IgG4 and IgE

Objectives Learn how to differentiate classes of adverse reactions to food Understand mechanism of sensitivity reactions Interpret reports of IgG4 food antibodies

Learn how to differentiate classes of adverse reactions to food

Understand mechanism of sensitivity reactions

Interpret reports of IgG4 food antibodies

Types of Adverse Reactions to Food Immunological Atopy or Allergy - IgE (Hyper) Sensitivity - IgG Physiological Lactose Intolerance Biochemical MSG Intolerance

Immunological

Atopy or Allergy - IgE

(Hyper) Sensitivity - IgG

Physiological

Lactose Intolerance

Biochemical

MSG Intolerance

Definition of Common Terms

Characteristics of IgE and IgG-Mediated Reactions to Food

IgE Mediates Classical Allergic Symptoms Sneezing, nose runs, eyes water Works by attaching to mast cells in mucosa linings Loaded with histamines Able to produce cytokines (chemicals that can influence the behavior of other cells)

Mediates Classical Allergic Symptoms

Sneezing, nose runs, eyes water

Works by attaching to mast cells in mucosa linings

Loaded with histamines

Able to produce cytokines (chemicals that can influence the behavior of other cells)

IgE Extremely Sensitive System Individual reacts from someone sitting at the next table eating crab Extreme Reaction  Anaphylaxis and Death Normal Function is Gating for IgA System Antigen detected by IgE in gut cells changes permeability, allowing IgA to stream out and intercept and destroy parasites

Extremely Sensitive System

Individual reacts from someone sitting at the next table eating crab

Extreme Reaction  Anaphylaxis and Death

Normal Function is Gating for IgA System

Antigen detected by IgE in gut cells changes permeability, allowing IgA to stream out and intercept and destroy parasites

IgG Protects tissues Initially called Gamma Globulin Early used intravenously, not knowing why it did good things Later found to produce “serum sickness” Highly inflammatory

Protects tissues

Initially called Gamma Globulin

Early used intravenously, not knowing why it did good things

Later found to produce “serum sickness”

Highly inflammatory

IgG IgG Molecules are Trans-Placental Only source of specific protection for newborn Transfers immunological memory from the mother

IgG Molecules are Trans-Placental

Only source of specific protection for newborn

Transfers immunological memory from the mother

IgG4 and IgE Food Antibody Testing Requires serum specimen Finger stick analysis measures 30 food reactions Patient motivational tool Straightforward interpretation of lab results Rotation diet provides easy implementation Significant improvements of many symptoms

Requires serum specimen

Finger stick analysis measures 30 food reactions

Patient motivational tool

Straightforward interpretation of lab results

Rotation diet provides easy implementation

Significant improvements of many symptoms

Treatment of Delayed Food Allergy Based on Specific IgG RAST Testing 114 patients with chronic, disabling symptoms Elimination of foods was sole treatment 70% of group obtained 75% improvement 20% of group obtained 100% improvement Dixon HS. Otolaryngol Head Neck Surg 2000 Jul: 123(1 part1):48-54

114 patients with chronic, disabling symptoms

Elimination of foods was sole treatment

70% of group obtained 75% improvement

20% of group obtained 100% improvement

Incidence of Food Allergies

Food Sensitivities They can occur at any age, triggering many different symptoms and contributing to a variety of disorders, including: Inflammatory Bowel Disease Fatigue ADD/ADHD Migraine Skin Problems Rheumatoid Arthritis Sinusitis Recurrent Ear Infections

They can occur at any age, triggering many different symptoms and contributing to a variety of disorders, including:

Inflammatory Bowel Disease

Fatigue

ADD/ADHD

Migraine

Skin Problems

Rheumatoid Arthritis

Sinusitis

Recurrent Ear Infections

Commonly Reported Symptoms in Patients with Delayed Food Sensitivities

Assessment of IgG Reactions 20 or Greater IgG4 Reactions: If more than twenty foods have an IgG reaction this is an indication of an intestinal permeability problem or "leaky gut.” 5 to 19 IgG4 Reactions: Intestinal permeability may be a problem, and steps should be taken as indicated above. Few IgG4 Reactions: If there are one to five reactions to foods, these should again be eliminated from the diet to test for involvement in patient symptoms.

20 or Greater IgG4 Reactions: If more than twenty foods have an IgG reaction this is an indication of an intestinal permeability problem or "leaky gut.”

5 to 19 IgG4 Reactions: Intestinal permeability may be a problem, and steps should be taken as indicated above.

Few IgG4 Reactions: If there are one to five reactions to foods, these should again be eliminated from the diet to test for involvement in patient symptoms.

No IgG Reactions The absence of reactions in this test may be due to several possibilities:

The absence of reactions in this test may be due to several possibilities:

Allergix Profile 52-year-old male

Allergix Profile

52-year-old male

52-year-old male, generally in good health Interested in losing weight Heartburn History of antibiotic use due to chronic diarrhea Regular, loose stools Oral thrush GIfx revealed dysbiosis and several opportunistic bacteria Presenting Symptoms

52-year-old male, generally in good health

Interested in losing weight

Heartburn

History of antibiotic use due to chronic diarrhea

Regular, loose stools

Oral thrush

GIfx revealed dysbiosis and several opportunistic bacteria

GIfx Immunology markers

Gluten-free diet Focused on healing the gut: Paleofiber 2 tbs/d Factor IV — Bifidobacter sp. only probiotic Biotagen prebiotic Digestive Enzymes Plant enzymes GI Revive Betaine HCl Treatment

Gluten-free diet

Focused on healing the gut:

Paleofiber 2 tbs/d

Factor IV — Bifidobacter sp. only probiotic

Biotagen prebiotic

Digestive Enzymes

Plant enzymes

GI Revive

Betaine HCl

Treatment Continued with previous protocol for gut healing and elimination diet Increased Betaine HCl Losing weight Follow-up (3 months)

Treatment

Continued with previous protocol for gut healing and elimination diet

Increased Betaine HCl

Losing weight

Anti-gliadin antibody has improved with elimination of gluten. Immunology

Anti-gliadin antibody has improved with elimination of gluten.

Patient’s diet is much improved Still gluten-free Weight loss of 65 lbs. Patient wasn’t mentally prepared to accept such dramatic improvements Follow-up (6 months)

Patient’s diet is much improved

Still gluten-free

Weight loss of 65 lbs.

Patient wasn’t mentally prepared to accept such dramatic improvements

Immunology

Conclusion IgG Reactions: High incidence Cause a variety of chronic symptoms Usually unsuspected as an offending food Offending foods removed and/or rotated from diet IgE Reactions: Low incidence Cause short term symptoms Usually known as offending food Offending foods permanently removed from diet

IgG Reactions:

High incidence

Cause a variety of chronic symptoms

Usually unsuspected as an offending food

Offending foods removed and/or rotated from diet

IgE Reactions:

Low incidence

Cause short term symptoms

Usually known as offending food

Offending foods permanently removed from diet