ABTEST Food Intolerances dsafafasdfa.pptx

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1. FOOD INTOLERANCE Detection of anti-food IgG and IgG4

2. FOOD INTOLERANCE – AN INTRODUCTION ONSET OF FOOD INTOLERANCE Food intolerance is a chronic inflammatory reaction determined by the passage of macromolecules of undigested food through the intestinal mucosa too permeable ("leaky") which triggers an immune response mediated by the production of IgG4 antibodies. Unlike allergies, in which the reaction is immune is immediate ( IgE production and release of histamine from Mast Cells), in case of food intolerance such reaction is delayed and consequent to a repeated stimulus by food antigens SELECTIVE PERMEABILITY (HEALTHY INDIVIDUALS) ALTERED PERMEABILITY (FOOD INTOLERANCE)

3. IgG and food intolerance 1 These are antibodies that provide long-term resistance to infections, called Immunoglobulin G (IgG), have a much longer half-life than the “traditional” IgE produced in allergy. This is where food sensitivities come in because they are much more subtle and most people live with them for years, if not their entire lives. A food sensitivity is an adverse reaction to a food with antigen-antibody response not triggering histamin release from Mast cells. Not digested food m acromolec ules , antigen s and toxins If the mucosa is “ leaky ” the macromolecules enter the bloodstream Production of anti-food IgG and immunocomplexes

4. IgG and food intolerance 2 In IgG mediated food allergy testing, the goal is to identify foods that are capable of causing inflammation that can trigger a large number of adverse reactions. IgG1, IgG2, and IgG3 all are capable of causing inflammation because these antibodies do not exchange heavy and light chains with other antibodies to form bispecific antibodies. Thus, IgG1, IgG2, and IgG3 antibodies to food antigens can and do form large immune complexes or lattices that fix complement and increase inflammation. Not digested food m acromolecol us , antigen s and toxins If the mucosa is “ leaky ” the macromolcules enter the bloodstream Production of anti-food IgG and immunocomplexes

5. IgG4 as biological markers of food intolerance IgG4 is found in the gut. Repeated exposure to a food antigen may lead to marked IgG4 antibody response. IgG4 reactions have been postulated as blocking agents of the more severe IgE reactions. Allergen immunotherapy (IT), known as allergy shots, is known to reduce symptoms of allergic rhinitis and asthma. IT has been shown to result in increases in IgG (2- to 10-fold) and IgG4 (10- to 100-fold), along with a gradual decline in anti-allergen IgE antibodies.

6. IgG4 as biological markers of food intolerance This IgG4 blocking action is not without side effects. Research has found that some subjects experience an elevation of IgG4 with no rise in IgE , but still have symptoms when specific foods are consumed. These symptoms may be due to IgG4 forming antigen complexes that the body reacts to. Avoidance or rotation diets have been shown to decrease the response and clinical symptoms. It thus holds to reason that long-term stimulation of IgG4 reactions may account for some chronic health conditions .

7. HOW TO RECOGNIZE FOOD INTOLERANCE • GASTROINTESTINAL DISORDERS ( diarrhea , constipation , irritable bowel syndrome , abdominal pain , vomiting and nausea) • RESPIRATORY PROBLEMS ( sinusitis , bronchial asthma , rhinitis , dyspnea , cough , recurrent bronchitis ) • SKIN DISORDERS (acne, eczema, itching , psoriasis , hives ) • NEUROLOGICAL AND PSYCHOLOGICAL DISORDERS ( dizziness , migraine , headache , anxiety , hyperactivity )

8. By the specific exclusion of foods from diet ,the titer of IgG4 will decrease over time , and so will the symptoms

9. HOW TO DIAGNOSE FOOD INTOLERANCE The diagnosis of food intolerance is carried out through the search of specific antibodies against food antigens by ELISA in the serum / plasma of patients

10. IgG o r IgG4 ? “LEAKY GUT” IMMUNE SYSTEM RESPONSE ANTIBODY PRODUCTION IgG IgG4

11. IgG IgG4 Antibody isotypes IgG3 IgG2 IgG1 Prod uced during infections ( viral and bacterial ) Produ ction activated with the same mechanism as IgE Less specific antibody Specific

12. ABTEST: THE IMMUNOENZYMATIC TEST FOR THE DETECTION OF FOOD INTOLERANCE ABTEST is an ELISA test higly sensitive, specific and reproducible for the detection of food-specific immunoglobulins by means of which it si possible to diagnose food intolerance . 1 pa t ient /p late 5 p lates /kit 3 p lates /kit 4 pa tients /p late AbTest Plus 130 AbTest Plus 60 AbTest Plus 30 IgG/IgG4 IgG/IgG4 IgG/IgG4 130 FOODS 60 FOODS 30 FOODS 2 patients / plate 3 p lates /kit

13. ABTEST PLUS KIT CONTENT MICROP LATES W I TH IMMOBILIZED ANTIGENS (FOOD EXCTRACTS) WASH BUFFER 20X SAMPLE DILUENT CONJUGATE SUBSTRATE STOP SOLUTION CALIBRATOR S (6 CALIBRATOR S ) CONTROL S

14. Altissima sensibilità (0,3 U/ml)

15. Bibliografia Zar S, Mincher L, Benson MJ, Kumar D. Food-specific lgG4 antibody-guided exc / usion diet improves symptoms and rectal compliance in irritab /e bowel syndrome. Scand J Gastroenterol . 2005 Jul;40(7):800-7. Zar S, Benson MJ, Kumar D. Food-specific serum lgG4 and lgE titers to common food antigens in irritable bowel syndrome. Am J Gastroenterol . 2005 Jul;100 (7):1550-7. Bernardi D, Borghesan F, Faggian D, Bianchi FC, Favero E, Billeri L. Time to reconsider the clinica / value of immunoglobulin lgG4 to foods? Clin Chem Lab Med. 2008;46(5):687-90. Garcia BE, Sanz ML, Fernàndez M, Diéguez l, Oehling A. Value of lgG4 antibodies against foods in atopic dermatitis. Allergollmmunopathol ( Madr ). 1990 Jul- Aug;18(4):187-90. Shakib F et al. Study of / gG subc l ass antibodies in patient with milk intolerance. Clin Allergy 1986; 16(5):451-8 . J Merrett , R S Barnetson , M L Burr, and TG Merrett Total and specific lgG4 antibody / evels in atopic eczema. Clin Exp lmmunol . 1984 June; 56(3): 645-652. A. Fernandez Flores. The ro /e of /gG4 in cutaneous pathology. J Morphol Embryol 2012, 53(2):221-231