Basophil histamine release induced by amoxicilloyl-poly-l-lysine compared with amoxicillin in patients with IgE-mediated allergic reactions to amoxicillin

F Arribas, S Falkencrone, J Sola, M P Gomez-Serranillos, J J Laguna, M I Montañez, T D Fernandez, D Rodríguez, F Pineda, P Stahl Skov, C Mayorga, M J Torres

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Amoxicillin (AX) is the ß-lactam most often involved in IgE-mediated reactions. Diagnosis is based mainly on skin testing, although sensitivity is not optimal. We produced a new AX derivative, amoxicilloyl-poly-L-lysine (APL), and analyzed its recognition of IgE using the passive histamine release test (pHRT). Methods: The study population comprised patients (n=19) with confirmed AX allergy and specific IgE to AX and controls (n=10) with good tolerance to AX. pHRT was performed using “IgE-stripped” blood from a single donor that was sensitized in vitro by patient sera and incubated with AX or APL. Histamine release was determined and expressed as nanograms of histamine released per milliliter of blood. Results: The clinical symptoms were anaphylaxis (n=9), urticaria (n=7), erythema (n=2), and nondefined immediate reactions (n=1). The median (IQR) time interval between reaction and study was 90 (60-240) days and between drug intake and development of symptoms 24 (10-60) minutes. The median sIgE level was 3.37 (0.95-5.89) kU A/L. The sensitivity of pHRT to APL was 79% and the specificity 100%, which were higher than data obtained with pHRT to AX (63% sensitivity and 90% specificity). There was a positive correlation between maximal histamine release levels obtained with AX and APL (r=0.63). Conclusions: In patients with immediate hypersensitivity reactions to AX, APL showed higher sensitivity and specificity than the culprit drug, AX, when tested in vitro by pHRT. This indicates that APL can improve the in vitro diagnostic accuracy of allergic reactions to AX. Further assessment of skin testing is necessary.

OriginalsprogEngelsk
TidsskriftJournal of Investigational Allergology and Clinical Immunology
Vol/bind27
Udgave nummer6
Sider (fra-til)356-362
ISSN1018-9068
DOI
StatusUdgivet - 20. jun. 2017

Fingeraftryk

Histamine Release
Lysine
Hypersensitivity
Immediate Hypersensitivity
Lactams
Skin
Urticaria
Erythema
Pharmaceutical Preparations

