TY - JOUR
T1 - Delayed hypersensitivity to aminopenicillins is related to major histocompatibility complex genes
AU - Romano, Antonino
AU - De Santis, Antonella
AU - Romito, Anna
AU - Di Fonso, Marina
AU - Venuti, Alberto
AU - Gasbarrini, Giovanni Battista
AU - Manna, Raffaele
PY - 1998/5
Y1 - 1998/5
N2 - Background: Although in some cases delayed hypersensitivity may be observed, beta-lactam antibiotics frequently induce immediate allergic IgE- mediated reactions with the specificity localized in the acyl-side chain structure. Generally, delayed immunologic reactions are related to sensitized T lymphocytes and major histocompatibility complex restricted. Objective: To investigate the prevalence of HLA class I and II antigens in patients with delayed hypersensitivity to aminopenicillins in order to evaluate a relationship between major histocompatibility complex immune response genes and aminopenicillins hypersensitivity. Methods: We assessed 24 patients with history of delayed hypersensitivity to aminopenicillins using (1) skin test with penicilloyl polylysine, minor determinant mixture, benzylpenicillin, amoxicillin, and ampicillin; (2) patch tests with benzylpenicillin, amoxicillin, and ampicillin; (3) RAST for penicilloyls G and V; and (4) oral challenges with amoxicillin, ampicillin, and penicillin V in 18/24 patients. All patients were typed by microlymphotoxicity standard test for HLA class I and II antigens. Statistical analysis by χ2 test 2 x 2 contigency tables, according to Svejgaard, were used for comparison between patients and random Italian population (522 subjects). Results: In the patients group we found higher prevalence of HLA A2 (12/24 = 50%, RR = 6.76 P <.001, EF = 0.425), DRw52 (20/24 = 83.3%, RR = 9.28, P <.001, EF = 0.74), and lower frequency of DR4 (3/24 = 12% ns). Conclusions: These data suggest that the immune mechanisms involved in adverse reactions to aminopenicillins in vivo are related to genetic markers of immune response and confirms that the presentation of penicillin-hapten determinants to lymphocyte is major histocompatibility complex restricted.
AB - Background: Although in some cases delayed hypersensitivity may be observed, beta-lactam antibiotics frequently induce immediate allergic IgE- mediated reactions with the specificity localized in the acyl-side chain structure. Generally, delayed immunologic reactions are related to sensitized T lymphocytes and major histocompatibility complex restricted. Objective: To investigate the prevalence of HLA class I and II antigens in patients with delayed hypersensitivity to aminopenicillins in order to evaluate a relationship between major histocompatibility complex immune response genes and aminopenicillins hypersensitivity. Methods: We assessed 24 patients with history of delayed hypersensitivity to aminopenicillins using (1) skin test with penicilloyl polylysine, minor determinant mixture, benzylpenicillin, amoxicillin, and ampicillin; (2) patch tests with benzylpenicillin, amoxicillin, and ampicillin; (3) RAST for penicilloyls G and V; and (4) oral challenges with amoxicillin, ampicillin, and penicillin V in 18/24 patients. All patients were typed by microlymphotoxicity standard test for HLA class I and II antigens. Statistical analysis by χ2 test 2 x 2 contigency tables, according to Svejgaard, were used for comparison between patients and random Italian population (522 subjects). Results: In the patients group we found higher prevalence of HLA A2 (12/24 = 50%, RR = 6.76 P <.001, EF = 0.425), DRw52 (20/24 = 83.3%, RR = 9.28, P <.001, EF = 0.74), and lower frequency of DR4 (3/24 = 12% ns). Conclusions: These data suggest that the immune mechanisms involved in adverse reactions to aminopenicillins in vivo are related to genetic markers of immune response and confirms that the presentation of penicillin-hapten determinants to lymphocyte is major histocompatibility complex restricted.
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M3 - Article
C2 - 9609616
AN - SCOPUS:0031861918
VL - 80
SP - 433
EP - 437
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
SN - 1081-1206
IS - 5
ER -