Kraft D, Berglund A, Rumpold H, Roth A, Ebner H
Clin Allergy. 1981 Nov;11(6):579-87. doi: 10.1111/j.1365-2222.1981.tb02178.x.
Penicillamine-polylysine, benzylpenicillanyl-human serum albumin and ampicillin-polymers were coupled to CNBr-activated paper discs and used in addition to penicilloyl G and penicilloyl V discs in RAST investigations. Sera from sixty patients with case histories of penicillin allergy and with positive or negative skin tests to different penicillin determinants and from seventeen subjects with atopic diseases caused by allergens other than penicillin were tested. The penicilloyl-('major' determinant) specific RAST (Phadebas RAST Penicilloyl G and V) was positive in twenty out of twenty-four patients with positive skin tests to penicilloyl-polylysine, in eight out of twelve patients with sole skin reactivity to 'minor' determinants, and in five out of twenty-four patients with negative skin tests to all antigens used. The penicillamine-specific RAST was the only positive in vitro test in four patients with negative skin tests (two) or sole positive skin reactivity to 'minor' determinants (two), whereas benzylpenicillanyl and ampicillin-polymer discs added no more information than the penicilloyl structures in all patients tested. Antibodies specific to 'minor' determinants apparently show strong in vitro cross-reactivity with the penicilloyl determinant. It is, therefore, concluded that 'minor' determinant specific conjugates are of marginal importance for in vitro diagnosis of penicillin-allergic patients.
青霉胺 - 聚赖氨酸、苄青霉素基 - 人血清白蛋白和氨苄青霉素聚合物被偶联到溴化氰活化的纸盘上，并在放射变应原吸附试验（RAST）研究中与青霉素酰G盘和青霉素酰V盘一起使用。检测了60例有青霉素过敏病史且对不同青霉素决定簇皮肤试验呈阳性或阴性的患者以及17例由青霉素以外的过敏原引起的特应性疾病患者的血清。在对青霉素酰 - 聚赖氨酸皮肤试验呈阳性的24例患者中的20例、对“次要”决定簇仅有皮肤反应性的12例患者中的8例以及对所有使用抗原皮肤试验呈阴性的24例患者中的5例中，青霉素酰（“主要”决定簇）特异性RAST（法德巴斯RAST青霉素酰G和V）呈阳性。在4例皮肤试验呈阴性（2例）或对“次要”决定簇仅有阳性皮肤反应性（2例）的患者中，青霉胺特异性RAST是唯一呈阳性的体外试验，而在所有检测患者中，苄青霉素基和氨苄青霉素聚合物盘提供的信息并不比青霉素酰结构更多。对“次要”决定簇特异性的抗体显然在体外与青霉素酰决定簇有很强的交叉反应性。因此，得出结论，“次要”决定簇特异性结合物对青霉素过敏患者的体外诊断重要性不大。
