青霉素类药物之间交叉过敏反应

目的 :探讨青霉素类抗生素之间交叉过敏反应性 ,并分析交叉过敏反应与药物化学结构之间的关系。方法 :收集青霉素过敏者血清 397例。采用放射过敏原吸附试验法 (radioallergsorbenttest,RAST) ,检测青霉素过敏病人血清中 8种主、次要抗原决定簇 ,分别为青霉素G(BPO、BPA)、青霉素V(PVO、PVA)、氨苄西林 (APO、APA)和阿莫西林 (AXO、AXA)特异性IgE抗体 ,分析血清中特异性IgE抗体的种类与过敏药物的关系。结果 :397例青霉素过敏病人血清特异性IgE抗体总阳性 2 34例 ( 5 8.9% )。 1～ 8种抗原决定簇特异性IgE抗体的阳性率分别…     

青霉素过敏反应与IL-4、IL-13、IFN-γ

目的 :探讨青霉素类抗生素过敏与IL 4、IL 1 3、IFN γ之间的关系。方法 :采用ELISA法检测了 1 45例过敏病人和 62例正常人血清中的IL 4、IL 1 3和IFN γ浓度 ;采用RAST法检测了过敏病人和正常人血清中的 8种特异性IgE抗体 (BPO PLL、PVO PLL、APO PLL、AXO PLL、BPA PLL、PVA PLL、APA PLL、AXA PLL)。结果 :特异性IgE抗体阳性的青霉素过敏病人组IL 4、IL 1 3、IFN γ血清浓度显著高于正常组 (P <0 .0 1 ) ;特异性IgE抗体阴性的青霉素过敏病人组IL 4、IFN γ浓度显著低于正常组 (P <0 .0 1 ) ;IL 4…     

青霉素类过敏反应病人血清中特异性IgE抗体

目的 :探讨青霉素类过敏反应与特异性IgE抗体的关系。方法 :采用放射过敏原吸附试验 (RAST)测定 3 97例青霉素过敏病人血清中 8种抗原决定簇(BPO PLL、PVO PLL、APO PLL、AXO PLL、BPA PLL、PVA PLL、APA PLL、AXA PLL)特异性IgE抗体。结果 :3 97例过敏病人中 ,特异性IgE抗体阳性率为 5 8.9% (2 3 4例 )。其中 ,男性组抗体阳性率显著高于女性组 (P <0 .0 5 )。在所检测的 8种特异性IgE抗体中 ,BPA IgE抗体阳性率 2 5 .44% (1 0 1例 )最高 ,PVA IgE抗体 2 5 .1 9% (1 0 0例 )次之 ,而APA IgE抗体 9.82 % (3 9…     

32例过敏疾病患者血清14种食物过敏原特异性IgG抗体的检测

为探讨过敏疾病患者血清中14种食物过敏原的特异性IgG抗体水平,采用酶联免疫吸附法(ELISA)检测病人组32例,正常组22名。结果显示,病人组血清食物过敏原特异性IgG抗体有不同程度增高,阳性率依次为:虾34.4%,花生21.9%,鸡蛋18.8%,蟹15.6%,小麦12.5%,鳕鱼9.4%,玉米6.3%,大豆6.3%,牛肉3.1%,蘑菇3.1%,西红柿3.1%,鸡肉、猪肉、大米均为0;正常组仅鸡蛋、猪肉特异性IgG抗体轻度增高,阳性率均为4.5%,其余阴性。结论:过敏疾病患者血清食物过敏原特异性IgG抗体升高,说明此类患者体内产生特异性IgG抗体。食物过敏患者血清特异性IgG抗体升高明显,提示对临床确诊与防治食物过敏有重要意义。     

青霉素皮肤试验与特异性IgE

目的 :探讨青霉素皮试与青霉素过敏病人血清中特异性IgE抗体相关性 ,评价皮试的准确性与特异性 ,改进和完善该类药物过敏的诊断方法。方法 :收集青霉素皮试阳性史者、青霉素皮试阳性即刻者和青霉素皮试阴性用药后出现过敏症状者三种过敏病人血清 ,共计 2 5 9例 ,采用放射过敏原吸附试验法 (ra dioallergsorbenttest,RAST)检测青霉素过敏病人血清中特异性IgE抗体。结果 :青霉素过敏病人血清特异性IgE抗体总阳性率为 62 .2 % (1 61 / 2 5 9) ;青霉素皮试阳性史者、青霉素皮试阳性即刻者和青霉素皮试阴性用药后出现过敏症状者三组之间特异…     

