Side Chain-Specific Lymphocyte Responses in Workers with Occupational Allergy Induced by Penicillins

Abstract

Eight workers with clinically diagnosed or suspected occupational allergy caused by penicillins were studied by the lymphocyte transformation test (LTT) and by skin test. The majority of the workers handled bacampicillin, some of them had been in contact with benzylpenicillin and one worked with azidocillin only. Six workers had eczema and 2 workers suffered from rhinitis only. Lymphocytes from workers with bacampicillin-induced symptoms responded to this drug in vitro by an increased ³H-thymidine incorporation and by lymphoblastogenesis. Bacampicillin-specific allergy had been confirmed by positive patch test in 5 workers. Lymphocytes from bacampicillin-allergic workers did not respond to other penicillins such as benzylpenicillin or azidocillin in vitro. However, such penicillins were antigenic in vitro since lymphocytes from an azidocillin patch test positive worker proliferated on exposure to azidocillin in vitro. The findings at the cellular level were further supported by the specificity of the skin test. Thus, bacampicillin patch test positive workers had a negative skin reaction to benzylpenicillin. In conclusion, these data suggest the role of penicillin side chains in the sensitization process underlying occupational allergy to penicillins. LTT can be used as a tool for studying antigenic specificities involved in a sensitization process leading to penicillin allergy.

Allergy to Drugs and Other Chemicals Diagnosed by the Presence of Specific Memory Cells in Human Blood

“…PcG-and PcV-specific lymphocytes of allergic patients did not cross-react with aminobenzylpenicillins such as bacampicillin or ampicillin. The similar penicillin side chain specificity has been described above (Table 3) and reported previously in workers with occupational hypersensitivity (Stejskal et al 1986(Stejskal et al , 1987.…”

“…Taken together, the results in therapeutically treated patients confirmed those obtained in occupationally exposed workers (Stejskal et al 1986(Stejskal et al , 1987. Memory cells from allergic subjects respond to penicillin haptens in vitro by side chain-specific proliferative responses.…”

“…As previously published (Stejskal et al 1986(Stejskal et al , 1987, occupational exposure to penicillins induces hypersensitivity reactions in some of the exposed workers. Bacampicillin was a major offending agent while phenoxymethylpenicillin (PcY) was virtually devoid of allergenic potential.…”

“…Since the amount of scientific effort necessary to summarize clinical and laboratory data was considerable, only part of the data have previously been published (Stejskal et al 1986(Stejskal et al , 1987. The results are summarized in Table 2.…”

Contribution of biological markers to occupational health

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Occupational diseases are now being assessed at the cellular and molecular levels; this presents new opportunities for prevention and control [Calleman et al, 1978;Ong et al, 1987;Stejskal et al, 1989;Welch and Cullen, 1988; Garry et al, 19891. The key to these opportunities is the ability to detect biological markers that reflect exposure, response, and susceptibility.

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