Baldo B A, Fisher M M
Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney, St Leonards NSW, Australia.
Ann Fr Anesth Reanim. 1993;12(2):131-40. doi: 10.1016/s0750-7658(05)81022-6.
The discovery of IgE antibodies to neuromuscular blocking drugs, to thiopentone and narcotics, particularly morphine, reinforced earlier beliefs formed from skin test and other clinical findings that many "anaphylactoid" reactions to drugs were true type 1 immediate hypersensitivity reactions. Immunochemical studies established the fine structural specificities of the drug-reactive IgE antibodies and provided an explanation in molecular terms for a number of observed clinical cross-reactions. Subtleties in interpreting relationships between skin tests and IgE radioimmunoassays are pointed out and mechanisms of drug-induced mediator release, persistence of IgE antibodies and the nature of the sensitizing sources are discussed.
针对神经肌肉阻断药物、硫喷妥钠和麻醉药（尤其是吗啡）的IgE抗体的发现，强化了早期基于皮肤试验和其他临床发现形成的观念，即许多药物的“类过敏反应”实际上是1型速发型超敏反应。免疫化学研究确定了药物反应性IgE抗体的精细结构特异性，并从分子角度解释了一些观察到的临床交叉反应。文中指出了皮肤试验和IgE放射免疫测定之间关系解释中的微妙之处，并讨论了药物诱导介质释放的机制、IgE抗体的持久性以及致敏源的性质。
