[Studies on the pathogenic mechanism of beta-lactam hypersensitivity by the detection of leucocyte migration...

In 145 suspected cases of beta-lactam hypersensitivity, the identities of the allergenic drugs were performed by leucocyte migration inhibition test (LMIT). The involvement of cell-mediated immunity using leucocyte migration activating factor (LMAF) and leucocyte migration inhibitory factor (LMIF) was investigated for each allergic symptom. The proportion of LMIT positives was 74% of all 145 cases, and more than 70% for each allergic symptom except for anaphylactic shock, and in particular more than 90% for fever and eosinophilia. LMAF and LMIF were detected 39% and 35% of 145 cases, respectively, however LMAF was more frequently detected than LMIF in cases with hepatopathy. LMAF was more frequently detected than LMIF when the latent period (the duration of sensitization) of skin eruption or fever was less than 10 days, whereas LMIF was more frequently detected than LMAF when it was more than 10 days. The same result also was obtained at the boundary between 14 days of the latent period in hepatopathy. These results indicate that in the pathogenesis of beta-lactam hypersensitivity, cell-mediated immunity plays a major role. Both LMAF and LMIF are involved, and their production is dependent on the duration of allergenic drug-sensitization, LMAF is produced during the early period of sensitization, whereas LMIF is produced during the late period of sensitization.