Transfer of a Drug‐induced Generalized Rash in Guinea Pigs

Self Cite

Skin test reactions were evaluated in 242 patients who appeared to develop delayed type drug eruptions from the clinical course. The patch testing was positive in 62 (31.5%) of 197 patients tested and the intradermal testing in 105 (89.7%) of 117 patients. The positive ratios of intradermal testing were higher in maculopapular (MP), erythema multiforme (EM), and erythrodermic (ED) types than in eczematous (Ecz) type drug eruptions, while those of patch testing were comparatively high in ED, Ecz type, and anticonvulsant-induced drug eruptions. It is considered that the combination of patch testing and intradermal testing is useful for determination of causative drugs in delayed type drug eruptions.

Section: Introductionmentioning

confidence: 99%

Evaluation of Skin Test Reactions in Patients with Non‐immediate Type Drug Eruptions

Osawa

Naito

Aihara

et al. 1990

Self Cite

“…rashes demonstrated that many test reactions have the properties of the JM type DH in morphology, time course and dosage of challenge drug required for the induction. They show erythema without induration, reach a peak usually 6 to 9 hours later but sometimes 12 to 24 hours later, and resolve rapidly (1)(2)(3)(4)(5)(6). The intradermal test often requires a 2 to 10% drug solution for induction of a positive reaction.…”

Section: +++++++++++++++--+--mentioning

confidence: 99%

“…We established an animal model with penicillins (PCs) and cephalosporins (CSs) for the generalized drug eruptions in man and demonstrated that experimentally drug-induced eruptions in guinea pigs shared many properties with delayed hypersensitivity (DH) skin test reactions, including time course, histology, development despite absence or low titer of detectable antibodies, and differences from the antibody response in hapten-carrier specificity and cross-reactivity (1). The cephalothin (CET)-induced generalized rash, as well as the DH skin test reaction to CET, was transferred into normal recipients by CET immunized lymphoid cells which did not adhere to the polystyrene petri dish coated with rabbit antiguinea pig y-globlin and were thus probably T cells (2). Therefore, it appeared that the druginduced rash was a cutaneous expression of DH to a drug and probably mediated by T cells rather than antibodies.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Skin Test Reactions in Patients with Delayed Type Rash Induced by Penicillins and Cephalosporins

Aihara

Ikezawa

1987

Skin test reactions were evaluated in 39 patients with delayed type generalized drug eruptions in which penicillins (PCs) or cephalosporins (CSs) were proved to be the causative drugs by intradermal testing and provocation. They were also compared with the experimental PC/CS rash of guinea pigs reported previously.The skin test was positive in 37 (95%) of 39 patients tested and in 13 (87%) of 15 patients, in whom the causative drugs were identified by provocation, in which intradermal testing with 2 to 10%PC/CS in saline solution was employed and the skin test reaction was observed not only 24 hours later but also 6 to 9 hours later. It is considered that the skin test is a valuable in vivo test for the diagnosis of drug allergy. From the skin test reaction, it appears that the PC/CS rash is classified into at least two different reactions, the Jones-Mote type reaction and the tuberculin type reaction. No cross reactions between PC and CS derivatives were observed in either the skin testing or the provocation in man, which is the same pattern seen in the animal model. Cross reactions among the PC derivatives in man were not found as frequently as expected from the results in animals.

“…induced GR (1) is a systemic expression of cellmediated delayed hypersensitivity (DH) reactions to drug-derived determinants in the skin, (2) has properties of Jones-Mote type reactions rather than tuberculin type classic DH reactions, and (3) may be a useful model for exanthematic eruptions with DH to drugs in man (2)(3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Genetic Control of Sulbenicillin (SBPC)‐Induced T Cell Proliferation in Mice

Ikezawa

Kawaguchi

1986

The major histocompatibility complex (MHC) control of T cell‐mediated response to drug‐derived determinants is not well understood. As a first step in studying the MHC control of drug hypersensitivity, semisynthetic penicillin, sulbenicillin (SBPC), was used as an antigen to establish an in vitro proliferative assay for mouse T cell response to this drug. The lymph node cells taken 7–9 days after immunization with 10 mg SBPC in complete adjuvant were tested for SBPC‐specific response in a standard 3 day proliferation assay. SBPC‐induced proliferation of the primed lymph node cells was mediated by the Thy‐1+, Lyt‐1+2– cells, i.e., helper type T (Th) cells. The Lyt‐1+2–, T cell proliferative responsiveness to SBPC was mapped on the I‐A locus within the H‐2 MHC regions. The proliferation was inhibited by the monoclonal antibody against Aβ molecules, product of the I‐A locus, but not by the monoclonal antibody against Eα molecules, product of the I‐E locus. These results indicate that the SBPC response of Lyt‐1+2–, Th cells is controlled by the I‐A locus, the products of which, the MHC class II A (AβAα) molecules, function as restriction molecules in the Th cell recognition of SBPC. The removal of the Lyt‐2+ suppressor type T (Ts) subset from the SBPC nonresponder cultures by a positive Lyt‐separation did not reverse the I‐A allele‐related nonresponsiveness. This result suggests that the nonresponsiveness is not due to the presence of the Lyt‐2+ Ts subset, but rather to the absence of the Lyt‐1+ Th subset, which recognizes SBPC together with self A molecules on the antigen presenting cell and proliferates in the SBPC nonresponder cultures.