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Intestinal permeability as assessed with polyethyleneglycols in birch pollen allergic children undergoing oral
Insights
Oral immunotherapy for birch pollen allergies did not alter intestinal permeability in treated children. However, placebo group showed decreased permeability, potentially due to the pollen season.
Area of Science:
- Allergy and Immunology
- Gastroenterology
- Pharmacology
Background:
- Rhinoconjunctivitis is a common allergic reaction to birch pollen.
- Oral immunotherapy (OIT) is a treatment for allergic diseases.
- Intestinal permeability may be affected by allergic inflammation and OIT.
Purpose of the Study:
- To investigate the effect of oral immunotherapy (OIT) with birch pollen extract on small intestinal permeability in children with birch pollinosis.
- To assess changes in intestinal permeability during OIT and at the onset of the pollen season.
Main Methods:
- A double-blind, placebo-controlled study involving 24 children with birch pollinosis.
- Administration of enteric-coated birch pollen preparation or placebo.
- Measurement of small intestinal permeability using polyethyleneglycols (PEG 400 and PEG 1000) recovery in urine at three time points.
- Analysis of small bowel biopsies in two openly treated children.
Main Results:
- Actively treated children showed no significant changes in intestinal permeability.
- The placebo group exhibited decreased recovery of larger PEG molecules after 3 months, potentially linked to the pollen season.
- Small bowel biopsies from openly treated children were normal.
Conclusions:
- Oral immunotherapy with birch pollen extract did not significantly alter small intestinal permeability in children with rhinoconjunctivitis.
- The observed changes in the placebo group suggest a potential influence of the pollen season on intestinal permeability.
- Further research is warranted to fully understand the relationship between OIT, intestinal permeability, and allergic rhinitis.
Abstract:
Twenty-four children with rhinoconjunctivitis due to birch pollinosis were treated in a double-blind manner with enteric-coated capsules containing either a high dose of a birch pollen preparation (n = 11) or placebo (n = 13). The permeability of the small intestine was analysed at three different occasions with a mixture of differently sized polyethyleneglycols (PEG 400 and PEG 1000), before the start of oral immunotherapy (OIT), at the moment of maximum allergen dose, and after 3 months of therapy which was at the beginning of the pollen season. The actively treated children did not significantly change their permeability characteristics as determined from PEG recovery in the urine. By contrast, in the control group of patients the recovery of larger PEG molecules was decreased after 3 months of therapy, possibly due to the commencing pollen season. In addition, small bowel biopsies were taken at the time of maximum allergen dose from two children openly treated with OIT. Both specimens were normal.