| BackgroundLupus erythematosus systemic (SLE) is a kind of autoimmune diffuse connective tissue disease involving multi system, which is long in duration, difficult to treat, easy to relapse, and has poor prognosis. The global prevalence of this disease is about 30-50/10 million people, about 70-100/10 million people in China, mainly in young women aged 20-40 years. Incidence of male and female ratio is about 1:9. The etiology and pathogenesis of SLE is still not clear, usually considered as relevant to genetic, environmental, sex hormones etc. Currently, it is considered that individuals with related genetic background under the coactions of multi factors such as environment, hormones, infection and so on, their self tolerance is destroyed, resulting in autoimmune disorders and leading to disease. The core is suppressed T cell anomalies appear earlier and polyclonal B cell activated, leading to increased production of autoantibodies, especially antinuclear antibodies and anti DNA antibodies, anticardiolipin antibodies. These antibodies and their corresponding antigen binding to become immune complexes, deposited in the blood vessels, joints, glomerular basement membrane and other places, resulting in occurrence and repeating of systemic lupus erythematosus. The clinical manifestations of SLE varied: persistent fever or repeated high fever, fatigue, joint pain accompanied with muscle pain, in skin appears facial butterfly erythema, periorbital edema, palm papular telangiectasia, hair loss. For those involved to the mucosa erosion, ulcer appears, kidney cardiovascular system, respiratory system, central nervous system, blood system are all involved, among which more than half of SLE patients will develop lupus nephritis which is the most common and most serious internal organs pathological changes caused by SLE. The prognosis of SLE is closely related to disease control. Therefore, reducing the recurrence is essential for SLE patients. Causes of recurrence of SLE is still not clear yet, domestic researches believe that anti SM antibody positive patients, infection, irregular use of therapeutics, pregnancy, negative life stimulation (unemployment, divorce, death, etc.), sun etc. may cause recurrence of SLE.Foods are one of the most important materials for life sustaining, however, the body adverse reaction caused by them is getting increasing attention. In 1905 the British reported the relationship between food and chronic disease for the first time, the study found that food can lead to symptoms in all systems. This discovery provides a new thinking to study the diagnosis and treatment of diseases. Symptoms caused by food intolerance onset in about 5% of adults and 8% of children. The prevalence rate is increasing year by year. Food intolerance is a complex allergic diseases, some of the food ingested into the digestive tract, due to the lack of certain enzymes in the body, these foods cannot be digested as amino acid glycerol and monosaccharide which are easy to absorb for the body, thus they enter into guts as polypeptide or other molecular forms, these forms are regarded as hazardous materials in lymphoid tissue and cause protective immune response in body, lead to food specific IgG antibody in vivo which forms immune complexes with food molecules. Large molecular immune complexes was swallowed by phagocytosis, small ones are excreted after filtered by the kidney, while those in middle size failed to pass through the kidney filtration system, exist in the blood vessels for a long time, blocking kidney filtration system, causing glomerular filtration pressure, resulting in secondary hypertension, vascular wall expansion, cholesterol deposition and related diseases.Food intolerance can cause symptoms similar to allergy, but specific IgE detection usually is negative, patients can have intolerance to 4 to 5, and even more kind of foods. The symptoms usually appear hours or days after in-taking those foods. Due to the secrecy of food intolerance, patients will still intake those intolerable foods, producing immune complexes continuously and deposit in the glomerular filtration membrane, aggravate the original symptoms and cause immune overload, aggravate the inflammatory response, evoke multi system diseases, such as obesity, hypertension, nephritis, rash, chronic diarrhea, headache or migraine pain. Studies show that IgG biding IgG high affinity receptor existed in mast cells and eosinophil induce allergic reaction, resulting in mast cells and eosinophils eosinophil degranulation, release histamine, arachidonic acid and other metabolites, further induce dilation of blood vessels, cardiac arthythmia and asthma and other multi system symptoms.Studied done by the British YORK nutrition laboratory based on 2567 cases of patients suspected of food intolerance show that food intolerance can cause symptoms in various system:(1) digestive system:abdominal pain, diarrhea, bad breath, mouth ulcers, nausea, flatulence (2) skin:eczema, urticaria, acne, skin amyloidosis (3) nervous system:anxiety, depression, irritability, inattention, on tenterhooks (4) respiratory system:asthma, chronic cough, chronic rhinitis, nasosinusitis (5) musculoskeletal:arthritis, arthralgia (6) genitourinary system:frequent micturition, urgency, vaginal itching, vaginal discharge abnormal (7) cardiovascular system:chest pain, hypertension, arrhythmia, tachycardia (8) other:rapid weight change, hyperglycaemia, obesity, molar etc.. It is necessary to notice that food intolerance does not include bacteria, viruses, fungi, chemical toxins, toxic reactions and subjective aversion to certain food psychological reaction. Food intolerance, as a kind of complex allergic disease is difficult to diagnose by patient themselves since the symptoms are atypical and not specific and there is no clear clinical data. At present, food intolerance is mainly detected by the ELISA to test the food IgG antibody in the serum. The existing technology is capable to detect more than 90 kinds of food IgG