Anti-acid drug sucralfate may increase risk for food allergy

Aluminium (ALUM) is used as experimental and clinical adjuvant for parenteral vaccine formulation. It is also contained in anti-acid drugs like sucralfate (SUC).

Chemical structure of sucralfate. Source: Wikipedia, public domain.

Sucralfate is an oral gastrointestinal medication primarily used for control of heartburn symptoms. It is a sucrose sulfate-aluminium complex that binds to the hydrochloric acid in the stomach and acts like an acid buffer with cytoprotective properties. Sucralfate was approved by the Food and Drug Administration (FDA) in 1981.

Sucralfate is a locally acting substance that in an acidic environment (pH lower than 4), reacts with hydrochloric acid in the stomach to form a cross-linking, viscous, paste-like material capable of acting as an acid buffer for as long as 6 to 8 hours after a single dose.

The aim of this study was to assess the oral adjuvant properties of ALUM in a mouse model.

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. Positive skin tests confirmed an allergic response.

The authors concluded 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.

Aluminium per se and in the anti-acid drug sucralfate promotes sensitization via the oral route. Brunner R, Wallmann J, Szalai K, Karagiannis P, Altmeppen H, Riemer AB, Jensen-Jarolim E, Pali-Schöll I. Allergy. 2009 Feb 5.

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