Toward an in Vitro Test for the Diagnosis of Allergy to Penicillins. Synthesis, Characterization, and Use of β-Lactam and β-Lactam Metabolite Poly-l-lysines Which Recognize Human IgE Antibodies

Abstract

Conjugates of poly-L-lysine (PLL) containing a penicillin or a penicilloyl residue were prepared and characterized by 1H NMR and by size-exclusion (SE) HPLC. These conjugates were used in a radio allergo sorbent tests (RAST) test for the determination of allergy toward beta-lactams. The chemiometric evaluation of the data indicates that allergy to amoxycillin is different from allergy to the other beta-lactams tested. Furthermore, careful chemical characterization of the conjugates appears to be crucial to obtain meaningful information from the RAST data.

Diagnosis of immediate allergic reactions to beta‐lactam antibiotics

“…Many methods have been developed for the quantitation of specific IgE antibodies to betalactams but the most widely used are the immunoassays (ELISA, RIA or FEIA), and the most validated are the RIA, mostly by RAST, and the FEIA (44–48). All are based on the detection of the hapten‐carrier‐antibody complex.…”

Side‐chain‐specific reactions to betalactams: 14 years later

“…For IR, the complement of the in vivo test is the in vitro quantification of IgE antibodies by immunoassay (ELISA, RIA or FEIA). Several in vitro tests are currently available [53–55], including those in which commercial tests have been modified [56,57]. These tests have resulted in the more precise identification of side‐chain‐specific reactions.…”