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Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients.

Abstract

Recently, we have demonstrated that anti-ulcer drugs, such as H2-receptor blockers and proton pump inhibitors, promote the development of immediate type food allergy toward digestion-labile proteins in mice. The aim of this study was to examine the allergological relevance of these findings in humans. In an observational cohort study, we screened 152 adult patients from a gastroenterological outpatient clinic with negative case histories for atopy or allergy, who were medicated with H2-receptor blockers or proton pump inhibitors for 3 months. IgE reactivities to food allergens before and after 3 months of anti-acid treatment were compared serologically. Ten percent of the patients showed a boost of preexisting IgE antibodies and 15% de novo IgE formation toward numerous digestion-labile dietary compounds, like milk, potato, celery, carrots, apple, orange, wheat, and rye flour. Thus, the relative risk to develop food-specific IgE after anti-acid therapy was 10.5 (95% confidence interval: 1.44-76.48). The long-term effect was evaluated 5 months after therapy. Food-specific IgE could still be measured in 6% of the patients, as well as significantly elevated serum concentrations of ST2, a Th2-specific marker. An unspecific boost during the pollen season could be excluded, as 50 untreated control patients revealed no changes in their IgE pattern. In line with our previous animal experiments, our data strongly suggest that anti-ulcer treatment primes the development of IgE toward dietary compounds in long-term acid-suppressed patients.

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  • Authors+Show Affiliations

    ,

    Center of Physiology and Pathophysiology, Medical University Vienna, Vienna, Austria.

    , , , , , , , , ,

    Source

    MeSH

    Adult
    Allergens
    Anti-Ulcer Agents
    Cohort Studies
    Diet
    Digestion
    Dyspepsia
    Food
    Food Hypersensitivity
    Histamine H2 Antagonists
    Humans
    Immunoglobulin E
    Interferon-gamma
    Interleukin-1 Receptor-Like 1 Protein
    Interleukin-13
    Interleukin-4
    Membrane Proteins
    Proton Pump Inhibitors
    Receptors, Cell Surface
    Risk Factors
    Skin Tests
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15671152

    Citation

    Untersmayr, Eva, et al. "Anti-ulcer Drugs Promote IgE Formation Toward Dietary Antigens in Adult Patients." FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology, vol. 19, no. 6, 2005, pp. 656-8.
    Untersmayr E, Bakos N, Schöll I, et al. Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients. FASEB J. 2005;19(6):656-8.
    Untersmayr, E., Bakos, N., Schöll, I., Kundi, M., Roth-Walter, F., Szalai, K., ... Jensen-Jarolim, E. (2005). Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients. FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology, 19(6), pp. 656-8.
    Untersmayr E, et al. Anti-ulcer Drugs Promote IgE Formation Toward Dietary Antigens in Adult Patients. FASEB J. 2005;19(6):656-8. PubMed PMID: 15671152.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients. AU - Untersmayr,Eva, AU - Bakos,Noémi, AU - Schöll,Isabella, AU - Kundi,Michael, AU - Roth-Walter,Franziska, AU - Szalai,Krisztina, AU - Riemer,Angelika B, AU - Ankersmit,Hendrik J, AU - Scheiner,Otto, AU - Boltz-Nitulescu,George, AU - Jensen-Jarolim,Erika, Y1 - 2005/01/25/ PY - 2005/1/27/pubmed PY - 2005/12/15/medline PY - 2005/1/27/entrez SP - 656 EP - 8 JF - FASEB journal : official publication of the Federation of American Societies for Experimental Biology JO - FASEB J. VL - 19 IS - 6 N2 - Recently, we have demonstrated that anti-ulcer drugs, such as H2-receptor blockers and proton pump inhibitors, promote the development of immediate type food allergy toward digestion-labile proteins in mice. The aim of this study was to examine the allergological relevance of these findings in humans. In an observational cohort study, we screened 152 adult patients from a gastroenterological outpatient clinic with negative case histories for atopy or allergy, who were medicated with H2-receptor blockers or proton pump inhibitors for 3 months. IgE reactivities to food allergens before and after 3 months of anti-acid treatment were compared serologically. Ten percent of the patients showed a boost of preexisting IgE antibodies and 15% de novo IgE formation toward numerous digestion-labile dietary compounds, like milk, potato, celery, carrots, apple, orange, wheat, and rye flour. Thus, the relative risk to develop food-specific IgE after anti-acid therapy was 10.5 (95% confidence interval: 1.44-76.48). The long-term effect was evaluated 5 months after therapy. Food-specific IgE could still be measured in 6% of the patients, as well as significantly elevated serum concentrations of ST2, a Th2-specific marker. An unspecific boost during the pollen season could be excluded, as 50 untreated control patients revealed no changes in their IgE pattern. In line with our previous animal experiments, our data strongly suggest that anti-ulcer treatment primes the development of IgE toward dietary compounds in long-term acid-suppressed patients. SN - 1530-6860 UR - https://www.unboundmedicine.com/medline/citation/15671152/full_citation L2 - http://www.fasebj.org/doi/full/10.1096/fj.04-3170fje?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -