To be honest, I possibly had the worst immunology professor ever. She was inattentive, always late, and made us memorize the intricacies of the immune system and then regurgitate them for multiple choice exams. I was 20, I didn’t care. No one did and no one generally does until something goes haywire with their immune system then they become acutely aware of its importance. As students we just wanted an A because it was a weeder class for Med School. Now that I no longer need to impress any one with letters and numbers on my transcript I don’t care about knowledge. I care about real understanding, subsequent action, and being able to explain complex topics simply. You may not care for all the big words that revolve around immunology but I hope by the end of this article you have a respect for how complicated and essential this system is to your everyday life.

In order for us to have an insightful discussion about chronic infections, autoimmunity, and food immunoreactivity we have to have a basic understanding of how this whole thing works. This can be tough as the immune system has all these branch thingies, lots of different cell types, and tons of fancy words like Cytotoxic Killer T Cells and Interleukin-1. This protective and potential destructive system is stupid but at the same time incredibly intelligent. Recently there has been a lot of yelling on the internet about the immune system as it relates to food and I feel that many people are quite confused about this subject. Thus, I want you to be able to discern what part of that conversation is just noise and what part is legitimate.

To get started we have two types of immunity

The Innate Immune System or Non-Specific Immune System – this branch provides immediate defense against an infection. The innate immune system includes cell like Natural Killer Cells, Mast Cells, Macrophages, and Dendritic Cells.

The Adaptive or Specific Immune System – this branch is much more sophisticated and highly specific. This system itself also has two branches cell mediated and humoral immunity. The adaptive immune system is made up of B and T lymphocytes.

Sooo many words…let’s watch a Moooooovie or two.

Immune System Overview

Adaptive Immunity Overview

Now that we have some understanding of Immunology under our belts we can get to the meat of what my clients tend to care about – immunoreactivities to  common foods and how this can be a trigger for autoimmunity or one’s own immune system seeing self-tissue as a pathogen. This is a very big deal as it is estimated that over 50 million Americans suffer from some kind autoimmunity (comparatively, heart disease “only” affects upwards of 22 million Americans) and the occurrence of autoimmunity is growing exponentially. It is now believed that around 30% of autoimmunity is due to genetic predisposition. But, this means that 70% of autoimmune cases are potentially caused by environmental and lifestyle triggers, the main culprits being intestinal permeability, infections, and chemical exposures.

“Bacterial toxins, chemicals, foods, and undigested proteins and peptides can induce systemic food immune reactivity by causing failure of immune tolerance. Immune tolerance is the immune system’s ability to recognize what is harmful and what is not. If immune tolerance is lost, then inflammation ensues and autoimmunity can occur.”
Andrew Campbell MD

The digestive system sees over 1 ton of food each year and contains north of 70% of our immune cells. Your GI tract also has more contact with the outside world than your skin and this mucosal lining is constantly being exposed to potential antigens. The reason our body does not wreck shop on all this food stuff all the time is because of oral tolerance which occurs through the deletion or immunosuppression of reactive immune cells.

Thus, reacting to common food items is not normal and may be due to impaired immunological development (which is outside the scope of this post and revolves around the hygiene hypothesis, maternal diet, how one was born, breast feeding, and the infant gut microbiota) or an immune system that is out of balance (cough low vitamin D) and over stimulated (SAD). Thus, if you were a bottle-fed c-section baby who took anti-biotics all through childhood you are going to be at much more at risk for losing oral tolerance. I have seen these patients food panels and they light up like a Christmas Tree, it sucks. Also, if you are frazzeled, consuming copious amounts of alcohol and caffeine, never outside, drinking scandalous water, don’t sleep, and are crashing face first into the Standard American Diet (SAD) of inflammatory processed foods that the human body has never seen before you are going to be pushing your luck as well.

Enter intestinal permeability which as Dr. Rakowski says, “In our current environment we are all leaky, it is just a matter of how much.” Intestinal permeability or leaky gut is induced by dysbiosis, gut pathogens, NSAIDS, chronic exercise, traumatic brain injury, stress, and basically any other inflammatory reaction in the GI tract.

The figure above is from Dr. Aristo Vojdani one of the leaders, if not the leader in food immunoreactivity. There is a lot going on above, but we can use our new found understanding of immunology and begin to grasp how this all works. An Antigen Presenting Cell (APC) (these cells are constantly sampling everything in the digestive tract) encounters a peptide which is bigger than it ought to be, maybe this is gliadin (a component of gluten) which our body doesn’t have the machinery to digest very well, it then presents this antigen to the T-Helper Cell which can induce cell-mediated immunity (a Th-1 response) which will create a fight in the guts and thus inflammation and more leakiness. T-Helper Cells can also induce humoral-mediated immunity (a Th-2 response) which will result in the activation and proliferation of B cells into plasma cells which will produce antibodies against this specific protein (this is what we are investigating with Cyrex immunoreactivity testing). Ala our immune system has tagged this peptide for destruction and will now also remember this protein/antigen and react to it faster and more aggressively the next time it comes down the chute.

The hook is that what happens in the gut doesn’t stay in the gut and these food particles can look a lot like our own tissues. Just one example of this is that gluten looks a lot like the tissue of the cerebellum and can result in the immune system seeing that part of your brain as foreign and then you can be left literally stumbling around with something called cerebellar ataxia all because you really liked bagels. Gluten is also implicated in many cases of Hashimoto’s which is autoimmunity to the thyroid gland. Hashimoto’s is the most prevalent autoimmune condition with an estimated 20 million Americans having some form of thyroid disease and 80-90% of those being Hashimoto’s cases.

Whew, that is definitely enough for one day but if this piqued your interest I would implore you to watch more videos and read more on this subject as it is a relatively new frontier and we as a scientific community by no means have this all figured out yet. But, now that we have the foundation laid I will write further posts on what we can do, as well as the differences between food allergies and immunoreactivities so that you can be the most knowledgeable one at the dinner table. Then when people start chattering about how they can’t eat this or that you can chose to speak or not, but at least you will be able to identify when someone is just spewing non-sense in-between bites of spaghetti.

If you just can’t wait for more information on this topic, Chris Kresser has a fantastic and detailed discussion here.

“Today’s clinician is faced with patients whose initial symptoms are vague and nonspecific, such as fatigue, joint aches and pains, sleep disturbance, brain fogginess, wide mood swings, cognitive function problems, changes in bowel habits, numbness and tingling, and a general feeling of malaise. There is good news in all this: There are laboratory analyses that can detect these antibodies early, years before the reactions with the immune system appear that cause the irreversible and chronic damages that lead to autoimmunity.”
– Dr. Andrew Campbell

Be Well!

Ben

References:

1.           The Gut is Not Like Las Vegas 2014, Alessio Fasano
2.            Bennett B, Galland, Hedaya, Houston, Rountree, Vasquez, Baker, Hyman. Textbook of Functional Medicine 2010.
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4.            Vojdani A. For the assessment of intestinal permeability, size matters. Alternative therapies in health and medicine. Jan-Feb 2013;19(1):12-24.
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