Antigens in Penicillin Allergy

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Abstract
The efficacy of pure and experimentally contaminated benzylpenicillin to induce formation particularly of Ig[immunoglobulin]E antibodies in CBA mice was analyzed. A daily administration schedule of 60 mg penicillin/kg body wt for 10 day periods with 25 days rest between periods was employed. When using pure benzylpenicillin, as verified by a radioimmunoassay, no IgE or other antibody formation with penicilloyl specificity could be shown as analyzed with passive cutaneous anaphylaxis in rats and double-antibody radioimmunoassay, respectively. If the animals were exposed to Bordetella pertussis bacteria simultaneously with the penicillin treatment or treated with hydrolyzed benzylpenicillin, an antibody response mainly of the IgM class could be shown, probably due to polyclonal activation by the bacteria. No IgE antibodies were found after treatment with pure penicillin. If the penicillin was contaminated with penicilloyl26-bovine .gamma. globulin at amounts of 3, 15 or 75 .mu.g/g penicillin, IgE antibodies and antibodies of the IgM and IgG classes could be demonstrated. Less contaminant needed more treatment periods to trigger the immune system. No adjuvant effect of B. pertussis bacteria could be noted, but bacteria sometimes suppressed antibody formation, probably due to daily exposure of the animals to the bacteria. Use of highly purified penicillin preparations would very likely decrease incidence of penicillin allergy, particularly reactivity mediated by IgE antibodies.

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