Iron III isomaltose induced hypersensitivity reaction.

Iron isomaltose is considered as safe form of iron with no test dose recommended. Here, we are describing the case of a patient who experienced allergic reaction with this formulation of iron. A 35-year-old South Asian woman experienced allergic reaction, she had mild wheeze on examination of chest. She was given intranasal oxygen at 2 L/min. She was given intravenous acetaminophen 1 g for pain relief, 45.4 mg intravenous chlorphenaramine and intravenous 100 mg hydrocortisone. Within half an hour, all her symptoms improved and her hypoxia resolved. Her chest wheezing also disappeared. Iron isomaltose, although relatively safe, can cause allergic reaction. Intravenous iron can cause allergic reaction therefore it should be administered at the facility where trained staff is present so that necessary treatment can be given in case of hypersensitivity reaction.

Variable region cDNA sequences and antigen binding specificity of mouse monoclonal antibodies to isomaltosyl oligosaccharides coupled to proteins. T-dependent analogues of alpha(1----6)dextran.

Four mouse hybridomas specific for alpha(1----6)dextran, 16.4.12E (IgA kappa, C57BL/6), 28.4.10A (IgM kappa, BALB/c), 35.8.2H (IgG1 kappa, BALB/c), and 36.1.2D (IgM kappa, BALB/c) were obtained by immunization with the T-dependent Ag isomaltohexaose or isomaltotriose coupled to keyhole limpet hemocyanin or to BSA. Immunochemical characterization of the hybridoma antibodies showed that 16.4.12E and 36.1.2D had cavity-type combining sites, recognizing the terminal non-reducing end of alpha(1----6)dextran, whereas 28.4.10A and 35.8.2H had groove-type sites, recognizing internal linear segments of the dextran. The V region cDNA of the H and L chains of the antibodies were cloned and sequenced. VH of 16.4.12E and VH of 36.1.2D belonged to the X24 and Q52 germ-line gene families, respectively. The VH and V kappa sequences of 16.4.12E and V kappa sequence of 36.1.2D were highly homologous to those of W3129, the only anti-alpha(1----6)dextran mAb with a cavity-type site thus far sequenced; 16.4.12E differed from W3129 in the D, JH, and J kappa. VH genes of 28.4.10A and 35.8.2H were homologous to those of several anti-alpha(1----6)dextrans with groove-type sites, but belonged to the J558 germ-line gene family, differed from the other J558 anti-alpha(1----6)dextrans, probably representing a different germ-line subfamily. The L chain sequence of 28.4.10A encoded by V kappa-Ars and J kappa 2 was almost identical to other groove-type anti-alpha(1----6)dextrans obtained by immunizing with the T-independent glycolipid Ag, stearyl-isomaltotetraose. Use of T-dependent Ag such as isomaltosyl oligosaccharide-protein conjugates provides an additional parameter for probing the fine structure of antibody combining sites and evaluating the V-gene repertoire of anti-alpha(1----6)dextrans.

The immune response to an isomaltohexosyl-protein conjugate, a thymus-dependent analogue of alpha(1 replaced by 6) dextran.

Two oligosaccharides derived from B512 dextran (Dex), isomaltohexaose (IM6), and isomaltotriose (IM3) have been coupled to keyhole limpet hemocyanin (KLH) and the conjugates studied as thymus-dependent (TD) immunogens analogous in their specificity to Dex. Both IM3-KLH and IM6-KLH stimulate an anti-Dex response in CBA mice. In C57BL mice, only IM6-KLH stimulated an anti-Dex response; IM3-KLH, although immunogenic, failed to elicit the production of anti-Dex antibodies. Similarly, CBA anti-Dex antibodies cross-reacted with both IM3 and IM6 coupled to bovine serum albumin (BSA), whereas C57BL anti-Dex antibodies cross-reacted with IM6-BSA and bound IM3-BSA only very poorly. This reciprocal lack of cross-reactivity between IM3 conjugates and Dex in C57BL mice was controlled by genes linked to the IgH locus, as shown in responses of allotype congenic CBA mice. This genetically regulated fine specificity pattern was overridden when IM6-KLH was used for immunization. C57BL antibodies that bound both Dex and IM3-BSA were produced in response to this antigen. Thus, isomaltohexosyl-protein conjugates provide Dex-like antigens that differ from Dex itself in terms of thymus dependency and the fine specificity of the precursors that are activated. They should provide important tools to study the activation requirements of antigen-specific B cells.

Binding constants of NZB myeloma antidextrans for dextrans and isomaltose oligosaccharides determined by affinity electrophoresis.

Association constants of dextrans (Ka) and oligosaccharides (Kia) from NZB myeloma antidextrans (PC3858 and PC3936) were studied by affinity electrophoresis. With linear dextrans or with those with a low degree of branching, Ka ranged from 2.7 X 10(3) to 5.4 X 10(4) ml/g for PC3858 and from 1.3 X 10(4) to 2.6 X 10(5) ml/g for PC3936. Completely linear alpha-(1 leads to 6)-linked dextrans, LD7 and D3, showed relatively high affinities for the two NZB antidextrans. With oligosaccharides, the Kia value increased as the number oa alpha-(1 leads to 6)-linked glycosyl residues increased. Isomaltoheptaose (IM7) showed the highest Kia (1.9 X 10(4) M-1 for PC3858 and 1.63 X 10(4) M-1 for PC3936), whereas isomaltose (IM2) had the lowest Kia (2.36 X 10(2)M-1 for PC3858 and 1.32 X 10(2)M-1 for PC3936). Pullulan and glycogen showed very weak affinity for PC3936, but they did not react at all with PC3858. These findings indicate that NZB myeloma antidextrans, PC3858 and PC3936, are specific for internal chains of alpha-(1 leads to 6)-linked dextrans. Data on the precision with which Ka and Kia can be determined are presented.