including animal food, Cereals, potatoes, beans, vegetables, fruits and other. Now, more reports are about the relations between food intolerance and irritable bowel syndrome and allergic skin diseases.Food intolerance and SLE share many similarities. Both of them are autoimmune disease caused by immune complex type; their onset are associated with genetic, endocrine, infection, immune abnormalities and some environmental factors; their pathogenesis are also similar, they are both acute and chronic inflammation and tissue necrosis result from immune complex deposition at the site of skin, joints, small blood vessels, glomerular with the participation of other elements; both with skin damage, oral ulcer as the main performance, and developed into systemic disease. Notably both of them have gender differences:higher incidence in female. Numbers of clinical practice found that the recurrence and exacerbation of the diseases may have relationship with food.PurposeThe purpose of our study is to understand and explore the relationship between SLE and food intolerance.MethodSLE group selected 30 patients with diagnosed with SLE in Dermatology Department of Zhujiang Hospital from March 2012 to September 2Q14, all in compliance with the American College of Rheumatology (ACR) 2009 revised SLE classification and diagnostic criteria of or the diagnostic criteria for SLE relapses. Among them, there are 2 males and 28 females, aged 18-42 years old, averaging 32.6 years old. The courses of disease are from 3 months to 6 years, averaging 16.2 months. Normal control group selected 30 patients with non-immune disease and allergic disease, without recent infection and tumor or suspected tumor, including 2 males and 28 females, aged 19-45 years old, averageing 32.8 years old. ELISA method was used to detect the concentration of 7 kinds of food intolerance specific IgG antibody in the serum of the two groups.Results were analyzed by spss19.0 statistical software, measurement data all noted with mean±standard deviation, t-test was used in case of homogeneity of variance, heterogeneity of variance with rank sum test, counting data test by X2, categorical variables is expressed as a percentage; P< 0.05 as the difference was statistically significant.Results1.Detection results of serum IgG antibody in two groups of 7 kind of foodIn the SLE group, the average values s of food intolerance specific IgG antibody of the 7 kinds of food from high to low in order were as follows:protein/ eggyolk>milk>soybean>shrimp>wheat>codfish>beef. In the control group, the order was protein/eggyolk>milk>shrimp>soybean>wheat>codfish>beef. The orders in the two groups were roughly the same, s, SLE group 7 kinds of food specific IgG antibody concentrations were higher than those in the control group, among which, in SLE group for protein/egg yolk, wheat, codfish the concentration of serum IgG antibody were significantly higher than those in healthy control group, the difference was statistically significant (P< 0.05)2.Comparison of positive rates of serum IgG for 7 groups in two groupsSLE group 7 kinds of food intolerance specific IgG positive rate from high to low was wheat (70%), shrimp (63.3%), egg yolk and protein/codfish (60%), soybean (56.6%), milk and beef (53.3%). Healthy control group was protein/egg yolk and milk (53.3%), shrimp and wheat (50%), COD (46.6%), soybean (43.3%), beef (36.7%), but the difference was not statistically significant (P> 0.05).In 30 SLE patients 1 cases (3.33%) food intolerance specific IgG all negative for 7 kinds. In 29 patients with positive results, IgG positive to lkind of food 0 cases,2 positive 4 cases (13.3%),3positive 5 cases (16.7%),4 positive 6 cases (20%), 5positive 8 cases (26.7%),6 positive 5 cases (16.7%6),7positive 1 cases (33.3%), the total positive rate was 96.7%. In all 30 patients in healthy controls group intolerance specific IgG 7 kinds of food all negative 0 case,1 positive 4 cases (13.3%) and 2 positive 6 cases (20%),3 positive 4 cases (13.3%),4 positive 8 cases (26.7%), 5 positive 8 cases (26.7%),6 positive and 7 positive 0 case, total positive rate was 100%. In the two groups, only the cases for 1 positive and 6 positive the difference was statistically significant (P was 0.038 and 0.020 respectively), and the difference was not statistically significant (P> 0.05) in addition to 1 positive and 6 positive.In 210 detection results got from 30 SLE patients food intolerance specific IgG, level 0 (< 50 U/ml) 85 cases (40.4%), level+1 (50 U/ml) 106 cases (50.5%), level +2 (100-200 U/ml) 12 cases (5.7%) and level+3 (> 200 U/ml) 7 cases (3.3%), the total positive results was 125 cases (59.5%). Results of the 30 patients in healthy control group, level 0 was 110 cases (52.3%), level+1 was 94cases (44.8%), level+2 was 5 cases (2.4%), levle+3 was 1 case (0.5%), and total positive 100 cases (47.6%). The positive rate of SLE group was higher than that of the control group with statistically significant difference (P< 0.05). In the two groups, the positive rate of level+3 SLE group was higher than that in the control group, and the difference was statistically significant (P< 0.05).Conclusion1.Food intolerance is ubiquitous among people.2.Protein/egg yolk, wheat, codfish 3 kinds of foods have certain effect in the food intolerance disease development.3.SLE and may be associated with the type of food intolerance, may be more types of food intolerance, the greater the possibility of SLE or recurrence.4.SLE may be related to the severity of the food intolerance, the higher the level of IgG test positive results of food intolerance, the greater the probability of occurrence of SLE.5. SLE patients shall take less or fasting foods with specific detection positive to ease the SLE condition.6. Sample size of this study is not large, the detection of food variety is not much, therefore, the role of food intolerance in the disease progression of SLE still need further in-depth study and research. |
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