Food sensitivity in individuals with altered and unaltered digestive tracts

W. Carson, R. Cederberg, J. Clarke, J. Izard Author

04/04/2021 Added

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Video Presentation for 2021 UNL Student Research Days

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[00:00:01.530]Good afternoon. My name is Walker Carson.
[00:00:03.510]I'm a master student in the food science and technology department here at the
[00:00:07.020]university of Nebraska Lincoln.
[00:00:09.570]Thank you very much for taking the time to listen to my presentation today.
[00:00:12.810]I'm going to be talking about food sensitivity in individuals with altered and
[00:00:16.230]unaltered digestive tracks to begin in order to get everybody on the same page.
[00:00:20.490]I want to talk a little bit about what I mean by food sensitivity and by altered
[00:00:24.060]and unaltered digestive tracks. That's with tracks,
[00:00:26.250]I'm talking about individuals who have primarily undergone surgeries to receive
[00:00:30.750]an Austin MI. Now, for those of you who don't know,
[00:00:33.780]and Austin has a surgery where part or all of the
[00:00:38.640]colon,
[00:00:39.090]and even some parts of the small intestine have been removed and fecal material
[00:00:42.810]is then rerouted to a hole on the abdomen called a stoma, um,
[00:00:48.450]which is then collected in a bag and disposed of in that way. Now,
[00:00:53.250]depending on the location and the extent of the surgery ostomies can be,
[00:00:57.630]can fall into several different categories.
[00:00:59.610]So if you see the picture here on the right, um,
[00:01:02.520]you can see that part of the descending colon has been removed with a stoma
[00:01:05.700]being placed on the lower left portion of the abdomen.
[00:01:08.130]This is known as a colostomy. Now it would still be called a colostomy,
[00:01:11.520]even if more of the colon had been removed and the stoma is created from the
[00:01:14.610]colon. However, if you look over on the right,
[00:01:17.430]you can see that the entire colon has been removed up to the ilium of the small
[00:01:20.880]intestine. And that is where the stoma has been created.
[00:01:24.180]This is known as an ileostomy in our study.
[00:01:26.700]We also looked at individuals who have had even more of their,
[00:01:29.520]their small intestine removed. And these individuals have,
[00:01:34.650]have what is known as judging ostomies.
[00:01:37.530]We've also looked at individuals with different pathologies along their
[00:01:40.500]digestive tract. And, um, um,
[00:01:45.140]what we're looking at for what we're looking for, okay,
[00:01:47.630]in these individuals is the presence of food sensitivity by way of food specific
[00:01:52.640]IgG. Now,
[00:01:54.020]IgG is one of the primary antibodies that's created by our immune system.
[00:01:58.220]And when partially digested food is consistently exposed to the immune system,
[00:02:02.600]the body can begin to create IgG antibodies against these typically consuming.
[00:02:07.700]And so this can really be a problem.
[00:02:09.080]And it's actually been estimated that 20% of people who live in industrialized
[00:02:13.010]countries can suffer from food, food intolerance or sensitivities.
[00:02:17.240]Now several studies have shown that elimination diets based on
[00:02:21.890]IgG testing for food specific IgG and serum have shown
[00:02:26.750]to be effective in managing symptoms of food sensitivity.
[00:02:30.410]And these studies have been done in individuals with Crohn's disease,
[00:02:32.960]ulcerative colitis, and irritable bowel syndrome.
[00:02:36.200]And so the objective of our study is kind of to determine the relationship
[00:02:40.580]between the presence of food specific IgG and digestive track alterations,
[00:02:44.690]or other disease status of interest, um,
[00:02:49.010]along the digestive track.
[00:02:50.720]And our hypothesis is that overall levels of food specific IgG are going to
[00:02:54.620]reflect present or past events of gut permeation and individuals with
[00:02:59.230]digestive tracks. Now, in order to evaluate this,
[00:03:02.920]we first had to acquire serum samples. Um, and we did this through the Nebraska.
[00:03:07.500]Bank,
[00:03:09.240]which is a effort from the.
[00:03:14.940]University of Nebraska medical center and Nebraska medicine to make serum
[00:03:19.500]samples available to researchers.
[00:03:21.540]So we requested.
[00:03:23.160]Samples from individuals with 10 different diagnoses. Um, as you can see here,
[00:03:27.360]individuals with periodontitis judging jejunostomy colostomy and ileoestomy
[00:03:32.340]as well as individuals from eosinophilic esophogitis,
[00:03:35.400]which is an inflammatory disease of the esophagus duodenitis,
[00:03:39.960]which is an inflammatory disease of the duodenum Crohn's disease,
[00:03:43.620]which can actually be located at any point along the digestive tract. However,
[00:03:47.430]ours is isolated to the small intestine,
[00:03:49.800]the individuals who we requested acute appendicitis,
[00:03:52.950]which is inflammation of the appendix ulcerative colitis,
[00:03:57.060]which is an inflammatory bowel disease of the colon,
[00:04:00.090]as well as generalized food intolerance.
[00:04:03.690]After, after.
[00:04:04.560]Receiving these samples,
[00:04:05.880]we then using an Eliza methodology in order to measure IgG in serum against
[00:04:10.440]109 different foods.
[00:04:12.270]And we ended we've ended up.
[00:04:14.190]Testing 189 individuals from those two.
[00:04:17.130]Can different diagnoses.
[00:04:21.090]What this Eliza allowed us to do is assign a grade of zero one, two or three,
[00:04:25.830]indicating the amount of each specific food IgG.
[00:04:30.630]In the serum.
[00:04:32.460]And then we use those grades to do a couple of hours.
