The Use of Epicutaenous Patch Testing in the Evaluation of Gastrointestinal Disease

Opinion statementTraditionally, gastrointestinal (GI) diseases such as gastroesophageal reflux, gastritis, esophagitis, and irritable bowel syndrome (IBS) have not been thought of as hypersensitivity (allergy)-mediated illnesses; however, there has been growing research suggesting that food and environmental allergens may play a role in the development of GI illnesses, particularly those with refractory symptoms not responding to traditional therapies. The GI system and skin share similar components of the immune system and in some cases respond to foreign antigens in the same manner. With respect to confirmatory diagnostic testing, the skin is the more easily accessible organ compared to the gastrointestinal system. Patch testing is a well-established standardized non-invasive skin based test utilized for the evaluation of hypersensitivity reactions to antigenic triggers. There is growing evidence that patch testing may be helpful in the diagnostic evaluation of gastrointestinal manifestations of immune-mediated diseases. We predict that further utilization of the standard patch test in the diagnostic assessment of patients with GI symptomatology will prove useful for the identification of specific allergens and etiologic agents responsible for gastrointestinal type IV hypersensitivity reactions.
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research