Due to its widespread use in pharmaceuticals, personal care products, industrial products, and even foods, 72% of the general population have pre-existing anti-PEG antibodies that can trigger severe immune responses. When the toxic overload reaches its tipping point from repeat exposure to Polyethylene Glycol, hypersensitivities can occur, causing thousands of pegylated drugs to lose therapeutic efficacy and may even cause deadly outcomes; anaphylaxis, cardiac arrest. Reasons for immune responses are poorly understood, but are becoming increasingly common, and known as Accelerated Blood Clearance or ABC phenomenon, something that happens up subsequent exposure. Upon repeat exposure, the body tries to rapidly clear PEG from the bloodstream, in turn triggering undesired immune responses. These immune responses can increase in frequency and severity with each subsequent PEG exposure, whether its via injection, ingestion, inhalation, even topical use, meaning one exposure may cause a mild rash, the next exposure may cause anaphylaxis.

Polyethylene Glycol derivatives, similar in structure, are also known to cause hypersensitivities due to the cross-reactivity of the structures. Polysorbate 20 (Polyoxyethylene sorbitan 20 monooleate) also known as Tween 20, is similar in the manner that the compound has 20 repeat units of Ethylene Glycol. Same goes for Polysorbate 80.

It’s speculated that speculated that injured skin or mucosa results in local inflammatory responses with recruitment of immune cells.

“Four different types of effects were observed in the 52 rats treated with the various polyethylene glycol, surfactant and phenytoin combinations. Polyethylene glycol had a definite necrotic effect on the rectal mucosa of the rat. This adverse effect was more pronounced when phenytoin and polyoxyl 59 stearate were combined with the polyethylene glycol.” Adverse Effects of Polyethylene Glycol and Phenytoin on the Rectal Mucosa of the Rat: Drug Development and Industrial Pharmacy: Vol 20, No 8 (tandfonline.com)

With that being said, all derivatives should be taken into account, that they too, may cause or increase more pronounced adverse reactions in people already sensitive to PEGs. Perhaps it’s the repeat units of EG that are triggering allergic reactions. Maybe it’s the inadvertent byproducts left behind in the PEGs triggering immune responses. Or possibly it is PEG damaging mucosal layers and causing bacterial genocide triggering side effects. Whatever the case may be, PEG allergy should be considered one of the most dangerous allergies of the era, considering it comes in so many forms and in so many products. Patients with severe PEG allergies have also been known to react to the following PEG drivatives:  

•      Ceteths

•      Ceteareths

•      Oleths

•      PEG ethers of glyceryl cocoates

•      Caprylic/Capric Glycerides

•      PEG fatty acids

• Polyglycerol

•      Esters

•      Palm Oil

•      Rapeseed Oil

•      Dimethicone

•      Laureths

•      PEG laurates

•      Dilaurates

•      Stearates

•      Distearates

•      PEG castor oils

•      PEG amine ethers (PEG cocamines)

•      Alkanes

•      PEG propylene glycols, and other derivates (e.g., PEG soy sterols and PEG beeswax). 

Companies not required to properly label their products are not only deceiving the consumer, but they’re also contributing to repeat exposure that will inevitably cause potentially fatal outcomes. Many consumers are not aware that some plant-based ingredients/products are pegylated, or ethoxylated, leaving them susceptible to adverse reactions, even from topical products. Deadly allergies that affect such a large number of the population should be properly labeled in bold in the allergen section. Anti-PEG antibodies are more prevalent than peanut, tree nut, and milk allergies, so caution should be used when labeling any type of product package. Limiting repeat exposure to PEG will not only benefit those allergic but also the 28% left that haven’t formed a detectable level of anti-PEG antibodies. Proper labeling will also help create much needed awareness among patients and healthcare professionals, that is critical for proper diagnosis since IgG and IgM testing isn’t always accurate. Allergies are evolving, product labels need to be updated to reflect that for the safety of the public.

 

·         Polyethylene glycols and polysorbates: Two still neglected ingredients causing true IgE-mediated reactions - The Journal of Allergy and Clinical Immunology: In Practice (jaci-inpractice.org)

·         Anaphylaxis to Polyethylene Glycol (Colyte®) in a Patient with Diverticulitis - PubMed (nih.gov)

·         Safety Evaluation of Polyethylene Glycol (PEG) Compounds for Cosmetic Use - PMC (nih.gov)

·         Skin safety and health prevention: an overview of chemicals in cosmetic products - PMC (nih.gov)

·         Immediate-type hypersensitivity to polyethylene glycols: a review - PubMed (nih.gov)

·         The accelerated blood clearance (ABC) phenomenon: clinical challenge and approaches to manage - PubMed (nih.gov)

 

Thank you for your time and attention in this matter of utmost importance.