Indication of immune activation in patients with perceived food hypersensitivity

Majority of the patients with perceived food hypersensitivity have irritable bowel syndrome (IBS), and a significant proportion of IBS patients also attribute their gastrointestinal complaints to food items. Different factors such as disturbed intestinal fermentation, enteric dysmotility, post-infectious changes and altered microbial flora in the colon as well as psychological disturbances likely play a role in the pathophysiology and symptoms generation in patients with food hypersensitivity. In addition, a number of studies in these patient groups indicate that local, systemic and mucosal immune systems are activated. The question now is no longer intestinal immune activation, but how the immune system is activated in these patients. In the following review, the potential pathogenetic role of the immune system and evidence of immune activation are reported in patients with perceived food hypersensitivity.