抗青霉素单克隆抗体的制备及初步应用

目的:制备抗青霉素的单克隆抗体(mAb)并建立双抗体夹心ELISA检测方法,对临床上引起青霉素过敏反应的过敏原青霉噻唑蛋白进行研究。方法:将半抗原青霉素和载体蛋白偶联后免疫BALB/c小鼠,应用杂交瘤技术建立稳定分泌抗青霉素mAb的杂交瘤细胞株。常规制备腹水,用辛酸-硫酸铵法纯化,并对纯化的mAb进行特异性鉴定。通过对不同抗体组合的分析和条件的优化,建立检测过敏原的双抗体夹心ELISA方法。结果:经细胞融合、筛选及克隆化,共获得9株稳定分泌抗青霉素mAb的杂交瘤细胞株,其中5株亲和力较高。建立了双抗体夹心ELISA相对定量检测方法,该方法灵敏度达到870 U/L,平均回收率为107.81%,批内变异系数平均为6.7%,批间变异系数平均为9.3%,可用于A群链球菌制剂中青霉噻唑蛋白的检测。结论:成功地制备了抗青霉素的mAb,并建立了相对定量检测青霉噻唑蛋白的双抗体夹心ELISA法。     

Cross reactions to antigens causing hypersensitivity pneumonitis

The sera of patients with asthma, aspergillosis, pigeon breeder's disease, farmer's lung, and a hypersensitivity pneumonitis in textile plant workers were screened by gel diffusion against a variety of fungal antigens and dust extracts. Patients with hypersensitivity pneumonitis were especially prone to develop precipitating antibody to numerous airborne antigens. From the results it was concluded that patients with hypersensitivity pneumonitis form precipitating antibodies to definite groups of antigens in their environment. Most of the patients had precipitins to house dust that formed lines of identity with fungi and thermophilic actinomycetes.     

Assessment of histamine release from basophils in whole blood by benzylpenieilloyl poly-L-lysine in penicillin-sensitized patients

Histamine release from basophil granulocytes in whole blood by benzylpenicilloyl poly-L-lysine (PPL) was investigated in 7 patients with penicillin allergy. All patients presented with systemic immediate hypersensitivity reactions after i.v. administration of penicillin G. Total histamine (of 7 patients) ranged from 27.5 ng/ml to 62.1 ng/ml (mean 43.2 ng/ml). The spontaneous histamine release ranged from 0.15% to 5.1% (mean 1.8%) of the total content. Addition of PPL in various concentrations resulted in values between 0.8 and 9.6%. Although PPL is a reliable allergen for prick- and intradermal testing in the diagnosis of penicillin allergy--demonstrating a histamine liberation in the skin--the in vitro experiment using the same allergen showed no histamine release above 10%. Using a threshold of 5% out of 7 patients, 4 (57%) would show a positive histamine release. Therefore it might indicate that in penicillin allergy a threshold of 5% must be used. In addition, basophils in whole blood and skin mast cells may be activated differently.     

Minimal agreement between basophil activation test and immunoassay in diagnosis of penicillin allergy

IntroductionBasophil activation test (BAT) and immunoassays are the most widely used in vitro tests to diagnose IgE-mediated allergic reactions to penicillin. However, studies to determine if one test is interdependent from another are limited.ObjectiveThe present study aimed to measure the agreement between BAT and immunoassay in diagnosis of penicillin allergy.MethodBAT was performed using penicillin G (Pen G), penicillin V (Pen V), penicilloyl-polylysine (PPL), minor determinant mix (MDM), amoxicillin (Amx) and ampicillin (Amp) in 25 patients. Immunoassay of total IgE (tIgE) and specific IgE (sIgE) antibodies to Pen G, Pen V, Amx and Amp were quantified. Skin prick test (SPT) using PPL-MDM, Amx, Amp and Clavulanic acid were also performed.ResultsMinimal agreement was observed between BAT and immunoassay (k = 0.25). Of two BAT-positive patients, one patient is positive to Amx (59.27%, SI = 59) and Amp (82.32%, SI = 82) but sIgE-negative to all drug tested. This patient is also SPT-positive to both drugs. Another patient is BAT-positive to Pen G (10.18%, SI = 40), Pen V (25.07%, SI = 100) and Amp (19.52%, SI = 79). In sIgE immunoassay, four patients were sIgE-positive to at least one of the drugs tested. The sIgE level of three patients was between low and moderate and they were BAT-negative. One BAT-positive patient had a high level of sIgE antibodies (3.50–17.5 kU/L) along with relatively high specific to total IgE ratio ≥0.002 (0.004–0.007).ConclusionsThe agreement between BAT and immunoassay is minimal. Performing both tests provides little increase in the sensitivity of allergy diagnosis work-up for immediate reactions to penicillin.     

