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International Medical Scientific Journal      Issue-2 

10.5281/zenodo.5140474 

51 

    



Art of Medicine          Volume-1 

International Medical Scientific Journal      Issue-2 

10.5281/zenodo.5140474 

52 

 

Art of Medicine International Medical Scientific journal 

 

Founder and Publisher Pascual Izquierdo-Egea 

Published science may 2021 year. Issued Quarterly. 

Internet address: http://artofmedicineimsj.us 
E-mail: info@artofmedicineimsj.us 

11931 Barlow Pl Philadelphia, PA 19116, USA +1 (929) 266-0862 

 

 
 
  



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DIAGNOSTIC ROLE OF IMMUNOLOGICAL AND BIOCHEMICAL 

PARAMETERS IN THE GASTROINTESTINAL FOOD ALLERGY IN 

CHILDREN 

1
 Ganieva Shakhzoda Shavkatovna – assistant of the Pediatrics department of 

Bukhara state medical institute 

 
2 
Juraeva Firuza Rakhmatovna - assistant of the Pediatrics department of Bukhara 

state medical institute,  

3
Hamdamova Gulhayo Rakhmatovna - assistant of the Internal medicine department 

of Bukhara state medical institute 

 

Abstract.  

Studies have shown that the gastrointestinal form of food allergy in children is 

often combined with diseases of the gastrointestinal tract associated with 

Helicobacter pylori infection. The aim of the study was to study the relationship 

between the immunological and biochemical parameters of blood and saliva in the 

gastrointestinal form of food allergy in children, depending on the Helicobacter 

pylori infection. To study the effect of concomitant pathology on the course of food 

allergy and non-invasive diagnostic methods, 63 patients from 3 to 10 years of age 

with gastrointestinal allergy were examined. For early non-invasive diagnosis and 

differentiation of gastrointestinal allergy in children, depending on the Helicobacter 

pylori infection, it is advisable to determine the concentration of IgE in saliva and 

diastasis in urine. The authors conducted a study of immunological and biochemical 

parameters in biological media in the gastrointestinal form of food allergy in children. 

The study proved an increase in the concentration of IL-8, TNF-α, IgE and a decrease 

in sIgA in saliva in patients with gastrointestinal allergy, regardless of the association 

with Helicobacter pylori; it was proved that the quantitative insufficiency of CD8+ T 

cells in Helicobacter pylori-associated gastrointestinal allergy is an informative factor 

in the development of chronic diseases of the gastrointestinal tract with a high risk of 



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developing an autoimmune mechanism. It was also revealed that IgE in saliva and 

urine diastasis are informative indicators of early and non-invasive diagnosis, 

differentiation of gastrointestinal allergy in children, depending on the infection with 

Helicobacter pylori. In patients with Helicobacter pylori-associated gastrointestinal 

allergy, a strong positive relationship of Helicobacter pylori infection with saliva IgE 

and urine diastasis was established, which was not typical for gastrointestinal 

allergies without Helicobacter pylori infection.   

Keywords: Allergy, Helicobacter pylori, gastrointestinal food allergy, 

correlation, children, non-invasive diagnosis, saliva 

 

 

Introduction 

Food allergy (FA) is characterized by polymorphism of clinical manifestations 

and complex immunological mechanisms. It has a high and uneven prevalence in 

various regions of the world, due to specific dietary traditions and the peculiar impact 

of environmental factors on the child's body [1].  

Recent scientific works prove the importance of the microbiocenosis of the 

gastrointestinal tract (GIT) in the process of allergy formation, that the prevalence of 

Helicobacter pylori infection significantly differed between children with and without 

allergies, and also revealed the role of the interaction of genetic (family history of 

allergies) and environmental (type of birth, breastfeeding, previous antibacterial 

therapy) factors in the development of allergies [2, 3, 4].  

In recent years, many studies have been conducted indicating that specific 

microorganisms can cause diseases even away from the main focus of infection, 

which also proves the importance of Helicobacter pylori in various extra-gastric 

diseases [5].  

Sang Pyo Lee's research has shown that Helicobacter pylori infection has a 

pathogenetic link to allergic diseases. Helicobacter pylori can provoke the release of 



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histamine from basophils and, apparently, also suppresses the allergic reaction of the 

immune response through T-helper cells [6].  

