J Neurogastroenterol Motil  
Cytokine Profile and Immunoglobulin E-mediated Serological Food Hypersensitivity in Patients With Irritable Bowel Syndrome With Diarrhea
Ryo Katsumata,1* Manabu Ishii,1 Suni Lee,2 Yukiko Handa,3 Takahisa Murao,1 Minoru Fujita,1 Hiroshi Matsumoto,1 Takemi Otsuki,3 and Akiko Shiotani1
1Division of Gastroenterology, Kawasaki Medical School, Kurashiki, Okayama, Japan; 2Department of Hygiene, Kawasaki Medical School, Kurashiki, Okayama, Japan; and 3Handa Clinic of Internal Medicine, Wakayama City, Wakayama, Japan
Correspondence to: Ryo Katsumata, MD
Division of Gastroenterology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 710-0192, Japan
Tel: +81-86-462-1111, Fax: +81-86-464-1195
E-mail: katsumata@med.kawasaki-m.ac.jp
Received: September 18, 2017; Revised: November 26, 2017; Accepted: December 12, 2017; Published online: May 9, 2018.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims
Food interaction, including food hypersensitivity, plays a key role in the pathogenesis of irritable bowel syndrome with diarrhea (IBS-D). Since only a few studies have been reported about the relationship between food hypersensitivity and IBS-D, we elucidate the prevalence of serological food hypersensitivity in patients with IBS-D and the characteristics of gastrointestinal symptoms and serum cytokine profiles in patients with IBS-D and serological food hypersensitivity.
Methods
Immunoglobulin E (Ig E)-mediated serological food hypersensitivity and serum cytokine levels were evaluated using the multiple allergen simultaneous test evaluating food allergen-specific serum IgE and Luminex Milliplex Panel containing multiple fluorescence-labeled beads. Class 2 or above was considered as IgE-mediated food hypersensitivity positive. The gastrointestinal symptom rating scale was used to evaluate symptoms.
Results
We enrolled 92 subjects, including 60 with IBS-D and 32 healthy controls. The percentages of patients with IgE-mediated serological food hypersensitivity were not significantly different between the groups (controls = 28.1% and IBS-D = 33.3%). Serum IL-1β, IL-6, IL-8, macrophage inflammatory protein-1alpha, and TNF-α levels were higher in patients with IBS-D than in controls. Serum concentration of TNF-α (43.4 vs 21.8 pg/mL, P = 0.009) was higher in patients with IBS-D without IgE-mediated serological food hypersensitivity than those with food hypersensitivity.
Conclusions
One-third of Japanese patients with IBS-D showed IgE-mediated serological food hypersensitivity. The serum cytokine profile differed and was characterized by lower inflammatory cytokine levels in IBS-D with IgE-mediated serological food hypersensitivity. Serological test regarding IgE-mediated food hypersensitivity can detect a certain cluster of IBS-D.
Keywords: Cytokines; Food hypersensitivity; Inflammation; Irritable bowel syndrome; Tumor necrosis factor-alpha


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