title: Analysis of sensitization to carboxymethylcellulose: identification of high risk group using ELISA and histamine release experiment.
abstract: OBJECTIVE
  Carboxymethylcellulose (CMC) has been considered to be inert and is commonly used as an additive in medicines, foods and cosmetics. However, we experienced a patient who developed an anaphylactic reaction to CMC after an upper gastrointestinal examination using a barium meal containing CMC. Therefore, we examined the incidence of sensitization by CMC in healthy subjects, and categorized the high risk group prone to developing anaphylactic response to CMC.
  
  
  METHODS
  An ELISA for detecting CMC-specific IgE antibody was developed using serum from the patient as a positive control. In the ten subjects exhibiting high anti-CMC IgE among 387 normal populations, histamine release from isolated leukocytes was performed.
  
  
  RESULTS
  Five of ten subjects with a high IgE titer showed a significant CMC-induced histamine release from leukocyte preparations in vitro as observed in the patient, and were classified as high risk group. There was a correlation between sensitization by CMC and that by Japanese cedar pollen. The incidence of sensitization in females was 2.4 fold higher than that in males.
  
  
  CONCLUSIONS
  The combination of ELISA and histamine release experiment made it possible to identify the high risk group for developing anaphylactic response. The administration of high dose CMC as a suspending agent in barium sulfate or injectable corticosteroids to this group should be avoided to prevent anaphylactic reactions in the clinic.
authors.affiliation: Department of Pharmacology, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.forename: N
authors.initials: N
authors.lastname: Muroi
authors.forename: S
authors.initials: S
authors.lastname: Ono
authors.forename: H K
authors.initials: HK
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Nishibori
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000209:etiology*; D002266:Carboxymethylcellulose Sodium / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006636:Histamine Release / Q000187:drug effects*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D007074:Immunoglobulin G; D007073:Immunoglobulin E; D002266:Carboxymethylcellulose Sodium