过敏性鼻炎患者血清食物特异性IgG检测结果分析

目的 探讨血清食物特异性IgG抗体检测在过敏性鼻炎中的临床意义.方法 采用酶联免疫吸附法检测1067例过敏性鼻炎患者血清14种食物特异性IgG抗体水平.结果 食物特异性IgG抗体阳性率为77.51％,其中单阳性的占32.53％,多重阳性的占67.47％;食物不耐受的程度,以轻度不耐受最为多见(61.62％),中度和重度不耐受分别占22.88％和15.51％,中、重度不耐受多见于鸡蛋、牛奶和小麦;检测阳性率从高到低依次为:鸡蛋(56.14％)、牛奶(28.40％)、小麦(20.43％)、西红柿(14.81％)、大米(13.12％)、大豆(11.90％)、鳕鱼(9.93％)、螃蟹(7.87％)、玉米(6.56％)、河虾(5.90％)、蘑菇(4.03％)、鸡肉(3.47％)、猪肉(2.44％)、牛肉(0.56％);阳性率较高的鸡蛋、牛奶、小麦、西红柿、大米在≤14岁患者组阳性率最高,随年龄增长而呈下降趋势.结论 过敏性鼻炎患者食物不耐受的发生率较高,血清食物特异性IgG检测可用于筛查不耐受食物.     

热致死发酵乳杆菌对牛乳β-乳球蛋白过敏小鼠的免疫调节作用

目的:观察热致死的发酵乳杆菌对牛乳β-乳球蛋白(BLG)致敏小鼠Th1/Th2细胞平衡、血清抗体水平及T细胞亚群数量的影响,探讨其缓解过敏反应的作用。方法:用牛乳BLG和弗氏佐剂的混合液腹腔注射诱发BALB/c小鼠致敏,建立动物过敏模型。将实验动物随机分为空白组、致敏组和不同剂量的热致死发酵乳杆菌组。采用ELISA法测定各组小鼠血清总IgE、BLG特异性IgE和总IgG含量。体外分离培养各组小鼠脾细胞,采用ELISA法检测细胞上清液中Th1型细胞因子(IL-12、IFN-γ)和Th2型细胞因子(IL-4)水平,采用流式细胞术检测脾淋巴细胞中CD3+、CD4+和CD8+T百分含量。结果:发酵乳杆菌组小鼠脾细胞培养上清液中IFN-γ/IL-4比值为13.53,显著高于致敏组的3.34(P<0.05);血清总IgE、BLG特异性IgE和总IgG水平显著降低(P<0.05);脾细胞中CD3+和CD4+T细胞比例升高,CD4+/CD8+比值趋近正常组。特别是高剂量的热致死发酵乳杆菌组小鼠脾细胞培养上清液中抑制IL-4分泌的效果显著优于致敏组(P>0.05),且该组小鼠血清的抗体水平和CD4+/CD8+比值与空白组相比无差异(P>0.05)。结论:热致死的发酵乳杆菌干预可改善小鼠的BLG过敏症状,其作用可能与促进Th1占优势的Th1/Th2细胞平衡,阻断IgE、IgG分泌及平衡T细胞亚群数量相关。     

患儿鸡蛋、牛奶过敏原体外检测分析

为了解患儿鸡蛋、牛奶过敏原分布情况,采用荧光ELISA法检测患儿血清中鸡蛋和牛奶过敏原SIgE抗体.结果表明:患儿中鸡蛋SIgE和牛奶SIgE阳性检出率分别为31.1%和21.7%.0～1岁组,1～3岁组和3～6岁组鸡蛋SIgE的阳性率显著高于6～14岁组(P＜0.05 ); 0～1岁组和1～3岁组牛奶SIgE的阳性率显著高于3～6岁组和6～14岁组(P＜0.05), 鸡蛋SIgE和牛奶SIgE阳性率都有随着年龄增长而逐渐降低的趋势;鸡蛋SIgE阳性同时牛奶SIgE阳性患儿的阳性率为40.9%,牛奶SIgE阳性同时鸡蛋SIgE阳性患儿的阳性率为44.3%.支气管肺炎患儿鸡蛋和牛奶SIgE阳性率最高,分别为30.3%和29.5%.建议在变态反应性疾病患儿和支气管肺炎患儿中检测鸡蛋SIgE和牛奶SIgE.     

1617例慢性过敏患者食物不耐受检测

探讨慢性过敏患者食物不耐受特异性抗体分布的临床特征及检测意义.用酶联免疫方法对北京地区1617例慢性过敏患者进行食物不耐受IgG抗体检测,并对其中100例检测阳性者进行IgE抗体检测,随后对检出食物特异性IgG阳性的539例患者进行饮食指导并随访3个月.1617例患者中1407例对1～6 种不等的食物特异性IgG升高,...     

