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The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis.

Abstract

OBJECTIVE

To investigate the effect of individualized diet challenges consisting of allergenic foods, defined by the skin prick test (SPT), on tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) levels in patients with rheumatoid arthritis (RA).

METHODS

Twenty patients with a positive SPT response for food extracts and 20 with a negative SPT response were enrolled. None of the patients had active disease. All patients were fasted for the most common allergenic foods for 12 days and then allocated to two groups according to SPT results. Food challenges were performed with allergenic foods in the prick-positive group (PPG) and with corn and rice in the prick-negative group (PNG) for a period of 12 days. Then, allergenic foods were excluded from the PPG patients' diet and corn and rice were removed from the PNG patients' diet. Clinical examinations were performed after fasting (baseline), at the end of the challenge phase and at the end of the re-elimination phase. Stiffness, pain, tender and swollen joint counts, health assessment questionnaire (HAQ), Ritchie's articular index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum TNF-alpha and IL-1beta levels were measured.

RESULTS

TNF-alpha (P < 0.01), IL-1beta (P < 0.05), ESR (P < 0.05) and CRP (P = 0.001) levels and all of the clinical variables, except HAQ, were increased with food challenges in the PPG. These increases were also recorded after the re-elimination phase. In the PNG, no significant change was seen in any of the variables, except pain (P < 0.05). During the study, important differences were observed for most of the variables between the two groups. Thirteen (72%) patients in the PPG and three (18%) in the PNG experienced disease exacerbation with challenges. This aggravation continued after elimination.

CONCLUSIONS

Our results suggest that individualized dietary revisions may regulate TNF-alpha and IL-1beta levels in selected patients with RA.

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  • Authors+Show Affiliations

    ,

    Department of Physical Medicine and Rehabilitation, Atatürk University, Erzurum, Turkey. skaratay73@hotmail.com

    , , , , , ,

    Source

    Rheumatology (Oxford, England) 43:11 2004 Nov pg 1429-33

    MeSH

    Adult
    Allergens
    Arthritis, Rheumatoid
    Diet
    Female
    Food Hypersensitivity
    Humans
    Interleukin-1
    Male
    Middle Aged
    Pain Measurement
    Severity of Illness Index
    Skin Tests
    Tumor Necrosis Factor-alpha

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    15304675

    Citation

    Karatay, S, et al. "The Effect of Individualized Diet Challenges Consisting of Allergenic Foods On TNF-alpha and IL-1beta Levels in Patients With Rheumatoid Arthritis." Rheumatology (Oxford, England), vol. 43, no. 11, 2004, pp. 1429-33.
    Karatay S, Erdem T, Yildirim K, et al. The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis. Rheumatology (Oxford). 2004;43(11):1429-33.
    Karatay, S., Erdem, T., Yildirim, K., Melikoglu, M. A., Ugur, M., Cakir, E., ... Senel, K. (2004). The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis. Rheumatology (Oxford, England), 43(11), pp. 1429-33.
    Karatay S, et al. The Effect of Individualized Diet Challenges Consisting of Allergenic Foods On TNF-alpha and IL-1beta Levels in Patients With Rheumatoid Arthritis. Rheumatology (Oxford). 2004;43(11):1429-33. PubMed PMID: 15304675.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis. AU - Karatay,S, AU - Erdem,T, AU - Yildirim,K, AU - Melikoglu,M A, AU - Ugur,M, AU - Cakir,E, AU - Akcay,F, AU - Senel,K, Y1 - 2004/08/10/ PY - 2004/8/12/pubmed PY - 2004/12/22/medline PY - 2004/8/12/entrez SP - 1429 EP - 33 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 43 IS - 11 N2 - OBJECTIVE: To investigate the effect of individualized diet challenges consisting of allergenic foods, defined by the skin prick test (SPT), on tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) levels in patients with rheumatoid arthritis (RA). METHODS: Twenty patients with a positive SPT response for food extracts and 20 with a negative SPT response were enrolled. None of the patients had active disease. All patients were fasted for the most common allergenic foods for 12 days and then allocated to two groups according to SPT results. Food challenges were performed with allergenic foods in the prick-positive group (PPG) and with corn and rice in the prick-negative group (PNG) for a period of 12 days. Then, allergenic foods were excluded from the PPG patients' diet and corn and rice were removed from the PNG patients' diet. Clinical examinations were performed after fasting (baseline), at the end of the challenge phase and at the end of the re-elimination phase. Stiffness, pain, tender and swollen joint counts, health assessment questionnaire (HAQ), Ritchie's articular index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum TNF-alpha and IL-1beta levels were measured. RESULTS: TNF-alpha (P < 0.01), IL-1beta (P < 0.05), ESR (P < 0.05) and CRP (P = 0.001) levels and all of the clinical variables, except HAQ, were increased with food challenges in the PPG. These increases were also recorded after the re-elimination phase. In the PNG, no significant change was seen in any of the variables, except pain (P < 0.05). During the study, important differences were observed for most of the variables between the two groups. Thirteen (72%) patients in the PPG and three (18%) in the PNG experienced disease exacerbation with challenges. This aggravation continued after elimination. CONCLUSIONS: Our results suggest that individualized dietary revisions may regulate TNF-alpha and IL-1beta levels in selected patients with RA. SN - 1462-0324 UR - https://www.unboundmedicine.com/medline/citation/15304675/full_citation L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/keh366 DB - PRIME DP - Unbound Medicine ER -