I'm sorry if this has been asked before but what is the difference between a having a sensitivity to a food and being allergic to a food? And is having a mast cell disorder a type of allergy since it involves histamines?
Thanks!
Question about sensitivity vs allergy
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Hi Kristine,
Basically, as you apparently understand, the classic food allergies cause the familiar allergy symptoms, such as a rash, itching, watery eyes, runny nose, etc, and more severe cases can involve anaphylactic symptoms. These reactions are associated with a serum increase in IgE antibodies, so I usually refer to them as IgE-based reactions. These are the kind of immune system issues that allergists and immunologists are trained to deal with.
The food-sensitivities that those of us with MC typically have to deal with, are more easily detected by IgA stool tests, so I refer to them as IgA-based reactions. These antibodies rarely show up in the blood, in amounts high enough to be detected by conventional blood tests. The classic celiac blood tests, for example, will detect fully-developed celiac disease with roughly an 80 to 90% reliability, but those tests are worthless for detecting the type of gluten-sensitivity that we have with MC, because the serum tests will only show a positive result when villus damage to the small intestine matches or exceeds a Marsh 3 score, (which correlates with mature celiac disease), whereas MC rarely results in a Marsh score higher than 1.
IgA-based reactions aren't usually associated with the release of histamines, so classically-defined MC does not normally involve classic allergy symptoms. MC is considered to be the result of inflammation caused by a T-cell-based reaction. (Of course, obviously, the T-cells have to be the result of a cytokine response, due to mast cell degranulation, but this is never discussed in polite gastroenterological circles.
).
Mast cell involvement simply brings into play a higher level of mast cell degranulation, primarily a higher level of histamine release. Statistically, at least 70% of people who have MC, histologically qualify for a diagnosis of mastocytic enterocolitis, but very, very few GI docs are aware of this fact. Many of those of us who do not have a mast cell level high enough to qualify for a diagnosis of MC, (greater than 20 mast cells per 100 enterocytes, on colonic biopsy examination under the microscope), have mast cell activation syndrome, (MCAS), instead, which results in the same symptoms, but is associated with a normal mast cell count.
So yes, technically, mast cell involvement is a poorly-understood version of a classic allergic event. Anyway, FWIW, these are my abbreviated views on those subjects.
Tex
Basically, as you apparently understand, the classic food allergies cause the familiar allergy symptoms, such as a rash, itching, watery eyes, runny nose, etc, and more severe cases can involve anaphylactic symptoms. These reactions are associated with a serum increase in IgE antibodies, so I usually refer to them as IgE-based reactions. These are the kind of immune system issues that allergists and immunologists are trained to deal with.
The food-sensitivities that those of us with MC typically have to deal with, are more easily detected by IgA stool tests, so I refer to them as IgA-based reactions. These antibodies rarely show up in the blood, in amounts high enough to be detected by conventional blood tests. The classic celiac blood tests, for example, will detect fully-developed celiac disease with roughly an 80 to 90% reliability, but those tests are worthless for detecting the type of gluten-sensitivity that we have with MC, because the serum tests will only show a positive result when villus damage to the small intestine matches or exceeds a Marsh 3 score, (which correlates with mature celiac disease), whereas MC rarely results in a Marsh score higher than 1.
IgA-based reactions aren't usually associated with the release of histamines, so classically-defined MC does not normally involve classic allergy symptoms. MC is considered to be the result of inflammation caused by a T-cell-based reaction. (Of course, obviously, the T-cells have to be the result of a cytokine response, due to mast cell degranulation, but this is never discussed in polite gastroenterological circles.
).Mast cell involvement simply brings into play a higher level of mast cell degranulation, primarily a higher level of histamine release. Statistically, at least 70% of people who have MC, histologically qualify for a diagnosis of mastocytic enterocolitis, but very, very few GI docs are aware of this fact. Many of those of us who do not have a mast cell level high enough to qualify for a diagnosis of MC, (greater than 20 mast cells per 100 enterocytes, on colonic biopsy examination under the microscope), have mast cell activation syndrome, (MCAS), instead, which results in the same symptoms, but is associated with a normal mast cell count.
So yes, technically, mast cell involvement is a poorly-understood version of a classic allergic event. Anyway, FWIW, these are my abbreviated views on those subjects.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Kristine,
That's basically correct. The chart omits mentioning the fact that the reactions on the right involve what are known as autoimmune reactions, (or maybe the author didn't recognize that).
The immunoglobulin responses shown are correct. The comment in the lower right corner about testing for serum IgG in a celiac screening test is incorrect, though. Actually the test measures antibodies to both IgG and IgA.
Tex
That's basically correct. The chart omits mentioning the fact that the reactions on the right involve what are known as autoimmune reactions, (or maybe the author didn't recognize that).
The immunoglobulin responses shown are correct. The comment in the lower right corner about testing for serum IgG in a celiac screening test is incorrect, though. Actually the test measures antibodies to both IgG and IgA.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Kristine,
I found this helpful.
I found this helpful.
The five major types of antibodies are:
IgA. IgA antibodies are found mainly in areas of the body such the nose, breathing passages, digestive tract, ears, eyes, and vagina. IgA antibodies protect body surfaces that are exposed to the outside from foreign organisms and substances. This type of antibody is also found in saliva and tears. About 10% to 15% of the antibodies usually present in the body are IgA antibodies. A small percentage of people do not make IgA antibodies.
