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Decrease of selective immunoglobulin E response to amoxicillin despite repeated administration of benzylpenicillin
T Fernandez1, M J Torres, R R-Pena
1Research Laboratory for Allergic Diseases, Carlos Haya Hospital, Malaga, Spain.
Summary
Subsequent penicillin administration did not alter IgE antibody specificity in subjects with selective amoxicillin responses. This suggests that repeated exposure to related penicillins does not increase the risk of cross-reactivity in these patients.
Area of Science:
- Immunology
- Pharmacology
Background:
- Beta-lactam antibiotics, like penicillin derivatives, can elicit IgE responses, leading to selective or cross-reactive allergic reactions.
- Hapten administration post-reaction can boost antibody titre and affinity, increasing the risk of allergies to other penicillins.
Purpose of the Study:
- To investigate if administering benzylpenicillin (BP) and penicillin V (PV) to subjects with selective amoxicillin (AX) responses alters IgE specificity.
- To determine if such changes predict the development of cross-reactivity using skin and in vitro testing.
Main Methods:
- Ten subjects with selective AX IgE responses received periodic BP and PV (Group A); ten controls did not (Group B).
- Specific IgE antibodies were measured via skin and RAST tests every six months for two years.
Main Results:
- Skin test reactivity and median RAST values decreased in both groups, with no significant difference between Group A and Group B.
- One patient in Group A developed a positive response to benzylpenicilloyl (BPO) while becoming negative to AX.
Conclusions:
- Selective IgE responses to side-chain-specific determinants in penicillins appear to wane over time.
- Subsequent administration of closely related penicillins does not seem to influence this change or increase cross-reactivity risk.