Antibody Reactivity in Penicillin-Sensitive Patients Determined with Different Penicillin Derivatives

Abstract

35 individuals showing reactions to penicillin of anaphylactic shock, angioedema or urticaria were investigated. Their skin sensitivity was analysed using 16 different penicillin derivatives. In addition, the content of circulating reagins against the penicilloyl structure in the patient’s sera were analysed using RAST. 17 of the patients had negative skin reactions and RAST results to all substances tested. The other 18 were skin test-positive to at least one derivative but showed markedly heterogeneous patterns of skin reactivity. 14 had positive reactions against penicilloyl structures accompanied by anti-penicilloyl reagins. Four patients showed doubtful reactions only to penicillin or penicilloate and/or penilloate. These patients also had very low levels of reagins against penicilloyl in their sera. Positive skin test results using monovalent penicillin derivatives such as penicillin, penicilloate, penilloate, penicilloyl amide, penicilloyl-formyl-lysine, penicillamine, which cannot form a multivalent antigen with penicillyol specificity, indicated formation of other derivatives of importance in penicillin allergy, e. g., penicillamine protein conjugates. Three patients showed skin reactions to ampicillin polymer and two to benzyl-penicillin polymer. The skin tests performed with the penicillin derivatives used do not seem to give more information on the sensitivity of the patiens than does the RAST using penicilloyl structures.

High-performance liquid chromatographic analysis of carbenicillin and its degradation products

“…The physical data obtained13 were consistent with those reported (8,11). The physical data obtained13 were consistent with those reported (8,11).…”

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

“…Penicillin al lergy may be diagnosed either clinically by skin test ing [1][2][3], by oral challenge [3] or in the laboratory by a penicillin-specific radioallergosorbent test (RAST) [4]. Recently, lymphocyte transformation test (LTT) has been routinely used for diagnosis of drug-induced occupational allergy [5].…”

Penizillinallergie als ein diagnostische Problem

“…Die Abklärung durch die Bestimmung des antibiotikumspezifischen IgE wird nicht einheitlich empfohlen, da der CAP-Test im Vergleich zu den Hauttestungen eine geringere Sensitivität be-sitzt und die Bestimmung mehr Zeit in Anspruch nimmt [27,28,29,49,58,59]. Außerdem ist eine Bestimmung der Minordeterminante im CAP-Test nicht möglich [18,58], aber wichtig, da gerade hier bei entsprechender Sensibilisierung schwere Allgemeinreaktionen beschrieben sind [19,30,34,40].…”