Reviewer's report
Title:IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case
control study in the general population
Version: 1Date:20 August 2012
Reviewer: Thierry PICHE
Reviewer's report:
This paper is a negative study showing no association between IBS symptoms
and IgG (4) against food. The topic is of interest since food intolerance seems to
play a role in the pathophysiology of IBS symptoms. Authors have chosen to
point out the role of late allergic phase using IgG against food.
The paper is well written and presented although there is some limitations that
need to be clarify:
Major points
The major point relates to the presentation of data that should be stratified
between IBS subtypes. In fact, taking IBS as a whole group includes the risk to
mask a putative association since the pathogenic role of allergic factors seems to
be more stringent in IBS patients with diarrhea predominance.
It is also important to better detail how was performed the diagnosis of IBS. Did
patients only answered to questionnaires at a time or IBS diagnosis was done
during a medical visit in the past ?
In this line, did patients had colonoscopy with histologic analysis to exclude
microscopic colitis or colitis associated with mucosal mast cell/eosinophils
increased numbers ?
The frequency of atopy and allergic rhinitis was slightly higher in IBS patients,
confirming the importance to separate between IBS subtypes and to test the
analysis also in patients having allergic symptoms.
Minor points
The possibility of cross reactivity between other major antigens coming from diet
but also inhalants should be briefly added in the discussion section.
The hypothesis of using IgG4 against food as IBS predictors needs to be
softened because of the complexity of various allergic responses/phases except
IgG4 and also cross reactivity between multiple antigens that are both possibly
involved in the pathophysiology of IBS. Therefore data in table 2 are not
surprising and should be limited in the manuscript only.
Details concerning medications (histamine antagonist, mast cell stabilizers), IBS
duration, origin of IBS (post-infective?), exclusion of celiac disease should be
given.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
i declare that i have no competing interests
Reviewer's report
Title:IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case
control study in the general population
Version: 1Date:20 August 2012
Reviewer: Thierry PICHE
Reviewer's report:
This paper is a negative study showing no association between IBS symptoms
and IgG (4) against food. The topic is of interest since food intolerance seems to
play a role in the pathophysiology of IBS symptoms. Authors have chosen to
point out the role of late allergic phase using IgG against food.
The paper is well written and presented although there is some limitations that
need to be clarify:
Major points
The major point relates to the presentation of data that should be stratified
between IBS subtypes. In fact, taking IBS as a whole group includes the risk to
mask a putative association since the pathogenic role of allergic factors seems to
be more stringent in IBS patients with diarrhea predominance.
It is also important to better detail how was performed the diagnosis of IBS. Did
patients only answered to questionnaires at a time or IBS diagnosis was done
during a medical visit in the past ?
In this line, did patients had colonoscopy with histologic analysis to exclude
microscopic colitis or colitis associated with mucosal mast cell/eosinophils
increased numbers ?
The frequency of atopy and allergic rhinitis was slightly higher in IBS patients,
confirming the importance to separate between IBS subtypes and to test the
analysis also in patients having allergic symptoms.
Minor points
The possibility of cross reactivity between other major antigens coming from diet
but also inhalants should be briefly added in the discussion section.
The hypothesis of using IgG4 against food as IBS predictors needs to be
softened because of the complexity of various allergic responses/phases except
IgG4 and also cross reactivity between multiple antigens that are both possibly
involved in the pathophysiology of IBS. Therefore data in table 2 are not
surprising and should be limited in the manuscript only.
Details concerning medications (histamine antagonist, mast cell stabilizers), IBS
duration, origin of IBS (post-infective?), exclusion of celiac disease should be
given.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
i declare that i have no competing interests
Please review this paper.
user
Reviewer's report
Title:IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case
control study in the general population
Version: 1Date:20 August 2012
Reviewer: Thierry PICHE
Reviewer's report:
This paper is a negative study showing no association between IBS symptoms
and IgG (4) against food. The topic is of interest since food intolerance seems to
play a role in the pathophysiology of IBS symptoms. Authors have chosen to
point out the role of late allergic phase using IgG against food.
The paper is well written and presented although there is some limitations that
need to be clarify:
Major points
The major point relates to the presentation of data that should be stratified
between IBS subtypes. In fact, taking IBS as a whole group includes the risk to
mask a putative association since the pathogenic role of allergic factors seems to
be more stringent in IBS patients with diarrhea predominance.
It is also important to better detail how was performed the diagnosis of IBS. Did
patients only answered to questionnaires at a time or IBS diagnosis was done
during a medical visit in the past ?
In this line, did patients had colonoscopy with histologic analysis to exclude
microscopic colitis or colitis associated with mucosal mast cell/eosinophils
increased numbers ?
The frequency of atopy and allergic rhinitis was slightly higher in IBS patients,
confirming the importance to separate between IBS subtypes and to test the
analysis also in patients having allergic symptoms.
Minor points
The possibility of cross reactivity between other major antigens coming from diet
but also inhalants should be briefly added in the discussion section.
The hypothesis of using IgG4 against food as IBS predictors needs to be
softened because of the complexity of various allergic responses/phases except
IgG4 and also cross reactivity between multiple antigens that are both possibly
involved in the pathophysiology of IBS. Therefore data in table 2 are not
surprising and should be limited in the manuscript only.
Details concerning medications (histamine antagonist, mast cell stabilizers), IBS
duration, origin of IBS (post-infective?), exclusion of celiac disease should be
given.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
i declare that i have no competing interests
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