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Tsvetelina VELIKOVA, Alexander KUKOV, Viktoriya GEORGIEVA, Milena PERUHOVA, Nonka YURUKOVA, Antoaneta MIHOVA, Tsanka MEHANDZHIYSKA – MARINOVA, Gergana MIZGOVA, Velislava TERZIEVA, Galina ZHELEZOVA, Iskra ALTANKOVA, Ludmila IVANOVA; Methods for detection of food intolerance; Recent Advances in Food Science; 2018; 1(3): 106-119
Literature data show that about 60% of the world's population suffers from food intolerance to at least one food antigen. This intolerance can cause various symptoms - mainly digestive disturbances, but also skin irritations, neurological disturbances, musculoskeletal symptoms, etc., which need to be diagnostically clarified. In most cases, allergen consumption causes an exacerbation of clinical signs. For food intolerance, the presence of specific IgE and IgG antibodies can be observed. Some subclasses of IgG (mainly IgG4) inhibits the degranulation of basophils and mast cells and the activation of the complement cascade. However, various studies have shown that people with inflammatory and alimentary intolerance have had IgG directed against food antigens alone, but not IgE. On the other hand, skin tests are rarely positively influenced by food allergies that are mainly bound to IgE antibodies. Moreover, IgE-related food allergy develops within the next hour after food intake, while intolerability to food allergens and specific IgG/IgG4 antibodies show a delayed response of 24 to 120 hours, and persistent symptoms may occur. This is also beneficial in testing patients in a more distant period of consumption of certain food allergens. Provocative and elimination diets may be used as additional diagnostic tools for food intolerance. Unfortunately, they depend heavily on motivation and performance of patients. The aim/purpose of this review is to describe the available methods for food intolerance diagnostics, particularly the determination of specific IgG antibodies to food antigens, and compare their usefulness in clinical practice as reliable diagnostic tools.