Introduction: Acid suppression medications, such as proton-pump inhibitors (PPIs) and histamine-2 receptor antagonists, are commonly prescribed for the treatment of gastroesophageal reflux disease and other gastrointestinal disorders. However, concerns regarding potential long-term side effects are brought up by the overuse of PPIs. This study aimed to investigate the relationship between PPI usage, allergy, and asthma in the general US population. Methods: Data of individuals aged ≥20 years who had information on PPI use and questionnaires on allergy and asthma in the US National Health and Nutrition Examination Survey (NHANES) 2005–2006 were analyzed. Univariate and multivariable logistic regression analyses were performed to determine the associations between PPI use, prevalent allergy, and asthma. Results: A total of 4,481 participants (representing 198,543,007 US individuals after weighting) were included in the analyses. PPI use was not significantly associated with the presence of allergy or asthma in the general study population after adjustment. However, in females without steroid exposure, PPI use was significantly associated with increased odds of allergy (adjusted odds ratio [aOR] = 1.69, 95% confidence interval [CI]: 1.002–2.86), among which esomeprazole use was significantly associated with increased odds of allergy (aOR = 2.68, 95% CI: 1.30–5.54) and lansoprazole with increased odds of asthma (aOR = 3.44, 95% CI: 1.50–7.87) as compared to no PPI use. Duration of PPI use was not significantly associated with allergy or asthma. Conclusions: In US women without steroid exposure, PPI use is associated with increased likelihood of prevalent allergy and asthma.

1.
Schnoll-Sussman
F
,
Niec
R
,
Katz
PO
.
Proton pump inhibitors: the good, bad, and ugly
.
Gastrointest Endosc Clin N Am
.
2020
;
30
(
2
):
239
51
. .
2.
Strand
DS
,
Kim
D
,
Peura
DA
.
25 Years of proton pump inhibitors: a comprehensive review
.
Gut Liver
.
2017
;
11
(
1
):
27
37
. .
3.
Liu
Y
,
Zhu
X
,
Li
R
,
Zhang
J
,
Zhang
F
.
Proton pump inhibitor utilisation and potentially inappropriate prescribing analysis: insights from a single-centred retrospective study
.
BMJ Open
.
2020
;
10
(
11
):
e040473
Published 2020 Nov 26. .
4.
Koyyada
A
.
Long-term use of proton pump inhibitors as a risk factor for various adverse manifestations
.
Therapie
.
2021
;
76
(
1
):
13
21
. .
5.
Savarino
V
,
Marabotto
E
,
Zentilin
P
,
Furnari
M
,
Bodini
G
,
De Maria
C
, et al
.
Proton pump inhibitors: use and misuse in the clinical setting
.
Expert Rev Clin Pharmacol
.
2018
;
11
(
11
):
1123
34
. .
6.
Malfertheiner
P
,
Kandulski
A
,
Venerito
M
.
Proton-pump inhibitors: understanding the complications and risks
.
Nat Rev Gastroenterol Hepatol
.
2017
;
14
(
12
):
697
710
. .
7.
Haastrup
PF
,
Jarbøl
DE
,
Thompson
W
,
Hansen
JM
,
Søndergaard
J
,
Rasmussen
S
.
When does proton pump inhibitor treatment become long term? A scoping review
.
BMJ Open Gastroenterol
.
2021
;
8
(
1
):
e000563
. .
8.
Ramirez
E
,
Cabanas
R
,
Laserna
LS
,
Fiandor
A
,
Tong
H
,
Prior
N
, et al
.
Proton pump inhibitors are associated with hypersensitivity reactions to drugs in hospitalized patients: a nested case-control in a retrospective cohort study
.
Clin Exp Allergy
.
2013
;
43
(
3
):
344
52
. .
9.
Trikha
A
,
Baillargeon
JG
,
Kuo
YF
,
Tan
A
,
Pierson
K
,
Sharma
G
, et al
.
Development of food allergies in patients with gastroesophageal reflux disease treated with gastric acid suppressive medications
.
Pediatr Allergy Immunol
.
2013
;
24
(
6
):
582
8
. .
