title: The influence of the carrier molecule on amoxicillin recognition by specific IgE in patients with immediate hypersensitivity reactions to betalactams.
abstract: The optimal recognition of penicillin determinants, including amoxicillin (AX), by specific IgE antibodies is widely believed to require covalent binding to a carrier molecule. The nature of the carrier and its contribution to the antigenic determinant is not well known. Here we aimed to evaluate the specific-IgE recognition of different AX-derived structures. We studied patients with immediate hypersensitivity reactions to AX, classified as selective or cross-reactors to penicillins. Competitive immunoassays were performed using AX itself, amoxicilloic acid, AX bound to butylamine (AXO-BA) or to human serum albumin (AXO-HSA) in the fluid phase, as inhibitors, and amoxicilloyl-poli-L-lysine (AXO-PLL) in the solid-phase. Two distinct patterns of AX recognition by IgE were found: Group A showed a higher recognition of AX itself and AX-modified components of low molecular weights, whilst Group B showed similar recognition of both unconjugated and conjugated AX. Amoxicilloic acid was poorly recognized in both groups, which reinforces the need for AX conjugation to a carrier for optimal recognition. Remarkably, IgE recognition in Group A (selective responders to AX) is influenced by the mode of binding and/or the nature of the carrier; whereas IgE in Group B (cross-responders to penicillins) recognizes AX independently of the nature of the carrier.
authors.affiliation: Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.
authors.forename: Adriana
authors.initials: A
authors.lastname: Ariza
authors.affiliation: Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.|Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.|Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Málaga, Spain.
authors.forename: Cristobalina
authors.initials: C
authors.lastname: Mayorga
authors.affiliation: Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Salas
authors.affiliation: Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Doña
authors.affiliation: Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.|Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Málaga, Spain.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Martín-Serrano
authors.affiliation: Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Málaga, Spain.|Department of Organic Chemistry, University of Málaga, IBIMA, Málaga, Spain.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Pérez-Inestrosa
authors.affiliation: Centro de Investigaciones Biológicas, CSIC, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Pérez-Sala
authors.affiliation: Pharmacy Unit, Regional University Hospital of Malaga, Málaga, Spain.
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Guzmán
authors.affiliation: Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.|Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Málaga, Spain.
authors.forename: María I
authors.initials: MI
authors.lastname: Montañez
authors.affiliation: Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.|Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Málaga, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Torres
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000276:immunology*; D000707:Anaphylaxis / Q000097:blood / Q000209:etiology / Q000276:immunology; D000918:Antibody Specificity; D002082:Butylamines / Q000276:immunology; D002352:Carrier Proteins / Q000097:blood / Q000276:immunology; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000097:blood / Q000209:etiology / Q000276:immunology*; D005260:Female; D006241:Haptens / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000097:blood / Q000209:etiology / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000009:adverse effects / Q000276:immunology; D011107:Polylysine / Q000276:immunology; D000075462:Serum Albumin, Human / Q000276:immunology; D014581:Urticaria / Q000097:blood / Q000209:etiology / Q000276:immunology; D055815:Young Adult; D047090:beta-Lactams / Q000009:adverse effects / Q000276:immunology
chemical_list: D002082:Butylamines; D002352:Carrier Proteins; D006241:Haptens; D010406:Penicillins; C000619194:amoxicilloic acid; D047090:beta-Lactams; D011107:Polylysine; D007073:Immunoglobulin E; D000658:Amoxicillin; D000075462:Serum Albumin, Human