IgE‐mediated anaphylaxis to Thiomucase®, a mucopolyssacharidase: allergens and cross‐reactivity

Caballero, Teresa; Alonso, A.; Miguel, Sergio de; Martín-Esteban, Manuel; Varga, B; Pascual, C.; López-Serrano, M C

doi:10.1034/j.1398-9995.2002.03322.x

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…It has been shown that the target molecule of SJ18 ε 1, a monoclonal IgE antibody to Schistosoma japonicum that induces significant protection toward a challenge infection, was a paramyosin and that the target epitope was common among paramyosins of S. mansoni, Taenia solium, and E. granulosus (105). Cross-reactivity with more distant molecules is suggested by the recent clinical observation of IgE-mediated anaphylaxis to Thiomucase ® , a mucopolysaccharidase of sheep origin, used in the treatment of joint disorders (106). In this patient treated with Thiomucase, positive prick tests and specific IgE were found using BSA, cat, and sheep allergens, but also E. granulosus extracts.…”

Section: Characterization Of Echinococcus Sp Allergensmentioning

confidence: 81%

Echinococcosis and allergy

Vuitton

2004

Clinic Rev Allerg Immunol

108

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The larval stages of Echinococcus granulosus and E. multilocularis are involved in parasitic diseases in humans: cystic echinococcosis (CE) ("hydatid disease") and alveolar echinococcosis (AE), respectively. Both diseases and parasites have tight links with allergy because of the immunological characteristics that contribute to maintain the larvae in their human host as well as their potential in inducing clinical anaphylactic reactions in some patients. Clinical observations in patients and data obtained from mass screenings in various countries have identified both forms of echinococcosis as "polar diseases," i.e., diseases where immunological background of the patients was related to the clinical presentation and course. In particular, abortive cases (i.e., spontaneous cures) have been found in many subjects in endemic areas. On the other hand, immune suppression was associated with severe disease. AE especially might be considered as an opportunistic infection. Experimental and clinical studies have shown that Th1-related immune response was associated with protection and Th2-related response was associated with parasite growth. Genetic characteristics of the host are related to both occurrence and severity of AE and are associated with the extent of IL-10 secretion, which is a major feature of chronic progressing echinococcosis. Anaphylactic reactions, including urticaria, edema, respiratory symptoms, and anaphylactic shock due to spontaneous or provoked rupture of the parasitic cyst, are well known in CE. Anaphylactic reactions in AE are far less frequent, and have been observed in rare cases at time of metastatic dissemination of the parasitic lesions. Echinococcus-specific IgE is present in most of the patients and associated with severity. Specific histamine release by circulating basophils stimulated with E. granulosus antigens is present in all patients with CE and AE. Echinococcus allergens include (1) AgB 12-kDa subunit, a protease inhibitor and a potent Th2 inducer; (2) Ag5, a serine protease; (3) EA 21, a specific cyclophilin, with a homology with other types of cyclophilins; (4) Eg EF-1 beta/delta an elongation factor, with a homology with Strongyloides stercoralis EF that shares the same IgE epitope. A clinical cross-reaction with Thiomucase, a mucopolysaccharidase used in arthritis treatment, has recently been published. However, despite the potential risk of allergic reactions, the dogma "never puncture a hydatid cyst" is no longer valid. International experience of therapeutic technique of "puncture, aspiration, injection, re-aspiration" of hydatid cysts developed at the beginning of the 1980s has proved to be successful in a variety of selected indications that have been reviewed by WHO recommendations. A better understanding of the immunological background of echinococcosis in humans has led to new therapeutic developments, such as immunomodulation using interferon alpha. Th2-driven immunological response and IL-10-related tolerance state are common characteristics of atopic allergy and echi...

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Section: Characterization Of Echinococcus Sp Allergensmentioning

confidence: 81%

Echinococcosis and allergy

Vuitton

2004

Clinic Rev Allerg Immunol

108

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“…SAs are minor allergens in animal dander and in milk but major allergens in meats. In view of the reported cross-reactivity between SAs from mammals, even if they are phylogenetically distinct [41], the diagnostic work-up in meat-allergic individuals should always include tests with meats from different mammals, and the use of alternative meats should always be carefully evaluated on an individual basis. Furthermore, due to cross-reactivity phenomena, children with persistent milk allergy and BSA sensitization show an increased risk of clinically relevant sensitization to animal dander [14].…”

Section: Discussionmentioning

confidence: 99%

Role of Sensitization to Mammalian Serum Albumin in Allergic Disease

Liccardi

Asero

D’Amato

et al. 2011

Curr Allergy Asthma Rep

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Serum albumin (SA) constitutes an intriguing puzzle that is involved in allergic sensitizations from different sources and induces different clinical manifestations. In this article, we describe the role of sensitization to SAs in inducing allergic diseases and the complex interactions and cross-reactivity between SA resulting from its presence in various mammalian tissues and fluids. SAs alone are an uncommon cause of allergic sensitization in airways, but these allergenic proteins likely play a significant role as cross-reacting allergens in individuals sensitized to several types of animal dander. SAs are a minor allergen in milk but a major allergen in meats. Recently, bovine SA has been added to the culture medium of spermatozoids used for artificial insemination. As a consequence, some case reports have shown that bovine SA may be a causative agent in severe anaphylaxis after standard intrauterine insemination or in vitro fertilization.

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“…Cross-reactivity seemed to be relevant as many antigens, including cyclophyllin of birch pollen, Malassezia furfur , Shistosomia japonica and Strongiloides stercoralis have been shown to cross-react with one of the antigens of E. granulosus [20, 21]. Cross-reactivity was also determined on thiomucase, a drug including mucopolysaccharidase of sheep origin, with cat, sheep and E. granulosus extracts [22]. Furthermore, cross-reactivity of streptococcal cell wall antigens with Mycobacterium tuberculosis was demonstrated with T cell lines [23].…”

Section: Discussionmentioning

confidence: 99%

Echinococcosis: A Possible Etiology in Psoriatic Disease

Apan

Kaygusuz²

2006

Dermatology

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We aimed to investigate seroprevalence of Echinococcus granulosus in patients with psoriasis to determine a possible etiologic role, since both echinococcosis and psoriasis are defined as T cell-mediated diseases. Forty psoriatic patients and 50 age- and sex-matched control subjects were included in the study. IgG-specific ELISA was used to determine seropositivity. E. granulosus-specific IgG antibodies were found to be positive in 17/40 (42.5%) of the patients with psoriasis and in 11/50 (22%) of the control subjects (p = 0.008). Our results suggest thatechinococcosis might be one of the causative pathogens in the etiopathogenesis of psoriasis in highly endemic regions.

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IgE‐mediated anaphylaxis to Thiomucase®, a mucopolyssacharidase: allergens and cross‐reactivity

Abstract: An IgE-mediated anaphylaxis to Thiomucase is documented. Multiple allergens are recognized in Thiomucase by the patient serum, the main with 43 kDa. Partial cross-reactivity with BSA, cat dander and sheep dander is documented.

Cited by 5 publications

References 8 publications

Echinococcosis and allergy

Echinococcosis and allergy

Role of Sensitization to Mammalian Serum Albumin in Allergic Disease

Echinococcosis: A Possible Etiology in Psoriatic Disease

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