Non-IgE-mediated hypersensitivity induced by multivitamins containing Tween-80

Area of Science:

• Pharmacology
• Toxicology
• Immunology

Background:

• Adverse reactions to multivitamins, particularly hypersensitivity, are increasingly recognized.
• The classification and triggers of multivitamin-induced hypersensitivity remain unclear.
• Multivitamins may contain excipients like Tween-80, potentially contributing to adverse effects.

Purpose of the Study:

• To investigate the mechanism of hypersensitivity reactions induced by multivitamins.
• To identify the specific component within multivitamins responsible for hypersensitivity.
• To differentiate between anaphylaxis and anaphylactoid reactions in multivitamin-induced hypersensitivity.

Main Methods:

• Animal models (beagle dogs, guinea-pigs) were used to assess behavioral changes, blood pressure, and plasma histamine and IgE levels.
• In vitro assays using RBL-2H3 cells evaluated degranulation (β-hexosaminidase release) and apoptosis.
• Comparisons were made between multivitamins with and without Tween-80, and different control groups.

Main Results:

• Dogs administered multivitamins containing Tween-80 exhibited anaphylactoid symptoms, decreased blood pressure, and elevated histamine levels.
• Guinea-pigs did not show anaphylaxis symptoms; plasma histamine and IgE remained unchanged.
• Tween-80 and multivitamins containing it significantly increased inflammatory mediator release (β-hexosaminidase, histamine) and RBL-2H3 cell apoptosis in a non-antigen-specific manner.

Conclusions:

• Multivitamin-induced hypersensitivity is likely an anaphylactoid reaction, not true anaphylaxis.
• The presence of Tween-80 is identified as the primary trigger for these reactions.
• The mechanism involves a non-immunoglobulin E (non-IgE)-mediated pathway leading to the release of inflammatory factors.