In children with allergic pathology, due to the atopic tendency of the immune 

response, the synthesis of IgE-antibodies to Helicobacter pylori is increased, which is 

manifested by their increased level and high frequency of detection with an 

exacerbation of the allergic process against the background of a decrease in the level 

of IgE - antibodies. The production of IgE-antibodies to Helicobacter pylori is a kind 

of protective reaction of the body in conditions of chronic infection of the mucous 

membranes. The protective effect of IgE-antibodies to Helicobacter pylori is also 

confirmed by their detection in insignificant concentrations, but with a high 

frequency of cases in the sera of practically healthy children. The presence of these 

antibodies indicates a predisposition to the Th2 response, which is characteristic of 

mucosal immunity, which provides asymptomatic persistence of the microorganism 

in the gastrointestinal tract [7].  

Children differ from adults regarding Helicobacter pylori infection in many 

aspects. Helicobacter pylori causes some extra-intestinal diseases along with 

gastrointestinal diseases. Although among these diseases in children, symptoms such 

as recurrent abdominal pain are not specific. A reliable way to detect Helicobacter 

pylori is a crucial issue that is still being actively discussed. The tests used to 

diagnose infection are grouped into invasive and non-invasive methods. Non-invasive 

tests include a urea breath test, fecal antigen test, serological examination, and 

molecular diagnostic approaches. The use of the endoscopic method is a prerequisite 

for all invasive methods and creates difficulties in children, as it is a complex 

procedure and requires the participation of the patient. For this reason, non-invasive 

tests are widely used in children [8]. Taking into account the above, it can be 

confidently stated that at present, it is extremely difficult to conduct a differential 

diagnosis between non-IgE-mediated gastrointestinal allergies (GIA) and functional 

disorders of the gastrointestinal tract [9].  



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Although knowledge of the various characteristics of Helicobacter pylori 

infection has been expanded since its discovery, much remains to be done to better 

understand its underlying mechanisms. In addition, new diagnostic methods should 

be better understood in order to reduce health care costs and provide patients with 

less invasive diagnostic alternatives [10,11].  

The purpose of the study was to study the relationship of immunological and 

biochemical parameters of blood and saliva in the gastrointestinal form of FA in 

children, depending on Helicobacter pylori infection. 

Materials and methods of research. To study the effect of concomitant 

pathology on the course and prognosis of FA, 63 sick children from 3 to 10 years of 

age with GIA were examined, who were undergoing inpatient examination and 

treatment at the Bukhara Regional Children's Multidisciplinary Medical Center.  The 

patients were divided into 2 groups: 32 children with Helicobacter pylori-associated 

GIA and 31 children with GIA without Helicobacter pylori. All patients were 

examined for general, biochemical tests of blood (bilirubin, ALT, AST, urea, 

diastasis) and urine (general analysis of urine, diastasis in urine).  Antibodies to 

Helicobacter pylori in the blood were determined by ELISA (Human, Germany). 

Immunological studies were carried out by studying the indicators of humoral 

immunity (IgA, IgM, sIgA, IgE) and cytokines (IL-8, TNF-α) in peripheral blood 

serum and saliva by the ELISA method (Vector Best JSC, Russia), according to the 

attached instructions. 

Statistical analysis of the obtained results was carried out using the methods of 

variation statistics. The reliability of the differences in the mean values was estimated 

on the basis of the Student's test (t) with the calculation of the error probability (P) 

when checking the normality of the distribution and the equality of the general 

variances (F – Fisher's test).  The data was considered reliable under the condition 

that t ≥2, and P<0.05.  

The correlation analysis was performed using Spearman (Rs) and Pearson (r) 

methods. The relationship criteria were evaluated on the Cheddock scale: 0.1 < r < 



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0.3: weak; 0.3 < r < 0.5: moderate; 0.5 < r < 0.7: noticeable; 0.7 < r < 0.9: high; 0.9 < 

r < 1: very high;  

Results and discussion.  The study of the factors of humoral immunity of the 

blood in patients with GIA showed a characteristic imbalance in the composition of 

immunoglobulins in GIA, depending on the Helicobacter pylori infection (Table 1). 

 

Table 1. 

