title: Susceptibility of a grass-pollen oral immunotherapy extract to the saliva and gastric fluid digestive process.
abstract: The oral and sublingual immunotherapy is still a controversial therapeutic procedure. One of the problems is knowing how much allergenic activity could the extracts loss due to the digestive process into the mouth and stomach. Using a grass-pollen oral and sublingual immunotherapy extract, we studied its degradation until reaching the small intestine. For this purpose we employed an in vitro model using the RAST-inhibition assay. We observed a 3.8 fold loss of allergenic activity after a 30 sec-incubation with saliva; a subsequent 5 min-incubation with gastric fluid got a final loss of allergenic activity of 10.3 fold. The incubation times were those expected occurring during the ingestion of the extract. It was surprising that after the enzymatic and acid actions of the gastric fluid, an important degree of allergenic activity still remained in the extract. This issue should be taken into account when considering the dose to be administered in oral and sublingual immunotherapy.
authors.affiliation: Clínica Alergoasma, Salamanca, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Igea
authors.forename: M
authors.initials: M
authors.lastname: Cuevas
authors.forename: M
authors.initials: M
authors.lastname: Lázaro
authors.forename: S
authors.initials: S
authors.lastname: Quirce
authors.forename: J
authors.initials: J
authors.lastname: Cuesta
mesh_terms: D000284:Administration, Oral; D000286:Administration, Sublingual; D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology / Q000378:metabolism*; D003888:Desensitization, Immunologic; D005750:Gastric Juice / Q000378:metabolism*; D006801:Humans; D010936:Plant Extracts / Q000008:administration & dosage / Q000276:immunology / Q000378:metabolism* / Q000493:pharmacokinetics; D010940:Plant Proteins / Q000276:immunology / Q000378:metabolism; D006109:Poaceae; D011058:Pollen / Q000276:immunology*; D011489:Protein Denaturation; D011852:Radioallergosorbent Test; D012463:Saliva / Q000378:metabolism*
chemical_list: D000485:Allergens; D010936:Plant Extracts; D010940:Plant Proteins