Gut epithelial disruption caused by rinse aids
Published: December 1, 2022
According to the epithelial barrier theory, exposure to many toxic substances in humans and animals damages the epithelium, the thin layer of cells that covers the surface of our skin, lungs and intestine. Defective epithelial barriers in the digestive system, and dysbiosis in the microbiota particularly in the gut have been linked to many diseases, such as food allergy, esophagitis, gastritis, diabetes, obesity, fatty liver, autoimmune hepatitis, liver cirrhosis, rheumatoid arthritis, multiple sclerosis, autism spectrum diseases, chronic depression, Alzheimer’s and Parkinson’s diseases. Overall defective epithelial barriers have been suggested to play a role in the pathogenesis of diseases affecting over two billion patients.
Professional dishwashers have become the state of the art for dishwashing in public places including restaurants, schools, military and hotels throughout the whole world. In a recent issue of The Journal of Allergy and Clinical Immunology (JACI), Ogulur et al. published a comprehensive study demonstrating the toxicity of professional dishwasher rinse aids. They hypothesized that if the detergent and rinse aid residues are not completely removed, once dry, they may remain on the surface of the dishware. Accordingly, they investigated the health hazard of exposure to professional and household dishwasher detergent and rinse aid, and its individual components on cytotoxicity, barrier function, transcriptome and protein expression in gastrointestinal epithelial cells.
In this study, they show the injury of gastrointestinal epithelial cells by professional dishwashing and identify the culprit as alcohol ethoxylates in the rinse aid. As an example of professional dishwashing, water is heated and the detergent is added for a maximum of a 60 seconds wash cycle at high pressures. A rinse/dry cycle follows with an addition of water and rinse aid. The wash cycle is completed within two minutes by drying the rinse aid on the dishes and cutlery. Interestingly, it should be noted that there are no additional washes to remove the rinse aid residue in many of the devices.
The research group demonstrated that a worldwide commonly used ingredient, alcohol ethoxylates in the professional dishwasher rinse aid was killing gut epithelial cells in 1:20,000 dilutions. The epithelial cells used in the study were in the form of a human gut organoid or gut-on-microchips, newly developed modern technologies representing the gut epithelium in 3 dimensions as close as possible to human organs. The underlying mechanisms of the epithelial barrier disruption in response to professional dishwasher rinse aid are cell death in high doses and epithelial barrier opening in low doses together with activation of multiple genes and proteins that induce inflammatory responses in the exposed cells. One of the most interesting findings of the present study is that after a finalized dishwashing, the researchers were able to extract a significant amount of remaining toxic substances from the washed and ready to use dishware. These findings may have an important impact on public health. Once confirmed, the use of this substance in professional dishwashers may need to be examined.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.
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