The concentration of immunoglobulins in children with food allergies 

Blood parameters Control group 

(n=30) 

GIA with 

Helicobacter 

pylori (n=32) 

GIA without 

Helicobacter 

pylori (n=31) 

Ig A (g/l) 3,1  0,5 8,8  1,2* 1,36±0,17* 

Ig M (g/l) 2,2  0,5 3,5 0,8 1,91±0,19 

Ig G (g/l) 14,8  1,0 21,51,0* 9,54±0,43* 

Ig E (IU/ml) 22,0  1,2 25,01,1 88,67±4,84*** 

Note: * - differences relative to the control group data are significant  

(* - P<0,05, ** - P<0,01, *** - P<0,001) 

 

Analysis of the results of blood tests in patients with GIA associated with 

Helicobacter pylori showed a significant increase in the concentration of Ig A-8.8 ± 

1.2 g/l versus 3.1 ± 0.5 g/l in the control and IgG-21.5±1.0 g/l versus 14.8 ± 1.0 g/l in 

the control (P < 0.05).  

Comparative characteristics of the content of immunoglobulins in the blood of 

patients with GIA without association with Helicobacter pylori revealed opposite 

shifts in the ratio of the studied immunoglobulins. It was characterized by a 

significant decrease in the concentration of IgA to 1.36±0.17 g/l and IgG to 

9.54±0.43 g / l (P<0.05) compared with the data of the control group.   

The IgM concentration had an unreliable tendency to increase relative to the 

control in GIA associated with Helicobacter pylori and vice versa, in GIA without 



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association with Helicobacter pylori, it tended to decrease against the background of 

a significant increase in the level of Ig E-88.67±4.84 IU/ml versus-22.0 ± 1.2 IU/ml 

in the control.  

In the study, patients with GIA without association with Helicobacter pylori 

showed a significant 4-fold increase in Ig E-88.67±4.84 µl compared to the control 

parameters-22.0 ± 1.2 µl (P<0.001). 

The study of secretory immunity in patients with GIA showed a significant 

decrease in sIgA in both follow-up groups (Table 2). 

Table 2. 

The concentration of immunoglobulins and cytokines in the saliva of GIA in 

children 

Parameters of 

saliva 

Control group 

(n=30) 

GIA with 

Helicobacter 

pylori 

(n=32) 

GIA without 

Helicobacter 

pylori 

(n=31) 

Ig A mg% 1,1  0,04 0,3  0,02*** 0,6±0,04*** 

Ig E mg% 1,2  0,05 21,51,29*** 27,9±1,82*** 

IL-8 pg/ml 16,2  0,6 95,36,12*** 57,3±3,26*** 

TNF-α pg/ml 21,2  1,0 60,88,63** 41,6±3,2*** 

Note: * - differences relative to the control group data are significant  

(* - P<0,05, ** - P<0,01, *** - P<0,001) 

It was noted a significant decrease in sIgA 3.7 times (0,3 ± 0,02 mg%) with GIA 

associated with Helicobacter pylori and 1.83 times (0,6 ± 0.04 mg%) with GIA no 

Association with Helicobacter pylori against benchmarks and 1.1 ± 0.04 mg% 

(P<0.001).  

 The concentration of sIgE is increased as in GIA Association with Helicobacter 

pylori (up to 21.5 ± 1,29 mg%) , and in its absence (up to 27.9 ± 1.82  mg%) vs 

control - 1,2 ± 0,05 mg% (P<0.001). 



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In order to introduce non-invasive manipulations in the practice of pediatric 

allergy and improve the methods of non-invasive diagnosis of FA in children, 

cytokines in saliva were studied. The results showed a significant increase in the level 

of IL-8 and TNF-α in saliva in GIA in children, regardless of Helicobacter pylori 

infection.  

IL — 8 is known to be produced by monocytes, fibroblasts, and endothelial 

cells. It acts as a neutrophil activator, because it is a chemokine, i.e. an endogenous 

chemoattractant. It stimulates the directional movement of various types of white 

blood cells. IL-8, TNF-α, and other cytokines produced by macrophages during the 

early inducible response are pro-inflammatory cytokines. Their action completely 

determines the development of the inflammatory process that develops when the 

antigen is introduced into the macroorganism. The study showed an increase in IL-8 

by 5.8 times (95.3 ± 6.12 pg/ml) in GIA associated with Helicobacter pylori and by 

3.53 times (57.3 ± 3.26 pg/ml) in GIA without association with Helicobacter pylori in 

relation to the control - 16.2 ± 0.6 pg / ml. 

