Heterogeneity of the IgE response to allergenic determinants of cefaclor in serum samples from patients with cefaclor-induced anaphylaxis

Kim, Sang-Hoon; Choi, Jeong‐Hee; Park, Hae‐Sim

doi:10.1016/s1081-1206(10)61331-2

Cited by 10 publications

(11 citation statements)

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“…Subsequently, hypersensitivity reactions to cefaclor are more often reported as rashes, urticaria, angioedema, serum sickness-like reactions, myocarditis, and even anaphylaxis. 5 , 8 , 11 , 17 , 18 , 19 Until a few years ago, anaphylaxis of cefaclor was recognized only as a rare case report; 5 , 20 however, numerous anaphylaxis reactions to cefaclor have been recently reported. 8 , 11 , 17 In general, the risk of anaphylaxis to cephalosporins appears low, with a reported incidence of 0.001-0.1%; however, the incidence of anaphylaxis to cefaclor was reported as being relatively higher (0.01%) than other cephalosporins in adults, as well as in children.…”

Section: Discussionmentioning

confidence: 99%

“…ELISA inhibition tests were performed (as described previously) to evaluate the specificities of specific IgE and IgG antibodies and possible cross-reactivities with other BL antibiotics. 11 , 12 Binding specificities were confirmed by ELISA with serial additions of increasing concentrations (1-100 µg/mL) of cefaclor-HSA conjugate and free cefaclor using serum samples from patients who had high levels of specific IgE, IgG1, or IgG4 antibodies to cefaclor. ELISA inhibition tests with the addition of free BL antibiotics (including cefaclor, penicillin, ampicillin, amoxicillin, and cephalexin) assessed cross-reactivities with cefaclor.…”

Section: Methodsmentioning

confidence: 95%

“…To detect serum specific IgE, IgG1, and IgG4 antibodies to cefaclor, cefaclor-human serum albumin (HSA) conjugate was prepared, and an enzyme-linked immunosorbent assay (ELISA) was conducted as described previously. 11 , 12 Microplates (Corning, New York, USA) were coated with cefaclor-HSA conjugate (10 µg/mL per well), and incubated with the sera of patients and controls. Goat anti-human IgE antibody (Kirkegaard & Perry laboratories Inc., Gaithersburg, MD, USA), alkaline phosphate-conjugated rabbit anti-goat IgG antibody (ReserveAPTM; Kirkegaard & Perry Laboratories Inc., Gaithersburg, MD, USA), and p -nitrophenyl phosphate (St. Louis, MO, USA) substrate were added to each well in consecutive order.…”

Section: Methodsmentioning

confidence: 99%

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Immunologic Evaluation of Immediate Hypersensitivity to Cefaclor

et al. 2014

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PurposeCefaclor is widely prescribed for various infectious diseases. As its consumption increases, the number of hypersensitivity reactions to cefaclor has increased. This study aimed to evaluate the immunologic findings of immediate hypersensitivity to cefaclor.Materials and MethodsWe enrolled 47 patients with immediate hypersensitivity to cefaclor from Ajou University Hospital and Asan Medical Center. Serum specific IgE, IgG1, and IgG4 antibodies to cefaclor-human serum albumin (HSA) conjugate were measured by enzyme-linked immunosorbent assay (ELISA).ResultsThe most common phenotype was anaphylaxis (Group I, 78.7%), followed by urticaria (Group II, 21.3%). The detection of specific IgE, IgG1, and IgG4 to cefaclor-HSA conjugate by ELISA tended to be higher in Group I (40.5%, 41.7%, 21.6%) than in Group II (20.0%, 20.0%, 0%) with no statistical significance. Significant associations were found between specific IgE and IgG1 or IgG4 (p<0.001, p=0.019). ELISA inhibition tests showed significant inhibitions by both free cefaclor and cefaclor-HSA conjugate. For basophil activation tests in patients having no specific IgE antibody, the CD63 expression level on basophils increased with incubations of free cefaclor.ConclusionThe most common manifestation of immediate hypersensitivity to cefaclor was anaphylaxis, most of which was mediated by IgE; however, a non-IgE mediated direct basophil activation mechanism was suggested in a subset of anaphylaxis patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