IgG. IgG antibodies are found in all body fluids. They are the smallest but most abundant of the antibodies, normally comprising about 75% to 80% of all the antibodies in the body. IgG antibodies are considered the most important antibodies for fighting bacterial and viral infections. IgG antibodies are the only type of antibody that can cross the placenta. Therefore, the IgG antibodies of a pregnant woman can also help protect her baby (fetus).
IgM. IgM antibodies are the largest type of antibody. They are found in blood and lymph fluid and are the first type of antibody produced in response to an infection. They also cause other immune system cells to produce compounds that can destroy invading cells. IgM antibodies normally comprise about 5% to 10% of all the antibodies in the body.
IgD. IgD antibodies are found in small amounts in the tissues that line the abdominal or chest cavity of the body. The function of IgD antibodies is not well-understood. They appear to play a role in allergic reactions to some substances such as milk, some medications, and some poisons.
IgE. IgE antibodies are found in the lungs, skin, and mucous membranes. They cause the body to react against foreign substances such as pollen, fungus spores, and animal dander. IgE antibody levels are often high in people with allergies.
The levels of each type of antibody can give your health professional information about the cause of a medical problem.
Why It Is Done
A test for immunoglobulins (antibodies) in the blood is done to:
Diagnose certain autoimmune diseases or allergies.
Diagnose certain types of cancer (such as multiple myeloma or macroglobulinemia) that affect immunoglobulin levels in distinctive ways.
Determine whether recurring infections are due to a low level of immunoglobulins (especially IgG).
Monitor treatment for certain types of cancer affecting the bone marrow.
Monitor treatment for Helicobacter pylori bacteria.
Monitor responses to immunizations to determine whether immunity is present.
This test is often done when the results of a protein electrophoresis or total blood protein test are abnormal.
High values
IgA. High levels of IgA may indicate IgA multiple myeloma. Levels of IgA also increase in some autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE), and in liver diseases, such as cirrhosis and long-term (chronic) hepatitis.
IgG. High levels of IgG may indicate a long-term (chronic) infection, such as AIDS. Levels of IgG also increase in IgG multiple myeloma, long-term hepatitis, multiple sclerosis (MS), and some autoimmune diseases. In multiple myeloma, tumor cells produce only one type of IgG antibody (monoclonal); the other conditions cause an increase in many types of IgG antibodies (polyclonal).
IgM. High levels of IgM can indicate macroglobulinemia, early viral hepatitis, mononucleosis, rheumatoid arthritis, kidney damage (nephrotic syndrome), or a parasite infection. Because IgM antibodies are the type that form when an infection occurs for the first time, high levels of IgM can indicate a new infection is present. High levels of IgM in a newborn usually indicate that the baby has an infection that started in the uterus before delivery.
IgD. The role of IgD in the immune system is not well-understood. A high level may indicate IgD multiple myeloma. IgD multiple myeloma is much less common than IgA or IgG multiple myeloma.
IgE. A high level of IgE can indicate a parasite infection. Also, high levels of IgE are found in people who have allergic reactions, asthma, atopic dermatitis, some types of cancer, and certain autoimmune diseases. In rare cases, a high level of IgE may indicate IgE multiple myeloma.
Low values
IgA. Low levels of IgA occur in some types of leukemia, kidney damage (nephrotic syndrome), a problem with the intestines (enteropathy), and a rare inherited disease that affects muscle coordination (ataxia-telangiectasia). Some people are born with low or absent levels of IgA antibodies, which increases their chances of developing an autoimmune disease.
IgG. Low levels of IgG occur in macroglobulinemia. In this disease, the high levels of IgM antibodies suppress the growth of cells that produce IgG. Other conditions that can result in low levels of IgG include some types of leukemia and a type of kidney damage (nephrotic syndrome). On rare occasions, some people are born with a deficiency of IgG antibodies. These people are more susceptible to infections.
IgM. Low levels of IgM occur in multiple myeloma, some types of leukemia, and in some inherited types of immune diseases.
IgE. Low levels of IgE can occur in a rare inherited disease that affects muscle coordination (ataxia-telangiectasia).
Zizzle,
Unlike the others, IgG antibodies are considered to be markers of "mature" reactions. IOW, they are slow to develop, and slow to recede. They are useful for monitoring chronic reactions, since their levels remain relatively stable for longer periods of time, (compared with other types of antibodies). So yes, they would be more likely than IgE antibodies to be associated with food "intolerances", in that they're connected with chronic conditions. IgE antibodies obviously do a better job of marking true allergic reactions, because their levels rise and fall rapidly, (in response to histamine levels).
Tex
Unlike the others, IgG antibodies are considered to be markers of "mature" reactions. IOW, they are slow to develop, and slow to recede. They are useful for monitoring chronic reactions, since their levels remain relatively stable for longer periods of time, (compared with other types of antibodies). So yes, they would be more likely than IgE antibodies to be associated with food "intolerances", in that they're connected with chronic conditions. IgE antibodies obviously do a better job of marking true allergic reactions, because their levels rise and fall rapidly, (in response to histamine levels).
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.