14种食物过敏原特异性IgG抗体与变态反应性皮肤病的关系分析

通过分析变态反应性皮肤病患者血清14种食物过敏原特异性IgG抗体（Ab）水平,探讨检测食物过敏原特异IgG Ab在变态反应性皮肤病诊断与预防中的意义。采用ELISA检测86例荨麻疹、54例异位性皮炎患者和30名健康人血清14种食物特异性IgG Ab水平。结果表明,荨麻疹和异位性皮炎患者中一种或一种以上食物特异性IgG Ab阳性患者112例,阳性率为80.0%,对照组阳性4例,阳性率13.3%,两组相比差异有统计学意义（P〈0.001）;荨麻疹和异位性皮炎患者IgG Ab阳性率排前两位是牛奶和鸡蛋;儿童组牛奶、鸡蛋阳性率和阳性级数均高于成人组,两组相比差异有统计学意义（P〈0.001）。变态反应性皮肤病患者血清中存在食物特异IgG Ab,提示变态反应性皮肤病与食物不耐受有关,并对变态反应性皮肤病的诊断以及预防食物过敏有重要意义。     

Specific IgG antibodies in sera in patients with penicillin allergy

The role of IgG antibodies in inducing or modifying allergic reaction has not been sufficiently clarified. The objective of this investigation is to elucidate the relationship between IgG antibodies and penicillin allergy, between IgG and IgE antibodies in allergic patients. Enzyme-linked immunosorbent assay and Radioallergosorbent test were used to examine eight kinds of specific IgG and IgE antibodies, including major antigenic determinants: benzylpenicilloyl (BPO), ampicilloyl (APO), amoxicilloyl (AXO) and phenoxomethylpenicilloyl (PVO), and minor antigenic determinants: benzylpenicillanyl (BPA), ampicillanyl (APA), amoxicillanyl (AXA) and phenoxomethylpenicillany (PVA), in the sera of 249 patients with penicillin allergy. Except BPA-IgG, seven kinds of antigenic determinants IgG antibodies levels were significantly higher than that of control group (P < 0.05). Positive rates of specific IgG and IgE were 47.0 and 57.8%, while positive rate of IgE and IgG together was 77.9%. The positive rate of IgG antibodies to major antigenic determinants (42.2%) was significantly higher than that of minor antigenic determinants (8.8%) (P < 0.05). The positive rate of IgG antibodies of patients with typical clinical symptoms after penicillin administration when skin tests were negative was significantly higher than that of patients with positive skin test (P < 0.01). There were no differences between the IgG positive rates to three kinds of determinants and that of all of eight kinds. The study indicates that IgG may be important in penicillin allergy with negative skin test and IgG antibodies to major antigenic determinants probably play a more important role in the process of allergic reaction. This project was supported by the Science Foundation for Distinguished Young Scholars of Henan Province (No. 0312002100) and the Nature Science Foundation of Henan Province (No. 0211040100).     

The relevance of specific serum IgG, IgG4 and IgE in the determination of shrimp and crab allergies in Malaysian allergic rhinitis patients

The significance of food specific serum IgG4 antibody in food allergy is unclear and this led us to investigate the relevance of specific IgG4, along with IgG and IgE antibodies to two common food allergens in Malaysia. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum antibodies in 143 allergic rhinitis patients' sera, of which 47 were from patients with clinical indication of shrimp allergy, 46 with clinical indication of crab allergy and 50 without indication to either allergy. Clinical indication of allergy was based on answers to a questionnaire or results of the skin prick test. We found that the elevation of specific IgE or IgG4 is associated with shrimp and crab allergies but elevation of specific IgG is not associated with either allergy. However, the clinical utility of elevated specific IgG and IgG4 levels is pending further investigation.     

Clinical research on specific IgE and IgG4 antibodies in allergic children. Correlation specific IgE and IgG4 antibodies to food allergens to other allergic factors

We examined the correlation specific IgE and IgG4 antibodies to food allergens to other allergic factors in 150 asthmatic children by Multiple Factor Analysis-Type II. The following results were obtained. 1) 3 explanation variables (IgE RIST, Eosinophil count, Family history of allergy) had the strong influence power to 8 objective variables of food allergens. 2) By calculating the category score of explanation variables, the high IgE RAST score to Dermatophagoides farinae group had the strong influence power to the high score groups of IgE RAST and IgG4 antibody titers to food allergens. The fact indicated the linkage between specific IgE and IgG4 antibodies to food allergens to specific IgE antibody to Dermatophagoides farinae. 3) In the same way, the severe group of asthma had the strong influence power to the high score groups of IgE RAST and IgG4 antibody titers to food allergens, and specific IgG4 antibody group had a same directivity of specific IgE antibody group to the other allergic factors. So specific IgG4 antibody may play a "role of reaginic antibody".     

