Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes

Background: Analysis of cross-reactivity is necessary for prescribing safe cephalosporins for penicillin allergic patients. Amoxicillin (AX) is the betalactam most often involved in immediate hypersensitivity reactions (IHRs), and cefadroxil (CX) the most likely cephalosporin to cross-react with AX,...

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Authors: Bogas, Gador, Mayorga, Cristobalina, Martín-Serrano, Ángela, Fernández-Santamaría, Rubén, Jiménez-Sánchez, Isabel M., Ariza, Adriana, Barrionuevo, Esther, Posadas, Teresa, Salas, María, Fernández, Tahía Diana, Torres, María José, Montañez, María Isabel
Format: article
Publication Date:2020
Country:España
Institution:Instituto de Salud Carlos III (ISCIII)
Repository:Repisalud
Language:English
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/18169
Online Access:http://hdl.handle.net/20.500.12105/18169
Access Level:Open access
Keyword:Amoxicillin
Betalactam
Cephalosporin
Cross-reactivity
Drug allergy
Antigenic determinant
Specific IgE
Amoxicilina
Beta-lactamas
Cefalosporinas
Hipersensibilidad a las Drogas
Reacciones cruzadas
Epítopos
Inmunoglobulina E
Cephalosporins
beta-Lactams
Cross Reactions
Drug Hypersensitivity
Epitopes
Immunoglobulin E
Humans
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oai_identifier_str oai:repisalud.isciii.es:20.500.12105/18169
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
title Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
spellingShingle Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
Bogas, Gador
Amoxicillin
Betalactam
Cephalosporin
Cross-reactivity
Drug allergy
Antigenic determinant
Specific IgE
Amoxicilina
Beta-lactamas
Cefalosporinas
Hipersensibilidad a las Drogas
Reacciones cruzadas
Epítopos
Inmunoglobulina E
Amoxicillin
Cephalosporins
beta-Lactams
Cross Reactions
Drug Hypersensitivity
Epitopes
Immunoglobulin E
Humans
title_short Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
title_full Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
title_fullStr Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
title_full_unstemmed Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
title_sort Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopes
dc.creator.none.fl_str_mv Bogas, Gador
Mayorga, Cristobalina
Martín-Serrano, Ángela
Fernández-Santamaría, Rubén
Jiménez-Sánchez, Isabel M.
Ariza, Adriana
Barrionuevo, Esther
Posadas, Teresa
Salas, María
Fernández, Tahía Diana
Torres, María José
Montañez, María Isabel
author Bogas, Gador
author_facet Bogas, Gador
Mayorga, Cristobalina
Martín-Serrano, Ángela
Fernández-Santamaría, Rubén
Jiménez-Sánchez, Isabel M.
Ariza, Adriana
Barrionuevo, Esther
Posadas, Teresa
Salas, María
Fernández, Tahía Diana
Torres, María José
Montañez, María Isabel
author_role author
author2 Mayorga, Cristobalina
Martín-Serrano, Ángela
Fernández-Santamaría, Rubén
Jiménez-Sánchez, Isabel M.
Ariza, Adriana
Barrionuevo, Esther
Posadas, Teresa
Salas, María
Fernández, Tahía Diana
Torres, María José
Montañez, María Isabel
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv [Bogas,G; Mayorga,G; Martín-Serrano,A; Fernández-Santamaría,R; Jiménez-Sánchez,IM; Ariza,A; Barrionuevo,E; Posadas,T; Salas,M; Fernández,TD; Torres,MJ; Montañez,MI] Allergy Research Group, Instituto de Investigación Biomédica de Málaga- IBIMA, Hospital Civil, Málaga, Spain. [Bogas,G; Mayorga,G; Barrionuevo,E; Posadas,T; Salas,M; Torres,MJ] Allergy Unit, Hospital Regional Universitario de Málaga, Hospital Civil, Málaga, Spain. [Mayorga,G; Martín-Serrano,A; Jiménez-Sánchez,IM; Torres,MJ; Montañez,MI] Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain. [Fernández,TD] Departamento de Biología Celular, Genética y Fisiología, Universidad de Málaga, Málaga, Spain. [Torres,MJ] Departamento de Medicina, Universidad de Málaga, Facultad de Medicina, Málaga, Spain.
