An Attempt to Demonstrate Cell-Mediated Reactivity to Penicillin

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Abstract
Using a direct heterologous modification of the macrophage migration inhibition (MMI) test, the postulated cell-mediated immune mechanism in patients with certain types of delayed penicillin G or ampicillin-allergic reactions was investigated. With human peripheral lymphocytes and guinea pig macrophages and with a tuberculin-purified protein derivative (PPD) and penicilloylpolylysine (PPL) as antigens, a good correlation between the MMI test and the positive delayed skin tests was confirmed. With PPL as antigen, delayed skin tests and MMI tests were found positive in only 2 out of 17 patients with ‘delayed’ penicillin or ampicillin allergy. Among 13 patients with ‘delayed’ ampicillin hypersensitivity, the MMI test was performed in 6 and found negative in all of them. It is concluded that, despite the claim of cell-mediated mechanism involved in ‘delayed’ penicillin or ampicillin hypersensitivity reactions, the macrophage migration inhibition techniques used do not permit, in the majority of cases, the demonstration of such a mechanism to the antigens studied.

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