Untersmayr Eva, Jensen-Jarolim Erika
Center of Physiology and Pathophysiology, Medical University Vienna, Vienna, Austria.
Curr Opin Allergy Clin Immunol. 2006 Jun;6(3):214-9. doi: 10.1097/01.all.0000225163.06016.93.
The role of the stomach as the primary location of protein digestion is very well recognized, leading to classification of proteins as digestion-resistant or digestion-labile. This review analyses the role of gastric digestion in food allergy.
Hindrance of gastric digestion by elevation of the gastric pH, the therapeutic goal of anti-ulcer medication, was recently shown to trigger food allergy via oral sensitization in a murine food allergy model. The relevance in humans was assessed in an observational study of 152 gastroenterological patients who were medicated with anti-ulcer drugs due to dyspeptic disorders. Twenty-five percent of all patients developed a boost or de-novo IgE formation towards regular constituents of the daily diet. The clinical relevance of the induced antibodies was confirmed by positive skin and oral-provocation tests. Moreover, the importance of gastric digestion was also proven for food-allergic patients, as the allergenicity of allergens were reduced up to a 10,000-fold by gastric digestion.
These recent studies indicate for the first time the important gate-keeping function of gastric digestion, both in the sensitization and the effector phases of food allergy.
胃作为蛋白质消化的主要场所，其作用已得到充分认识，据此可将蛋白质分为抗消化型或易消化型。本综述分析了胃消化在食物过敏中的作用。
在小鼠食物过敏模型中，胃pH值升高（这是抗溃疡药物的治疗目标）会阻碍胃消化，进而通过口服致敏引发食物过敏。在一项针对152名因消化不良而服用抗溃疡药物的胃肠病患者的观察性研究中评估了其在人类中的相关性。所有患者中有25%对日常饮食中的常规成分产生了IgE升高或新发形成。皮肤和口服激发试验阳性证实了诱导抗体的临床相关性。此外，胃消化对食物过敏患者也很重要，因为胃消化可使过敏原的致敏性降低多达10000倍。
这些最新研究首次表明胃消化在食物过敏的致敏和效应阶段均具有重要的把关功能。