dc.subject.none.fl_str_mv Amoxicillin
Betalactam
Cephalosporin
Cross-reactivity
Drug allergy
Antigenic determinant
Specific IgE
Amoxicilina
Beta-lactamas
Cefalosporinas
Hipersensibilidad a las Drogas
Reacciones cruzadas
Epítopos
Inmunoglobulina E
Amoxicillin
Cephalosporins
beta-Lactams
Cross Reactions
Drug Hypersensitivity
Epitopes
Immunoglobulin E
Humans
topic Amoxicillin
Betalactam
Cephalosporin
Cross-reactivity
Drug allergy
Antigenic determinant
Specific IgE
Amoxicilina
Beta-lactamas
Cefalosporinas
Hipersensibilidad a las Drogas
Reacciones cruzadas
Epítopos
Inmunoglobulina E
Amoxicillin
Cephalosporins
beta-Lactams
Cross Reactions
Drug Hypersensitivity
Epitopes
Immunoglobulin E
Humans
description Background: Analysis of cross-reactivity is necessary for prescribing safe cephalosporins for penicillin allergic patients. Amoxicillin (AX) is the betalactam most often involved in immediate hypersensitivity reactions (IHRs), and cefadroxil (CX) the most likely cephalosporin to cross-react with AX, since they share the same R1 side chain, unlike cefuroxime (CO), with a structurally different R1. We aimed to analyse cross-reactivity with CX and CO in patients with confirmed IHRs to AX, including sIgE recognition to AX, CX, CO, and novel synthetic determinants of CX. Methods: Fifty-four patients with confirmed IHRs to AX based on skin test (ST) and/or drug provocation test (DPT) were included. Serum sIgE to AX and benzylpenicillin was determined by Radioallergosorbent test (RAST). Two potential determinants of CX, involving intact or modified R1 structure, with open betalactam ring, were synthesised and sIgE evaluated by RAST inhibition assay. Results: Tolerance to CX (Group A) was observed in 64.8% cases and cross-reactivity in 35.2% cases (Group B). Cross-reactivity with CO was only found in 1.8% cases from Group B. ST to CX showed a negative predictive value of 94.6%. RAST inhibition assays showed higher recognition to CX as well as to both synthetic determinants (66% of positive cases) in Group B. Conclusions: Cross-reactivity with CX in AX allergic patients is 35%, being ST not enough for prediction. R1, although critical for recognition, is not the unique factor. The synthetic determinants of CX, 1-(HOPhG-Ser-Bu) and 2-(pyrazinone) are promising tools for determining in vitro cross-reactivity to CX in AX allergic patients. Background: Betalactams (BLs) are the drugs most frequently involved in immediate (IgE-mediated) hypersensitivity reactions (IHRs) [1,2,3], which could be explained by their ability to act as haptens due to their high chemical reactivity against proteins [4, 5]. BL chemical structure is formed by a 4-membered ring (the so-called BL ring) that in penicillins is fused to a 5-membered thiazolidine ring, and in cephalosporins to a 6-membered dihydrothiazine ring (Fig. 1). These drugs have a side chain (R1) bound to the BL ring; besides, cephalosporins have a second side chain (R2) bound to the dihydrothiazine ring, whose chemical structures distinguish the different compounds [6, 7].
