Intestinal Barrier Function Test

Heal the Gut with state-of-the-art diagnostics.

  • Restore optimal health and prevent disease by restoring balance to the critical intestinal barrier.
  • Assess: integrity of the gut’s mucosal barrier; antigen penetration; dysbiosis; leaky gut; malabsorption; dietary protein sensitivity; secretory IgA production; intestinal permeability; crypt hyperplasia.
  • Measure antibody response to: Candida, aerobic and anaerobic bacteria, and dietary proteins.
  • Single sIgA and IgA+IgM to: Combined dietary proteins (Wheat/gliadin, corn, soy, cow’s milk, egg); aerobic bacteria (Escherichia coli and E. enterococcus); anaerobic bacteria (Bacteroides fragilis and Clostridium perfringens); Candida albicans yeast
  • Visit intestinalbarriertest.com for more information on this amazing panel.
  • Interpretation guidelines below.

Reed Davis on the Intestinal Barrier Panel – BH #304:

Take Gut Healing and Diagnostics to a Higher Level

A new generation of testing for intestinal permeability or “leaky gut” is available. This scientifically advanced assessment takes into consideration the individual patient’s immune system response to proteins and peptides (macromolecules) which, upon entry into the bloodstream, can challenge the immune system resulting in IgA and IgM antibody production against them. In healthy, normal intestinal immune conditions, antigens are passed through the lumen into circulation, and for many people this common event does not evoke an overreaction in the systemic response. However, for susceptible persons even this passage of antigens can erupt into the beginning of numerous health disorders, most notably cancers of the bowel and neurological-immune problems.

How do mucosal barriers function?

Mucosal barriers provide both mechanical and immunological protection to the internal body environment from external agents. A thick, healthy layer of mucus can successfully exclude external agents from entering the internal environment of the body and wash them out of the body with other eliminated materials. This is called the “mucosal exclusion principle.” The mucosal barrier also contains secretory antibodies, principally IgA and to a lesser extent IgM and IgG, that provide an immunological barrier to recognize, compartmentalize and process antigens (proteins) that it is presented with.

These secretory antibodies are formed within plasmacytes (immunocytes) and mature within lymphatic tissue. A healthy mucosal barrier contains an appropriate level of secretory antibodies, which readily recognize and process commonly encountered antigens from dietary proteins consumed and enteric yeasts and bacteria. With a healthy mucosal barrier, approximately two percent of encountered antigens penetrate into the general circulation.

When a healthy mucosal barrier is first challenged by an infectious agent, sIgA rises and elevations of specific antibodies may occur. At this point the antigen load is compartmentalized within the GI tract. As the infection begins to overwhelm the mucosal barrier defenses, the humoral immune system becomes more involved. As an infection overpowers the mucosal barrier defenses, at some point the tight junctions between the intestinal cells open up and antigen penetration into the general circulation increases resulting in an increase in allergy and inflammation. Also, if antibodies are elevated in each of the four compartments on the BH #304 (dietary proteins, yeasts, anaerobic bacteria, and aerobic bacteria) this would indicate leaky gut (increased permeability).

If no intervention occurs, eventually the mucosal immune response begins to weaken and can eventually shut down. As time goes on it loses its ability to recognize and process antigens properly. Ever increasing antigen penetration can eventually result in overstimulation of the humoral immune system leading to hyperimmune response and eventually humoral immune system burn out.

The Critical Role of the Intestinal Barrier

Optimal health is not possible without healthy intestinal mucosal barrier function. The mucosal barrier—the body’s first-line immune defense—refers to all of the mucous membranes that comprise the primary interface between the external environment and the internal environment of the body. This mucosal barrier lets beneficial things into general circulation and keeps harmful ones out.

To clarify this, an analogy can be made between the earth’s ozone layer and your body’s mucosal barriers. The ozone layer lets the right amount of sunlight through, sustaining life on earth; mucosal barriers allow nutrients through, sustaining health. The ozone layer prevents harmful radiation from getting through; the mucosal barriers prevent infectious agents and allergens from invading the body. But just as our planet has a damaged ozone layer, many patients have damaged mucosal barriers. Consequently, they are not protected from harmful substances such as parasites, viruses, and bacteria.

