Allergy Asthma Immunol Res.  2012 Nov;4(6):367-369. 10.4168/aair.2012.4.6.367.

Immunologic Evaluation of Ofloxacin Hypersensitivity

Affiliations
  • 1Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. hspark@ajou.ac.kr
  • 2Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 3Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

Abstract

Quinolone hypersensitivity, most of which is immediate type, is rare but has increased in recent years. The pathogenic mechanisms underlying immediate reactions are not defined clearly. This study was aimed to observe the clinical characteristics of immediate hypersensitivity to ofloxacin and to investigate the pathogenic mechanism with detection of serum specific IgE to ofloxacin using an enzyme-linked immunoasorbent assay (ELISA). We recruited 5 patients with immediate hypersensitivity reactions to ofloxacin (group I), and as control groups, 5 subjects with ciprofloxacin hypersensitivity (group II) and 20 healthy subjects with no history of drug allergy. Serum specific-IgE to ofloxacin-human serum albumin (HSA) conjugate was detectable in four group I subjects (80%) and three group II subjects (60%). The ELISA inhibition test showed significant inhibition with both ofloxacin-HSA conjugate and free ofloxacin in a dose-dependent manner. As to ciprofloxacin, significant inhibition was noted upon addition of free ciprofloxacin in one subject, while minimal inhibition was noted in the other. We confirmed that an IgE-mediated response is a major pathogenic mechanism of ofloxacin hypersensitivity. Cross reactivity between ofloxacin and ciprofloxacin was noted with individual difference.

Keyword

Cross reactivity; enzyme-linked immunosorbent assay; IgE; immediate hypersensitivity; ofloxacin

MeSH Terms

Ciprofloxacin
Drug Hypersensitivity
Enzyme-Linked Immunosorbent Assay
Humans
Hypersensitivity
Hypersensitivity, Immediate
Immunoglobulin E
Individuality
Ofloxacin
Serum Albumin
Ciprofloxacin
Immunoglobulin E
Ofloxacin
Serum Albumin

Figure

  • Fig. 1 Serum specific IgE levels to ofloxacin-human serum albumin (HSA) conjugate by ELISA in patients with ofloxacin (•) and ciprofloxacin (▴) hypersensitivity and healthy controls (○). Horizontal bar indicates the cut-off value for positive specific IgE bindings.

  • Fig. 2 The IgE ELISA inhibition test results with serial additions of ofloxacin-HSA conjugate (•), free forms of ofloxacin (○) and ciprofloxacin (▴), and human serum albumin alone (▪). Significant inhibitions were noted upon addition of free ciprofloxacin in patient 3 of group I (A), while minimal inhibition was noted in patient 1 of group II (B).


Cited by  1 articles

An Ofloxacin-Induced Anaphylaxis through an IgG4-Mediated but Not IgE-Mediated Basophil Activation Mechanism
Ji Hye Kim, Dae-Hong Seo, Ga-Young Ban, Eun-Mi Yang, Yoo Seob Shin, Young-Min Ye, Hae-Sim Park
Korean J Crit Care Med. 2017;32(3):302-305.    doi: 10.4266/kjccm.2017.00108.


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