Food allergy to wheat: identification of immunogloglin E and immunoglobulin G-binding proteins with sequential extracts and purified proteins from wheat flour.

BACKGROUND: Cereal-associated allergy is particularly considered a serious problem, because cereals are essential in our daily diet. Wheat proteins are classified into albumins, globulins and prolamins (insoluble gliadins and glutenins). OBJECTIVES: Our objectives were to study the involvement in food allergy to wheat of these different protein types by using purified fractions and to identify those binding IgE and IgG antibodies. METHODS: Sera were obtained from 28 patients with food allergy to wheat. Albumins/globulins, gliadins and glutenins were obtained by sequential extraction based on differential solubility; alpha-, beta-, gamma- and omega-gliadins and low molecular weight (LMW) and high molecular weight (HMW) glutenin subunits were purified by chromatography. IgE binding to these extracts and fractions were analysed by radioallergosorbent test (RAST), and immunoblotting; IgG binding was detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: In RAST, 60% of sera were shown to have specific IgE antibodies against alpha-, beta-gliadins and LMW glutenin subunits, 55% to gamma-gliadins, 48% to omega-gliadins and 26% to HMW glutenins. Immunoblotting analysis confirmed results obtained in RAST concerning LMW and HMW glutenin subunits and showed that 67% of patients have IgE antibodies to the albumin/globulin fraction. CONCLUSION: Results obtained in the different tests showed common features and in agreement with other studies indicated the presence of numerous allergens in food allergy to wheat; alpha-, beta-, gamma- and omega-gliadins, LMW glutenin subunits and some water/salt-soluble proteins appeared as major IgE binding allergens, whereas HMW glutenins were only minor allergens. The same type of antigenic profile against gliadins and glutenins was observed with IgG antibodies. Important sequence or structural homologies between the various gliadins and LMW glutenin subunits could certainly explain similarity of IgE binding to these proteins.     

Challenge of Penicillin-Allergic Volunteers with Penicillin-Contaminated Meat

In order to obtain information about the clinical course and immunological background of possible allergic reactions due to penicillin-containing food, nine volunteers with penicillin allergy proved by case history, positive skin tests and/or positive penicilloyl-specific RAST were exposed to penicillin-contaminated pork. For this purpose a farm pig from an inbred strain received "therapeutic" doses of benzyl procain penicillin before being slaughtered. Meat samples were taken from muscle tissues, kidney and liver and analyzed by diffusion and extraction methods. Very small amounts of penicillin were detectable in muscle tissue, whereas kidney material contained up to five times as much (0.12 mcg/g). Except two cases which reacted with itchy sensations after ingestion of penicillin contaminated meat "á la tartare", all probands were clinically free of symptoms. Assaying penicilloyl-specific IgE antibodies by RAST during the trial, a tendency to increased levels in the serum after 2 and 24 h was noted, whereas the titers of BPO-specific IgG antibodies measured by the red cell-linked antigen-antiglobulin reaction (RCLAAR) remained unchanged. It is concluded from this study that small and hidden amounts of penicillin and its derivatives in food seldom induce anaphylactic reactions in penicillin allergic patients.     

Demonstration of specific serum IgG with an "in vitro" radioimmunoassay (RAST IgG) (author's transl)]

By using discs coated with allergens (RAST, Pharmacia) anti-human gammaglobulin goat antibodies, we could demonstrate specific IgG on sera whose IgE had been destroyed by heating at 56 degrees C for 4 hours. A detailed protocol is given. Preliminary results demonstrate absence of specific IgG in untreated patients with pollen allergy, and conversely presence of these IgG in patients treated with immunotherapy against pollens; most patients with epithelia, food and/or mould allergies had specific IgG prior to immunotherapy.     

