Intestinal Barrier Permeability in Allergic Diseases

The role of intestinal permeability (IP) markers among children and adults with food allergies is not fully understood, and the identification of biological indicators/markers that predict growth retardation in children with allergic diseases and atopy has not been well explained. Studies have shown that patients with atopic diseases respond abnormally to food allergens. Accordingly, differences in the types of immune complexes formed in response to antigen challenges are significant, which seems to underlie the systemic signs of the food allergy. Increased intestinal permeability over the course of a food allergy allows allergens to penetrate through the intestinal barrier and stimulate the submucosal immune system. Additionally, the release of cytokines and inflammatory mediators enhances the degradation of the epithelial barrier and leads to an improper cycle, resulting in increased intestinal permeability. Several studies have also demonstrated increased permeability of the epithelial cells in those afflicted with atopic eczema and bronchial asthma. Ongoing research is aimed at finding various indicators to assess IP in patients with atopic diseases

Intestinal Barrier Permeability in Allergic Diseases

The role of intestinal permeability (IP) markers among children and adults with food allergies is not fully understood, and the identification of biological indicators/markers that predict growth retardation in children with allergic diseases and atopy has not been well explained. Studies have shown that patients with atopic diseases respond abnormally to food allergens. Accordingly, differences in the types of immune complexes formed in response to antigen challenges are significant, which seems to underlie the systemic signs of the food allergy. Increased intestinal permeability over the course of a food allergy allows allergens to penetrate through the intestinal barrier and stimulate the submucosal immune system. Additionally, the release of cytokines and inflammatory mediators enhances the degradation of the epithelial barrier and leads to an improper cycle, resulting in increased intestinal permeability. Several studies have also demonstrated increased permeability of the epithelial cells in those afflicted with atopic eczema and bronchial asthma. Ongoing research is aimed at finding various indicators to assess IP in patients with atopic diseases

Assessment of Selected Intestinal Permeability Markers in Children with Food Allergy Depending on the Type and Severity of Clinical Symptoms

Background: Food allergy (FA) has a broad range of symptoms, and clinical manifestations may concern several reactions from one system or organ. Aim: The aim of the study was to assess intestinal permeability (IP) based on the analysis of serum zonulin and bacterial lipopolysaccharides (LPS) levels in children with FA, taking into account the pathomechanism of immune reaction, clinical symptoms of FA and their severity. Material and methods: The study comprised 103 patients aged 7–60 months (median 34); 49 children with IgE-mediated allergy and 25 children with non-IgE-mediated allergy; the reference group comprised 29 children with functional gastrointestinal disorders. IP markers were determined using ELISA. Results: There was no correlation between the severity of clinical symptoms and the level of IP markers in children with FA. Zonulin and LPS levels were significantly higher in children with FA and gastrointestinal symptoms. Zonulin levels in the subgroup of children with non-IgE-mediated FA and gastrointestinal symptoms were significantly higher than in the subgroup of children with IgE-mediated FA and these symptoms. The level of LPS was significantly higher in the subgroup with IgE-mediated FA and atopic dermatitis. Conclusions: Zonulin and LPS levels were significantly higher in children with FA compared to children from the reference group. Zonulin levels were significantly higher in children with non-IgE-mediated FA than in children with IgE-mediated FA

Atopowe zapalenie skóry u dzieci

The incidence of atopic diseases worldwide has shown a growing trend in recent years. This situation is associated with environmental factors and cha nges in dietar y habits. Therefore, allergic diseases are common reasons why the pa rents of infants and young children visit a family physician and a pa ediatrician. The research shows that the most frequent clinical manifestations of food allergy in the youngest age group are gastrointestinal and/or skin signs and symptoms. Eight key allergens are considered to trigger food hypersensitivity, including products of animal origin, i.e. cow’s milk protein, hen’s egg protein, fish and shellfish, and products of plant or igin, i.e. nuts, soybeans and wheat. The most common skin manifestation of the food allergy is atopic dermatitis    Częstotliwość występowania chorób atopowych w ostatnich latach na całym świecie wykazuje tendencję wzrostową. Zjawisko to związane jest z czynnikami środowiskowymi i zmianami zachodzącymi w nawykach żywieniowych. To powoduje, że choroby alergiczne są częstym powodem zgłoszenia się rodziców niemowląt i małych dzieci do lekarza rodzinnego i lekarza pediatry. Badania pokazują, że najczęstszą manifestacją kliniczną alergii pokarmowej, w najmłodszej grupie wiekowej, są objawy ze strony przewodu pokarmowego i/lub skóry. Za kluczowe alergeny odpowiedzialne za proces rozwoju nadwrażliwości pokarmowej podaje się 8 produktów, w tym alergeny pochodzenia zwierzęcego tj.: białka mleka krowiego, białka jaja kurzego, ryby, skorupiaki oraz alergeny pochodzenia roślinnego tj.: orzechy, soję, pszenicę. Najczęstsza manifestacja skórną alergii pokarmowej jest atopowe zapalenie skóry (AZS, wyprysk atopowy/endogenny). Jest to przewlekła i nawrotowa dermatoza zapalna dotykająca naskórka i skóry właściwej, która cechuje się silnym świądem, typową morfologią oraz lokalizacją zmian skórnych. Rozpoczyna się zwykle w okresie wczesnego dzieciństwa i współistnieje z innymi chorobami atopowymi u pacjenta i jego rodziny. W niniejszej pracy omówiono przyczyny, objawy, diagnostykę oraz postępowanie lecznicze. Zwrócono uwagę na najczęstsze czynniki wyzwalające i zaostrzające objawy AZS. Ponadto zaprezentowano narzędzia diagnostyczne do oceny stopnia nasilenia AZS, szczegółowo omówiono wskaźnik SCORAD