INFLAMMATORY BOWEL DISEASES AND FOOD ALLERGY: PATHOGENETIC AND CLINICAL PARALLELS

Inflammatory bowel diseases (IBD), like allergic diseases, are referred to «diseases of civilization», and their prevalence is growing throughout the world, including in the pediatric population. Both diseases refer to immunopathological conditions and have not only some common pathogenesis, but also similar clinical picture. It is also known about common factors that contribute to the predisposition to both groups of diseases – both genetic and environmental – vitamin D deficiency, changes in the intestinal microbiota composition etc. However, the mechanisms of observed relationship between IBD and food allergy (FA) are not fully understood. In this review, devoted to the current state of the problem, the pathogenetic and clinical parallels between FA and IBD are considered in detail. FA gastrointestinal symptoms may not differ from IBD onset, and the endoscopic picture may mimic the symptoms seen in patients with IBD. Indeed, the verification of gastrointestinal FA is still difficult due to the lack of reliable laboratory diagnostic methods. Besides misdiagnosis, comorbidity between FA and IBD is described. The complex pathogenetic mechanism of both IBD and allergic reactions is based on eosinophils, helper Th2 and Th17 cells, and transforming growth factor β. The common pathogenetic mechanisms lead to similar clinical manifestations, when not only the digestive system, but also the respiratory system and skin can be affected, although this is much less common in IBD. An important role is played by intestinal barrier state and intestinal microbiota – it was revealed that in children with certain genotypes, intestinal dysbiosis can cause immune abnormalities, leading to both allergic diseases and IBD.