1.
[Frequency of determining markers of casein's inhability and gluten in children with disorders of autistic spectrum].
Bavykina, IA, Popov, VI, Zvyagin, AA, Bavykin, DV
Voprosy pitaniia. 2019;(4):41-47
Abstract
The most optimal approach to the problem of managing children with autism spectrum disorders (ASD) is a complex one that involves a pediatric gastroenterologist, a nutritionist, a neurologist, a psychiatrist. Currently, there are studies that confirm the effectiveness of diet in the correction of neuropsychiatric status and gastroenterological disorders in ASD. Evidence supporting the therapeutic value of diets is limited and inconclusive. Diet therapy should be used only if food allergy or gluten or casein intolerance is diagnosed. Aim. To study the frequency of detection of markers of gluten and casein intolerance in children with ASD. Material and methods. The study involved 51 children (39 boys and 12 girls) aged 3 to 15 years with a diagnosis of ASD. Among the study participants, 20 children used gluten-free diet and casein-free diet for more than 6 months. The material for the study was venous blood taken from the elbow vein in the morning on an empty stomach. Determination of specific IgG-antibodies to casein and gliadin, IgA-antibodies to deamidized gliadin peptides was carried out by enzyme immunoassay. The level of total IgA to exclude selective deficiency was also determined. Results and discussion. Most children with ASD (79.5%) had increased levels of specific IgG antibodies to casein. The increase in IgG antigliadin antibodies was determined in 19.3% of children who do not follow a gluten-free diet, and antibodies to deamidized gliadin Ig peptides were not detected in any patient. Gluten intolerance in children with ASD is characterized by sensitivity to it and occurs in 40-50%. Conclusion. According to the literature and the results of own studies, some children with ASD have gluten and casein intolerance. Before the appointment of diet therapy for children with ASD, it is necessary to conduct a survey to clarify the nature of intolerance and the choice of optimal tactics of diet therapy.
2.
Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial.
Atkinson, W, Sheldon, TA, Shaath, N, Whorwell, PJ
Gut. 2004;53(10):1459-64
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Abstract
BACKGROUND Patients with irritable bowel syndrome (IBS) often feel they have some form of dietary intolerance and frequently try exclusion diets. Tests attempting to predict food sensitivity in IBS have been disappointing but none has utilised IgG antibodies. AIMS To assess the therapeutic potential of dietary elimination based on the presence of IgG antibodies to food. PATIENTS A total of 150 outpatients with IBS were randomised to receive, for three months, either a diet excluding all foods to which they had raised IgG antibodies (enzyme linked immunosorbant assay test) or a sham diet excluding the same number of foods but not those to which they had antibodies. METHODS Primary outcome measures were change in IBS symptom severity and global rating scores. Non-colonic symptomatology, quality of life, and anxiety/depression were secondary outcomes. Intention to treat analysis was undertaken using a generalised linear model. RESULTS After 12 weeks, the true diet resulted in a 10% greater reduction in symptom score than the sham diet (mean difference 39 (95% confidence intervals (CI) 5-72); p = 0.024) with this value increasing to 26% in fully compliant patients (difference 98 (95% CI 52-144); p<0.001). Global rating also significantly improved in the true diet group as a whole (p = 0.048, NNT = 9) and even more in compliant patients (p = 0.006, NNT = 2.5). All other outcomes showed trends favouring the true diet. Relaxing the diet led to a 24% greater deterioration in symptoms in those on the true diet (difference 52 (95% CI 18-88); p = 0.003). CONCLUSION Food elimination based on IgG antibodies may be effective in reducing IBS symptoms and is worthy of further biomedical research.