| To elucidate the underlying mechanism of allergic reaction to penicillins, we explored the relationship between allergic reaction to penicillins and IgG antibodies, the relationship between IgG antibodies and IgE antibodies, and the correlation between genetic polymorphism of interferon-gamma, IFNR1 and penicillin allergy. RAST and ELISA were used to examine 8 kinds of specific IgE and IgG antibodies of different antigenic determinants in serum (BPO, BPA, APO, APA, AXO, AXA, PVO, PVA) among 249 patients with allergic reaction to penicillin and 88 healthy subjects, respectively. 144 patients with penicillin allergy and 88 healthy subjects were chosen from all subjects to examine genetic polymorphism of interferon-gamma and IFNR1. 1. The relationship between allergic reaction and specific IgG antibodies1.1 The serum level and positive rate of specific IgG antibodiesExcept BPA-IgG antibodies, 7 kinds of antigenic determinants IgG antibodies levelsare higher than control (PO.05) . Values over the mean+2.33 SD of the results in the control group were considered to be positive against to corresponding antigen. The positive rate of specific IgG antibodies in 249 patients was 58.63% (146), and the positive rate of IgG antibodies of patients with negative skin test (66.15%) was significantly higher than that of IgG antibodies to those with positive skin test (50.42%,P<0.05). In terms of allergic symptoms, there was no difference among anaphylactic shock group, urticaria group, and other symptoms group. According to allergic reaction types, there was no difference between patients with immediate hypersensitivity reaction (IHR) and those with delayed hypersensitivity reaction (DHR) either. The same was true in the positive rate of IgG antibodies to the male and female .1.2 Allergic reaction and kinds of specific IgG antibodiesAmong 8 kinds of antigenic determinants, the positive rate of BPO-IgG was the highest (33.73%), followed by AXO-IgG (16.47%), and that of BPA-IgG was the lowest (0.80%). According to allergic symptoms, the positive rate of BPO-IgG was highest in the anaphylactic shock group, the positive rate of AXO-IgG was highest in the urticaria group and the positive rate of BPO-IgG was highest in the other symptoms group. In three groups, the lowest positive rate was BPA-IgG . The positive rate in patients with only one specific IgG screened was 33.73% (84), but that in patients with all 8 kinds of specific IgG examined was 58.63% (146). It showed significant differences (P<0.01). There was no difference in the positive rate of IgG antibodies between 3 kinds determinants examined and 8 kinds determinants examined. The positive rates of antibodies to major and minor antigenic determinants were 56.22% (140) and 8.84% (22), respectively. Clearly, it also showed significant differences (P<0.01). The positive rates of antibodies to major and minor antigenic determinants in patients with anaphylactic shock were 58.14% (25) and 6.98% (23) respectively, and those in patients with urticaria were 68.49% (50) and 2.74% (2) respectively, and those in patients with other symptoms were 57.14% (8) and 7.14% (1) respectively, whereas those in patients with positive skin test were 47.90% (57) and 14.29% (17) respectively. The positive rate of IgG antibodies to major antigenic determinants of patients was significantly higher than that of IgG antibodies to minor antigenic determinants (P<0.01) in four groups. The major antigenic determinants to IgG probably play an important role in the process of penicillin allergic reaction. 1.3 CrossreactivityThe cross positive rate of BP, AP, AX and PV with others was 15.75%. 15.75%. 23.97% and 14.38%,respectively. The total cross positive rate was 26.71%. The results showed that partial crossreactivity existed in different penicillins.2. The relationship between IgE and IgGAmong 249 patients, the positive rate of specific IgE antibodies was 57.83% (144). Specific IgG positive rate in patients with positive specific IgE was 46.53 %, and that was 53.47% in patients with negative...
|
PDF Full Text Request