subgroup. Those findings suggest the possibility that the IgG4-related immune reaction to some foods is usually involved in the pathogenesis of IBS symptoms. Previous studies showed that serum IgG4 antibodies to common foods are elevated in IBS patients.16,17 Like atopic conditions, those observations suggest the possibility of a role of IgG4-related immune reaction in the pathophysiology of IBS. In a study from the United Kingdom, IBS patients experienced significantly higher IgG4 titers to wheat, beef, pork, and lamb compared to controls.16 In contrast, a study from China showed that IBS patients had significantly higher levels of IgG antibody to crab, egg, shrimp, soybean, and wheat than controls.17 In that study, patients with functional dyspepsia also had significantly higher titers of IgG antibody to egg and soybean, compared with controls. Those studies suggest that symptoms associated with IBS or Rimantadine Hydrochloride functional dyspepsia maybe related to food hypersensitivity. In the present study, IBS patients who overlapped with functional dyspepsia were excluded, because we aimed to investigate the relationship of IgG4-related immune reaction to food antigens with IBS symptoms. We exhibited that IBS patients experienced significantly higher IgG4 titers to wheat, leek, and taro compared to controls. Moreover, serum IgG4 titers to ginger, cocoa, walnut, white radish, onion, and lettuce in IBS patients tended to be higher than controls. Although higher levels of IgG4 to wheat antigen were also observed in previous studies, the type of foods showing higher IgG4 titers in IBS patients in the present study was mostly different from that in other previous studies. This difference may be related to the difference in ethnicity or the type of favorite food among countries, and this warrants further investigation. The level of IgG4 antibodies against foods may just reflect the intake of the food. However, certain.
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