Food specific IgG-based elimination diet decreased IL-6, TNF-α and CGRP and improved symptoms in adults with migraine

Zhiming Zhao¹Meimei Yang²Fujun Wan¹Baoli Ning¹Tao Song¹Jun Fu^1*Liming Zhang^1*

• ¹First Affiliated Hospital of Harbin Medical University, Harbin, China
• ²Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

Background: Food specific IgG antibodies have been proposed to be biomarkers to identify food that triggers inflammation response. We aimed to evaluate the effect of food specific IgG based elimination diet by assessing the changes in the symptoms of migraine and its comorbidities, inflammatory cytokines, neuropeptide and neurotransmitters and their correlation. Methods: This was a sham-controlled randomized trial. 98 migraine patients who had at least one positive food specific IgG antibody were randomly assigned to either the true diet group (IgG positive foods were excluded, n = 52) or sham diet group (alternative IgG negative foods were excluded, n = 46). At baseline and the end of 12 weeks, seven questionnaires were administered regarding the symptoms of migraine, gastrointestinal symptoms, anxiety, depression, and sleeping quality. 14 food specific IgG antibodies, IL-6, IL-10, TNF-α, 5-HT, CGRP and VIP in serum were assessed using enzyme-linked immunosorbent assays. Results: At the end of 12 weeks, the true diet group had a larger reduction in questionnaires of migraine (except for MSQ), gastrointestinal symptoms and poor sleeping as well as food specific positive IgG, IL-6, TNF-α and CGRP in serum. The difference in the change of "days with migraine in past 4 weeks" between sham and true diet groups was significantly attenuated after adjusting IL-6 and TNF-α. Conclusion: IgG positive food elimination diet improved migraine and its comorbidities and reduced IL-6, TNF-α and CGRP, which might be associated with the alleviated systemic chronic inflammation and downregulation of the sensitivity of trigeminal nerve endings.