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Cross-reactivity

Cross-reactivity

Drug Toxicity: Allergic Reactions

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...

Amines to Sulfonamides: The Hinsberg Test

Amines to Sulfonamides: The Hinsberg Test

The Hinsberg test is a method to identify primary, secondary and tertiary amines, named after its pioneer, Oscar Hinsberg. Here, amines are treated with benzenesulfonyl chloride, also known as the Hinsberg reagent, in the presence of an excess of aqueous base, followed by acidification. Based on the nature of the amines, different changes are observed.
Generally, a primary amine reacts with the Hinsberg reagent to produce an N-substituted benzenesulfonamide. The electron-withdrawing sulfonyl...

Phase II Reactions: Sulfation and Conjugation with α-Amino Acids

Phase II Reactions: Sulfation and Conjugation with α-Amino Acids

Sulfation and α-amino acid conjugation are two critical biotransformation reactions in drug metabolism. Sulfation, a phase II biotransformation reaction, involves adding a polar sulfate group to a drug, enhancing its water solubility and promoting excretion. This process can either co-occur with or occur independently of glucuronidation. Nonmicrosomal sulfotransferase enzymes catalyze the process. The reaction involves 3'-phosphoadenosine-5'-phosphosulfate or PAPS coenzyme activation, sulfur...

Allergic Drug Reactions

Allergic Drug Reactions

Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing numerous...

Drug Metabolism: Phase II Reactions

Drug Metabolism: Phase II Reactions

Phase II reactions are essential for the detoxification and elimination of drugs from the body. These reactions involve the conjugation of parent drugs or their phase I metabolites with endogenous molecules, resulting in more hydrophilic drug conjugates. The primary conjugation reactions in this phase are sulfation and glucuronidation. Both sulfation and glucuronidation typically produce biologically inactive metabolites. However, in some cases involving prodrugs, active metabolites may be...

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Related Experiment Video

Updated: Jul 14, 2026

Basophil Activation Test for Allergy Diagnosis

Basophil Activation Test for Allergy Diagnosis

Published on: May 31, 2021

Sulfonamide allergy and cross-reactivity.

Carolyn C Brackett¹

¹The Ohio State University, 500 West 12th Avenue, Columbus, OH 43210, USA. brackett.2@osu.edu

Current Allergy and Asthma Reports

|May 17, 2007

Summary

Sulfonamide antibiotic allergies are not typically linked to nonantibiotic sulfonamide drugs. Different structures on these drugs prevent cross-reactivity, clarifying drug hypersensitivity.

Area of Science:

Pharmacology
Immunology
Drug Safety

Background:

Cross-allergenicity between sulfonamide antibiotics and nonantibiotic sulfonamide drugs complicates treatment.
Previous research indicates no interaction between the sulfonamide group and immune responses.

Purpose of the Study:

To clarify the immunologic basis for hypersensitivity reactions to sulfonamide antibiotics.
To determine the likelihood of cross-reactivity between sulfonamide antibiotics and nonantibiotic sulfonamide-containing drugs.

Main Methods:

Review of existing immunologic investigations on sulfonamide hypersensitivity.
Analysis of the structural determinants of immunologic responses to sulfonamide antibiotics.

Main Results:

Related Experiment Videos

Last Updated: Jul 14, 2026

Basophil Activation Test for Allergy Diagnosis

Basophil Activation Test for Allergy Diagnosis

Published on: May 31, 2021

Type I hypersensitivity to sulfonamide antibiotics is linked to the N1 heterocyclic ring, absent in nonantibiotic sulfonamides.
Non-type I hypersensitivity reactions are often due to stereospecific reactive metabolites of sulfonamide antibiotics at the N4 amino nitrogen, a feature absent in nonantibiotic sulfonamides.
Cellular immune responses, while involved in dermatologic reactions, are stereospecific, making cross-reactivity unlikely.

Conclusions:

Cross-reactivity between sulfonamide antibiotics and nonantibiotic sulfonamides is highly unlikely due to distinct structural features.
Apparent cross-reactivity is more likely due to multiple independent drug hypersensitivities occurring concurrently.