Humoral Immune Response to Some Benzylpenicillin Preparations

In this study the humoral immune responses to long-term administration of benzylpenicillin preparations with and without adjuvants were compared. In 44.4% of the patients on long-term treatment with a benzylpenicillin preparation containing oil and alum monostearate, an induction of benzylpenicilloyl (BPO)-specific IgG, IgM and IgE was demonstrated during and after the course. Patients treated with a benzylpenicillin preparation containing no oil and alum monostearate showed only a very weak BPO-specific IgM and IgG response during the course. In patients in whom long-term treatment with a benzylpenicillin preparation without adjuvants was initiated by a benzylpenicillin preparation containing oil and alum monostearate, not only BPO-speific IgM and/or IgG but also IgE were demonstrated in 13.0%. The differences in immunoesponse in the various long-term courses were significant ( P < 0.05). The data suggest that the presence of such adjuvants as oil and alum monostearate has an influence on the synthesis of BPO-specific antibodies. However, it can not be excluded that the difference in immunogenicity had some unknown connection with the differences in penicillin/blood levels.     

Induction of immunological tolerance to the penicilloyl antigenic determinant--IV. The effect of BPO-oligolysines and cholestanol-bearing BPO-oligolysines on murine IgE responses

Penta-, deca- and eicosalysine carriers were synthesized in solution and conjugated with benzylpenicillin to give BPO-conjugates of high haptenic density. Each oligolysine conjugate was prepared in two forms--with a free C-terminus and with an esterified C-terminus carrying via a benzylester bridge in essence a lipophilic cholestanol moiety [p-oxymethylbenzylcholestan-3 beta-yl succinate (OSuco group)]. Decalysines that carried a single haptenic BPO group and succinyl groups on the other amino functions were also prepared. Suppression of IgE responses was studied in BALB/c mice. It was found that BPO-specific suppression could be induced by injecting OSuco-bearing deca- or eicosalysine conjugates before immunization with BPO-Asc in A1(OH)3. The pentalysine conjugate was only slightly effective as were all OSuco-deficient conjugates. Ongoing IgE responses were only slightly suppressed and OSuco-bearing conjugates were not more effective than OSuco-deficient derivatives. When the monohaptenic OSuco-bearing decalysine, which exhibited weak tolerogenic effects on primary as well as on ongoing responses, was applied under conditions that favour suppressor T-cell induction, a pronounced unresponsiveness resulted. Direct evidence for suppressor T-cell involvement in the abrogation of anti-BPO responses by OSuco-bearing BPO-conjugates was obtained from cell transfer experiments. The study shows that relatively small haptenic conjugates, the lower limit of effectiveness being approximately represented by decalysine conjugates, may be effective tolerogens depending on the immune status.     

Determination of IgE antibodies to the benzylpenicilloyl determinant: A comparison of the sensitivity and specificity of three radio allergo sorbent test methods

The quantitation of in vitro IgE antibodies to the benzylpenicilloyl determinant (BPO) is a useful tool for evaluating suspected penicillin allergic subjects. Although many different methods have been employed, few studies have compared their diagnostic specificity and sensitivity. In this study, the sensitivity and specificity of three different radio allergo sorbent test (RAST) methods for quantitating specific IgE antibodies to the BPO determinant were compared. Thirty positive control sera (serum samples from penicillin allergic subjects with a positive clinical history and a positive penicillin skin test) and 30 negative control sera (sera from subjects with no history of penicillin allergy and negative skin tests) were tested for BPO-specific IgE antibodies by RAST using three different conjugates coupled to the solid phase: benzylpenicillin conjugated to polylysine (BPO-PLL), benzylpenicillin conjugated to human serum albumin (BPO-HSA), and benzylpenicillin conjugated to an aminospacer (BPO-SP). Receiver operator control curves (ROC analysis) were carried out by determining different cut-off points between positive and negative values. Contingence tables were constructed and sensitivity, specificity, negative predictive values (PV–), and positive predictive values (PV+) were calculated. Pearson correlation coefficients (r) and intraclass correlation coefficients (ICC) were determined and the differences between methods were compared by χ² analysis. Analysis of the areas defined by the ROC curves showed statistical differences among the three methods. When cut-off points for optimal sensitivity and specificity were chosen, the BPO-HSA assay was less sensitive and less specific and had a lower PV– and PV+ than the BPO-PLL and BPO-SP assays. Assessment of r and ICC indicated that the correlation was very high, but the concordance between the PLL and SP methods was higher than between the PLL and HSA or SP and HSA methods. We conclude that for quantitating IgE antibodies by RAST to the BPO determinant, BPO-SP or BPO-PLL conjugates offer advantages in sensitivity and specificity compared with BPO-HSA. These results support and extend previous in vitro studies by our group and highlight the importance of the carrier for RAST assays. J. Clin. Lab. Anal. 11:251–257, 1997. © 1997 Wiley-Liss, Inc.