Allergy to human seminal fluid: characterization of the allergen and experience with immunotherapy

A 20-year-old woman was observed with a history of a severe generalized systemic reaction after topical contact with seminal fluid. A prick test with undiluted seminal fluid produced a 5.0 mm wheal-and-flare response with pseudopods. Prick tests with saliva and serum from the same source as the seminal fluid were negative. Measurement of IgE antibody to seminal-fluid allergen with a Biotin-Avidin ELISA technique yielded strong activity. No IgG antibody could be detected. Significant prick test reactivity could be found in Sephadex G-100 fractions that had a molecular weight range of 12,000 to 75,000 daltons and that contained approximately 5% of the total protein in the starting material. Isoelectric focusing fractions with strong skin test reactivity had a pI range of 5.4 to 6.6. These fractions contained one major protein band. Immunotherapy was conducted with a Sephadex fraction of seminal fluid during a 24-month period. A cumulative dose of 32 mg of protein was administered. No side effects other than local swelling occurred. Ten months after the start of immunotherapy, IgE antibody became unmeasureable, an effect that was demonstrated not due to the inhibitory effect of IgG antibody. IgG antibody rose progressively in this period. Clinically, the patient became less sensitive to topical contact. Although the natural history of seminal-fluid allergy is not known, immunotherapy may be effective.