ABSTRACT
Recent clinical evidence suggests that papain and chymopapain may share common allergenicity. Patients that become sensitized to papain may subsequently experience an allergic reaction when they are exposed to chymopapain. This study demonstrates a cross antigenicity between the proteolytic enzyme preparations papain and chymopapain. Serum samples from six patients who demonstrated 4+ skin reactions to papain also revealed positive RAST ratios to both papain and chymopapain. In addition, serum samples from 12 clinically nonreactive patients who had discolysis with chymopapain demonstrated positive RAST results to papain as well as to chymopapain.
Subject(s)
Chymopapain/immunology , Papain/immunology , Allergens/immunology , Asthma/etiology , Cross Reactions , Evaluation Studies as Topic , Humans , Radioallergosorbent Test , Statistics as Topic , Time FactorsABSTRACT
Discolysis (chemonucleolysis) with chymopapain, the proteolytic enzyme, is currently being used in the treatment of herniated lumbar discs. Of the patients receiving treatment, approximately 1% experience an anaphylactic reaction. This reaction is thought to be mediated by IgE antibodies to chymopapain. Because of this, it may be possible to predict potential reactors using in vitro testing. In the current study, five out of seven patients who experienced allergic anaphylaxis during discolysis demonstrated high IgE serum levels to chymopapain before treatment.
Subject(s)
Chymopapain/immunology , Hypersensitivity/immunology , Immunoglobulin E/analysis , Chymopapain/therapeutic use , Humans , Intervertebral Disc Displacement/drug therapy , Radioallergosorbent TestABSTRACT
Patients suffering from herniated lumbar intervertebral disks can currently be treated by chemonucleolysis. This procedure involves reducing the nucleus pulposus by injecting chymopapain into the affected intervertebral disk. A small percentage of the patients who undergo this treatment experience an immediate hypersensitivity reaction. In this study the IgE and IgG specific for sensitivity to chymopapain of 21 patients receiving chymopapain (Discase for injection) was monitored over a 6-month period after injection. This study demonstrates that serum levels of IgE and IgG to chymopapain increase after chemonucleolysis.
Subject(s)
Chymopapain/immunology , Endopeptidases/immunology , Immunoglobulin E/biosynthesis , Immunoglobulin G/biosynthesis , Intervertebral Disc Displacement/immunology , Antigen-Antibody Reactions , Binding Sites, Antibody , Binding, Competitive , Chymopapain/therapeutic use , Female , Humans , Intervertebral Disc Displacement/drug therapy , Male , Radioallergosorbent TestABSTRACT
In patients receiving long-term hemodialysis (HD), we have examined the presence of IgE-dependent sensitization to ethylene oxide (EO) gas, which is used for sterilization of disposable medical products including dialyzers. Serum was obtained from 25 patients who experienced acute allergic reactions during HD, five patients receiving HD with isolated eosinophilia, and 37 unselected patients receiving HD. Sera from 22 of 25 of the allergic reaction group and from five of 35 of the unselected group were demonstrated to contain IgE antibodies with specificity for EO. Corresponding IgG antibodies were also present. No such antibodies were detected in serum from normal controls or ragweed-allergic patients. The serum from one patient with isolated eosinophilia had a borderline elevated IgE antibody level. These results demonstrate a close relationship between the presence of IgE antibodies to EO and HD-related allergic reactions in this patient population.
Subject(s)
Ethylene Oxide/immunology , Renal Dialysis/adverse effects , Gases , Humans , Hypersensitivity/diagnosis , Hypersensitivity/immunology , Radioallergosorbent TestABSTRACT
A subunit prepared from transmissible gastroenteritis (TGE) virus and used to immunize 24 gilts prior to farrowing induced production of specific antibody in the serum and milk. Challenge of pigs, two to seven days of age and suckling on the vaccinated gilts, with the Illinois strain of TGE virus resulted in morbidity of 28% and mortality of 4% as compared with 100 and 73%, respectively, for control piglets. Piglets nursing on a sow which had been immunized approximately 10 months previously were not protected, indicating that lactogenic immunity may be of short duration. Revaccination of this animal resulted in an anamnestic response.