IgE antibody‐mediated shock reaction caused by topical application of chlorhexidine

Ohtoshi, Takayuki; Yamauchi, Norihiro; Tadokoro, Kenji; Miyachi, Sumiki; Suzuki, Shuji; Miyamoto, Toru; Muranaka, M

doi:10.1111/j.1365-2222.1986.tb00759.x

Cited by 97 publications

(51 citation statements)

References 10 publications

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“…Allergic IgE antibody-mediated sensitivity to the drug can be demonstrated by positive skin tests and tests for specific serum IgE antibodies. Following the development in Japan in 1986 of a specific immunoassay for detecting chlorhexidine-reactive IgE by linking a chlorhexidine-albumin conjugate to paper discs and demonstration of specificity by inhibition with chlorguanide and the parent drug [68], experiments to identify allergenic determinants were subsequently undertaken using chlorhexidine linked to a bis-oxirane-activated solid phase [69]. To identify the fine structural features of the determinant(s) complementary to chlorhexidine-reactive IgE antibodies, a number of analogs were selected for examination.…”

Section: Chlorhexidinementioning

confidence: 99%

IgE and Drug Allergy: Antibody Recognition of ‘Small’ Molecules of Widely Varying Structures and Activities

Baldo

2014

Antibodies

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Abstract:The variety of chemically diverse pharmacologically-active compounds administered to patients is large and seemingly forever growing, and, with every new drug released and administered, there is always the potential of an allergic reaction. The most commonly occurring allergic responses to drugs are the type I, or immediate hypersensitivity reactions mediated by IgE antibodies. These reactions may affect a single organ, such as the nasopharynx (allergic rhinitis), eyes (conjunctivitis), mucosa of mouth/throat/tongue (angioedema), bronchopulmonary tissue (asthma), gastrointestinal tract (gastroenteritis) and skin (urticaria, eczema), or multiple organs (anaphylaxis), causing symptoms ranging from minor itching and inflammation to death. It seems that almost every drug is capable of causing an immediate reaction and it is unusual to find a drug that has not provoked an anaphylactic response in at least one patient. These facts alone indicate the extraordinary breadth of recognition of IgE antibodies for drugs ranging from relatively simple structures, for example, aspirin, to complex molecules, such as the macrolide antibiotics composed of a large macrocyclic ring with attached deoxy sugars. This wide recognition profile is borne out at the molecular level by results of quantitative immunochemical studies where hapten inhibition investigations have identified structural determinants complementary to IgE antibodies in the sera of allergic subjects. Allergenic determinants have been identified on a variety of drugs including neuromuscular blockers, penicillins, cephalosporins, opioids, thiopentone, sulfonamides, trimethoprim, quinolones, chlorhexidine and the non-steroidal anti-inflammatory drug aspirin. It is already clear that IgE can distinguish fine structural differences on a wide variety of molecules, determinants OPEN ACCESSAntibodies 2014, 3 57 may be at least as small as an amino group or encompass the whole molecule, and individual drugs may demonstrate allergenic heterogeneity.

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Section: Chlorhexidinementioning

confidence: 99%

IgE and Drug Allergy: Antibody Recognition of ‘Small’ Molecules of Widely Varying Structures and Activities

Baldo

2014

Antibodies

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“…Therefore, the final concentration was 48-80 times weaker than the 0.12-0.2% product. In Japan, chlorhexidine use for sterilization of the oral cavity, hands, and catheters resulted in more than 10 cases of anaphylactic shock in the 1980s (21,22). Stephens et al (23) reported that chlorhexidine allergy has been described mainly in Japanese individuals.…”

Section: Discussionmentioning

confidence: 99%

The effects of essential oil, povidone-iodine, and chlorhexidine mouthwash on salivary nitrate/nitrite and nitrate-reducing bacteria

Mitsui

Harasawa²

2017

J Oral Sci

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Dietary nitrate is reduced to nitrite and nitric oxide by microbial flora, and this activity is beneficial to vascular health. It has been reported that this bacterial process is inhibited by chlorhexidine mouthwash, although the effects of other products are largely unknown. This study examined the effects of several treatments on salivary nitrate/nitrite and nitrate-reducing bacteria. Twelve university staff and students performed mouth-washing with water (control), essential oil, 0.35% povidone-iodine, or 0.0025% chlorhexidine and then ate 100 g lettuce (110 mg nitrate content), followed by collection of saliva and tongue bacteria at the baseline, and 1, 5, and 10 h thereafter. The individual treatments were separated by an interval of one week. Salivary nitrate/nitrite was measured by the calorimetric method, and a representative nitrate-reducing bacterial species, Veillonella dispar, was detected and semi-quantified using a polymerase chain reaction (PCR) assay. Significant increases in salivary nitrate/nitrite were observed for all treatments (all P < 0.05). The PCR assay showed that water, essential oil, and povidone-iodine mouthwash had little effect, whereas V. dispar DNA bands were markedly inhibited after washing with chlorhexidine. These results suggest that essential oil and povidone-iodine mouthwash have little effect on oral nitrate-reducing activity. Salivary nitrite production was not reduced by chlorhexidine, but the fainter band of V. dispar DNA suggests that longer daily use might blunt this nitrate-reducing activity.

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“…[30][31][32] Studies with radiolabeled chlorhexidine mouthrinse have shown its ability to penetrate the intact mucosal barrier of the oral cavity or intestinal tract. 33,34 Ohtoshi et al 35 reported more than 30 cases of anaphylactic shock after the topical application of chlorhexidine.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2016

IJPSR

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ABSTRACT:To evaluate the antimicrobial activity of Octenidine (OCT) 0.1%, Chlorhexidine (CHX) 0.2% against bacterial strains of Enterococcus faecalis and Staphylococcus aureus. The strains were inoculated in 7ml of brain heart infusion broth and diluted to reach the concentration equivalent (0.5 McFarland standard). 1ml of organism suspension was contacted with 1ml of each mouthwash and was removed at time interval of 3,5 and 10 minute and plated on Brain Heart Infusion agar. After 72 hours of incubation, colony counts were measured using stereomicroscope. Kruskal Wallis test was conducted on mean number of CFU. Post-hoc tests were conducted by using the Mann Whitney U test and Duncan's-test of multiple comparisons. The results showed that OCT 0.1% was found to be the most effective in substantially reducing total bacterial counts after 3, 5 and 10 min time interval. OCT 0.1% was found to be the most effective in substantially reducing total bacterial counts.

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IgE antibody‐mediated shock reaction caused by topical application of chlorhexidine

Cited by 97 publications

References 10 publications

IgE and Drug Allergy: Antibody Recognition of ‘Small’ Molecules of Widely Varying Structures and Activities

IgE and Drug Allergy: Antibody Recognition of ‘Small’ Molecules of Widely Varying Structures and Activities

The effects of essential oil, povidone-iodine, and chlorhexidine mouthwash on salivary nitrate/nitrite and nitrate-reducing bacteria

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