DETECTION AND SIDE-CHAIN SPECIFICITY OF IGE ANTIBODIES TO FLUCLOXACILLIN IN ALLERGIC SUBJECTS
DETECTION AND SIDE-CHAIN SPECIFICITY OF IGE ANTIBODIES TO FLUCLOXACILLIN IN ALLERGIC SUBJECTS
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DOI：
10.1002/jmr.300080302
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发表时间：
1995-05-01
影响因子：
2.7
通讯作者：
WEINER, J
中科院分区：
文献类型：
--
作者：
BALDO, BA;PHAM, NH;WEINER, J
与在实验动物中对青霉素抗原性的研究不同，关于青霉素在人体中的致敏性的信息有限，特别是关于许多不同青霉素之间细微的结构致敏性差异。与其他人早期的结论不一致，我们的研究表明青霉素分子上的侧链结构是许多反应的主要致敏决定因素。在一些患者中观察到氟氯西林立即过敏反应，这些患者通过皮肤试验和检测氟氯西林反应性IgE抗体确诊。定量半抗原抑制研究显示氟氯西林和三种结构相关的青霉素：氧苄西林、氯氯西林和双氯西林具有强抑制作用。抑制结果分析表明，氟氯西林的侧链基团3-（2-氯-6-氟苯基）-5-甲基-4-异恶唑基可被某些抗体识别，而5-甲基-3-苯基-4-异恶唑基，无论是否有卤素取代基，都能引起其他抗体的反应性，并与其他一些青霉素发生交叉反应。由于是侧链基团区分了许多不同的青霉素，并且由于侧链基团在许多过敏反应中被IgE抗体识别，因此很明显，需要对每种不同青霉素的IgE抗体进行特异性检测。
Unlike studies on the antigenicity of penicillins in laboratory animals, limited information is available on the allergenicity of penicillins in man, especially with regard to fine structural allergenic differences between the many different penicillins. Inconsistent with the earlier conclusions of others, our studies suggest that side-chain structures on the penicillin molecule are the major allergenic determinants in many reactions. Immediate allergic reactions to flucloxacillin were observed in a number of patients where diagnosis was confirmed by skin testing and detection of flucloxacillin-reactive IgE antibodies. Quantitative hapten inhibition studies revealed potent inhibition by flucloxacillin and three structurally related penicillins: oxacillin, cloxacillin and dicloxacillin. Analysis of the inhibition results showed that the side-chain group of flucloxacillin, 3-(2-chloro-6-fluorophenyl)-5-methyl-4-isoxazolyl, is recognized by some antibodies and that the 5-methyl-3-phenyl-4-isoxazolyl group, with or without halogen substituents, accounts for the reactivity of other antibodies and for the cross-reactions seen with some other penicillins. Since it is the side-chain group that distinguishes the many different penicillins, and since the side-chain groups are recognized by IgE antibodies in many of the allergic reactions, it is becoming clear that specific assays are required for the detection of IgE antibodies to each of the different penicillins.