No disease or symptom needs to be present to warrant protecting the mucosal barrier of the intestines; keeping it healthy helps to keep us strong and disease-resistant. Strengthening the gut lining can relieve or prevent the impacts of asthma, arthritis, food allergies, ulcers, Crohn’s, ulcerative colitis, celiac disease, autoimmune diseases, alcoholism, chronic fatigue, joint pain, migraines, diarrhea, parasitic infections, dysbiosis, candidiasis, multiple sclerosis, and diabetes, all of which can have their origin in harmful substances penetrating through the intestinal wall.

Being on the front lines in defending the body, the mucosal layer/extrinsic barrier of the GI tract is exposed to a multitude of stressors, antigens, pathogens, imbalances of neurotransmitters, toxins, and more; this barrage often weakens or even degrades the protective barrier. What follows is a cascade beginning with the formation of immune complexes and inflammatory cytokine responses. These abnormal levels of regulatory cytokine production such as in IL-10 and TGF-beta lead to enhanced intestinal permeability in which the tight junctions in the intrinsic barrier open and allow the passage of dietary proteins and peptides into the blood stream. Commonly known as leaky gut, enhanced gut permeability is the precursor to autoimmune disorders such as Type I Diabetes, RA, Lupus, MS and autoimmune hypothyroidism. It is also the pathway to neurologic dysfunction associated with gluten intolerance, Celiac disease, Autism and ADHD.

Secretory IgA

Inflammation erodes the structures of the mucosal barrier. A structurally sound mucosal barrier is vital to preventing infection and illness—and not just because it acts as a border through which harmful substances are denied access. It is also a functional component of immunity. A healthy mucosal barrier contains adequate amounts of secretory antibodies, proteins released to neutralize foreign substances that have entered the body. These mucosal antibodies are known as immunoglobulins, with the most abundant being secretory immunoglobulin A, or secretory IgA (sIgA).

SIgA represents 75-90 percent of the mucosal antibodies produced in the mucous membranes by cells called immunocytes. All of these antibodies recognize and neutralize commonly encountered pathogens such as bacteria, fungi, parasites, viruses, and yeast. SIgA also recognizes and processes the proteins in foods. When sIgA levels are adequate, food proteins are efficiently processed and the potential for adverse reactions, including allergies, is reduced.

Hormones play an important role in the body’s production of sIgA. Elevated cortisol and low DHEA create a deficiency of sIgA. In addition to suppressing the immunocytes that produce sIgA, high cortisol/low DHEA causes a state of “fight-or-flight response.” In this state, the body behaves as if under threat; increasing demands for cortisol production while depriving hormone production down other pathways (see the BH #205 – Functional Adrenal Stress Profile). The longer the body remains in fight-or-flight under chronic stress, the longer it takes for the immunocytes to recover and stabilize secretory IgA production.

Test Result Interpretation

Below is an example of the BH #304 test report, showing the sliding graph with its three respective “zones” of reporting. Remember the rule: Reference ranges are just that, references; do not consider a result on the low or high end of the reference range to be ‘normal’. Watch for borderline results. The results are grouped into 4 “compartments” with a sIgA result. The 4 compartments are based on IgA + IgM antibody responses. These 2 antibodies are pooled because some patients do not produce IgA in detectable amounts so adding IgM helps in detection of antibody responses in these cases.

  • IgA – Critical role in mucosal immunity. More IgA is produced in mucosal linings than all other types of antibody combined.
  • IgM – Antibody produced by B cells. The largest antibody in the circulatory system. It is the first antibody to appear in response to initial exposure to antigen.

