Antacids and dietary supplements with an influence on the gastric pH increase the risk for food sensitization

TY - JOUR

T1 - Antacids and dietary supplements with an influence on the gastric pH increase the risk for food sensitization

AU - Pali-Schöll, I

AU - Herzog, R

AU - Wallmann, J

AU - Szalai, K

AU - Brunner, R

AU - Lukschal, A

AU - Karagiannis, P

AU - Diesner, S C

AU - Jensen-Jarolim, E

PY - 2010/7

Y1 - 2010/7

N2 - BACKGROUND: Elevation of the gastric pH increases the risk for sensitization against food allergens by hindering protein breakdown. This can be caused by acid-suppressing medication like sucralphate, H2-receptor blockers and proton pump inhibitors, as shown in recent murine experimental and human observational studies.OBJECTIVE: The aim of the present study was to assess the sensitization capacity of the dietary supplement base powder and of over-the-counter antacids.METHODS: Changes of the pH as well as of protein digestion due to base powder or antacids were measured in vitro. To examine the in vivo influence, BALB/c mice were fed codfish extract with one of the acid-suppressing substances. Read-out of antibody levels in the sera, of cytokine levels of stimulated splenocytes and of intradermal skin tests was performed.RESULTS: The pH of hydrochloric acid was substantially increased in vitro by base powder as well as antacids in a time- and dose-dependent manner. This elevation hindered the digestion of codfish proteins in vitro. A significant increase in codfish-specific IgE antibodies was found in the groups fed codfish combined with Rennie Antacidum or with base powder; the latter also showed significantly elevated IgG1 and IgG2a levels. The induction of an anaphylactic immune response was proven by positive results in intradermal skin tests.CONCLUSIONS: Antacids and dietary supplements influencing the gastric pH increase the risk for sensitization against allergenic food proteins. As these substances are commonly used in the general population without consulting a physician, our data may have a major practical and clinical impact.

AB - BACKGROUND: Elevation of the gastric pH increases the risk for sensitization against food allergens by hindering protein breakdown. This can be caused by acid-suppressing medication like sucralphate, H2-receptor blockers and proton pump inhibitors, as shown in recent murine experimental and human observational studies.OBJECTIVE: The aim of the present study was to assess the sensitization capacity of the dietary supplement base powder and of over-the-counter antacids.METHODS: Changes of the pH as well as of protein digestion due to base powder or antacids were measured in vitro. To examine the in vivo influence, BALB/c mice were fed codfish extract with one of the acid-suppressing substances. Read-out of antibody levels in the sera, of cytokine levels of stimulated splenocytes and of intradermal skin tests was performed.RESULTS: The pH of hydrochloric acid was substantially increased in vitro by base powder as well as antacids in a time- and dose-dependent manner. This elevation hindered the digestion of codfish proteins in vitro. A significant increase in codfish-specific IgE antibodies was found in the groups fed codfish combined with Rennie Antacidum or with base powder; the latter also showed significantly elevated IgG1 and IgG2a levels. The induction of an anaphylactic immune response was proven by positive results in intradermal skin tests.CONCLUSIONS: Antacids and dietary supplements influencing the gastric pH increase the risk for sensitization against allergenic food proteins. As these substances are commonly used in the general population without consulting a physician, our data may have a major practical and clinical impact.

KW - Allergens/immunology

KW - Animals

KW - Antacids/adverse effects

KW - Dietary Supplements/adverse effects

KW - Dose-Response Relationship, Drug

KW - Enzyme-Linked Immunosorbent Assay

KW - Female

KW - Fish Proteins/immunology

KW - Food Hypersensitivity/complications

KW - Humans

KW - Hydrogen-Ion Concentration

KW - Mice

KW - Nonprescription Drugs/adverse effects

KW - Stomach Ulcer/complications

U2 - 10.1111/j.1365-2222.2010.03468.x

DO - 10.1111/j.1365-2222.2010.03468.x

M3 - SCORING: Journal article

C2 - 20214670

VL - 40

SP - 1091

EP - 1098

JO - CLIN EXP ALLERGY

JF - CLIN EXP ALLERGY

SN - 0954-7894

IS - 7

ER -