A significant increase in the concentration of TNF–α in saliva was found in 

patients with GIA, regardless of Helicobacter pylori infection. In GIA associated with 

Helicobacter pylori, TNF-α increases to 60.8±8.63 pg / ml, and in GIA without 

association with Helicobacter pylori to 41.6±3.2 pg/ml versus control - 21.2 ± 1.0 

pg/ml (P<0.01).  

Correlation analysis helps to predict the possible values of one indicator, 

knowing the value of the other, which is very important when performing non-

invasive diagnostic manipulations with high accuracy and significance.  

During the exacerbation of GIA in patients without Helicobacter pylori, the 

linear correlation coefficient showed a strong positive relationship between blood and 

saliva IgE (r=0.80) and an inverse strong relationship between saliva sIgA and blood 

IgE (r=-0.78)  

 



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Based on the results of the study, it can be stated that the increase in the 

concentration of IgE in both blood and saliva is accompanied by a decrease in the 

level of sIgA in saliva in children with GIA.  The established relationships between 

salivary and blood immunoglobulins allow early and accurate non-invasive diagnosis 

of GIA, which, due to the presence of a correlation, is sufficient to study IgE in 

saliva.  

It is known that IL-8 is a pro-inflammatory cytokine and plays a huge role in the 

innate immune system. IL-8 stimulates the secretion of histamine by basophils and is 

one of the stimulators of angiogenesis [4].  In our studies in patients with 

Helicobacter pylori unassociated GIA, an average positive relationship was found 

between saliva IL-8 and blood IgE (r=0.49), and between saliva IL-8 and saliva IgE 

(r=0.39). There is also an average negative feedback in the saliva of IL-8 with sIgA 

(r=-0.45). Consequently, in saliva, an increase in IgE is accompanied by an increase 

in IL-8 and a decrease in sIgA. 

 Studies on Helicobacter pylori infection in GIA showed a weak negative 

association of saliva IL-8 with blood Helicobacter pylori (r=-0.29).   

Of interest was the study of the relationship between blood Helicobacter pylori 

and other blood parameters in GIA.  In this respect, weak positive relationships were 

found between the content of Helicobacter pylori and white blood cells (r=0.27), and 

TNF-α of saliva (r=0.27). The average positive association of blood Helicobacter 

pylori with blood AST was also revealed (r=0.39). The average positive association 

of urine diastase with saliva sIgA (r=0.40) and negative association with saliva IgE 

(r=-0.50) was also revealed.  

It should be noted that there is a positive relationship between saliva and blood 

IgA (r=0.47), while saliva sIgA has a strong negative relationship with blood IgM 

(r=-0.59). 

The established pattern makes it possible to predict Helicobacter pylori infection 

by the level of diastasis in the urine, which proves the possibility of limiting non-

invasive diagnostics and reducing the financial costs of tests. 



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In studies in patients with Helicobacter pylori-associated GIA, a strong positive 

relationship was established between Helicobacter pylori infection and saliva 

silencing (P=0.83), blood IgE (P=0.71), and blood IdM (P=0.56), which was not 

typical for GIA without Helicobacter pylori infection. 

A characteristic moderate positive relationship of Helicobacter pylori in the blood 

with blood leukocytes (r = 0.28), blood eosinophils (r = 0.38) and with blood AST (r 

= 0.26) was also established in the presence of a moderate negative relationship with 

urine diastasis (r = - 0.26). 

In contrast to the correlations in Helicobacter pylori unassociated GIA, the 

association of GIA with Helicobacter pylori infection shows an average positive 

association of TNF-α saliva with IL-8 saliva (P=0.44) and a weak positive association 

of TNF-α saliva with IgA in the blood (P=0.20). Consequently, in studies on the 

correlation relationships of immuno-biochemical parameters, it was found that saliva 

immunoglobulin and urine diastasis are more informative indicators for the urgent 

and non-invasive diagnosis of GIA. 

Thus, for early non-invasive diagnosis and differentiation of GIA in children, 

depending on Helicobacter pylori infection, it is advisable to determine the 

concentration of salivator IgE and diastase in the urine. 

  



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