Sub-class of IgG in allergic disease I. IgG sub-class antibodies in immediate and non-immediate food allergy

Abstract. Previous studies have suggested that, apart from IgE-mediated reactions, some of the symptoms of food allergy may be caused by IgG antibodies to food proteins. This study was carried out to see if there were any distinctive features of the IgG sub-class antibody response to dietary antigens which occurs in food allergic patients. IgG subclass antibodies were measured using a quantitative enzyme-linked immuno-sorbent assay (ELISA) to wheat gliadin, ovalbumin and bovine casein in twenty patients who had coeliac disease and in twenty-eight egg allergic patients. These were compared with twenty-one atopic dermatitis patients who did not have food allergy and twenty-six healthy control subjects. Coeliac disease patients tended to have raised IgG antibody levels (especially IgG1) to all three antigens but these overlapped considerably with that seen in egg allergic and atopic dermatitis patients. Coeliacs who avoided gluten had anti-gliadin antibody levels which did not differ from those seen in healthy subjects but nevertheless had raised anti-ovalbumin and casein-specific antibodies. The IgG antibody was largely restricted to IgG1 and IgG4 sub-class although the relative amount of each varied with the antigen. Although gliadin-specific antibodies were mainly IgG1, ovalbumin-specific antibodies were mainly IgG4. The increased antibody levels to all three antigens in coeliacs were caused by a raised IgG1 response, IgG4 antibodies were usually normal. Egg allergic patients also had raised IgG1 but not IgG4 antibodies to ovalbumin. These data show that the response to different dietary antigens can vary with the antigen. The fact that IgG1 and not IgG4antibodies were raised to all three antigens in patients with coeliac disease suggests that they are a secondary consequence of the disease, perhaps reflecting increased transport of antigens across a damaged gut mucosa rather than a specific immunopathological reaction. However, the observation that antibodies to gliadin, and not ovalbumin or casein, fell following gluten avoidance shows that the response to gliadin, at least, is dependent upon continued exposure to antigen.     

Food allergy diagnostics: scientific and unproven procedures

PURPOSE OF REVIEW: The accurate diagnosis of food allergy is crucial not only for the right treatment but also for the avoidance of unnecessary diets. The diagnostic work-up of suspected food allergy includes the measurement of food-specific IgE antibodies using serologic assays, the skin prick test, elimination diets and oral provocation tests. In addition, some approaches are either under further rigorous investigation (the atopy patch test) or are already in widespread use, particularly by practitioners of alternative or complementary medicine, but are considered unproven. These diagnostic methods include specific IgG to foods, provocation/neutralization testing, kinesiology, cytotoxic tests and electrodermal testing. This review covers some of the most common scientifically validated and unproven approaches used in the diagnosis of food allergy. RECENT FINDINGS: For specific serum IgE and the SPT, decision points have been established for some foods, allowing prediction of clinical relevance. The APT may be helpful, especially when considered in combination with defined levels of specific IgE. In regard to other approaches, most scientific studies do refute the usefulness of these approaches. SUMMARY: In most patients, controlled oral food challenges remain the gold standard in the diagnostic work-up of suspected food allergy. The skin prick test and measurement of specific IgE antibodies to food extracts, individual allergens or allergenic peptides are helpful in the diagnostic approach. Food-specific IgG continues to be an unproven or experimental test. The other alternative and complementary techniques have no proven benefit and may endanger patients via misdiagnosis.     

Clinical research of specific IgE and IgG4 antibody in allergic children. Correlation specific IgE antibody to specific IgG4 antibody to food allergen

We analysed the correlation specific IgE antibodies to specific IgG4 antibodies to food allergens in 150 asthmatic children by Multiple Factor Analysis-Type II and examined the role of both antibodies. The following results were obtained. 1) Of soybean, there was the stronger influence power between specific IgE and IgG4 antibody than the other 2 food allergens. 2) IgE antibody to soybean had the strong influence power to IgG4 antibodies to egg white and cow's milk and IgG4 antibody to soybean had same influence power to IgE antibodies to egg white and cow's milk. So, the specific IgE and IgG4 antibodies to soybean may be play the role of "the bride" between specific IgE antibody group and specific IgG4 antibody group of food allergens.     

A dot immunobinding assay for penicillin specific antibodies: allergic diagnosis and prediction

A dot immunobinding assay was used to determine benzylpenicillin (BPO) specific IgE and IgG antibodies. Sera from 39 patients who had a positive history of penicillin allergy and the same number of sera from normal donors without penicillin-allergic history were assessed. The results showed that the mean value of BPO-specific IgE in the group of patients was 3.6 ng/ml while in the group of normal donors it was 0.38 ng/ml. BPO-specific IgE values of 35 samples in the group of patients were greater than 2 ng/ml. In contrast, only one sample in the group of normal donors amounted to 2 ng/ml. Thus 2 ng/ml was arbitrarily chosen to discriminate between normal and patients' sera. Based on this assumption the positive rate is 89.7 percent; the false positive rate would only be 2.6 percent. Furthermore, in the group of patients, the mean value of BPO-specific IgG was 49.1 ng/ml, while in the group of normal donors it was 7.4 ng/ml. However, due to the large variability of serum IgG levels it was not possible to determine a BPO-specific IgG concentration useful for diagnosis or prediction of penicillin allergy.