[Studies on the pathogenic mechanism of beta-lactam hypersensitivity by the detection of leucocyte migration activating factor and leucocyte migration inhibitory factor--structural correlations with allergic symptoms due to beta-lactam antibiotics].
Structural correlations between allergic symptoms and beta-lactam antibiotics were investigated by the use of leucocyte migration inhibition tests on 147 patients in whom allergy to the drugs was detected from among 193 patients suspected of having beta-lactam hypersensitivity. No significant difference was found in the allergic symptoms between the mother nucleus structure of beta-lactam antibiotics or the C-3 side chain structure of cephem antibiotics. But, in both beta-lactam and cephem antibiotics, those with an aminothiazolyl group in the acylamido in their side chain structure induced fever or hepatopathy significantly more often than skin eruption. In contrast, drugs with a benzyl group induced skin eruptions significantly more often than hepatopathy. Leucocyte migration activating factor (LMAF) was found significantly more often than leucocyte inhibitory factor in patients with fever or hepatopathy, and cephem antibiotics with an aminothiazolyl group in the 7-acylamido side chain produced LMAF at a very high rate (80%). Our findings indicate that the specificity of the chemical structure of beta-lactam antibiotics and allergic symptoms is dependent on the acylamido side chain structure, and an aminothiazolyl group structure has a high capability of inducing fever or hepatopathy. Moreover, the high LMAF-inducing ability of the aminothiazolyl group structure is involved in this pathogenic mechanism.
Uno
K
K
Suibarago Hospital.
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000737:chemistry; D002630:Chemotactic Factors / Q000032:analysis*; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007961:Leukocyte Migration-Inhibitory Factors / Q000032:analysis*; D008264:Macrophages; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D002630:Chemotactic Factors; D007961:Leukocyte Migration-Inhibitory Factors; D047090:beta-Lactams; C053609:macrophage migration enhancement factor