Citer dette

Arribas, F ; Falkencrone, S ; Sola, J ; Gomez-Serranillos, M P ; Laguna, J J ; Montañez, M I ; Fernandez, T D ; Rodríguez, D ; Pineda, F ; Stahl Skov, P ; Mayorga, C ; Torres, M J. / Basophil histamine release induced by amoxicilloyl-poly-l-lysine compared with amoxicillin in patients with IgE-mediated allergic reactions to amoxicillin. I: Journal of Investigational Allergology and Clinical Immunology. 2017 ; Bind 27, Nr. 6. s. 356-362.
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title = "Basophil histamine release induced by amoxicilloyl-poly-l-lysine compared with amoxicillin in patients with IgE-mediated allergic reactions to amoxicillin",
abstract = "Background: Amoxicillin (AX) is the {\ss}-lactam most often involved in IgE-mediated reactions. Diagnosis is based mainly on skin testing, although sensitivity is not optimal. We produced a new AX derivative, amoxicilloyl-poly-L-lysine (APL), and analyzed its recognition of IgE using the passive histamine release test (pHRT). Methods: The study population comprised patients (n=19) with confirmed AX allergy and specific IgE to AX and controls (n=10) with good tolerance to AX. pHRT was performed using “IgE-stripped” blood from a single donor that was sensitized in vitro by patient sera and incubated with AX or APL. Histamine release was determined and expressed as nanograms of histamine released per milliliter of blood. Results: The clinical symptoms were anaphylaxis (n=9), urticaria (n=7), erythema (n=2), and nondefined immediate reactions (n=1). The median (IQR) time interval between reaction and study was 90 (60-240) days and between drug intake and development of symptoms 24 (10-60) minutes. The median sIgE level was 3.37 (0.95-5.89) kU A/L. The sensitivity of pHRT to APL was 79{\%} and the specificity 100{\%}, which were higher than data obtained with pHRT to AX (63{\%} sensitivity and 90{\%} specificity). There was a positive correlation between maximal histamine release levels obtained with AX and APL (r=0.63). Conclusions: In patients with immediate hypersensitivity reactions to AX, APL showed higher sensitivity and specificity than the culprit drug, AX, when tested in vitro by pHRT. This indicates that APL can improve the in vitro diagnostic accuracy of allergic reactions to AX. Further assessment of skin testing is necessary.",
keywords = "Journal Article, Allergy, Basophil histamine release, Immediate reactions, Amoxicillin, Amoxicilloyl-poly-L-lysine, Amoxicillin/adverse effects, Basophils/immunology, Skin Tests, Drug Hypersensitivity/diagnosis, Humans, Middle Aged, Male, Anaphylaxis/diagnosis, Polylysine/chemistry, Young Adult, Immunoglobulin E/immunology, Histamine Release/immunology, Biomarkers, Adult, Female, ROC Curve, Aged, Antibody Specificity/immunology",
author = "F Arribas and S Falkencrone and J Sola and Gomez-Serranillos, {M P} and Laguna, {J J} and Monta{\~n}ez, {M I} and Fernandez, {T D} and D Rodr{\'i}guez and F Pineda and {Stahl Skov}, P and C Mayorga and Torres, {M J}",
year = "2017",
month = "6",
day = "20",
doi = "10.18176/jiaci.0180",
language = "English",
volume = "27",
pages = "356--362",
journal = "Journal of Investigational Allergology and Clinical Immunology",
issn = "1018-9068",
publisher = "Esmon Publicidad",
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}

Arribas, F, Falkencrone, S, Sola, J, Gomez-Serranillos, MP, Laguna, JJ, Montañez, MI, Fernandez, TD, Rodríguez, D, Pineda, F, Stahl Skov, P, Mayorga, C & Torres, MJ 2017, 'Basophil histamine release induced by amoxicilloyl-poly-l-lysine compared with amoxicillin in patients with IgE-mediated allergic reactions to amoxicillin', Journal of Investigational Allergology and Clinical Immunology, bind 27, nr. 6, s. 356-362. https://doi.org/10.18176/jiaci.0180

Basophil histamine release induced by amoxicilloyl-poly-l-lysine compared with amoxicillin in patients with IgE-mediated allergic reactions to amoxicillin. / Arribas, F; Falkencrone, S; Sola, J; Gomez-Serranillos, M P; Laguna, J J; Montañez, M I; Fernandez, T D; Rodríguez, D; Pineda, F; Stahl Skov, P; Mayorga, C; Torres, M J.

I: Journal of Investigational Allergology and Clinical Immunology, Bind 27, Nr. 6, 20.06.2017, s. 356-362.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Basophil histamine release induced by amoxicilloyl-poly-l-lysine compared with amoxicillin in patients with IgE-mediated allergic reactions to amoxicillin