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Immunologic Evaluation of Immediate Hypersensitivity to Cefaclor

et al. 2014

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“…They are reported to be involved in various types of hypersensitivity (Kim et al, 2005;Rubio et al, 2010). T helper (Th) 1 and Th2 cells are the two types of T cells.…”

Section: Relationship Between Genetic Polymorphisms Of T Cell-relatedmentioning

confidence: 99%

Correlation analysis of gene polymorphisms and β-lactam allergy

Liu

et al. 2015

J. Zhejiang Univ. Sci. B

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A total of 64 patients with β-lactam allergy and 30 control subjects were enrolled in a case-control study.This study is aimed to analyze the relationship between β-lactam allergy and 10 single nucleotide polymorphisms (SNPs) in interleukin-10 (IL-10), IL-13, IL-4Rα, high-affinity immunoglobulin E-receptor β chain (FcεRIβ), interferon γ receptor 2 (IFNGR2), and CYP3A4, and within the Han Chinese population of Northwest China. Genotyping for the SNPs was conducted using the Sequenom MassARRAY ® platform. SPSS 17.0 was employed to analyze the statistical data and SHEsis was used to perform the haplotype reconstruction and analyze linkage disequilibrium of SNPs of IL-10 and IL-13. The results showed that the genotype distribution of CYP3A4 rs2242480/CT differed significantly between case and control groups of males (P=0.022; odds ratio (OR)=0.167, 95% confidence interval (CI): 0.032-0.867). Further analysis showed that CCA, CCG, and TAA haplotypes of IL-10 had no significant correlation in patients with β-lactam allergy. The correlation between CCT and CAC haplotypes of IL-13 and β-lactam allergy needs to be further studied. The analysis did not reveal any differences in the distribution of others gene polymorphisms between cases and controls.

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“…This can be due to the not inclusion of the culprit cephalosporin. For many years only cefaclor has been available for in vitro testing and it is well known that for this betalactam the side chain at R1 position is very important in the specific IgE recognition 25,42-44. Similar assays have been developed for other drugs, being in most cases experimental prototypes that need further validations in a sufficient number of positives controls 45-52…”

Section: Immediate Type Ige Mediated Reactionsmentioning

confidence: 99%

Immunologic Evaluation of Drug Allergy

Gómez

Torres

Mayorga

et al. 2012

Allergy Asthma Immunol Res

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Hypersensitivity drug reactions (HDR) consist of an individual abnormal response with the involvement of the immunological system. In addition to specific immunological mechanisms where specific antibodies or sensitised T cells participate, release of inflammatory mediators by non-specific immunological recognition may also occur. Within this category are one of the most common groups of drugs, the non-steroidal anti-inflammatory drugs. In addition to chemical drugs new emerging ones with an increasing protagonism are biological agents like humanised antibodies and others. For IgE dependent reactions both in vivo and in vitro tests can be used for the immunological evaluation. Sensitivity of these is not optimal and very often a drug provocation test must be considered for knowing the mechanism involved and/or establishing the diagnosis. For non-immediate reactions also both in vivo and in vitro tests can be used. Sensitivity for in vivo tests is generally low and in vitro tests may be needed for the immunological evaluation. Immunohistochemical studies of the affected tissue enable a more precise classification of non-immediate reactions. The monitorization of the acute response of the reactions has given clues for understanding these reactions and has promising results for the future of the immunological evaluation of HDR.

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Heterogeneity of the IgE response to allergenic determinants of cefaclor in serum samples from patients with cefaclor-induced anaphylaxis

Cited by 10 publications

References 17 publications

Immunologic Evaluation of Immediate Hypersensitivity to Cefaclor

Immunologic Evaluation of Immediate Hypersensitivity to Cefaclor

Correlation analysis of gene polymorphisms and β-lactam allergy

Immunologic Evaluation of Drug Allergy

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