Jennifer Pryor1,2,3, Grace L Burns1,2,3, Kerith Duncanson2,3,4, Jay C Horvat1,3, Marjorie M Walker2,3,4, Nicholas J Talley2,3,4, Simon Keely5,6,7. 1. School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. 2. Priority Research Centre for Digestive Health and Neurogastroenterology, University of Newcastle, Newcastle, NSW, Australia. 3. Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. 4. School of Medicine and Public Health, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. 5. School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. simon.keely@newcastle.edu.au. 6. Priority Research Centre for Digestive Health and Neurogastroenterology, University of Newcastle, Newcastle, NSW, Australia. simon.keely@newcastle.edu.au. 7. Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. simon.keely@newcastle.edu.au.
Abstract
PURPOSE OF REVIEW: Functional dyspepsia (FD) is a chronic functional gastrointestinal disorder characterised by upper gastrointestinal symptoms. Here, we aimed to examine the evidence for immune responses to food in FD and overlap with food hypersensitivity conditions. RECENT FINDINGS: A feature of FD in a subset of patients is an increase in mucosal eosinophils, mast cells, intraepithelial cytotoxic T cells and systemic gut-homing T cells in the duodenum, suggesting that immune dysfunction is characteristic of this disease. Rates of self-reported non-celiac wheat/gluten sensitivity (NCW/GS) are higher in FD patients. FD patients commonly report worsening symptoms following consumption of wheat, fermentable oligosaccharides, disaccharides, monosaccharides, or polyols (FODMAPs), high-fat foods and spicy foods containing capsaicin. Particularly, wheat proteins and fructan in wheat may drive symptoms. Immune mechanisms that drive responses to food in FD are still poorly characterised but share key effector cells to common food hypersensitivities including non-IgE-mediated food allergy and eosinophilic oesophagitis.
PURPOSE OF REVIEW: Functional dyspepsia (FD) is a chronic functional gastrointestinal disorder characterised by upper gastrointestinal symptoms. Here, we aimed to examine the evidence for immune responses to food in FD and overlap with food hypersensitivity conditions. RECENT FINDINGS: A feature of FD in a subset of patients is an increase in mucosal eosinophils, mast cells, intraepithelial cytotoxic T cells and systemic gut-homing T cells in the duodenum, suggesting that immune dysfunction is characteristic of this disease. Rates of self-reported non-celiac wheat/gluten sensitivity (NCW/GS) are higher in FDpatients. FDpatients commonly report worsening symptoms following consumption of wheat, fermentable oligosaccharides, disaccharides, monosaccharides, or polyols (FODMAPs), high-fat foods and spicy foods containing capsaicin. Particularly, wheat proteins and fructan in wheat may drive symptoms. Immune mechanisms that drive responses to food in FD are still poorly characterised but share key effector cells to common food hypersensitivities including non-IgE-mediated food allergy and eosinophilic oesophagitis.