Evaluation of a new reactive solid phase for radioimmunoassay of serum specific IgE against muscle relaxant drugs

Abstract

Until now, immunoassays for detection of anti-muscle relaxant IgE in serum have been performed with the drug coupled to epoxy-activated Sepharose or to RAST papers dics. In the present work we have used a quaternary ammonium-Sepharose in which the quaternary ammonium reactive group (choline chloride) was directly coupled to Sepharose via an ether linkage. 50 microliters of the quaternary ammonium solid phase (QAS) was incubated with 50 microliters of serum for 3 h, washed, incubated 18 h with 125I-anti-IgE and washed again. The results were expressed as the percentage of 125I-anti-IgE absorbed onto the solid phase. The results were at 1.3 +/- 0.5% for 20 control sera, with an upper normal limit estimated to 2.3%. The within-run reproducibility ranged from 3.2% to 10.0%. The results were significantly correlated with those obtained with either alcuronium-epoxy-Sepharose, choline-epoxy-Sepharose, the RAST-alcuronium or with the RAST-succinyl choline (respectively, r = 0.66, r = 0.80, r = 0.81, r = 0.40 and r = 0.85). The values obtained with the sera of 83 patients ranged from 0.3 to 38.5%. The sensitivity was estimated at 87.9%, 66.7% and 40.7% with the QAS-RIA, the RAST-succinyl choline and the RAST-alcuronium, respectively. The inhibition of adsorption of specific IgE onto the gel ranged from 13.0 to 90.6% in presence of 130 nmol of soluble muscle relaxants. In 83.3% of 30 cases, the highest inhibition was obtained with the muscle relaxant which was clinically incriminated.(ABSTRACT TRUNCATED AT 250 WORDS)

Perioperative Anaphylaxis: What Should Be Known?

“…In vitro tests for the detection of specific IgE directed to the tertiary or quaternary ammonium groups of NMBAs using a quaternary ammonium (choline chloride) have been developed [38,39]. A morphine-based solid-phase IgE has also been proposed, since the tertiary methyl-amino group of morphine cross-reacts in vitro with NMBAs [40].…”

Quaternary ammonium compounds and occupational asthma

“…She did not have IgE speci®c to latex, ethylene oxide, formaldehyde, anaesthetic agents (RAST, Pharmacia, Sweden) and quaternary ammonium reactive groups (dosage according to Gueant et al) [10]. Peak¯ow monitoring demonstrated a more than 60% drop while she was at work.…”

What investigation after an anaphylactic reaction during anaesthesia?

“…The presence of specific IgEs of NMBAs in serum has been initially demonstrated using NMBA coupled to epoxy-sepharose (Cap-RAST). The sensitivity of this test, however, is limited and therefore was improved by coupling an analogue of choline to sepharose (quaternary ammonium sé pharose or QAS) [15], or p-aminophenylphosphoryl-choline (PAPPC) on agarose [16]. A morphine-based solid phase IgE assay was also proposed to diagnose anaphylaxis to NMBAs as common antigens were involved [17].…”