Antacids and dietary supplements with an influence on the gastric pH increase the risk for food sensitization.

BACKGROUND: Elevation of the gastric pH increases the risk for sensitization against food allergens by hindering protein breakdown. This can be caused by acid-suppressing medication like sucralphate, H2-receptor blockers and proton pump inhibitors, as shown in recent murine experimental and human observational studies. OBJECTIVE: The aim of the present study was to assess the sensitization capacity of the dietary supplement base powder and of over-the-counter antacids. METHODS: Changes of the pH as well as of protein digestion due to base powder or antacids were measured in vitro. To examine the in vivo influence, BALB/c mice were fed codfish extract with one of the acid-suppressing substances. Read-out of antibody levels in the sera, of cytokine levels of stimulated splenocytes and of intradermal skin tests was performed. RESULTS: The pH of hydrochloric acid was substantially increased in vitro by base powder as well as antacids in a time- and dose-dependent manner. This elevation hindered the digestion of codfish proteins in vitro. A significant increase in codfish-specific IgE antibodies was found in the groups fed codfish combined with Rennie Antacidum or with base powder; the latter also showed significantly elevated IgG1 and IgG2a levels. The induction of an anaphylactic immune response was proven by positive results in intradermal skin tests. CONCLUSIONS: Antacids and dietary supplements influencing the gastric pH increase the risk for sensitization against allergenic food proteins. As these substances are commonly used in the general population without consulting a physician, our data may have a major practical and clinical impact.

Reproductive toxicity studies of benzalazine in rats and rabbits.

Embryotoxicity studies of benzalazine (2-hydroxy-5-[(4-carboxyphenyl) azo]benzoic acid, CAS 64896-26-0), a new agent for the treatment of ulcerative colitis and Crohn's disease of the large intestine, were performed in rats and rabbits. Benzalazine elicited no evidence of teratogenicity when administered orally during the fetal organogenesis period to pregnant rats at doses up to 2000 mg/kg b.w./d, or to pregnant rabbits at doses up to 1000 mg/kg b.w./d. Rat fetuses in the 400 and 2000 mg/kg groups exhibited decreased body weights; the placentae weights were decreased in these dose groups, too. Rabbit fetuses in the high-dose group (1000 mg/kg b.w./d p.o.) also showed decreased body weights. Decreased body weight gain and reduced food intake were seen in rat dams in the high-dose group (2000 mg/kg b.w./d p.o.). In rabbit dams a decrease in body weight gain in the high-dose group (1000 mg/kg b.w./d p.o.) and a dose-dependent reduction in food intake from 200 mg/kg b.w./d p.o. onwards were noted. No further disturbances were observed in the behaviour of the rat and rabbit dams. External appearance, faeces, consumption of drinking water and macroscopical inspection during autopsy did not indicate any influence of the test compound. No retardations or malformations were seen even at the highest tested dose levels (rat: 2000 mg/kg b.w./d p.o.; rabbit: 1000 mg/kg b.w./d p.o.).

Oncogenicity studies of benzalazine in mice and rats.

Oncogenicity studies of benzalazine (2-hydroxy-5-[(4-carboxyphenyl) azo]benzoic acid, CAS 64896-26-0), a new agent for the treatment of ulcerative colitis and Crohn's disease of the large intestine, were carried out in male and female mice and rats. The compound was administered in the diet for 119 weeks (rats) and 120 weeks (mice) at dose levels of 100, 300 and 900/1800 mg/kg b.w./d for mice and of 300, 900 and 2700/1800 mg/kg b.w./d for rats. The administration of benzalazine produced no effects on survival, appearance or behaviour. Body weights of the high-dosed male mice and rats (both sexes) were occasionally significantly decreased when compared to the controls. A slight but in most cases statistically significant reduction of the relative food consumption of the female mice of all treated groups was observed between test weeks 6 and 12. In the high-dosed rats a statistically significant increase of the relative food consumption was found between test weeks 17 and 109. At necropsy, there was no evidence of treatment-related changes, nor were these seen on histopathological examination. All microscopic changes seen in mice and rats were of the usual type commonly occurring in untreated aged NMRI mice and Sprague-Dawley rats. However, an increased incidence of thyroid cystic hyperplasia was found in the rats of the high dose-level group. In addition, an increased incidence of thyroid adenomas was found in the male rats of the high-dosed group only as compared to the control groups. This increased tumour incidence is regarded as a marginal finding and may be of a spontaneous nature within the normal range of the background data. However, a substance-related influence cannot completely be excluded. In conclusion, the administration of benzalazine for more than 24 months to NMRI mice and Sprague-Dawley rats produced only slight effects on body weight in the high-dosed male mice and in rats (both sexes) with a no-effect level of 300 mg/kg b.w./d in the diet for mice or 900 mg/kg b.w./d in the diet for rats. There was no evidence of an oncogenic effect of benzalazine.

[Results of a double-blind study on the effectiveness of ERU (extractum radicis Urticae) capsules in conservative treatment of benign prostatic hyperplasia]. / Ergebnisse einer Doppelblindstudie über die Wirksamkeit von ERU-Kapseln in der konservativen Behandlung der benignen Prostatahyperplasie.

In 50 patients with prostatic hyperplasia the effect on symptomatology and objective findings of ERU-capsules versus placebo was investigated in a double-blind study over a 9 week treatment period. Admitted to the study were patients in phases I and II who had been referred to the clinic in order to evaluate up the indication for operation. Concerning subjective complaints there was an improvement in dysuric symptoms in both patient groups. The evaluation of the objective parameters showed significant differencies. There was a statistically highly significant (p = 0.0005) decrease of the sex hormone binding globulin in the group of patients treated with ERU as well as a significant improvement of the micturition volume and maximum urinary flow. The improvement of the average flow in the ERU group was not significant. The increase of residual urine volume in both groups seems not to be significant according to the Covariance-analysis and is difficult to interpret. It is assumed, that, up to a certain grade, for a selected group of patients, mainly in the phase of beginning decompensation, length and dosage of therapy were possibly not sufficiently adjusted.

[A new peptide alkaloid from Discaria febrifuga Mart]. / Ein neues Peptidalkaloid aus Discaria febrifuga Mart.

On the basis of spectroscopic investigations (1H-NMR, 13C-NMR, UV, IR and MS spectroscopy), elemental analysis and degradation reactions the structure of a new alkaloid discarine G from the bark extract of Discaria febrifuga Mart. is elucidated.

[Recto-vaginal fistulae: causes, treatment, results (author's transl)]. / Darm-Scheiden-Fisteln. Ursachen-Behandlung-Ergebnisse

Among recto-vaginal fistulae in 41 patients 22 were due to radiotherapy, 6 to inflammatory disease, 4 occurred as a postoperative complication and 9 were carcinomatous fistulous tracts. Passage of stool or air per vaginam is a pathognomonic sign. The fistula can usually be diagnosed by routine gynaecological examination. Barium enema, barium meal with follow-through or colpography often demonstrate the fistula. Except for a few cases in which the fistula closes spontaneously (most frequently those which occur postoperatively), treatment is surgical. Intestinal resection is often necessary in the inflammatory fistulae and those after radiotherapy. In fistulae due to carcinoma colostomy will improve symptoms: radical removal of the tumour is rarely possible. 31 of the 44 women are cured, while in two a fistula has persisted.