Pichler W J, Campi P
Institute for Clinical Immunology, Inselspital, Bern, Switzerland.
Ann Allergy. 1992 Dec;69(6):521-5.
Seven patients who received a lysozyme, nystatin, and tetracycline containing vaginal suppository because of suspected vaginal infection, developed local or systemic allergic reactions. The coincidence of the symptoms with the repeated use of the suppository as well as skin and lymphocyte transformation tests indicated that the lysozyme in the suppository was responsible for the allergic reactions. This lysozyme preparation contained additional egg proteins, which contributed to the allergic reaction in certain patients: three patients with a previous history of egg allergy and serologic and/or skin test evidence for egg-white sensitization developed the allergic reaction after the first suppository. Four patients had urticaria or anaphylaxis after treatment for at least three days; none of these four patients developed egg allergy. Five of seven individuals had positive skin tests (prick or scratch) to ovomucoid and lysozyme, but none of the patients had lysozyme-specific IgE in the circulation. All seven patients, with or without egg allergy, showed vigorous T cell responses to purified lysozyme and partly to other egg-white proteins in the lymphocyte transformation test, which was absent in controls. Vaginal suppositories that contain lysozyme and other contaminating egg white proteins can either elicit allergic reactions in patients with a preexisting egg white allergy or induce sensitization to lysozyme and other egg white components.
7名因疑似阴道感染而接受含溶菌酶、制霉菌素和四环素阴道栓剂治疗的患者出现了局部或全身过敏反应。症状与栓剂的重复使用同时出现，以及皮肤和淋巴细胞转化试验表明，栓剂中的溶菌酶是过敏反应的原因。这种溶菌酶制剂含有额外的鸡蛋蛋白，这在某些患者中导致了过敏反应：3名有鸡蛋过敏史且有蛋清致敏的血清学和/或皮肤试验证据的患者在首次使用栓剂后出现了过敏反应。4名患者在治疗至少三天后出现荨麻疹或过敏反应；这4名患者均未发生鸡蛋过敏。7名患者中有5名对卵类粘蛋白和溶菌酶的皮肤试验（点刺或划痕）呈阳性，但所有患者循环中均无溶菌酶特异性IgE。所有7名患者，无论有无鸡蛋过敏，在淋巴细胞转化试验中均对纯化的溶菌酶以及部分蛋清蛋白表现出强烈的T细胞反应，而对照组则无此反应。含有溶菌酶和其他污染性蛋清蛋白的阴道栓剂可在已有蛋清过敏的患者中引发过敏反应，或诱导对溶菌酶和其他蛋清成分的致敏。
