Aluminium per se and in the anti-acid drug sucralfate promotes sensitization via the oral route

TY - JOUR

T1 - Aluminium per se and in the anti-acid drug sucralfate promotes sensitization via the oral route

AU - Brunner, R

AU - Wallmann, J

AU - Szalai, K

AU - Karagiannis, P

AU - Altmeppen, H

AU - Riemer, A B

AU - Jensen-Jarolim, E

AU - Pali-Schöll, I

PY - 2009/6

Y1 - 2009/6

N2 - BACKGROUND: Aluminium (ALUM) is used as experimental and clinical adjuvant for parenteral vaccine formulation. It is also contained in anti-acid drugs like sucralfate (SUC). These anti-acids have been shown to cause sensitization to food proteins via elevation of the gastric pH. The aim of this study was to assess the oral adjuvant properties of ALUM, alone or contained in SUC, in a BALB/c mouse model.METHODS: Mice were fed SUC plus ovalbumin (OVA) and compared with groups where ALUM or proton pump inhibitors (PPI) were applied as adjuvants. The humoral and cellular immune responses were assessed on antigen-specific antibody and cytokine levels. The in vivo relevance was investigated in skin tests.RESULTS: The highest OVA-specific immunoglobulin G1 (IgG1) and IgE antibody levels were found in mice fed with OVA/SUC, followed by OVA/ALUM-treated animals, indicating a T helper 2 (Th2) shift in both groups. Antibody levels in other groups revealed lower (OVA/PPI-group) or baseline levels (control groups). Positive skin tests confirmed an allergic response in anti-acid or adjuvant-treated animals.CONCLUSIONS: Our data show for the first time that ALUM acts as a Th2-adjuvant via the oral route. This suggests that orally applied SUC leads to an enhanced risk for food allergy, not only by inhibiting peptic digestion but also by acting as a Th2-adjuvant by its ALUM content.

AB - BACKGROUND: Aluminium (ALUM) is used as experimental and clinical adjuvant for parenteral vaccine formulation. It is also contained in anti-acid drugs like sucralfate (SUC). These anti-acids have been shown to cause sensitization to food proteins via elevation of the gastric pH. The aim of this study was to assess the oral adjuvant properties of ALUM, alone or contained in SUC, in a BALB/c mouse model.METHODS: Mice were fed SUC plus ovalbumin (OVA) and compared with groups where ALUM or proton pump inhibitors (PPI) were applied as adjuvants. The humoral and cellular immune responses were assessed on antigen-specific antibody and cytokine levels. The in vivo relevance was investigated in skin tests.RESULTS: The highest OVA-specific immunoglobulin G1 (IgG1) and IgE antibody levels were found in mice fed with OVA/SUC, followed by OVA/ALUM-treated animals, indicating a T helper 2 (Th2) shift in both groups. Antibody levels in other groups revealed lower (OVA/PPI-group) or baseline levels (control groups). Positive skin tests confirmed an allergic response in anti-acid or adjuvant-treated animals.CONCLUSIONS: Our data show for the first time that ALUM acts as a Th2-adjuvant via the oral route. This suggests that orally applied SUC leads to an enhanced risk for food allergy, not only by inhibiting peptic digestion but also by acting as a Th2-adjuvant by its ALUM content.

KW - Adjuvants, Immunologic/adverse effects

KW - Administration, Oral

KW - Alum Compounds/adverse effects

KW - Animals

KW - Antacids/adverse effects

KW - Female

KW - Food Hypersensitivity/etiology

KW - Gastric Acidity Determination

KW - Immunoglobulin E/blood

KW - Immunoglobulin G/blood

KW - Interferon-gamma/biosynthesis

KW - Interleukin-5/biosynthesis

KW - Mice

KW - Mice, Inbred BALB C

KW - Ovalbumin/immunology

KW - Skin Tests

KW - Sucralfate/adverse effects

KW - Th2 Cells/immunology

U2 - 10.1111/j.1398-9995.2008.01933.x

DO - 10.1111/j.1398-9995.2008.01933.x

M3 - SCORING: Journal article

C2 - 19210370

VL - 64

SP - 890

EP - 897

JO - ALLERGY

JF - ALLERGY

SN - 0105-4538

IS - 6

ER -