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IgE‐mediated anaphylaxis to Thiomucase®, a mucopolyssacharidase: allergens and cross‐reactivity
Author(s) -
Caballero T.,
Alonso A.,
De Miguel S.,
MartínEsteban M.,
Varga B.,
Pascual C. Y.,
LópezSerrano M. C.
Publication year - 2002
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1034/j.1398-9995.2002.03322.x
Subject(s) - immunoglobulin e , dander , anaphylaxis , immunology , cross reactivity , allergy , bovine serum albumin , allergen , medicine , chemistry , biology , antibody , cross reactions
Background: Thiomucase® is a mucopolysaccharidase obtained from ovine tissues mainly used to facilitate the diffusion of local anaesthetics and in the treatment of cellulitis. A patient with an anaphylaxis in relation to the intramuscular administration of Thiomucase® is reported. Objective: To investigate Thiomucase® allergens and their possible relationship with dander allergens and animal albumins. Material and methods: Skin prick tests (SPT) and serum‐specific IgE were performed with Thiomucase® and danders. Thiomucase® SDS‐PAGE immunoblotting was performed in order to study allergens. RAST/CAP inhibition and SDS‐PAGE immunoblotting inhibition were carried out to study the cross‐reactivity. Results: Skin prick tests (SPT) were positive to Thiomucase®, animal dander (cat, dog, sheep, other), bovine serum albumin (BSA), and echinococcus. Specific IgE was also positive to Thiomucase®, animal dander (cat, dog, sheep, other), BSA and echinococcus. In the RAST‐CAP inhibition assays BSA was nearly completely inhibited by Thiomucase®, Thiomucase® was partially inhibited by BSA and cat and Echinococcus granulosus was partially inhibited by sheep and Thiomucase®. In the Thiomucase® SDS‐PAGE immunoblotting several proteins fixed IgE, ranging from 20 kDa to > 94 kDa, the strongest with 43 kDa. The IgE fixation to BSA, cat and sheep in the SDS‐PAGE immunoblotting was completely inhibited by the preincubation of the serum with Thiomucase®. Conclusions: An IgE‐mediated anaphylaxis to Thiomucase® is documented. Multiple allergens are recognized in Thiomucase® by the patient serum, the main with 43 kDa. Partial cross‐reactivity with BSA, cat dander and sheep dander is documented.