Antigenic specificities of skin-sensitizing antibodies in sera from patients with immediate systemic allergic reactions to penicillin

Penicillin allergy and the heterogenous immune responses of man to benzylpenicillin.

“…Skin-sensitizing antibodies 2 were assayed by direct skin tests for wheal and flare reactions and in some cases also by passive transfer (6).…”

“…BPO-polylysine detects BPO-specific skin-sensitizing antibodies, and penicillin and sodium benzylpenicilloate deItect minor determinant-specific skin-sensitizing antibodies 5 (see reference 6 for hapten inhibition data). Serum assays for skin-sensitizing antibodies were done by passive transfer to the skin of nonsensitive human recipients with local challenge with the three reagents after a 48-hour latent period (6). In virtually all cases where skin-sensitizing antibodies could be detected in the serum, they could also be detected by direct skin test.…”

Minor Haptenic Determinant-Specific Reagins of Penicillin Hypersensitivity in Man

“…This was not done as previously it was shown that univalent BPO-haptcns inhibit BPO-specific passive transfer reactions but not passive transfer reactions elicited with penicillin [3].…”

“…Thus, Siegel and L ev in e [3] found that treatment of penicillin with traces of penicillinase under mild conditions completely destroyed its ability to elicit specific wheal-and-flare reaction in skin sites passively sensitized with the reagin reactive with penicillin. In the present experiments, the crystalline penicillin used for skin testing (obtained from Bristol Laboratories) was found to be free of protein contaminants by the manufacturer, and was also recrystallized (or precipitated) from organic solvents in this laboratory prior to use.…”

“…As to the reagins reactive with penicillin or benzylpenicil loate, it has been postulated that these reagins are specific for other haptenic determinants derived from penicillin [3,4]. They have been termed 'minor' determinants since it appears likely that these hypothet ical haptens are formed in small quantities from penicillin, relative to the comparatively larger quantities of BPO-haptenic groups formed [3,4].…”