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

机译：抗酸剂和膳食补充剂会影响胃的pH值，增加食物过敏的风险

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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~RAntacidum or with base powder; the latter also showed significantly elevated IgGl 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.
机译：背景技术胃pH升高会通过阻碍蛋白质分解而增加对食物过敏原致敏的风险。如最近的鼠类实验和人类观察性研究中所示，这可能是由诸如舒舒尔特，H2受体阻滞剂和质子泵抑制剂等抑酸药物引起的。目的本研究的目的是评估膳食补充剂基质的敏化能力。方法：测定了由基础粉末或抗酸剂引起的pH值变化和蛋白质消化的变化。为了检查体内影响，给BALB / c小鼠喂鳕鱼提取物一种抑酸物质。进行血清中抗体水平，刺激的脾细胞的细胞因子水平和皮内皮肤测试的读出。结果碱粉和抗酸剂在时间和剂量上均显着提高了盐酸的pH值。这种升高阻碍了鳕鱼蛋白在体外的消化。在与Rennie〜RAntacidum或碱粉联合喂养的鳕鱼中，发现鳕鱼特异性IgE抗体显着增加。后者也显示出显着升高的IgG1和IgG2a水平。皮内皮肤试验的阳性结果证明了过敏性免疫反应的诱导。结论抗酸剂和膳食补充剂会影响胃的pH值，从而增加了对过敏性食物蛋白致敏的风险。由于这些物质通常在一般人群中使用而无需咨询医生，因此我们的数据可能会产生重大的实际和临床影响。

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