Polysorbate 80 in medical products and nonimmunologic anaphylactoid reactions
Polysorbate 80 in medical products and nonimmunologic anaphylactoid reactions
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DOI：
10.1016/s1081-1206(10)61024-1
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发表时间：
2005-12-01
影响因子：
5.9
通讯作者：
Mahler, V
中科院分区：
文献类型：
--
作者：
Coors, EA;Seybold, H;Mahler, V
背景：聚氧乙烯脱水山梨醇20-单油酸酯（也称为聚山梨醇酯 80 和吐温 80）是一种增溶剂，广泛用于营养品、乳膏、软膏、洗剂和多种医疗制剂（例如维生素油、疫苗和抗癌剂）中，并作为片剂的添加剂。虽然其作为接触性过敏原的相关性在过去几十年中有所下降，但目前它作为类过敏反应的“隐藏”诱导剂具有相关性。 目的：确定聚山梨醇酯 80（通常被认为是一种惰性媒介物）作为严重类过敏反应的诱导剂。 方法：在对照者和患有过敏反应的患者中进行皮肤点刺试验、酶联免疫吸附测定、IgE 免疫印迹和嗜碱性粒细胞活化的流式细胞术检测。妊娠期间静脉注射多种维生素产品导致过敏性休克病史。结果：聚山梨醇酯 80 被确定为患者非免疫源性过敏样反应的病原体。酶联免疫吸附试验和免疫印迹检查中未发现聚山梨酯特异性 IgE 抗体，证实了类过敏反应的非免疫性质。结论：聚山梨酯 80 是一种广泛使用的增溶剂，可引起严重的非免疫类过敏反应。
Background: Polyoxyethylene-sorbitan-20-monooleate (also known as polysorbate 80 and Tween 80) is a solubilizing agent ubiquitously used in nutritives, creams, ointments, lotions, and multiple medical preparations (eg, vitamin oils, vaccines, and anticancer agents) and as an additive in tablets. Whereas its relevance as a contact allergen has declined during the past decades, it is of current relevance as a "hidden" inductor of anaphylactoid reactions.Objective: To identify polysorbate 80 (generally believed to be an inert vehicle) as an inductor of a severe anaphylactoid reaction.Methods: Skin prick testing, enzyme-linked immunosorbent assay, IgE immunoblotting, and flow cytometric detection of basophil activation were performed in controls and in a patient with a medical history of anaphylactic shock due to intravenous administration of a multivitamin product during pregnancy.Results: Polysorbate 80 was identified as the causative agent for the anaphylactoid reaction of nonimmunologic origin in the patient. Polysorbate specific IgE antibodies were not identified in enzyme-linked immunosorbent assay and immunoblot examinations, confirming the nonimmunologic nature of the anaphylactoid reaction.Conclusions: Polysorbate 80 is a ubiquitously used solubilizing agent that can cause severe nonimmunologic anaphylactoid reactions.