Alterations in the bowel flora are now believed to be contributing factors to many chronic diseases such as allergies, autoimmune and inflammatory disorders, or degenerative diseases.
A number of factors such as antibiotic use, stress, certain dietary components, can have a detrimental impact on the gut microflora. Overgrowth of pathogenic bacteria results in the production of toxic bacterial compounds (such as endotoxins) which are absorbed into the bloodstream and cause abnormal immune activation. Gut inflammation, that may result from food intolerances or allergies, leads to an increased permeability of the intestinal wall (“leaky gut”), facilitating the passage of bacterial compounds to the blood.
Intestinal dysbiosis is very often found in CFS patients, and may significantly contribute to the development of the disease.
For intestinal dysfunction assessment we offer the following assays:
- Faecal microbial analyses
- Stool analysis, digestive function
- Stool analysis, inflammatory markers
- IgA/IgM against intestinal bacteria
- Lactase deficiency assay
FAECAL MICROBIAL ANALYSIS (Code: FMA1, FMA2)
Background
The intestinal microflora can be considered as a postnatally acquired organ, composed of a large diversity of bacterial cells, that performs different functions for the host. The microflora plays a significant role in gut maturation, gut integrity, prevention of pathogenic and opportunistic bacterial colonization and modulates the immune system. It is also involved in vitamin synthesis, production of short chain fatty acids, metabolism of carcinogenic substances.
Although the intestinal flora is quite stable over time, a number of factors can disturb the normal balance leading to intestinal dysbiosis. The GI microflora can be altered by immune mechanisms of the host, redox state, adrenal function, intestinal PH, peristalsis, diet, aging, drugs, exogenous organisms, climate and emotional stress. Intestinal dybiosis is seen in a number of chronic diseases such as Crohn's disease, IBS, CFS and may be associated with atopy and developmental disorders such as autism and ADHD.
The FMA is an extended investigation of the microscopic gut flora of the lower intestinal tract. Microbes from a faecal sample are cultured and various species of faecal bacteria, both aerobes and anaerobes, as well as yeasts, are quantified. If these microbes are significantly outside normal reference ranges an imbalance of the intestinal ecosystem can be identified. FMA1 looks at aerobic and anaerobic bacteria, as well as yeast and fungi; FMA2 is a follow up test, it only looks at aerobic bacteria.
Method
Culture.
Result
Quantitative.
Sample requirement
Stool. The sample must be sent in our test kit. Contact us for further details and to order a test kit. Ship within 48 hours at 4°C.
Please download our FMA booklet for more information:
- FMA booklet Nederlandse versie
- FMA booklet version française
STOOL ANALYSIS, DIGESTIVE FUNCTION (Code: DIGS)
Background
DIGS assay will look for the presence of undigested muscle fibers, starch and fats in faecal samples, as an indicator of digestive process efficiency. The panel also includes a determination of chymotrypsin activity (chymotrypsin is a digestive protease produced by the pancreas).
Method
Microscopic examination and ELISA.
Result
Qualitative for muscle fibers, starch and fat (presence of undigested fibers, starch and fat is reported if applicable). For chymotrypsin, quantitative result expressed in µg/mL faeces (normal range: more than 6,4 µg/mL).
Sample requirement
Stool. Freeze within two hours at -20°C/-80°C.
STOOL ANALYSIS, INFLAMMATORY MARKERS (Code: INFS)
Background
INFS assay will detect and quantify secretory IgA and hemoglobin in a faecal sample. Secretory IgA is the major immunoglobulin produced by the intestinal mucosa. It prevents adhesion of micro-organisms to mucosal sites, and is also involved in activation of inflammatory reactions; high sIgA in stools is an indicator of imbalanced mucosal immunity. Presence of hemoglobin in stool is also an indication of damaged and inflammed gastro-intestinal mucosa, and is often observed in the context of intestinal disorders like Crohn's disease or ulcerative colitis.
Method
ELISA.
Result
Quantitative. Results expressed in µg IgA and hemoglobin per mL faeces. Normal ranges: 0-2 µg/mL for hemoglobin; 510-2040 µg/mL for IgA.
Sample requirement
Stool. Freeze within two hours at -20°C/-80°C.
BACTERIAL IMMUNOBILAN (Code: IMBA)
Background
The Immunobilan test is an antibody screening assay for antibodies (IgA and IgM) directed against antigens from intestinal pathogens. IgA are secreted from intestinal cells, IgM are produced by immune cells in the blood. In healthy individuals pathogenic bacteria are only found in low quantities in the gut, and antibody titers in the blood are very low. In case of bacterial overgrowth however, large quantities of IgA are produced and some IgA will be found in the bloodstream. In case of leaky gut, bacterial proteins may make their way to the bloodstream, and specific IgM will be produced. Therefore, high titers of IgM for intestinal bacteria is an indicator of increased intestinal permeability. All Immunobilan bacteria are strictly associated with the gut, with the exception of Klebsiella, which is also associated with respiratory and urinary tract infections.
Method
Indirect ELISA.
Result
Semi-quantitative. IgA and IgM levels are measured for seven different bacteria: Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Citrobacter koseri, Pseudomonas putida, Morganella morganii, Hafnia alvei. Results are reported as negative, low-positive or high positive for each bacteria tested. Normal range is "Negative".
Sample requirement
2 ml serum. Stable for 24 hours at ambient temperature,for one week at 4°C. For longer periods aliquot serum, freeze and ship at -20°C/-80°C.
LACTASE DEFICIENCY ASSAY (Code: LACT)
Background
Intolerance to lactose (dairy products) can lead to strong intestinal dysfunction. This relatively common condition (10-20% of the population in Northern Europe) has a genetic origin: a polymorphism in the gene coding for lactase, an enzyme responsible for the digestion of lactose (C/T-13910 polymorphism). In affected people, production of the enzyme declines during or shortly after childhood, resulting in lactose malabsorption. Undigested lactose sugars affect the development of gut microflora, leading to dysbiosis.
Method
Genotyping assay, using allele-specific PCR.
Result
Two copies (alleles) of the lactase gene are present in the genome. Each allele can be either T-type (normal, production of lactase), or C-type (abnormal, lactase deficiency). A patient can have three possible genotypes:
- T/T: normal expression of the enzyme, patients are lactose tolerant.
- C/T: only one functional copy, however this is sufficient for lactose metabolism, therefore these patients can be considered lactose tolerant.
- C/C: these patients are lactase deficient, their tolerance to lactose is limited.
Sample requirement
2 ml whole blood in anticoagulant tube (EDTA, heparin or citrate). Blood can be kept at ambient temperature but must reach our laboratory within 48 hours; otherwise freeze sample and ship at -20°C/-80°C.