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Sulfonamide allergy and cross-reactivity.
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:
- 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.
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