Pancreatic enzymes block food allergy reactions - Literature Review & Commentary - Brief Article

Townsend Letter for Doctors and Patients, Nov, 2002 by Alan R. Gaby

Ten patients (mean age, 43 years) with food allergy documented by double-blind, placebo-controlled food challenges underwent further double-blind food challenges through a nasogastric tube with a known offending food, with or without the addition of an enteric-coated pancreatic enzyme preparation (Panzytrat; 120,000 IE per challenge). Compared with no enzymes, administration of pancreatic enzymes markedly reduced the severity of foodinduced symptoms in all 10 patients, and significantly blunted the rise in urinary methylhistamine excretion following the food challenge. Urinary histamine was not found to be of diagnostic value,, either for monitoring allergic reactions or for assessing the effect of pancreatic enzymes.

Comment: These results suggest that administration of pancreatic enzymes reduces the severity of allergic reactions to foods. However, it is possible that some of the improvement (e.g., the intestinal symptoms) was due to an enhancement of digestive function, rather than to an anti-allergy mechanism. All 10 patients in the study suffered from postprandial abdominal symptoms, whereas fewer experienced allergic rhinoconjunctivitis (60%), skin reactions (50%), or asthma (20%). According to a personal communication from one of the authors (Raithel; May 26, 2002), extra-intestinal symptoms did improve, but to a lesser extent than intestinal symptoms. The foods that were challenged were not, in general, high-fat foods; this supports the anti-allergy mechanism, rather than the improved-digestion mechanism.

The dose of pancreatic enzymes used in this study (120,000 IE per challenge) was listed in units not familiar to American doctors. If any readers are able to convert this dose into units used in the US, please write to the Townsend Letter.

Raithel M, et al. Pancreatic enzymes: a new group of antiallergic drugs? Inflamm Res 2002;51(Suppl 1):S13-S14.