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IgG4 and IgE
Objectives
 Learn how to differentiate
 classes of adverse reactions
 to food
 Understand mechanism
 of sensitivity reactions
 Interpret reports of IgG4 food
 antibodies
Types of
Adverse Reactions to Food
 Immunological
   Atopy or Allergy - IgE
   (Hyper) Sensitivity - IgG
 Physiological
   Lactose Intolerance
 Biochemical
   MSG Intolerance
Definition of Common Terms
Characteristics of IgE and IgG-
Mediated Reactions to Food
IgE
 Mediates Classical Allergic Symptoms
   Sneezing, nose runs, eyes water
 Works by attaching to
 mast cells in mucosa linings
   Loaded with histamines
   Able to produce cytokines (chemicals that can
   influence the behavior of other cells)
IgE
 Extremely Sensitive System
   Individual reacts from someone
   sitting at the next table eating crab
 Extreme Reaction    Anaphylaxis and Death
 Normal Function is Gating for IgA System
   Antigen detected by IgE in gut cells changes
   permeability, allowing IgA to stream out and intercept
   and destroy parasites
IgG
 Protects tissues
 Initially called Gamma Globulin
   Early used intravenously,
   not knowing why it did good things
   Later found to produce “serum sickness”
 Highly inflammatory
IgG
 IgG Molecules are Trans-Placental
   Only source of specific
   protection for newborn
   Transfers immunological
   memory from the mother
IgG4 and IgE
Food Antibody Testing
 Requires serum specimen
 Finger stick analysis measures 30 food reactions
 Patient motivational tool
 Straightforward interpretation of lab results
 Rotation diet provides easy implementation
 Significant improvements of many symptoms
Treatment of Delayed Food Allergy
Based on Specific IgG RAST Testing

 114 patients with chronic, disabling symptoms
 Elimination of foods was sole treatment
 70% of group obtained 75% improvement
 20% of group obtained 100% improvement
 Dixon HS. Otolaryngol Head Neck Surg 2000 Jul: 123(1 part1):48‐54
Incidence of Food Allergies
Food Sensitivities
They can occur at any age, triggering many
different symptoms and contributing to a variety of
disorders, including:
    Inflammatory Bowel Disease
    Fatigue
    ADD/ADHD
    Migraine
    Skin Problems
    Rheumatoid Arthritis
    Sinusitis
    Recurrent Ear Infections
Commonly Reported Symptoms in
Patients with Delayed Food Sensitivities
 Nasal             Dry cough         Watery eyes
 congestion        Sneezing          Itchy skin
 Nasal             Hoarseness        Asthma
 Drainage          Diarrhea          Burping
 Sinus             Migraine          Cramps
 headaches         headaches         Rash
 Fatigue after     Itchy eyes        Ear popping
 meals
                   Ringing in ears
 Throat clearing
                   Ear fullness
 Gas
                   Nausea
 Chronic fatigue
                   Cervical
 Dizziness         headache
Assessment of IgG Reactions
 20 or Greater IgG4 Reactions: If more than twenty
 foods have an IgG reaction this is an indication of an
 intestinal permeability problem or quot;leaky gut.”

 5 to 19 IgG4 Reactions: Intestinal permeability may
 be a problem, and steps should be taken as
 indicated above.

 Few IgG4 Reactions: If there are one to five
 reactions to foods, these should again be eliminated
 from the diet to test for involvement in patient
 symptoms.
No IgG Reactions
The absence of reactions in this test may
be due to several possibilities:

  First: The gut may actually be      Third: Since this test
  intact and there is no intestinal   measures the immune
  permeability.                       response to exposure of the
                                      system to food antigens, the
  Second: Steroidal anti-             test will not show a positive
  inflammatory drugs are known        reaction if the patient is not
  to suppress the immune              consuming a food for reasons
  response and IgG4 production.       of known intolerance.
Allergix Profile
52-year-old male
Presenting Symptoms
 52-year-old male, generally in good health
 Interested in losing weight
 Heartburn
 History of antibiotic use due to chronic diarrhea
 Regular, loose stools
 Oral thrush
 GIfx revealed dysbiosis and
 several opportunistic bacteria
GIfx Immunology markers
Treatment
 Gluten-free diet
 Focused on healing the gut:
   Paleofiber 2 tbs/d
   Factor IV — Bifidobacter sp. only probiotic
   Biotagen prebiotic
   Digestive Enzymes
   Plant enzymes
   GI Revive
   Betaine HCl
Follow-up (3 months)
Treatment
  Continued with previous protocol for
  gut healing and elimination diet
  Increased Betaine HCl
Losing weight
Immunology



  Anti-gliadin antibody has improved
  with elimination of gluten.
Follow-up (6 months)
 Patient’s diet is much improved
 Still gluten-free
 Weight loss of 65 lbs.
 Patient wasn’t mentally prepared to accept such
 dramatic improvements
Immunology
Conclusion
 IgG Reactions:             IgE Reactions:
   High incidence             Low incidence
   Cause a variety of         Cause short term
   chronic symptoms           symptoms
   Usually unsuspected        Usually known as
   as an offending food       offending food
   Offending foods            Offending foods
   removed and/or rotated     permanently removed
   from diet                  from diet

