Atopic Patients Who Fulfilled Rome III Criteria for Irritable Bowel Syndrome Had Higher Animal Danders Sensitization

• Published in: Journal of neurogastroenterology and motility Vol. 26; no. 2; pp. 267 - 273
• Main Authors: Siah, Kewin T H, Santosa, Amelia, Cheung, Cynthia K Y, Soh, Alex Y S, Bigliardi, Paul L
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Neurogastroenterology and Motility 30-04-2020
• Subjects: Original; Allergens; Allergy and immunology; Fel d1 protein; Irritable bowel syndrome
• ISSN: 2093-0879; 2093-0887
• DOI: 10.5056/jnm19181

The relationship between animal exposure and irritable bowel syndrome (IBS) is debated. Epidemiological studies have shown that atopy is more prevalent in IBS patients and vice versa. We set out to examine the association between animal danders sensitization and IBS-like symptoms in atopic patients.
We recruited 69 consecutive atopic patients from the allergy clinic of a tertiary hospital. Subjects completed validated bowel questionnaires, underwent skin prick test, blood was collected for serum total immunoglobulin E, and ImmunoCAP immune solidphase allergen chip (ISAC) IgE multiplex assay.
Twenty-eight (41.0%) atopic patients fulfilled the Rome III IBS criteria (atopy-IBS). There were no differences in gender, age, pet ownership, total serum IgE, or food allergen sensitization between atopy-IBS group and atopy-non-IBS group. We found that atopy- IBS group had significantly higher number of positive skin prick test for cat dander (64.3% vs 24.4%,
< 0.001), dog dander (64.3% vs 41.5%,
= 0.015) and weed pollens (32.1% vs 14.6%,
= 0.050) compared to atopy-non-IBS group. Out of 112 components from 51 allergen sources (both aeroallergen and food allergens), only Fel d1 (a major cat dander antigen) IgE is significantly higher in atopy-IBS group than atopy-non-IBS group (21.4% vs 2.4%,
= 0.029). Majority of atopy-IBS patients had mixed-type IBS.
We demonstrated an association between animal danders sensitization, in particular cat dander sensitization, and IBS-like symptoms in atopic patients. Future studies are needed to explore the relationship between aeroallergen and functional gastrointestinal disorders. Sensitization may be related to the pathophysiology of IBS or it could be that we are missing aeroallergen-induced gut allergy.