[00:04:36.660]Things.
[00:04:37.020]What we first did was determine the total number of foods that were present in
[00:04:40.770]each individual.
[00:04:42.330]And then we created, we use this data to create.
[00:04:46.410]A categorical sum,
[00:04:47.520]which is essentially a sum of all of the grades for every food,
[00:04:50.940]for each individual in order to indicate overall reactivity within these
[00:04:54.780]individuals.
[00:04:56.430]And finally, what we did is we.
[00:04:59.170]Looked at responders versus non-responders those who had the presence of some
[00:05:03.420]food IgG and those who didn't have any food IgG and performed a logistic
[00:05:06.930]regression in order to tell if the diagnosis that we were
[00:05:11.730]testing had any, um,
[00:05:14.610]any specific impact on the likelihood of whether or not an individual would
[00:05:19.500]or would not generate food specific IgG. Now,
[00:05:23.310]one thing that's really important to note here.
[00:05:25.440]Is that by far and away the most common.
[00:05:29.880]And IgGs that we saw were for, um, cows milk, sheep and goats, milk,
[00:05:34.950]egg yolk, and egg.
[00:05:36.000]White. We chose.
[00:05:38.130]To exclude those from the analysis in order to.
[00:05:41.790]In order to more clearly see what was happening in the data.
[00:05:47.130]So we ran across called Wallace and Nova, and then a postdoc done test on first,
[00:05:51.990]the number of foods positive. And what we saw is the ileoestomy rates,
[00:05:55.770]judging estimates and individuals with food intolerance and individuals with
[00:05:59.960]eosinophilic esophogitis have a significantly higher number of foods
[00:06:04.760]positive when compared to individuals with appendicitis duodenitis and
[00:06:08.960]periodontitis, we then looked at the categorical sums,
[00:06:12.800]which I described in order to assess overall reactivity towards the foods
[00:06:17.390]tested. And once again, we saw the early estimates, judging estimates,
[00:06:21.050]individuals with food sensitivity and eosinophilic esophogitis have
[00:06:25.340]significantly higher categorical sums. However,
[00:06:28.160]we also saw the individuals with Crohn's disease have significantly high or
[00:06:31.370]categorical sums of food specific IgG than individuals with duodenitis
[00:06:36.230]and periodontitis. Next, as I mentioned,
[00:06:39.620]we wanted to look at the impact of the disease state specifically
[00:06:44.300]on,
[00:06:46.190]on whether or not individuals were going to have food specific IgG or not.
[00:06:51.290]And you can see the results of the logistic regression here on the right in
[00:06:54.830]table two on the right. And what we can see is that food intolerance,
[00:06:59.000]judging ostomy and colostomy all, um,
[00:07:01.910]do have an impact on the likelihood of an individual
[00:07:06.440]to have food IgG or not food specific IgG.
[00:07:11.000]And what we saw is the individuals diagnosed with food intolerance were actually
[00:07:14.660]8.46 more times,
[00:07:17.000]like times more likely to have food specific IgG than those with periodontitis,
[00:07:21.830]which we used as our baseline, because.
[00:07:24.970]Individuals with periodontitis typically had.
[00:07:28.630]The lowest number of foods, food specific IgG, and their serum,
[00:07:32.110]as well as the lowest categorical sums or overall reactivity.
[00:07:36.100]We also saw the individuals with judging ostomies were 5.6 5.06
[00:07:40.960]times more likely to have food specific IgG than individuals with periodontitis.
[00:07:45.520]And the individuals with colostomies were 3.8,
[00:07:48.130]five times more likely to have food specific IgG than those with
[00:07:52.480]periodontitis. Now,
[00:07:54.940]other things that are trending towards significant here that you can see would
[00:07:58.090]be Crohn's disease with individuals being 3.4,
[00:08:02.020]six times more likely. However,
[00:08:04.450]this did not reach our significance threshold of 0.05. Well,
[00:08:07.390]as eosinophilic esophogitis,
[00:08:09.280]you can see is trending towards being significant as well.
[00:08:14.650]Ostomies surgeries are frequently required.
[00:08:17.380]Due to the intensification of some type.
[00:08:21.880]Of irritable bowel disease, inflammatory bowel disease,
[00:08:23.920]such as Crohn's disease or ulcerative colitis,
[00:08:26.110]as well as radiation damage from colon cancer, um,
[00:08:30.700]or some type of traumatic injury individuals with ostomies and with
[00:08:35.470]inflammatory bowel diseases can have a much harder time whenever it comes to
[00:08:40.420]managing their diet and nutrition.
[00:08:42.970]This study allows us to further understand the relationship of ostomies and IgG
[00:08:47.620]generation against foods. In order to,
[00:08:51.010]to open the door to further studies of IgG looking specifically food
[00:08:55.500]sensitivity,
[00:08:56.640]as well as the impact of GI alteration on the digestive track and immune.
[00:09:00.380]Systems and immune system in the us.
[00:09:04.880]And our hope is that individuals with inflammatory bowel diseases and ostomies
[00:09:09.800]will be able to benefit from this information.
[00:09:11.840]And insofar as that they're able to more effectively manage their health with
[00:09:15.710]relation to diet specifically, I'd like to thank my advisor, Dr.
[00:09:19.940][inaudible] for all of his support and help as well as Rebecca Cedarburg our lab
[00:09:24.890]manager and Dr.
[00:09:26.930]Jennifer Clark are the statistician in the food science and
[00:09:31.760]technology department for all of her help, um, generating this data.
[00:09:35.540]Thank you so much.

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Food sensitivity in individuals with altered and unaltered digestive tracts

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