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. 1974 Feb;26(2):425–440.

Tests for penicillin allergy in man

I. Carrier effect on response to penicilloyl conjugates

Margaret R Vickers, E S K Assem
PMCID: PMC1423090  PMID: 4137237

Abstract

The value of using benzylpenicilloyl (BPO) conjugates rather than benzylpenicillin (B.Pen.) itself in skin tests and in in vitro diagnostic tests for penicillin allergy in man is assessed. The effect of various carriers on the outcome of these tests has also been investigated in order to find the most appropriate. Skin tests with B.Pen. and BPO conjugates (with polylysine, PL, and human serum albumin, HSA) in penicillin allergic patients were positive in 36 per cent and up to 50 per cent respectively. The two carriers used were equally effective. Negative results were obtained in the non-allergic control subjects. For in vitro studies two tests were selected on the basis of their well established value, the lymphocyte transformation test (LTT) and histamine release from sensitized leucocytes (HRL). In the HRL test BPO conjugates with PL, HSA, bovine serum albumin (BSA) and bovine gamma globulin (BGG) were also compared with B.Pen. The BPO conjugates were all more effective than B.Pen. and the proportion of patients giving positive results with these conjugates was much higher than with B.Pen. (up to 86 per cent compared with 29 per cent). The rank order of effectiveness of the various carriers as judged from maximal histamine release by various penicilloyl conjugates was PL<BSA<HSA<BGG, BGG being the most effective. In the LTT, where BPO:PL, BPO:HSA, BPO:BGG as well as BPO human gamma globulin have been used, the BPO conjugates were also more effective than B.Pen. but the difference was relatively less marked than in HRL test (positive results being obtained with conjugates in up to 92 per cent of patients as compared with 57 per cent with B.Pen.). The rank order of effectiveness of the carriers in the LTT, as judged by comparing the maximum response obtained with each BPO-protein conjugate with the maximum response obtained with BPO:PL, was PL<HSA<HGG<BGG, BGG being the most effective. However, BPO:HGG was effective in lower concentrations. The HRL and LTT were negative in nine out of ten non-allergic subjects, and in control experiments with the carrier molecules alone.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Assem E. S., McAllen M. K. Serum reagins and leucocyte response in patients with house-dust mite allergy. Br Med J. 1970 May 30;2(5708):504–507. doi: 10.1136/bmj.2.5708.504. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Assem E. S., Schild H. O. Detection of allergy to penicillin and other antigens by in-vitro passive sensitization and histamine release from human and monkey lung. Br Med J. 1968 Aug 3;3(5613):272–276. doi: 10.1136/bmj.3.5613.272. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Assem E. S., Vickers M. R. Serum IgE and other in vitro tests in drug allergy. Clin Allergy. 1972 Dec;2(4):325–334. doi: 10.1111/j.1365-2222.1972.tb01297.x. [DOI] [PubMed] [Google Scholar]
  4. BROWN B. C., PRICE E. V., MOORE M. B., Jr PENICILLOYL-POLYLYSINE AS AN INTRADERMAL TEST OF PENICILLIN SENSITIVITY. JAMA. 1964 Aug 24;189:599–604. doi: 10.1001/jama.1964.03070080005001. [DOI] [PubMed] [Google Scholar]
  5. Chalmers D. G., Cooper E. H., Evans C., Topping N. E. Quantitation of the response of lymphocytes in culture to specific and non-specific stimulation. Int Arch Allergy Appl Immunol. 1967;32(2):117–130. doi: 10.1159/000229922. [DOI] [PubMed] [Google Scholar]
  6. Coulson A. S., Chalmers D. G. Response of human blood lymphocytes to tuberculin PPD in tissue culture. Immunology. 1967 Apr;12(4):417–429. [PMC free article] [PubMed] [Google Scholar]
  7. LEVINE B. B. N(ALPHA-D-PENICILLOYL) AMINES AS UNIVALENT HAPTEN INHIBITORS OF ANTIBODYDEPENDENT ALLERGIC REACTIONS TO PENICILLIN. J Med Pharm Chem. 1962 Sep;91:1025–1034. doi: 10.1021/jm01240a016. [DOI] [PubMed] [Google Scholar]
  8. LEVINE B. B., PRICE V. H. STUDIES ON THE IMMUNOLOGICAL MECHANISMS OF PENICILLIN ALLERGY. II. ANTIGENIC SPECIFICITIES OF ALLERGIC WHEAL-AND-FLARE SKIN RESPONSES IN PATIENTS WITH HISTORIES OF PENICILLIN ALLERGY. Immunology. 1964 Sep;7:542–556. [PMC free article] [PubMed] [Google Scholar]
  9. LEVINE B. B. STUDIES ON THE IMMUNOLOGICAL MECHANISMS OF PENICILLIN ALLERGY. I. ANTIGENIC SPECIFICITIES OF GUINEA-PIG SKIN SENSITIZING RABBIT ANTI-BENZYLPENICILLIN ANTIBODIES. Immunology. 1964 Sep;7:527–541. [PMC free article] [PubMed] [Google Scholar]
  10. LEVINE B. B. Studies on the dimensions of the rabbit antibenzylpenicilloyl antibody-combing sites. J Exp Med. 1963 Jan 1;117:161–183. doi: 10.1084/jem.117.1.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. LICHTENSTEIN L. M., OSLER A. G. STUDIES ON THE MECHANISMS OF HYPERSENSITIVITY PHENOMENA. IX. HISTAMINE RELEASE FROM HUMAN LEUKOCYTES BY RAGWEED POLLEN ANTIGEN. J Exp Med. 1964 Oct 1;120:507–530. doi: 10.1084/jem.120.4.507. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. PARKER C. W. Penicillin allergy. Am J Med. 1963 Jun;34:747–752. doi: 10.1016/0002-9343(63)90083-4. [DOI] [PubMed] [Google Scholar]
  13. PARKER C. W., THIEL J. A. STUDIES IN HUMAN PENICILLIN ALLERGY: A COMPARISON OF VARIOUS PENICILLOYL-POLYLYSINES. J Lab Clin Med. 1963 Sep;62:482–491. [PubMed] [Google Scholar]
  14. RYTEL M. W., KLION F. M., ARLANDER T. R., MILLER L. F. DETECTION OF PENICILLIN HYPERSENSITIVITY WITH PENICILLOYL-POLYLYSINE. JAMA. 1963 Dec 7;186:894–898. doi: 10.1001/jama.1963.03710100032007. [DOI] [PubMed] [Google Scholar]

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