青霉素过敏病人血清特异性IgG抗体

目的探讨IgG抗体与青霉素过敏反应的关系,从而进一步完善青霉素类抗生素过敏反应的诊断。方法化学合成8种青霉素抗原决定簇与HSA结合的全抗原,采用酶联免疫吸附试验(ELISA)检测241例青霉素过敏病人血清中IgG抗体。结果241例过敏病人中,除了BPA-IgG抗体外,其他7种特异性IgG抗体血清水平均高于正常对照组,特异性IgG抗体阳性率为46.5%,其中皮试阴性组IgG抗体的阳性率(64.0%)高于皮试阳性组(27.6%)。主要抗原决定簇IgG抗体的阳性率(41.5%)高于次要抗原决定簇IgG抗体的阳性率(9.1%),并且在皮试阴性组及不同症状组也同样如此。特异性IgG抗体检出阳性率随检测抗体的增多而增加,且检测3种和检测8种特异性IgG抗体所得阳性率差异无显著性。结论特异性IgG抗体参与了青霉素过敏反应的发生和发展,青霉素过敏反应与主要抗原决定簇IgG抗体关系更为密切。

Specific IgG antibodies in sera in patients with penicillin allergy

Aim To elucidate the relationship between IgG antibodies and penicillin allergy.Methods Enzyme-linked immunosorbent assay was used to examine 8 kinds of specific IgG antibodies,including major antigenic determinants:benzylpenicilloyl(BPO),ampicilloyl(APO),amoxicilloyl(AXO)and phenoxomethylpenicilloyl(PVO),and minor antigenic determinants:benzyl-penicillanyl(BPA),amoxicillanyl(AXA),ampicillanyl(APA)and phenoxomethylpenicillany(PVA),in the sera of 241 patients with penicillin allergy.Results Except BPA-IgG,levels of 7 kinds of antigenic determinants IgG antibodies were significantly higher than those of control group(P<0.05).Positive rate of specific IgG was 46.5%.The positive rate of IgG antibodies of patients with negative skin test was significantly higher than those of patients with positive skin test(P<0.05).The positive rate of IgG antibodies to major antigenic determinants(41.5%)was significantly higher than that of minor antigenic determinants(9.1%,P<0.01).The total positive rates of IgG antibodies increased according to the enhanced kinds of determinant and there was no difference between the IgG positive rates to three determinants and that of all eight kinds.Conclusions IgG antibodies were involved in the development of penicillin allergy.IgG antibodies to major antigenic determinants probably played a more important role in the process of allergic reaction.