Anti-acid medications may be a risk factor for food allergy

An important feature for oral allergens is their digestion-resistance during gastrointestinal (GI) transit.

Gastric acid levels determine the activation of gastric enzyme pepsin and also the release of pancreatic enzymes.

Some effect of the anti-acid medications related to food allergy include the following:

- When anti-ulcer drugs neutralize gastric acid, they allow persistence of intact food allergens (and protein-bound drugs) to elicit allergic reactions

- Anti-ulcer drugs containing aluminum compounds act as Th2 adjuvants

- Proton pump inhibitors (PPI) act on expression of the morphogen "Sonic hedgehog", which has been related to the development of atrophic gastritis. Atrophic gastritis and hypoacidity are correlated with enhanced sensitization food allergens in elderly patients

Impairment of gastric function is a documented risk factor for sensitization against oral proteins in food allergy and drugs.

Pali-Schöll I, Jensen-Jarolim E. Anti-acid medication as a risk factor for food allergy. Allergy 2010; DOI: 10.1111/j.1398-9995.2010.02511.x.
Image source: Omeprazole (brand names include Losec, Prilosec, Zegerid), Wikipedia, public domain.

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