AU - Arribas, F

AU - Falkencrone, S

AU - Sola, J

AU - Gomez-Serranillos, M P

AU - Laguna, J J

AU - Montañez, M I

AU - Fernandez, T D

AU - Rodríguez, D

AU - Pineda, F

AU - Stahl Skov, P

AU - Mayorga, C

AU - Torres, M J

PY - 2017/6/20

Y1 - 2017/6/20

N2 - Background: Amoxicillin (AX) is the ß-lactam most often involved in IgE-mediated reactions. Diagnosis is based mainly on skin testing, although sensitivity is not optimal. We produced a new AX derivative, amoxicilloyl-poly-L-lysine (APL), and analyzed its recognition of IgE using the passive histamine release test (pHRT). Methods: The study population comprised patients (n=19) with confirmed AX allergy and specific IgE to AX and controls (n=10) with good tolerance to AX. pHRT was performed using “IgE-stripped” blood from a single donor that was sensitized in vitro by patient sera and incubated with AX or APL. Histamine release was determined and expressed as nanograms of histamine released per milliliter of blood. Results: The clinical symptoms were anaphylaxis (n=9), urticaria (n=7), erythema (n=2), and nondefined immediate reactions (n=1). The median (IQR) time interval between reaction and study was 90 (60-240) days and between drug intake and development of symptoms 24 (10-60) minutes. The median sIgE level was 3.37 (0.95-5.89) kU A/L. The sensitivity of pHRT to APL was 79% and the specificity 100%, which were higher than data obtained with pHRT to AX (63% sensitivity and 90% specificity). There was a positive correlation between maximal histamine release levels obtained with AX and APL (r=0.63). Conclusions: In patients with immediate hypersensitivity reactions to AX, APL showed higher sensitivity and specificity than the culprit drug, AX, when tested in vitro by pHRT. This indicates that APL can improve the in vitro diagnostic accuracy of allergic reactions to AX. Further assessment of skin testing is necessary.

AB - Background: Amoxicillin (AX) is the ß-lactam most often involved in IgE-mediated reactions. Diagnosis is based mainly on skin testing, although sensitivity is not optimal. We produced a new AX derivative, amoxicilloyl-poly-L-lysine (APL), and analyzed its recognition of IgE using the passive histamine release test (pHRT). Methods: The study population comprised patients (n=19) with confirmed AX allergy and specific IgE to AX and controls (n=10) with good tolerance to AX. pHRT was performed using “IgE-stripped” blood from a single donor that was sensitized in vitro by patient sera and incubated with AX or APL. Histamine release was determined and expressed as nanograms of histamine released per milliliter of blood. Results: The clinical symptoms were anaphylaxis (n=9), urticaria (n=7), erythema (n=2), and nondefined immediate reactions (n=1). The median (IQR) time interval between reaction and study was 90 (60-240) days and between drug intake and development of symptoms 24 (10-60) minutes. The median sIgE level was 3.37 (0.95-5.89) kU A/L. The sensitivity of pHRT to APL was 79% and the specificity 100%, which were higher than data obtained with pHRT to AX (63% sensitivity and 90% specificity). There was a positive correlation between maximal histamine release levels obtained with AX and APL (r=0.63). Conclusions: In patients with immediate hypersensitivity reactions to AX, APL showed higher sensitivity and specificity than the culprit drug, AX, when tested in vitro by pHRT. This indicates that APL can improve the in vitro diagnostic accuracy of allergic reactions to AX. Further assessment of skin testing is necessary.

KW - Journal Article

KW - Allergy

KW - Basophil histamine release

KW - Immediate reactions

KW - Amoxicillin

KW - Amoxicilloyl-poly-L-lysine

KW - Amoxicillin/adverse effects

KW - Basophils/immunology

KW - Skin Tests

KW - Drug Hypersensitivity/diagnosis

KW - Humans

KW - Middle Aged

KW - Male

KW - Anaphylaxis/diagnosis

KW - Polylysine/chemistry

KW - Young Adult

KW - Immunoglobulin E/immunology

KW - Histamine Release/immunology

KW - Biomarkers

KW - Adult

KW - Female

KW - ROC Curve

KW - Aged

KW - Antibody Specificity/immunology

U2 - 10.18176/jiaci.0180

DO - 10.18176/jiaci.0180

M3 - Journal article

C2 - 28628008

VL - 27

SP - 356

EP - 362

JO - Journal of Investigational Allergology and Clinical Immunology

JF - Journal of Investigational Allergology and Clinical Immunology

SN - 1018-9068

IS - 6

ER -