Is children’s medicine too sweet?

Why do some young patients grimace when they swallow an oral suspension of ibuprofen while others do so without complaint? Not all children perceive the taste of medications in the same way, shows a new study conducted by researchers at the Monell Chemical Senses Center in Philadelphia. Turns out genetics have a lot to do with it. Children's syrups containing ibuprofen are artificially sweetened to disguise the bitter, irritating taste of the active ingredient. “There is always the fear that a medicine might taste ‘too good’ for children because of the excipients they contain such as sweeteners and other pleasant flavors,” the researchers explain. (In the United States, ibuprofen is one of the main sources of accidental poisoning among children under six years old.) Read: 'You're on your own': Quebec parents grapple with lack of pediatrician follow-up A rather unpleasant burning and stinging sensation therefore persists in pediatric oral suspensions in order to avoid poisoning by overdose. But it seems that these sensations are not universal. “We found genetic markers that allow us to predict whether a person considers a medication irritating or sweet,” the authors noted. There was great diversity among the 154 participants (64 men and 90 women) recruited for the study published in the International Journal of Molecular Science. After genetic analysis, the panel was composed of 63 participants of African ancestry, 51 of European origin, 20 of Asian origin and seven of American ancestry. Participants tasted berry-flavored pediatric ibuprofen oral suspension (at a concentration of 100 mg/5 mL). They also evaluated the excipients, namely sucrose and acesulfame potassium (Ace-K). Read: New research discoveries are more likely to be put to use in pediatricians’ offices if patients and their caregivers get involved Participants first had to evaluate the intensity of the taste (sweet or irritating) then identify which of eight sensations they had felt, such as tingling, burning, scratching, an urgency to cough or sneeze, as well as the place in the throat where this sensation was felt. The experiment took place in three stages. First, they had to rinse their mouth with the product for five seconds then spit it out. After a minute's break, they were invited to take another sip, but this time to swallow it. Then, researchers collected their impressions again five minutes later to assess the persistence of the sensation. Sensations of tingling or urgency to cough were significantly less present in participants of African ancestry, who rated the medication as sweeter and more pleasant than their counterparts of European ancestry. Researchers delved deep into their genes to find the source of this difference. They were able to establish associations between participants' phenotypes and certain genetic variations. For example, they found an allele common to those who detected a stronger sweet taste and less urge to cough. It appears that this allele is rather rare in individuals of European origin, but very common in African genetics. Regardless of genetic ancestry, an association was also established between individuals carrying the TRPA1 gene and a greater tingling sensation linked to ibuprofen. For simplicity and control purposes, the current study was performed on adults, but it could potentially be tested in toddlers. It is still possible to partly extrapolate the results obtained in children, since previous studies have shown that some children feel a burning or tingling sensation in the mouth or throat after ingesting such a product, while others feel nothing at all. This article was translated from French and originally ran in our sister publication Profession Santé.

Is children’s medicine too sweet?

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