Szabó I, Gonda A, Bakos B, Tóth K, Hunyadi J
Debreceni Orvostudományi Egyetem, Börgyógyászati Klinika.
Orv Hetil. 1998 Oct 4;139(40):2379-82.
Diagnosis of drug allergy has been considered to be a multistage procedure consisting of detailed history of previous medication, analysis of symptoms, laboratory tests and provocation with the supposed sensitizing drug. Many laboratory methods are used for demonstration drug allergy, but opinions differ with regard to their specificity, sensitivity and reproducibility. Lymphocyte transformation test (LTT) is considered to be a valuable in vitro method in the diagnosis of drug allergy. For evaluation of LTT we introduced a tetrazolium-based colorimetric assay (MTT). Comparison of MTT assay with 3H-Thymidine incorporation in evaluation of Phytohaemagglutinin induced LTT resulted no significant difference in the dose-response curve. During the past 3 years 315 patients were tested with LTT-MTT method; 736 lymphocyte transformation tests mainly with antibiotics, topical anesthetics and painkillers were evaluated by MTT resulting 280 positive results. Physicians requested skin tests were performed with drugs induced no in vitro lymphocyte transformation and only 8 topical reactions without general symptoms were observed. MTT method was found to be a sensitive laboratory test in evaluation of LTT performable even in routine laboratories. Its application can lead to a substantial decrease in the number of patients who must be subjected to the possible risk of in vivo tests for the determination of the sensitizing drug.
药物过敏的诊断被认为是一个多阶段的过程,包括详细的既往用药史、症状分析、实验室检查以及用疑似致敏药物进行激发试验。许多实验室方法被用于证明药物过敏,但关于它们的特异性、敏感性和可重复性,观点存在差异。淋巴细胞转化试验(LTT)被认为是诊断药物过敏的一种有价值的体外方法。为了评估LTT,我们引入了基于四氮唑的比色法(MTT)。在评估植物血凝素诱导的LTT时,将MTT法与3H-胸腺嘧啶核苷掺入法进行比较,结果剂量反应曲线无显著差异。在过去3年中,315例患者接受了LTT-MTT法检测;736次淋巴细胞转化试验主要针对抗生素、局部麻醉药和止痛药,通过MTT评估,结果有280例呈阳性。对未引起体外淋巴细胞转化的药物进行了医生要求的皮肤试验,仅观察到8例无全身症状的局部反应。发现MTT法是评估LTT的一种敏感的实验室检测方法,甚至在常规实验室也可进行。它的应用可以大幅减少必须接受体内试验以确定致敏药物的患者数量,而体内试验可能存在风险。