Cephalosporin chemical reactivity
Cephalosporin chemical reactivity
Purpose of Review: The aim of this article is to analyze the chemical reactivity of cephalosporins resulting in the epitope responsible for recognition by IgE antibodies and to establish the basis of the allergenicity.
Recent Findings: Increasing evidence supports the role of cephalosporins in IgE hypersensitivity reactions. Third and fourth generation cephalosporins appear to be more involved in specific IgE reactions and often no cross-reactivity with traditional benzyl penicillin determinants exists. In some instances selective responses to unique cephalosporins occur and in others common side-chain similarities exist.
Summary: Lack of knowledge of the exact chemical structure of cephalosporin antigenic determinants has hindered clinical interpretation of allergic reactions to these drugs and hampered understanding of the specific recognition by IgE molecules of these determinants. Data indicate that R2 is not present in the final conjugate and that recognition by IgE antibodies is mainly directed to the R1 acyl side chain and to the β-lactam fragment that remains linked to the carrier protein in the cephalosporin conjugation process.
Allergic reactions to cephalosporins can be induced by the β-lactam ring structure common to all antibiotics from this family or by specific recognition to cephalosporin determinants. Although no standardized diagnostic tests are currently available to clinicians for use in allergy to β-lactams, cephalosporins are nevertheless widely prescribed in clinical practice for treatment of different bacterial infections and as prophylactic agents in surgery.
Lack of understanding of the exact chemical structure of cephalosporin antigenic determinants has hampered adequate evaluation of allergic reactions to these antibiotics, study of the specific molecular recognition by specific IgE antibodies, and hence development of standardized in-vitro and in-vivo diagnostic tests.
This review provides a detailed analysis of the chemical structures generated by cephalosporins and furnishes information concerning the possible final determinant involved in the specific IgE response.
Purpose of Review: The aim of this article is to analyze the chemical reactivity of cephalosporins resulting in the epitope responsible for recognition by IgE antibodies and to establish the basis of the allergenicity.
Recent Findings: Increasing evidence supports the role of cephalosporins in IgE hypersensitivity reactions. Third and fourth generation cephalosporins appear to be more involved in specific IgE reactions and often no cross-reactivity with traditional benzyl penicillin determinants exists. In some instances selective responses to unique cephalosporins occur and in others common side-chain similarities exist.
Summary: Lack of knowledge of the exact chemical structure of cephalosporin antigenic determinants has hindered clinical interpretation of allergic reactions to these drugs and hampered understanding of the specific recognition by IgE molecules of these determinants. Data indicate that R2 is not present in the final conjugate and that recognition by IgE antibodies is mainly directed to the R1 acyl side chain and to the β-lactam fragment that remains linked to the carrier protein in the cephalosporin conjugation process.
Allergic reactions to cephalosporins can be induced by the β-lactam ring structure common to all antibiotics from this family or by specific recognition to cephalosporin determinants. Although no standardized diagnostic tests are currently available to clinicians for use in allergy to β-lactams, cephalosporins are nevertheless widely prescribed in clinical practice for treatment of different bacterial infections and as prophylactic agents in surgery.
Lack of understanding of the exact chemical structure of cephalosporin antigenic determinants has hampered adequate evaluation of allergic reactions to these antibiotics, study of the specific molecular recognition by specific IgE antibodies, and hence development of standardized in-vitro and in-vivo diagnostic tests.
This review provides a detailed analysis of the chemical structures generated by cephalosporins and furnishes information concerning the possible final determinant involved in the specific IgE response.
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