The four (pooled) compartments tested on the BH #304:

  • Aerobic Bacteria – Escherichia coli and Escherichia enterococcus
  • Anaerobic Bacteria – Bacteroides fragilis and Clostridium perfringens
  • Dietary Proteins – Wheat/gliadin, corn, soy, cow’s milk, egg
  • Yeast – Candida albicans

Reading the Results The immune system should have normal (reported as “equivocal”) recognition of these antigens and process them appropriately. Under chronic stress, this is rarely what the results will show.

  • If all results are elevated – the upper limit of the detectable range being >128 – it is an indication of severe loss of intestinal immune tolerance to all antigens present on a daily basis. This severe loss of immune tolerance may result in gut barrier dysfunction or leaky gut syndrome.
  • If all results are at the lowest detectable limit of the reference range (<4), then the mucosal barrier is totally shut down, regardless of the level of sIgA. This means that there is effectively no mucosal immune response to antigens that present and also indicates severe intestinal permeability AKA “leaky gut.”
  • High levels of antibodies against dietary proteins may indicate a mucosal immune dysregulation or a loss of tolerance to these antigens.
  • An overgrowth of either aerobic bacteria, or anaerobic bacteria, indicates an imbalanced gut flora. This condition may expose GALT (Gut-Associated Lymphoid Tissue) to many bacterial toxins resulting in dysregulation of the mucosal immune system.
  • High aerobic bacteria may be an indication of aerobic bacteria overgrowth and intestinal imbalance. High anaerobic bacteria may be an indication of anaerobic bacteria overgrowth due to intestinal imbalance.
  • Determining the levels and ratio of bacterial groups to each other helps assess digestive and absorptive function. The ratios of the levels of the aerobic and anaerobic bacteria should be about one to one. If these ratios are >2 or <0.5, then a dysbiotic condition exists. Specific infections should be ruled in or ruled out (see BH #401H). However, dysbiosis could have also resulted from a course of antibiotic therapy without proper efforts to recolonize the gut with healthy microflora/probiotics.
  • High levels of antibodies against yeast may indicate a Candida albicans overgrowth and possibly colonization of Candida in mucosal tissues.

Testing Recommendations

If you have not already run the BH #205 on this patient, do so at this time. The link between adrenal/hormone problems and gut issues is strong and must be diagnosed. The #401H and #101 should follow.

  • Diagnosing
    • In the event of abnormal results demonstrating compromised intestinal barrier function, start testing to determine underlying causes while also evaluating lifestyle and environmental factors.
    • Run BioHealth tests #401H, #230/234, #205, #101, and #290.
    • Run broad food allergy/sensitivity testing (especially with IgG antibodies).

The following graphic illustrates the profound implications on health with compromised mucosal immunity.

© Immunosciences Lab, Inc.

Being on the front lines in defending the body, the mucosal layer, the extrinsic barrier, of the GI tract is exposed to a multitude of stressors, antigens, pathogens, imbalances of neurotransmitters, toxins and medications, and sometimes this barrage can weaken and break down the protective barrier. What follows the loss of mucosal immune tolerance is a cascade beginning with the formation of immune complexes and inflammatory cytokine responses. These abnormal levels of regulatory cytokine production such as in IL-10 and TGF-beta lead to enhanced intestinal permeability in which the tight junctions in the intrinsic barrier open and allow the passage of dietary proteins and peptides into the blood stream.

Commonly known as leaky gut, enhanced gut permeability is the precursor to autoimmune disorders such as Type I Diabetes, RA, Lupus, MS and autoimmune hypothyroidism. It is also the pathway to neurologic dysfunction associated with gluten intolerance, Celiac disease, Autism and ADHD. The patented Intestinal Barrier Function Test not only provides a proper immune response assessment in regards to intestinal permeability, it also includes evaluation of factors important to the overall health of the intestinal tract. GI imbalance cannot be understood fully, in its diagnostic and therapeutic implications, without the coordination of the intestinal flora, their toxins (LPS) and dietary proteins. Use of the Intestinal Barrier Function Screen gives clinicians etiologically based analysis of intestinal integrity and its accurate ELISA methodology provides quantitative results which can be used in case management of intestinal-related health problems.

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