Hapten inhibition and dextran anaphylaxis

Ljungström, Karl-Gösta; Renck, H.; Hedin, H.; Richter, Wolfgang; Wiholm, Bengt‐Erik

doi:10.1111/j.1365-2044.1988.tb05741.x

Cited by 56 publications

(19 citation statements)

References 10 publications

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“…ICs are known to mediate type 3 HSRs in a small subset of people receiving dextran infusions. In these cases, ICs are formed and mediate severe reactions in patients with high antidextran IgG antibody levels (Bircher, Hedin, and Berglund 1995;Hedin et al 1980;Hedin and Richter 1982;Kraft et al 1982;Ljungstrom et al 1983Ljungstrom et al , 1988.…”

Section: Infusion Reactions and Generalized Type 3 Hsrsmentioning

confidence: 99%

Formation, Clearance, Deposition, Pathogenicity, and Identification of Biopharmaceutical-related Immune Complexes

et al. 2014

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Vascular inflammation, infusion reactions, glomerulopathies, and other potentially adverse effects may be observed in laboratory animals, including monkeys, on toxicity studies of therapeutic monoclonal antibodies and recombinant human protein drugs. Histopathologic and immunohistochemical (IHC) evaluation suggests these effects may be mediated by deposition of immune complexes (ICs) containing the drug, endogenous immunoglobulin, and/or complement components in the affected tissues. ICs may be observed in glomerulus, blood vessels, synovium, lung, liver, skin, eye, choroid plexus, or other tissues or bound to neutrophils, monocytes/macrophages, or platelets. IC deposition may activate complement, kinin, and/or coagulation/fibrinolytic pathways and result in a systemic proinflammatory response. IC clearance is biphasic in humans and monkeys (first from plasma to liver and/or spleen, second from liver or spleen). IC deposition/clearance is affected by IC composition, immunomodulation, and/or complement activation. Case studies are presented from toxicity study monkeys or rats and indicate IHC-IC deposition patterns similar to those predicted by experimental studies of IC-mediated reactions to heterologous protein administration to monkeys and other species. The IHC-staining patterns are consistent with findings associated with generalized and localized IC-associated pathology in humans. However, manifestations of immunogenicity in preclinical species are generally not considered predictive to humans.

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Section: Infusion Reactions and Generalized Type 3 Hsrsmentioning

confidence: 99%

Formation, Clearance, Deposition, Pathogenicity, and Identification of Biopharmaceutical-related Immune Complexes

et al. 2014

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“…Re cent studies suggest that reticuloendothelial function is well preserved after splenic repair [9]. For those in dividuals where splenectomy cannot be avoided or when splenectomy is indicated because of hemato logical diseases pneumococcal vaccination has been recommended, since overwhelming pneumococcal septicemia is the most frequent type of severe post splenectomy infection [4], It would be unfortunate if such vaccination in duced an increased risk for these patients to develop severe dextran reactions upon exposure to dextran, especially since the problems with these reactions in other patients lately have been considerably reduced by hapten inhibition [10]. The DR A titers observed in this group of patients were already before vaccination surprisingly high, suggesting that they constitute a group different from the general population in this re spect.…”

Section: Discussionmentioning

confidence: 99%

Does Vaccination of Splenectomized Patients against Pneumococci Induce Dextran-Reactive Antibodies?

Ljungström

Hedin²,

Richter³

et al. 1989

Int Arch Allergy Immunol

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Polyvalent pneumococcal vaccine containing polysaccharides from serotypes known to be cross-reactive with dextran was used for vaccination of 72 patients either shortly before or on the average 6.25 years after splenectomy. The titer of dextran-reactive antibodies was determined by passive hemagglutination before as well as 6 weeks and 6 months after vaccination. Already prior to vaccination the patients had moderately elevated titers of these antibodies and the titer was somewhat reduced during the study period. Small inter-group differences were observed but the titers of patients who had received cytostatic and/or radiation therapy did not appear to react differently to vaccination. It is concluded that this type of vaccine does not induce dextran-reactive antibodies when given to asplenic individuals.

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“…Patients with high titres of these antibodies have an elevated risk of life-threatening adverse reac tions after dextran administration [6,[10][11][12][13][14][15]. Introducing the prophylactic application of monovalent hapten dextran reduced the inci dence and severity of these side effects [13][14][15][16], Preformed gelatine-reactive antibodies in some animal species and in man were de tected by haemagglutination. An increased in cidence of gelatine-reactive antibodies was found in patients suffering from rheumatoid arthritis and degenerative arthrosis [17,18].…”

Section: Discussionmentioning

confidence: 99%

No Evidence for the Existence of Preformed Antibodies against Hydroxyethyl Starch in Man

et al. 1992

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Using the highly sensitive ELISA technique for detecting anti-hydroxyethyl starch (HES) antibodies in man sera from 1,056 patients were analyzed. Patients of both sex, who had never had any prior contact with HES, were included in the study. In none of the cases could any titer of HES-reactive antibodies be detected. These data suggest that in man preformed HES-reactive antibodies do not exist or are extremely rare. In any case, unlike dextran-reactive antibodies, they should not have a high clinical importance. The mechanism behind the very rarely observed anaphylactoid reactions after HES application is still unknown.

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Hapten inhibition and dextran anaphylaxis

Cited by 56 publications

References 10 publications

Formation, Clearance, Deposition, Pathogenicity, and Identification of Biopharmaceutical-related Immune Complexes

Formation, Clearance, Deposition, Pathogenicity, and Identification of Biopharmaceutical-related Immune Complexes

Does Vaccination of Splenectomized Patients against Pneumococci Induce Dextran-Reactive Antibodies?

No Evidence for the Existence of Preformed Antibodies against Hydroxyethyl Starch in Man

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