Evaluation of the Potential for Dietary Proteins to Contribute to Systemic Diseases

摘要

An ad hoc group discussed evidence for absorption of dietary proteins, disposition of absorbed antigens, and potential adverse effects from the interaction of dietary proteins with the immune system. Membranous epithelial cells overlie gut-associated-lymphoid tissue and may facilitate absorption and exposure of antigens to the mucosal immune system. Normal physiologic mechanisms severely restrict absorption of antigenically intact proteins into the circulatory system. There is still no firm evidence that immune complexes containing food proteins, which may occur periodically in a significant proportion of serum samples from an otherwise healthy population, play a role in pathogenesis of systemic diseases. Evidence from experimental animal studies and from patients with gluten-sensitive enteropathy, selective IgA deficiency, Berger's disease, various food sensitivities, and systemic sicca syndrome indicate that the interaction of antigenic materials including food proteins with the mucosal immune system may be an important component of certain diseases, either causative of an important manifestation or of the disease itself. However, with the possible exception of gluten-sensitive enteropathy, these interactions have not been shown to involve a specific protein. Suggestions for further research are developed.