Cross-Allergy of Sulfonamide-Containing Drugs in Sulfonamide Allergic Patients: A Literature Review and Case Study

The purpose of this study is to find out whether there are broad cross-reactivity between antibacterial and nonantibacterial sulfonamide agents, the method of the study contained two parts, one is literature research mainlyfrom PubMed database by using the MeSH terms (“Drug name” + allergy); (“Drug name” + hypersensitivity);(“Drug name” + cross-allergenicity) and (“Drug name + cross-reactivity), the search drugs included somecommonly seen medication such as carbonic anhydrase inhibitor, COX-2 inhibitor, loop diuretic, sulfonylurea,thiazide and certain antiviral drugs; the other parts of this thesis is to conduct a statistical review, we screen outpatients who have a previous allergic history of antimicrobial sulfonamides from hospital medical record systemduring Jan 1st, 2015 to Dec 31th, 2016, we did a descriptive statistics of general patients medical information,analyze the suspect cases which patients present potential allergic reaction after using non-antimicrobialsulfonamides agents. Result of literature research reveal there are no convincing evidences and research toconfirm there are bored allergenicity between non-antimicrobial sulfonamides and antimicrobial sulfonamide inthe aspects of chemical structure, immunological study, and large scale population study as well; Result ofhospital patient’s statistics found out there are only 3 suspected cases that the patients were having adverseeffect during their pharmacotherapy from 506 cases. However, we did not found any strong correlation of broadallergenicity between non-antimicrobial sulfonamides and antimicrobial sulfonamides from these suspectedcases. Conclusion: There is minimal evidence of cross-reactivity between the antimicrobial sulfonamides and thenon-antimicrobial sulfonamides. However, the non-antimicrobial sulfonamides are rarely implicated inhypersensitivity reactions as well, so it is impossible to say with certainty that cross-reactivity does not occur.

Cross-allergenicity between dandelion and major weed pollens

PURPOSE: The prevalence of pollinosis is increasing, and it is expected to increase further with climate change. Mugwort and ragweed pollens are well known as prevalent allergenic weed pollens in Korea. However, the clinical significance of dandelion pollen as an inhalant allergen has not yet been studied. The purpose of this study was to evaluate the clinical significance and cross-allergenicity between dandelion and major weed pollens. METHODS: Ninety-seven patients with allergic rhinitis and asthma or with allergic rhinitis alone who were sensitized to dandelion pollens on skin prick tests (allergen/histamine ratio>3) were enrolled between December, 2012 and November, 2013. Serum specific IgE levels to dandelion pollen extracts were measured by using enzyme-linked immunosorbent assay (ELISA). ELISA inhibition tests were performed to evaluate cross allergenecity with other weed pollens. RESULTS: When the positive cutoff value for serum specific IgE was set at the mean+/-3 standard deviation of absorbance values, 52 patients (53.6%) had a high serum specific IgE antibody level. ELISA inhibition tests showed significant inhibitions with serial addition of dandelion pollen extracts, and 5 different inhibition patterns were noted with addition of 4 weed pollen extracts: significant inhibitions with pollens of mugwort, ragweed, chenopodium and Hop J (25%, 13 of 52), inhibitions with pollens of mugwort, ragweed and chenopodium (17.3%, 9 of 52), inhibitions with 2 pollens of mugwort and ragweed (32.6%, 17 of 52), inhibitions with mugwort pollen (21.1%, 11 of 52), and inhibitions with dandelion pollen alone (4%, 2 of 52). CONCLUSION: These findings suggest that dandelion pollen may be a causative inhalant allergen to induce pollinosis in the autumn season. Cross-allergenicity with other weed pollens showed individual differences; most patients had cross-reactivity with mugwort, ragweed, and chenopodium pollens, while some with Hop J pollen. Few patients were sensitized to dandelion pollen alone.

Panonychus citri induced allergy among Yuzu farm workers in Koheung area / 천식및알레르기

BACKGROUND: Citrus red mite (CRM; Panonychus citri), which damages the peels and leaves of Citrus, has been reported as an important occupational allergen in Citrus farm workers. Yuzu belongs to the Citrus genus and its peels are the favorite material for tea in Korea. AIMS: We evaluated the prevalence of the sensitization to CRM in Yuzu farm workers in Koheung area (Southern provinces of Korean peninsula) and analyzed the allergenicity of CRM and the cross-reactivity between CRM and Dermatophagoides pteronyssinus (DP) with the sera of the workers and urbanites. METHODS: One hundred and eleven Yuzu farm workers and 36 respiratory allergic urban patients were enrolled in this study. Skin prick test (SPT) to CRM and DP was performed. CRM specific IgE was detected by ELISA and immunoblotting method. Cross-reactivity was investigated through inhibition ELISA and inhibition immunoblotting. RESULTS: About 39% of the workers showed positive response to CRM in SPT. Prevalence of allergic disease was 66%. Symptoms were associated with their work in 53% of patients. CRM-specific IgE from workers was not inhibited by DP crude antigen but CRM-specific IgE from urban patients was inhibited by DP crude antigen by an average of 70%. With immuno- blotting, we could identify 14.5, 15, 17, 18, 21, 22, 32, 33, 49.5 kDa CRM allergens with the sera of the worker. CONCLUSIONS: These results suggest that CRM is one of the unique occupational allergens to the Yuzu farm workers. Cross-reactivity between CRM and DP was found in urban patients.

A Study on the Cross-allergenicity between Buckwheat and Rice Flour Using IgE-immunoblot Inhibition and ELISA-inhibition Test / 소아알레르기및호흡기학회지

PURPOSE: Buckwheat is one of the potent allergenic foods, whereas rice is considered as the safest and hypoallergenic food in Korea. However rice can be a causative food allergen, and several report about allergic reactions to rice in Japan. And it is partially true that there is some cross-allergenicity among cereal allergens such as buckwheat, barley, wheat, rice. So, we should consider a false positive reaction to rice during allergic skin tests, especially in cereal allergic patients. We found that a part of buckwheat allergic children showed positive skin reactions to rice antigens, without any allergic reactions after rice ingestion. Therefore the positive skin test results to rice were considered as the false positive reactions due to cross-allergenicity with buckwheat allergen. To evaluate this possibility, we undertook this study. METHODS: To evaluate the cross-allergenicity between rice and buckwheat antigens. With the buckwheat sensitive sera and crude extracts of buckwheat flour and rice flour obtained in Korea, we carried out SDS-PAGE analysis, IgE immunoblot, IgE-immouoblot inhibition test and ELISA inhibition test. RESULTS: Buckwheat extract showed more than 13 antigenic bands and rice extract showed more than 9 bands by SDS-PAGE analysis. IgE immunoblot revealed at least 20 IgE-binding components (ranged 120-4 kDa) with buckwheat extract. IgE-binding capacity of 22 kDa buckwheat component was markedly inhibited by rice extract and 8 kDa component was inhibited slightly. Using IgE ELISA inhibition test, we confirmed buckwheat IgE-ELISA was profoundly inhibited by rice extract, and 50% inhibition was shown in 10-100 ug/ml concentration of rice extract. CONCLUSION: Taken together, the positive reactions to rice antigen would be shown by the result of cross-allergenicity of rice with buckwheat antigen.