Girsh L S, Perelmutter L L
Allergol Immunopathol (Madr). 1982 May-Jun;10(3):229-40.
With the ever-increasing use of pharmaceuticals and the relatively high risk of developing drug allergies, particularly for patients in hospitals and for ambulatory patients with a history of drug allergy, the need to develop in vitro assays for drug allergy is great. In the early 1970's a mast cell technique was developed for diagnosis of drug allergies. A PRIST inhibition assay has also recently been developed to detect IgE antibodies to drug allergens. This test has also been referred to as the Total IgE Inhibition Test by Specific Drug Allergen, and is a variant of the in vitro RAST Test. In vitro mast cell and IgE inhibition tests are applied for identification of drug and chemical allergens and for their cautious clinical trial to prevent future drug and chemical reactions. Over the last eight years, over 1,300 patients were examined utilizing the mast cell technique. Over 100 drugs were tested, with penicillin, barbiturates, "caine" derivatives and sulfonamides most frequently employed. Of 270 patients with well-defined drug reactions, 190 (70 per cent) gave a positive response to the mast cell test. Eighty-five per cent of sera tested with Type I reactions gave a mast cell response. Of these, a group of 30 patients was studied with PRIST inhibition as well. Procedures for comparative testing of necessary drugs and/or chemicals in cases of high anaphylaxis risk of reaction in the clinical setting, hospital or office are included in the study as well as individual case reports. Mast cell assay coupled with IgE inhibition has been successfully used to diagnose drug and chemical allergic reactions. The incidence of positivity is high when the offending drug causes a Type I allergic reaction. The cases reported indicate that both the Mast Cell and the PRIST inhibition assays are useful for diagnosing and setting the clinical treatment and clinical course of the patient. The mast cell assay would be potentially employed for patient use in hospitals where the incidence of drug allergy is highest and for occupational health in the chemical industry. The greatest potential would be in outpatient care applied to patients with multiple drug allergies in the selection of safe drugs (test negative by both methods, and other clinical studies) for future drug usage.
随着药物使用的不断增加以及发生药物过敏的风险相对较高，尤其是对于医院中的患者和有药物过敏史的门诊患者而言，开发药物过敏的体外检测方法的需求十分迫切。20世纪70年代初，一种用于诊断药物过敏的肥大细胞技术得以开发。最近还开发了一种PRIST抑制试验来检测针对药物过敏原的IgE抗体。该试验也被称为特定药物过敏原总IgE抑制试验，是体外RAST试验的一种变体。体外肥大细胞和IgE抑制试验用于识别药物和化学过敏原，并对其进行谨慎的临床试验以预防未来的药物和化学反应。在过去八年中，利用肥大细胞技术对1300多名患者进行了检查。测试了100多种药物，其中青霉素、巴比妥类药物、“卡因”衍生物和磺胺类药物使用最为频繁。在270例明确有药物反应的患者中，190例（70%）对肥大细胞试验呈阳性反应。对I型反应进行检测的血清中，85%出现了肥大细胞反应。其中，还对一组30例患者进行了PRIST抑制试验研究。该研究还包括在临床环境、医院或办公室中，对有高过敏反应风险的病例进行必要药物和/或化学物质的对比测试程序以及个别病例报告。肥大细胞试验与IgE抑制相结合已成功用于诊断药物和化学过敏反应。当致病药物引起I型过敏反应时，阳性率很高。报告的病例表明，肥大细胞试验和PRIST抑制试验均有助于诊断并确定患者的临床治疗和病程。肥大细胞试验可能会用于药物过敏发生率最高的医院中的患者，以及化学工业中的职业健康领域。最大的潜力在于门诊护理，应用于有多种药物过敏的患者，以便在选择未来用药的安全药物时（两种方法检测均为阴性，以及其他临床研究）。
