Delayed hypersensitivity to aminopenicillins is related to major histocompatibility complex genes.

Abstract

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 chi2 test 2 x 2 contingency 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.

• Authors: A Romano, A De Santis, A Romito, M Di Fonso, A Venuti, G B Gasbarrini, R Manna
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 80 Issue 5 Pg. 433-7 (May 1998) ISSN: 1081-1206 [Print] United States
• PMID: 9609616 (Publication Type: Journal Article)

Chemical References

• Bronchodilator Agents
• Aminophylline

Topics

• Adolescent
• Adult
• Aminophylline (adverse effects)
• Bronchodilator Agents (adverse effects)
• Drug Hypersensitivity (etiology)
• Female
• Humans
• Hypersensitivity, Delayed (etiology)
• Major Histocompatibility Complex
• Male
• Middle Aged