title: Interleukin-4 and interferon-γ are possible allergic markers in pediatric patients with β-lactam hypersensitivity.
abstract: BACKGROUND
  β-lactam agents are known to elicit T-cell-mediated immune responses that play a central role in the onset of allergic reactions, but the involvement of specific type of cytokines in drug allergy remains largely unexplored in humans.
  
  
  OBJECTIVE
  This study was undertaken to investigate the role of cytokines involvement in pediatric patients with β-lactam hypersensitivity and to determine whether involvement of cytokines in drug-mediated reactions are important for the perspective of allergic patient's management.
  
  
  METHODS
  β-lactam-induced hypersensitivity reactions in eighty pediatric patients were determined by clinical manifestations and skin prick or intradermal testing. Production of T-helper (Th) type-1 cytokine interferon (INF)-γ, Th-2 cytokine interleukin (IL)-4, regulatory T-cell cytokine IL-10, and other cytokines IL-6 and IL-12 were determined by sandwich ELISAs.
  
  
  RESULTS
  Diagnosis of β-lactam allergy was confirmed in 53 pediatric patients. IL-4 secretion in patients' sera was significantly higher as compared with healthy controls (P< 0.05). However, INF-γ level in patients' sera was significantly lower as compared with controls (P< 0.05). No significant alterations were found in the protein secretion of IL-10, IL-12, and IL-6 in allergic patients as compared with controls (P> 0.05).
  
  
  CONCLUSIONS
  We conclude that IL-4 is specific marker for the diagnosis of β-lactam-induced hypersensitivity. Moreover, IL-4 in combination with INF-γ is more sensitive for the diagnosis of these reactions. This study also concludes that both IL-4 and INF-γ may play an active role in the onset of allergic reactions against β-lactam antibiotics.
authors.affiliation: Department of Pediatrics, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
authors.forename: Khaled H
authors.initials: KH
authors.lastname: Mahmoud
authors.affiliation: Department of Dermatology, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
authors.forename: Abdullateef A
authors.initials: AA
authors.lastname: Alzolibani
authors.affiliation: Department of Medical Biochemistry, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Rasheed
authors.affiliation: Department of Pediatrics, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Farouk
authors.affiliation: Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ghada Bin
authors.initials: GB
authors.lastname: Saif
authors.affiliation: Department of Dermatology, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Al Robaee
keywords: Hypersensitivity; interferon-γ; interleukin-4; pediatric patients; β-lactam