title: IgE against ethylene oxide-altered human serum albumin (ETO-HSA) as an etiologic agent in allergic reactions of hemodialysis patients.
abstract: Ethylene oxide (ETO) is used to sterilize hemodialyzers and other medical equipment. In an attempt to confirm a link between ETO and hypersensitivity reactions during hemodialysis (HD) we quantitated IgE and total antibody directed against ETO-altered human serum albumin (ETO-HSA) in the sera of 65 hemodialysis patients. In 24 patients who had experienced anaphylaxis during HD, the levels of IgE and total antibody against ETO-HSA were significantly higher than the corresponding levels in 41 patients who had not. Our data demonstrate an association between the presence of IgE and total antibody against ETO-HSA and immediate anaphylactic reactions to HD. In further studies we characterized the ETO-HSA antigen by immunoelectrophoresis, gel filtration chromatography, and cross-inhibition immunoassay. Our results suggested that ETO gas can alter HSA and induce new antigenic determinants on the molecule. Recently, we encountered a peritoneal dialysis patient with rash and eosinophilia. Suspecting ETO allergy, we measured serum IgE and total antibody to ETO-HSA and found both to be present. The data suggest that, in addition to the familiar HD reactions, ETO sensitization might cause other allergic diseases as well.
mesh_terms: D000707:Anaphylaxis / Q000209:etiology / Q000276:immunology; D000906:Antibodies / Q000276:immunology; D000941:Antigens / Q000276:immunology; D002850:Chromatography, Gel; D004802:Eosinophilia / Q000209:etiology; D005027:Ethylene Oxide / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007118:Immunoassay / Q000379:methods; D007122:Immunoelectrophoresis; D007073:Immunoglobulin E / Q000276:immunology*; D007223:Infant; D007688:Kidneys, Artificial / Q000009:adverse effects; D010530:Peritoneal Dialysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012709:Serum Albumin / Q000009:adverse effects / Q000276:immunology
chemical_list: D000906:Antibodies; D000941:Antigens; D012709:Serum Albumin; D007073:Immunoglobulin E; D005027:Ethylene Oxide