A leukocyte activation test identifies food items which induce release of DNA by innate immune peripheral blood leucocytes

Ather Ali,1 Theresa R Weiss,1 Douglas McKee,2 Alisa Scherban,1 Sumiya Khan,1 Maxine R Fields,1 Damian Apollo,1 Wajahat Z Mehal1

 

Published in BMJ Open Gastroenterology

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Summary

What is already known about this subject?

  • Over 60% of IBS patients report symptoms related to food, such as symptomatic exacerbations and improvement when avoiding these foods.
  • Previous trials of elimination diets for irritable bowel syndrome (IBS) found varying levels of efficacy, with trials of the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet demonstrating promise.
  • No previous randomised trials have been published assessing the efficacy of leucocyte activation testing in IBS.

What are the new findings?

  • Statistically significant benefits were seen in global improvement and in symptom severity in a 4-week diet guided by leucocyte activation testing compared to a matched sham diet.
  • This study provides novel data suggesting that a leucocyte activation test can be used to develop an individualised diet that can alleviate symptom burden in IBS, distinct from other types of dietary interventions.
  • A broad proteomic screen found a reduction in plasma elastase in strong responders to the intervention diet.

How might it impact on clinical practice in the foreseeable future?

  • This study provides data suggesting that a leucocyte activation test can be used to develop an individualised diet that can alleviate symptom burden in IBS. These dietary changes may be less restrictive than a low-FODMAP diet and may result in better long-term adherence.