J Neurogastroenterol Motil.  2020 Apr;26(2):267-273. 10.5056/jnm19181.

Atopic Patients Who Fulfilled Rome III Criteria for Irritable Bowel Syndrome Had Higher Animal Danders Sensitization

Affiliations
  • 1Division of Gastroenterology and Hepatology, University Medicine Cluster, National University Health System, Singapore
  • 2Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 3Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore
  • 4Department of Medicine, The University of Hong Kong, Hong Kong, China
  • 5Department of Dermatology, Division of Dermato-Allergy, University of Minnesota, Minneapolis, MN, USA

Abstract

Background/Aims
The relationship between animal exposure and irritable bowel syndrome (IBS) is debated. Epidemiological studies have shown that atopy is more prevalent in IBS patients and vice versa. We set out to examine the association between animal danders sensitization and IBS-like symptoms in atopic patients.
Methods
We recruited 69 consecutive atopic patients from the allergy clinic of a tertiary hospital. Subjects completed validated bowel questionnaires, underwent skin prick test, blood was collected for serum total immunoglobulin E, and ImmunoCAP immune solidphase allergen chip (ISAC) IgE multiplex assay.
Results
Twenty-eight (41.0%) atopic patients fulfilled the Rome III IBS criteria (atopy-IBS). There were no differences in gender, age, pet ownership, total serum IgE, or food allergen sensitization between atopy-IBS group and atopy-non-IBS group. We found that atopy- IBS group had significantly higher number of positive skin prick test for cat dander (64.3% vs 24.4%, P < 0.001), dog dander (64.3% vs 41.5%, P = 0.015) and weed pollens (32.1% vs 14.6%, P = 0.050) compared to atopy-non-IBS group. Out of 112 components from 51 allergen sources (both aeroallergen and food allergens), only Fel d1 (a major cat dander antigen) IgE is significantly higher in atopy-IBS group than atopy-non-IBS group (21.4% vs 2.4%, P = 0.029). Majority of atopy-IBS patients had mixed-type IBS.
Conclusions
We demonstrated an association between animal danders sensitization, in particular cat dander sensitization, and IBS-like symptoms in atopic patients. Future studies are needed to explore the relationship between aeroallergen and functional gastrointestinal disorders. Sensitization may be related to the pathophysiology of IBS or it could be that we are missing aeroallergen-induced gut allergy.

Keyword

Allergens; Allergy and immunology; Fel d1 protein; Irritable bowel syndrome
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