Abstract
M O N D A Y 755 Different Patterns Of IgE Recognition To Amoxicillin In Patients With Immediate Hypersensitivity Reactions A. Ariza, C. Mayorga, I. Do~na, F. Gomez, E. Perez-Inestrosa, M. I. Monta~nez, J. L. Rodriguez-Bada, M. A. Guerrero, M. Blanca, M. J. Torres; Research Laboratory F-IMABIS, M alaga, SPAIN, Allergy Service, Carlos Haya Hospital, M alaga, SPAIN, Organic Chemistry Department, Chemistry University, M alaga, SPAIN. RATIONALE: The optimal recognition of penicillin determinants, including amoxicillin, by specific IgE antibodies requires a covalent binding to a carrier molecule. The nature of the carrier and its contribution to the antigenic determinant is not well known. The aim of this study was to evaluate the recognition of different amoxicillin structures by specific IgE antibodies in patients with immediate hypersensitivity reactions. METHODS: Patients (N521) with immediate hypersensitivity reactions to amoxicillin and positive radioallergosorbent test (RAST) were included. RASTwas done using benzylpenicillin and amoxicillin bound to poly-Llysine (BPO-PLL and AXO-PLL). RAST inhibition assays used AXOPLL in the solid phase and amoxicillin, amoxicilloic acid, amoxicillin bound to butilamine (AXO-BA), human serum albumin (AXO-HSA) and dendrimers (AXO-DN) in the fluid phase. RESULTS:We observed two clear defined patterns of IgE recognition: A) Cases (N58) with a higher recognition to free amoxicillin being lower to amoxicilloic acid, AXO-BA, AXO-HSA and AXO-DN; B) Cases (N513) which recognize both free and conjugated amoxicillin in similar degree with low recognition to amoxicilloic acid. Group A corresponds to patients with RAST only positive to AXO-PLL and Group B to those positive to BPO-PLL and AXO-PLL. CONCLUSIONS: These results seems to indicate that IgE recognition is influenced by the binding and nature of the carrier molecule (Group A), with others mainly recognizing the amoxicillin structure independently of the nature of the carrier (Group B). The fact that amoxicilloic acid is not optimally recognized in Group B reinforced the need of conjugation to a carrier in this group of patients.
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