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Allergix Presentation

  • 2. Objectives Learn how to differentiate classes of adverse reactions to food Understand mechanism of sensitivity reactions Interpret reports of IgG4 food antibodies
  • 3. Types of Adverse Reactions to Food Immunological Atopy or Allergy - IgE (Hyper) Sensitivity - IgG Physiological Lactose Intolerance Biochemical MSG Intolerance
  • 5. Characteristics of IgE and IgG- Mediated Reactions to Food
  • 6. IgE Mediates Classical Allergic Symptoms Sneezing, nose runs, eyes water Works by attaching to mast cells in mucosa linings Loaded with histamines Able to produce cytokines (chemicals that can influence the behavior of other cells)
  • 7. IgE Extremely Sensitive System Individual reacts from someone sitting at the next table eating crab Extreme Reaction Anaphylaxis and Death Normal Function is Gating for IgA System Antigen detected by IgE in gut cells changes permeability, allowing IgA to stream out and intercept and destroy parasites
  • 8. IgG Protects tissues Initially called Gamma Globulin Early used intravenously, not knowing why it did good things Later found to produce “serum sickness” Highly inflammatory
  • 9. IgG IgG Molecules are Trans-Placental Only source of specific protection for newborn Transfers immunological memory from the mother
  • 10. IgG4 and IgE Food Antibody Testing Requires serum specimen Finger stick analysis measures 30 food reactions Patient motivational tool Straightforward interpretation of lab results Rotation diet provides easy implementation Significant improvements of many symptoms
  • 11. Treatment of Delayed Food Allergy Based on Specific IgG RAST Testing 114 patients with chronic, disabling symptoms Elimination of foods was sole treatment 70% of group obtained 75% improvement 20% of group obtained 100% improvement Dixon HS. Otolaryngol Head Neck Surg 2000 Jul: 123(1 part1):48‐54
  • 12. Incidence of Food Allergies
  • 13. Food Sensitivities They can occur at any age, triggering many different symptoms and contributing to a variety of disorders, including: Inflammatory Bowel Disease Fatigue ADD/ADHD Migraine Skin Problems Rheumatoid Arthritis Sinusitis Recurrent Ear Infections
  • 14. Commonly Reported Symptoms in Patients with Delayed Food Sensitivities Nasal Dry cough Watery eyes congestion Sneezing Itchy skin Nasal Hoarseness Asthma Drainage Diarrhea Burping Sinus Migraine Cramps headaches headaches Rash Fatigue after Itchy eyes Ear popping meals Ringing in ears Throat clearing Ear fullness Gas Nausea Chronic fatigue Cervical Dizziness headache
  • 15. Assessment of IgG Reactions 20 or Greater IgG4 Reactions: If more than twenty foods have an IgG reaction this is an indication of an intestinal permeability problem or quot;leaky gut.” 5 to 19 IgG4 Reactions: Intestinal permeability may be a problem, and steps should be taken as indicated above. Few IgG4 Reactions: If there are one to five reactions to foods, these should again be eliminated from the diet to test for involvement in patient symptoms.
  • 16. No IgG Reactions The absence of reactions in this test may be due to several possibilities: First: The gut may actually be Third: Since this test intact and there is no intestinal measures the immune permeability. response to exposure of the system to food antigens, the Second: Steroidal anti- test will not show a positive inflammatory drugs are known reaction if the patient is not to suppress the immune consuming a food for reasons response and IgG4 production. of known intolerance.
  • 18. Presenting Symptoms 52-year-old male, generally in good health Interested in losing weight Heartburn History of antibiotic use due to chronic diarrhea Regular, loose stools Oral thrush GIfx revealed dysbiosis and several opportunistic bacteria
  • 19.
  • 21. Treatment Gluten-free diet Focused on healing the gut: Paleofiber 2 tbs/d Factor IV — Bifidobacter sp. only probiotic Biotagen prebiotic Digestive Enzymes Plant enzymes GI Revive Betaine HCl
  • 22. Follow-up (3 months) Treatment Continued with previous protocol for gut healing and elimination diet Increased Betaine HCl Losing weight
  • 23. Immunology Anti-gliadin antibody has improved with elimination of gluten.
  • 24. Follow-up (6 months) Patient’s diet is much improved Still gluten-free Weight loss of 65 lbs. Patient wasn’t mentally prepared to accept such dramatic improvements
  • 25.
  • 27. Conclusion IgG Reactions: IgE Reactions: High incidence Low incidence Cause a variety of Cause short term chronic symptoms symptoms Usually unsuspected Usually known as as an offending food offending food Offending foods Offending foods removed and/or rotated permanently removed from diet from diet