Subjective food hypersensitivity: assessment of enterochromaffin cell markers in blood and gut lavage fluid

Abstract

Kine Gregersen1,2, Jørgen Valeur1,3, Kristine Lillestøl1,3, Livar Frøyland2, Pedro Araujo2, Gülen Arslan Lied1,3, Arnold Berstad1,31Institute of Medicine, University of Bergen, 2National Institute of Nutrition and Seafood Research; 3Department of Medicine, Section for Gastroenterology, Haukeland University Hospital, Bergen, NorwayBackground: Food hypersensitivity is commonly suspected, but seldom verified. Patients with subjective food hypersensitivity suffer from both intestinal and extraintestinal health complaints. Abnormalities of the enterochromaffin cells may play a role in the pathogenesis. The aim of this study was to investigate enterochromaffin cell function in patients with subjective food hypersensitivity by measuring serum chromogranin A (CgA) and 5-hydroxytryptamine (5-HT, serotonin) in gut lavage fluid.Methods: Sixty-nine patients with subjective food hypersensitivity were examined. Twenty-three patients with inflammatory bowel disease and 35 healthy volunteers were included as comparison groups. CgA was measured in serum by enzyme-linked immunosorbent assay. Gut lavage fluid was obtained by administering 2 L of polyethylene glycol solution intraduodenally. The first clear fluid passed per rectum was collected and 5-HT was analyzed by liquid chromatography tandem mass spectrometry.Results: Serum levels of CgA were significantly lower in patients with subjective food hypersensitivity than in healthy controls (P = 0.04). No differences were found in 5-HT levels in gut lavage fluid between patients with subjective food hypersensitivity and the control groups. There was no correlation between serum CgA and gut lavage 5-HT.Conclusion: Decreased blood levels of CgA suggest neuroendocrine alterations in patients with subjective food hypersensitivity. However, 5-HT levels in gut lavage fluid were normal.Keywords: food hypersensitivity, chromogranin A, serotonin, gut lavage fluid, liquid chromatography