Torres Maria J, Mayorga Cristobalina, Blanca-López Natalia, Blanca Miguel
Allergy Service, pabellón 6, primera planta, IBIMA, Carlos Haya Hospital (Pabellon C), Plaza del Hospital Civil, 29009, Malaga, Spain,
Exp Suppl. 2014;104:165-84. doi: 10.1007/978-3-0348-0726-5_11.
Beta-lactam antibiotics (BLs) are the most frequent cause of hypersensitivity reactions mediated by specific immunological mechanisms, with two main types, IgE reactions or T-cell-dependent responses. From a practical point of view, these reactions can be classified into immediate, for those appearing within 1 h after drug intake, and non-immediate, for those appearing at least 1 h after and usually within 24 h of BL administration. The clinical symptoms differ according to this classification. Urticaria and anaphylaxis are the most frequently recorded symptoms in immediate reactions and maculopapular exanthema and delayed urticaria in non-immediate reactions. Although the exact diagnostic approach differs depending on the underlying mechanism, it is based on the performance of skin testing, laboratory tests, and drug provocation tests.T cells are a key factor in all types of hypersensitivity reactions to BLs, regulating both IgE production or acting as effector cells, with a different profile of cytokine production. A Th1 pattern is observed in both CD4(+) and CD8(+) peripheral T cells in non-immediate reactions, whereas a Th2 pattern is expressed in CD4(+) T cells in immediate reactions.
β-内酰胺类抗生素（BLs）是由特定免疫机制介导的超敏反应的最常见原因，主要有两种类型，即IgE反应或T细胞依赖性反应。从实际角度来看，这些反应可分为速发型，即服药后1小时内出现的反应，以及非速发型，即至少在服用BLs后1小时出现且通常在24小时内出现的反应。根据这种分类，临床症状有所不同。荨麻疹和过敏反应是速发型反应中最常记录到的症状，而斑丘疹和迟发性荨麻疹是非速发型反应中的症状。尽管确切的诊断方法因潜在机制而异，但它基于皮肤试验、实验室检查和药物激发试验的实施。T细胞是所有类型BLs超敏反应的关键因素，调节IgE产生或作为效应细胞，产生不同的细胞因子谱。在非速发型反应中，CD4(+)和CD8(+)外周T细胞均观察到Th1模式，而在速发型反应中，CD4(+) T细胞表达Th2模式。
