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Local immune response to food antigens drives meal-induced abdominal pain.

ABSTRACT: Up to 20% of people worldwide develop gastrointestinal symptoms following a meal¹, leading to decreased quality of life, substantial morbidity and high medical costs. Although the interest of both the scientific and lay communities in this issue has increased markedly in recent years, with the worldwide introduction of gluten-free and other diets, the underlying mechanisms of food-induced abdominal complaints remain largely unknown. Here we show that a bacterial infection and bacterial toxins can trigger an immune response that leads to the production of dietary-antigen-specific IgE antibodies in mice, which are limited to the intestine. Following subsequent oral ingestion of the respective dietary antigen, an IgE- and mast-cell-dependent mechanism induced increased visceral pain. This aberrant pain signalling resulted from histamine receptor H₁-mediated sensitization of visceral afferents. Moreover, injection of food antigens (gluten, wheat, soy and milk) into the rectosigmoid mucosa of patients with irritable bowel syndrome induced local oedema and mast cell activation. Our results identify and characterize a peripheral mechanism that underlies food-induced abdominal pain, thereby creating new possibilities for the treatment of irritable bowel syndrome and related abdominal pain disorders.

SUBMITTER: Aguilera-Lizarraga J

PROVIDER: S-EPMC7610810 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Local immune response to food antigens drives meal-induced abdominal pain.

Aguilera-Lizarraga Javier J Florens Morgane V MV Viola Maria Francesca MF Jain Piyush P Decraecker Lisse L Appeltans Iris I Cuende-Estevez Maria M Fabre Naomi N Van Beek Kim K Perna Eluisa E Balemans Dafne D Stakenborg Nathalie N Theofanous Stavroula S Bosmans Goele G Mondelaers Stéphanie U SU Matteoli Gianluca G Ibiza Martínez Sales S Lopez-Lopez Cintya C Jaramillo-Polanco Josue J Talavera Karel K Alpizar Yeranddy A YA Feyerabend Thorsten B TB Rodewald Hans-Reimer HR Farre Ricard R Redegeld Frank A FA Si Jiyeon J Raes Jeroen J Breynaert Christine C Schrijvers Rik R Bosteels Cédric C Lambrecht Bart N BN Boyd Scott D SD Hoh Ramona A RA Cabooter Deirdre D Nelis Maxim M Augustijns Patrick P Hendrix Sven S Strid Jessica J Bisschops Raf R Reed David E DE Vanner Stephen J SJ Denadai-Souza Alexandre A Wouters Mira M MM Boeckxstaens Guy E GE

Nature 20210113 7844

Up to 20% of people worldwide develop gastrointestinal symptoms following a meal<sup>1</sup>, leading to decreased quality of life, substantial morbidity and high medical costs. Although the interest of both the scientific and lay communities in this issue has increased markedly in recent years, with the worldwide introduction of gluten-free and other diets, the underlying mechanisms of food-induced abdominal complaints remain largely unknown. Here we show that a bacterial infection and bacteria ...[more]

PMID: 33442055

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Project description:BackgroundPatients with disorders of gut-brain interaction (DGBI) report meal intake to be associated with symptoms. DGBI patients with meal-related symptoms may have more severe symptoms overall and worse health outcomes, but this subgroup has not been well characterized. We aimed to describe the global prevalence of meal-related abdominal pain and characterize this subgroup.MethodsThe data analyzed originated from the Internet survey component of the population-based Rome Foundation Global Epidemiology Study, completed in 26 countries (n = 54,127). Adult subjects were asked whether they had abdominal pain and how often this was meal-related. Respondents were categorized into "no," "occasional," and "frequent" meal-related abdominal pain groups based on 0%, 10-40%, and ≥50% of the pain episodes being meal-related, respectively. DGBI diagnoses, frequency of other GI symptoms, psychological distress, non-GI somatic symptoms, quality of life, and healthcare utilization were compared between groups. Mixed linear and ordinal regression was used to assess independent associations between psychological distress, non-GI somatic symptoms, quality of life, other GI symptoms, and meal-related abdominal pain.ResultsOverall, 51.9% of the respondents reported abdominal pain in the last 3 months, and 11.0% belonged to the group with frequent meal-related abdominal pain, which included more females and younger subjects. DGBI diagnoses were more common in subjects with frequent meal-related abdominal pain, and the frequency of several GI symptoms was associated with having more frequent meal-related abdominal pain. Having meal-related abdominal pain more frequently was also associated with more severe psychological distress, non-GI somatic symptoms, and a poorer quality of life. The group with frequent meal-related abdominal pain also more often consulted a doctor for bowel problems compared to the other groups of meal-related abdominal pain.ConclusionReporting frequent meal-related abdominal pain is common across the globe and associated with other GI and non-GI somatic symptoms, psychological distress, healthcare utilization, and a poorer quality of life. Individuals who frequently experience meal-related abdominal pain also more frequently fulfill the diagnostic criteria for DGBI. Assessing meal-related symptoms in all DGBI patients could be of major importance to improve and individualize symptom management.

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Local immune response to food antigens drives meal-induced abdominal pain.

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Local immune response to food antigens drives meal-induced abdominal pain.

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