Food IgG4 antibodies are elevated not only in children with wheat allergy but also in children with gastrointestinal diseases

Abstract

Background: Food sIgG and sIgG4 are highly individually versatile. We put a hypothesis that one of the responsible factors is the presence of gastrointestinal inflammatory diseases. The objectives were: 1. An analysis of wheat and rice sIgG and sIgG4 in healthy children, children with IgE-mediated wheat allergy (WA), coeliac disease (CD) and Helicobacter pylori infection (HP). 2. Usability of wheat sIgG and sIgG4 in the WA diagnostics.

Methods: We compared 388 each wheat and rice sIgG and sIgG4 in a group of 200 children: 50 WA (diagnosis, diet treatment, tolerance), 50 CD (diagnosis and remission), 50 HP and 50 healthy. SIgE, sIgG, sIgG4 were determined with the FEIA method (Pharmacia CAP System).

Results: In healthy children food sIgG were the lowest; no sIgG4 were found. In the CD diagnosis group wheat and rice sIgG and rice sIgG4 were the most common and their concentrations were the highest (p < .001, p < .05). Wheat sIgG4 were the highest in WA children (diagnosis and tolerance) to fall during the elimination diet (p < .05). Wheat and rice sIgG remained the same in all allergy phases. Rice sIgG also did not differ in the class G4.

Conclusions: 1. Serum concentrations of wheat and rice sIgG and sIgG4 are elevated in children with CD, HP and WA. 2. Sub-clinical incidence of some gastrointestinal inflammatory diseases may be responsible for high individual versatility of food sIgG and sIgG4 concentrations in serum. 3. Wheat sIgG and sIgG4 in children do not correlate with WA clinical picture.

Keywords: Children; Coeliac disease; Helicobacter pylori infection; Specific IgG; Specific IgG4; Wheat allergy.

Fig. 1

Serum concentrations and medians of wheat and rice sIgG in children from the control group and in children with IgE mediated wheat allergy. *wheat/rice: p < 0,05; Mann–Whitney test, **control group: children not suffering from atopy and gastrointestinal diseases in the upper part of the digestive tract (endoscopic and histological examination). In the control group the median titer of wheat sIgG was 2850 μg/L (0–7250 μg/L), while that of rice sIgG was 0 (0–4780 μg/L). In each of the wheat allergy phases the titers of sIgG were significantly higher for wheat than for rice (p < .005). They did not differ significantly over the three allergy phases both in the case of wheat and rice

Fig. 2

Serum concentrations and medians of wheat and rice sIgG4 in children from the control group and in children with IgE mediated wheat allergy. *wheat/rice: p < 0,05; Mann–Whitney test, **control group: children not suffering from atopy and gastrointestinal diseases in the upper part of the digestive tract (endoscopic and histological examination). In children from the control group wheat or rice sIgG₄ were not found. In each of the wheat allergy phases the titers of sIgG₄ were significantly higher for wheat than for rice (p < .001). Wheat sIgG₄ titers were the same at the time of diagnosis and in the period of tolerance, and decreased during the wheat-free diet (p < .05). Rice sIgG₄ the titers were also the same over the three allergy phases

Fig. 3

Serum concentrations and medians of wheat and rice sIgG in children from the control group and in children with coeliac diseases and Helicobacter pylori infection. wheat/rice: *p < 0,05, **ns; Mann–Whitney test, ***control group: children not suffering from atopy and gastrointestinal diseases in the upper part of the digestive tract (endoscopic and histological examination). The titers of wheat and rice sIgG were always more elevated in children with active celiac disease than in remission of celiac disease (p < .001). In active celiac disease the serum concentrations of wheat sIgG were higher than the rice-specific ones (p < .05), to remain the same in remission of celiac disease. In the children with Helicobacter infection the median wheat sIgG were higher than that for rice (p < .05). Their serum concentrations of wheat sIgG were the same as in children with the remission of celiac disease

Fig. 4

Serum concentrations and medians of wheat and rice sIgG₄ in children from the control group and in children with coeliac diseases and Helicobacter pylori infection. *wheat/rice: p < 0,05; Mann–Whitney test, **control group: children not suffering from atopy and gastrointestinal diseases in the upper part of the digestive tract (endoscopic and histological examination). The titers of wheat and rice sIgG₄ were always more elevated in children with active celiac disease than in children with remission of celiac disease (p < .001). In children with active celiac disease the serum concentrations of wheat sIgG₄ were higher than the rice-specific ones (p < .05), to remain the same in children with remission of celiac disease. In the children with the Helicobacter pylori infection the median wheat of sIgG₄ were higher than that for rice (p < .05). Their serum concentrations of wheat sIgG₄ were the same as in children with the remission of celiac disease