publishDate 2020
dc.date.none.fl_str_mv 2020
2020-12-04
2020
2020-12-04
2024
2024-02-12
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/18169
url http://hdl.handle.net/20.500.12105/18169
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central (BMC)
publisher.none.fl_str_mv BioMed Central (BMC)
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869420557177454592
spelling Penicillin and cephalosporin cross-reactivity: role of side chain and synthetic cefadroxil epitopesBogas, GadorMayorga, CristobalinaMartín-Serrano, ÁngelaFernández-Santamaría, RubénJiménez-Sánchez, Isabel M.Ariza, AdrianaBarrionuevo, EstherPosadas, TeresaSalas, MaríaFernández, Tahía DianaTorres, María JoséMontañez, María IsabelAmoxicillinBetalactamCephalosporinCross-reactivityDrug allergyAntigenic determinantSpecific IgEAmoxicilinaBeta-lactamasCefalosporinasHipersensibilidad a las DrogasReacciones cruzadasEpítoposInmunoglobulina EAmoxicillinCephalosporinsbeta-LactamsCross ReactionsDrug HypersensitivityEpitopesImmunoglobulin EHumansBackground: Analysis of cross-reactivity is necessary for prescribing safe cephalosporins for penicillin allergic patients. Amoxicillin (AX) is the betalactam most often involved in immediate hypersensitivity reactions (IHRs), and cefadroxil (CX) the most likely cephalosporin to cross-react with AX, since they share the same R1 side chain, unlike cefuroxime (CO), with a structurally different R1. We aimed to analyse cross-reactivity with CX and CO in patients with confirmed IHRs to AX, including sIgE recognition to AX, CX, CO, and novel synthetic determinants of CX. Methods: Fifty-four patients with confirmed IHRs to AX based on skin test (ST) and/or drug provocation test (DPT) were included. Serum sIgE to AX and benzylpenicillin was determined by Radioallergosorbent test (RAST). Two potential determinants of CX, involving intact or modified R1 structure, with open betalactam ring, were synthesised and sIgE evaluated by RAST inhibition assay. Results: Tolerance to CX (Group A) was observed in 64.8% cases and cross-reactivity in 35.2% cases (Group B). Cross-reactivity with CO was only found in 1.8% cases from Group B. ST to CX showed a negative predictive value of 94.6%. RAST inhibition assays showed higher recognition to CX as well as to both synthetic determinants (66% of positive cases) in Group B. Conclusions: Cross-reactivity with CX in AX allergic patients is 35%, being ST not enough for prediction. R1, although critical for recognition, is not the unique factor. The synthetic determinants of CX, 1-(HOPhG-Ser-Bu) and 2-(pyrazinone) are promising tools for determining in vitro cross-reactivity to CX in AX allergic patients. Background: Betalactams (BLs) are the drugs most frequently involved in immediate (IgE-mediated) hypersensitivity reactions (IHRs) [1,2,3], which could be explained by their ability to act as haptens due to their high chemical reactivity against proteins [4, 5]. BL chemical structure is formed by a 4-membered ring (the so-called BL ring) that in penicillins is fused to a 5-membered thiazolidine ring, and in cephalosporins to a 6-membered dihydrothiazine ring (Fig. 1). These drugs have a side chain (R1) bound to the BL ring; besides, cephalosporins have a second side chain (R2) bound to the dihydrothiazine ring, whose chemical structures distinguish the different compounds [6, 7].BioMed Central (BMC)[Bogas,G; Mayorga,G; Martín-Serrano,A; Fernández-Santamaría,R; Jiménez-Sánchez,IM; Ariza,A; Barrionuevo,E; Posadas,T; Salas,M; Fernández,TD; Torres,MJ; Montañez,MI] Allergy Research Group, Instituto de Investigación Biomédica de Málaga- IBIMA, Hospital Civil, Málaga, Spain. [Bogas,G; Mayorga,G; Barrionuevo,E; Posadas,T; Salas,M; Torres,MJ] Allergy Unit, Hospital Regional Universitario de Málaga, Hospital Civil, Málaga, Spain. [Mayorga,G; Martín-Serrano,A; Jiménez-Sánchez,IM; Torres,MJ; Montañez,MI] Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain. [Fernández,TD] Departamento de Biología Celular, Genética y Fisiología, Universidad de Málaga, Málaga, Spain. [Torres,MJ] Departamento de Medicina, Universidad de Málaga, Facultad de Medicina, Málaga, Spain.20242024-02-1220202020-12-0420202020-12-04research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articlehttp://hdl.handle.net/20.500.12105/18169reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/181692026-06-12T12:43:37Z
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