10.
Untersmayr
E
,
Bakos
N
,
Schöll
I
,
Kundi
M
,
Roth-Walter
F
,
Szalai
K
, et al
.
Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients
.
FASEB J
.
2005
;
19
(
6
):
656
8
. .
11.
Riemer
AB
,
Gruber
S
,
Pali-Scholl
I
,
Kinaciyan
T
,
Untersmayr
E
,
Jensen-Jarolim
E
.
Suppression of gastric acid increases the risk of developing immunoglobulin E-mediated drug hypersensitivity: human diclofenac sensitization and a murine sensitization model
.
Clin Exp Allergy
.
2010
;
40
(
3
):
486
93
. .
12.
Mitre
E
,
Susi
A
,
Kropp
LE
,
Schwartz
DJ
,
Gorman
GH
,
Nylund
CM
.
Association between use of acid-suppressive medications and antibiotics during infancy and allergic diseases in early childhood
.
JAMA Pediatr
.
2018
;
172
(
6
):
e180315
. .
13.
Wang
YH
,
Wintzell
V
,
Ludvigsson
JF
,
Svanstrom
H
,
Pasternak
B
.
Association between proton pump inhibitor use and risk of asthma in children
.
JAMA Pediatr
.
2021
;
175
(
4
):
394
403
. .
14.
Salloum
A
,
Nasr
D
,
Maalouf
D
.
Dermatologic adverse reactions to proton-pump inhibitors: a synthetized review
.
J Cosmet Dermatol
.
2021
;
20
(
4
):
1073
9
. .
15.
Robinson
LB
,
Camargo
CA
Jr
.
Acid suppressant medications and the risk of allergic diseases
.
Expert Rev Clin Immunol
.
2018
;
14
(
9
):
771
80
. .
16.
Devine
RE
,
McCleary
N
,
Sheikh
A
,
Nwaru
BI
.
Acid-suppressive medications during pregnancy and risk of asthma and allergy in children: a systematic review and meta-analysis
.
J Allergy Clin Immunol
.
2017
;
139
(
6
):
1985
8 e12
. .
17.
Lai
T
,
Wu
M
,
Liu
J
,
Luo
M
,
He
L
,
Wang
X
, et al
.
Acid-Suppressive drug use during pregnancy and the risk of childhood asthma: a meta-analysis
.
Pediatrics
.
2018
;
141
(
2
):
e20170889
. .
18.
Pali-Schöll
I
,
Untersmayr
E
,
Klems
M
,
Jensen-Jarolim
E
.
The effect of digestion and digestibility on allergenicity of food
.
Nutrients
.
2018
;
10
(
9
):
1129
. .
19.
Yepuri
G
,
Sukhovershin
R
,
Nazari-Shafti
TZ
,
Petrascheck
M
,
Ghebre
YT
,
Cooke
JP
.
Proton pump inhibitors accelerate endothelial senescence
.
Circ Res
.
2016
;
118
(
12
):
e36
42
. .
20.
Levy
EI
,
Hoang
DM
,
Vandenplas
Y
.
The effects of proton pump inhibitors on the microbiome in young children
.
Acta Paediatr
.
2020
;
109
:
1531
8
. .
21.
Freedberg
DE
,
Toussaint
NC
,
Chen
SP
,
Ratner
AJ
,
Whittier
S
,
Wang
TC
, et al
.
Proton pump inhibitors alter specific taxa in the human gastrointestinal microbiome: a crossover trial
.
Gastroenterology
.
2015
;
149
(
4
):
883
5 e9
. .
22.
Jordakieva
G
,
Kundi
M
,
Untersmayr
E
,
Pali-Schöll
I
,
Reichardt
B
,
Jensen-Jarolim
E
.
Country-wide medical records infer increased allergy risk of gastric acid inhibition
.
Nat Commun
.
2019
;
10
(
1
):
3298
. .
23.
Sugimoto
M
,
Furuta
T
.
Efficacy of esomeprazole in treating acid-related diseases in Japanese populations
.
Clin Exp Gastroenterol
.
2012
;
5
:
49
59
. .
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