Release of Mediators from Human Gastric Mucosa and Blood in Adverse Reactions to Benzoate

Abstract

A study was carried out on 29 patients to investigate the amount of histamine liberation and release of platelet-activating factor and 6-keto-prostaglandin F_1α from gastric mucosa and whole blood or mononuclear cells by sodium benzoate. The patients suffered from asthma (10), atopic dermatitis (7) and chronic urticaria (4). 8 patients with unrelated, non-immunologic diseases served as controls. In the oral provocation test (OPT) 3 patients experienced a recurrence of their original disease, whilst 1 asthmatic patient reacted with abdominal disorder. The release of histamine and prostaglandin from mucosa was significantly increased by sodium benzoate in comparison to the spontaneous release observed in patients. The mucosa of the control persons did not react to sodium benzoate. Furthermore, there was a significant difference in prostaglandin release between patients with positive OPT and the control persons. No difference could be found between patients with negative OPT and those with positive OPT. Additionally, in the mediator release from whole blood or mononuclear cells there was no obvious difference apparent. These results suggest a possible involvement of prostacyclin and histamine in adverse reactions to benzoate. Due to the sensitivity of the method, a mediator release from mucosa can already be demonstrated in a preclinical state of the pseudoallergic reaction in the absence of clinical symptoms.

Etiologic aspects of chronic urticaria

“…The pathogenetic mechanism may be a direct release of histamine and prostaglandins from mucosal cells, as suggested by an in vitro experiment in which human gastric biopsy specimens were incubated with sodium benzoate. 23 A significant increase in both histamine and prostaglandins was seen when biopsy specimens from urticaria patients and patients with a history of atopy were analyzed.…”

Sodium benzoate-induced repeated episodes of acute urticaria/angio-oedema: randomized controlled trial

“…Some authors suggest that because benzoates are structurally similar to acetyl salicylic acid (aspirin), they may act on eicosanoid production 16 . Schaubsclager et al 17 . investigated the release of mediators from the gastric mucosa after challenge with benzoate.…”

“…Some authors suggest that because benzoates are structurally similar to acetyl salicylic acid (aspirin), they may act on eicosanoid production. 16 Schaubsclager et al 17 investigated the release of mediators from the gastric mucosa after challenge with benzoate. They demonstrated increased release of histamine and 6-keto prostaglandin F in patients with positive oral challenges in comparison with normal controls.…”

Irritable Bowel Syndrome

“…Other non–IgE‐based serologic tests for evaluating food reactions have not been as extensively studied as the serologic IgG 4 antibody method. Indeed, the mediator release test (MRT) is an in vitro–based assay that involves co‐culturing food antigens with the patients’ mononuclear cells and is used by many dietitians in practice today 36 , 37 …”