Lymphocyte proliferation response in patients with delayed hypersensitivity reactions to heparins

被引:38
作者
Lopez, S. [1 ]
Torres, M. J. [2 ]
Rodriguez-Pena, R. [1 ]
Blanca-Lopez, N. [3 ]
Fernandez, T. D. [1 ]
Antunez, C. [1 ]
Canto, G. [3 ]
de Luque, V. [4 ]
Mayorga, C. [1 ]
机构
[1] Carlos Haya Hosp Fdn IMABIS, Res Lab, Malaga 29009, Spain
[2] Carlos Haya Hosp, Allergy Serv, Malaga, Spain
[3] Hosp 12 Octubre, Allergy Serv, E-28041 Madrid, Spain
[4] Virgen Macarena Hosp, Allergy Serv, Seville, Spain
关键词
allergy; delayed reactions; dendritic cells; heparins; lymphocytes; MOLECULAR-WEIGHT HEPARIN; CROSS-REACTIVITY; IN-VITRO; TOLERANCE;
D O I
10.1111/j.1365-2133.2008.08875.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Heparins can induce delayed-type hypersensitivity (DTH) reactions mediated by specific T lymphocytes. However, the interaction between heparins and lymphocytes has not been sufficiently studied. To analyse the lymphocyte response to heparins using different types of antigen-presenting cells in patients with DTH reactions to these drugs. We studied seven patients with DTH reactions to heparins diagnosed by delayed reading of intradermal skin testing (n = 5) or drug provocation test (n = 2) and nine tolerant controls. Biopsies were obtained from intradermal testing or during the acute reaction. Peripheral blood mononuclear cells were used to obtain T and B lymphocytes, monocytes and monocyte-derived dendritic cells (DC). T-lymphocyte proliferation was assayed by means of H-3-thymidine incorporation. Skin testing showed a high degree of cross-reactivity within low molecular weight heparins with good tolerance to sodium heparin, fondaparinux and lepirudin in most cases. The proliferative response was positive in six patients to most of the heparins tested with both monocytes and B cells (the classical lymphocyte transformation test) or immature DC as antigen-presenting cells, giving a higher response with DC. At a second evaluation 1 year later, the proliferative response was found only with DC, and mainly to the culprit drug. A model using DC in the lymphocyte proliferation test is a more appropriate way to assess the immunological response in DTH to heparins; additionally, it can detect a response over a longer time. These findings may be useful for the diagnostic evaluation of drug reactions.
引用
收藏
页码:259 / 265
页数:7
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