Mori S, Muroi N, Ono S, Takahashi H K, Nishibori M
Department of Pharmacology, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Inflamm Res. 2004 Apr;53(4):164-9. doi: 10.1007/s00011-003-1238-9. Epub 2004 Mar 18.
Carboxymethylcellulose (CMC) has been considered to be inert and is commonly used as an additive in medicines, foods and cosmetics. However, we experienced a patient who developed an anaphylactic reaction to CMC after an upper gastrointestinal examination using a barium meal containing CMC. Therefore, we examined the incidence of sensitization by CMC in healthy subjects, and categorized the high risk group prone to developing anaphylactic response to CMC.
An ELISA for detecting CMC-specific IgE antibody was developed using serum from the patient as a positive control. In the ten subjects exhibiting high anti-CMC IgE among 387 normal populations, histamine release from isolated leukocytes was performed.
Five of ten subjects with a high IgE titer showed a significant CMC-induced histamine release from leukocyte preparations in vitro as observed in the patient, and were classified as high risk group. There was a correlation between sensitization by CMC and that by Japanese cedar pollen. The incidence of sensitization in females was 2.4 fold higher than that in males.
The combination of ELISA and histamine release experiment made it possible to identify the high risk group for developing anaphylactic response. The administration of high dose CMC as a suspending agent in barium sulfate or injectable corticosteroids to this group should be avoided to prevent anaphylactic reactions in the clinic.
羧甲基纤维素（CMC）一直被认为是惰性的，常用于药品、食品和化妆品中作为添加剂。然而，我们遇到一名患者，在使用含CMC的钡餐进行上消化道检查后，出现了对CMC的过敏反应。因此，我们研究了健康受试者中CMC致敏的发生率，并对易发生CMC过敏反应的高危人群进行了分类。
以患者血清为阳性对照，开发了一种检测CMC特异性IgE抗体的ELISA方法。在387名正常人群中，对10名抗CMC IgE水平高的受试者进行了分离白细胞组胺释放试验。
10名IgE滴度高的受试者中有5名在体外表现出与患者相似的显著的CMC诱导白细胞制剂组胺释放，被归类为高危组。CMC致敏与日本雪松花粉致敏之间存在相关性。女性致敏发生率比男性高2.4倍。
ELISA和组胺释放试验相结合能够识别出发生过敏反应的高危人群。为防止临床过敏反应，应避免向该组人群高剂量使用CMC作为硫酸钡中的悬浮剂或注射用皮质类固醇。
