ペニシリンによる皮膚反応 : 特に因子分析による解析について(皮膚反応シンポジウム(1))

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Skin test with benzylpenicilloyl-human serum albumin (BPO-HSA) in 2242 patients hospitalized for unrelated conditions yielded positive results in 66 patients, 2.9 per cent. The incidence of positive responses was higher in patients with allergic reactions to penicillin than in patients with no history of penicillin allergy. The test material, therefore, seemed to be a reliable agent for the diagnosis of penicillin hypersensitivity. Forty-six patients who gave positive reactions to BPO-HSA were further skin tested simultaneously with 14 kinds of test materials; Penicillin G, BPO-S-aminocaproate, BPO-hexamethylenediamine BPO_2-HMD), polyvalent BPO-L-polylysine, several kinds of penicilloyl haptens of synthetic penicillin and so on. Mean diameters of wheal reactions to each of these test materials were evaluated by factor analysis. Although the BPO group was found to be the major antigenic determinant, at least other five factors which were almost independent on each other and characterized by different antibody specificity were also detected in these BPO reactive patients. In other words, human anti-penicilloyl antibody was shown to be quite heterogenous and a variety of combinations of antibody specificities were observed in the majority of BPO reactive patients. The combing sites of these heterogenous antibodies were specifically adapted to one of the following antigenic determinants; (1) phenylacetylglycine, the acyl side chain portion of the BPO molecule, (2) 6-aminopenicillanic acid, (3) the penicilloyl molecule of synthetic penicillins, (4) divalent BPO hapten (BPO_2-HMD) and polyvalent BPO hapten (BPO_<345>-Lpolylysine) and (5) the whole benzylpenicilloyl molecule. Evidence was also presented which indicates that divalent BPO-hapten was much inferior to the polyvalent in its ability of histamine rlease in vitro, while the former was as strongly antigenic as the later in its ability to evoke cutaneous responses and Prausnitz-Kustner reactions. Furthermore, it seems noteworthy that two of the three patients who had a positive reaction to penicillin G had a history of immediate systemic, or anaphylactic, allergic reactions to penicillin. From these findings as well as the results of factor analysis, it seems likely that an antibody responsible for this type of penicillin allergy may be different from anti-penicilloyl antibodies.
1966-06-30

ペニシリンによる皮膚反応 : 特に因子分析による解析について(皮膚反応シンポジウム(1))

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