C16-methyl corticosteroids are far less allergenic than the non-methylated molecules

Baeck, Marie; Chemelle, Julie-Anne; Rasse, Catherine; Terreux, Raphaël; Goossens, An

doi:10.1111/j.1600-0536.2011.01874.x

Cited by 33 publications

(16 citation statements)

References 13 publications

(17 reference statements)

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“…However, the C 16 -methyl-substituted CSs produced significantly fewer positive reactions than the ones without this particular substitution (P < 0.0001) (5).…”

Section: Patch-test Resultsmentioning

confidence: 89%

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Corticosteroid cross-reactivity: clinical and molecular modelling tools

Baeck

Chemelle

Goossens

et al. 2011

Allergy

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Two patient profiles with probably different areas of immune recognition are identified as follows: the profile 1 patients were allergic to the frequently positively reacting cluster 1 only, for whom electrostatic fields (molecular charge) seem important; the profile 2 patients reacted to clusters 1 and 2 and/or 3, for whom steric fields (structure) are determinant and who probably presented a global recognition of the corticosteroid skeleton. A modified classification is thus proposed.

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“…However, the C 16 -methyl-substituted CSs produced significantly fewer positive reactions than the ones without this particular substitution (P < 0.0001) (5).…”

Section: Patch-test Resultsmentioning

confidence: 89%

“…We observed (5) that positive patch‐test reactions occurred much more frequently to CS molecules with no C 16 ‐methyl substitution or halogenation, i.e. groups A and D2, than to those that were halogenated and had a C 16 ‐methyl group, i.e.…”

Section: Corticosteroid Classification According To Coopman Et Al (1)mentioning

confidence: 98%

Corticosteroid cross-reactivity: clinical and molecular modelling tools

Baeck

Chemelle

Goossens

et al. 2011

Allergy

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“…Allergic reactions are most frequently observed with CS molecules without C 16 ‐methyl substitution or halogenation, such as hydrocortisone and methylprednisolone and their esters, as well as budesonide (24).…”

Section: Delayed Reactionsmentioning

confidence: 99%

Immediate and delayed allergic hypersensitivity to corticosteroids: practical guidelines

Baeck

Goossens

2011

Contact Dermatitis

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“…However, some studies were unable to demonstrate cross-reactions between corticosteroids [111]. In 2011, Baeck et al [1213] proposed a new classification based on cross-reactions and molecular structure, which divided corticosteroids into 3 groups (Table 2). Allergic reactions were found to occur more frequently in group I corticosteroids, whereas group III had the fewest cross-reactions [14].…”

Section: Discussionmentioning

confidence: 99%

Anaphylaxis following intralesional triamcinolone acetonide (Kenacort) injection

Laisuan

Wongsa

Dchapaphapeaktak

et al. 2017

Asia Pacific Allergy

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Intralesional triamcinolone acetonide injection is indicated for multiple skin conditions such as keloid scars, alopecia areata, and hypertrophic lichen planus. Immediate hypersensitivity reaction remains uncommon. We report on a 24-year-old woman who had received multiple intralesional injections with triamcinolone acetonide (Kenacort) plus lidocaine for keloid scar treatment without any reaction for the previous 10 years. The immediate reaction occurred 15 minutes after injection, with numbness on her face and 5 minutes later with urticaria on her chest wall and upper extremities, together with hypotension (blood pressure of 90/60 mmHg). Allergology workup revealed positive skin prick test for triamcinolone acetonide (Kenacort). Skin tests for other corticosteroids (hydrocortisone, methylprednisolone, and dexamethasone), excipients (carboxymethylcellulose, benzyl alcohol, and polysorbate 80) and lidocaine were negative, including subcutaneous challenge for lidocaine and oral challenge for carboxymethylcellulose. IgE-mediated hypersensitivity reaction must be considered in cases of multiple applications of triamcinolone acetonide injection.

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C16-methyl corticosteroids are far less allergenic than the non-methylated molecules

Abstract: C(16)-methyl substitution, interfering with protein binding, and halogenation, seem to reduce the allergenicity of corticosteroid molecules. Hence, when indicated, C(16)-methylated corticosteroids should be preferentially prescribed.

Cited by 33 publications

References 13 publications

Corticosteroid cross-reactivity: clinical and molecular modelling tools

Corticosteroid cross-reactivity: clinical and molecular modelling tools

Immediate and delayed allergic hypersensitivity to corticosteroids: practical guidelines

Anaphylaxis following intralesional triamcinolone acetonide (Kenacort) injection

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