医薬品アレルギーとヒスタミン　　医薬品添加物カルボキシメチルセルロースナトリウムによるアレルギー反応に関する研究

DOI NDLデジタルコレクション 被引用文献5件 参考文献36件

書誌事項

タイトル別名
  • Drug Allergy and Histamine. A Study on the Allergic Response to the Carboxymethylcellulose Sodium in Barium Meal.
  • A Study on the Allergic Response to the Carboxymethylcellulose Sodium in Barium Meal
  • -医薬品添加物カルボキシメチルセルロースナトリウムによるアレルギー反応に関する研究-

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Histamine plays an important role in both inflammation and gastric acid secretion, while it also acts as a neurotransmitter in the mammalian brain. In particular, histamine plays a central role in the immediate hypersensitivity and allergic response as a mediator released from mast cells and basophils.<BR>The use of in vitro histamine release experiments to identify antigens in drug allergies is thus considered to be useful. A highly sensitive assay for histamine is required for in vitro release experiments.<BR>We experienced a patient who developed an anaphylactic reaction to a barium sulfate suspension after under-going an upper gastrointestinal examination, and identified carboxymethylcellulose sodium (CMC-Na) to be an antigen in the barium sulfate suspension, using the skin-scratch test and in vitro histamine release.<BR>A 63-year-old woman was admitted to the hospital because of an anaphylactic reaction after undergoing a double-contrast upper gastrointestinal examination. After obtaining the patient informed consent, we conducted skin-scratch tests for each of the components in the barium sulfate suspension to identify any antigens. A positive reaction was observed for CMC-Na. No such reaction was observed for any other components of the barium sulfate suspension and gas producing granules. The three normal subjects had no response to all agents tested. In addition, the degree of histamine release from the isolated leukocytes induced by CMC-Na was studied in vitro. The leukocytes were isolated by the centrifugation of the peripheral blood on the Ficoll-iothalamate meglumine solution. The histamine content was determined by lon-Pair HPLC.<BR>The leukocytes from the patient responded to CMC-Na at a concentration range from 10-4.5% to 10-2.6%, while those from normal subjects did not. The dose-response curve for the effect of CMC-Na on the histamine release from leukocytes from the patient was bell-shaped. The results of the present study as a whole indicated CMC-Na to be the antigen responsible for the anaphylactic response to the barium suspension in our patient. Although not a common complication, such a reaction may occur in patients sensitized to CMC-Na.<BR>CMC-Na is widely used as a suspending agent in pharmaceuticals, certain food products and cosmetics. Although CMC-Na has been thought to be inert and not absorbed, our findings suggest that the patient was sensitized to CMC-Na through such routes.

収録刊行物

  • 医療薬学

    医療薬学 27 (2), 93-104, 2001

    一般社団法人日本医療薬学会

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