A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs
Abstract
:1. Introduction
2. Results
2.1. Anaphylactoid Reactions Provoked in Different Ways
2.2. Selection of Physiological Index
2.3. Measurement of Endotoxin in Each Injection
2.4. Anaphylactoid Reaction Provoked by SHL Injection, YXC Injection, Paclitaxel Injection, Levofloxacin Injection and Diammonium Glycyrrhizinate Injection
2.5. Inflammatory Reaction Provoked by Amiodarone Hydrochloride Injection and Toad Venom Injection
3. Discussion
4. Experimental Section
4.1. Animals
4.2. Reagents
4.3. Anaphylactoid Reactions Provoked by Different Ways
4.4. Anaphylactoid Reactions, Anaphylactic Reactions and Inflammatory Reactions Provoked by Different Drugs
4.5. Measurement of SC5b-9, 5-HT, Bb, C4d, Histamine, C3a and IL-6 in Animals’ Plasma
4.6. Measurement of Endotoxin in Different Injections
4.7. Anaphylactoid Reactions Provoked by SHL Injection, YXC Injection, Paclitaxel Injection, Levofloxacin Injection and Diammonium Glycyrrhizinate Injection in Vivo
4.8. Inflammatory Reaction Provoked by Amiodarone Hydrochloride Injection and Toad Venom Injection
4.9. Statistical Analysis
5. Conclusions
Acknowledgments
Author Contributions
Conflict of Interest
References
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- Sample Availability: Samples of the compounds are not available from the authors.
Name | Definitions | General Features |
---|---|---|
Hypersensitivity | A state of altered reactivity where people react with an exaggerated immune response to a foreign agent. The term includes allergic and pseudo-allergic reactions, but sometimes it is also used synonymously with immune-mediated allergic reactions. | If it is used synonymously with true allergy, it requires a pre-sensitized (immune) state of the host. There are four basic types of allergic reactions: immediate hypersensitivity, cytotoxicity, immune-complex mediated reactions and delayed type hypersensitivity. |
Type-I allergy or immediate type allergy | A type of allergic reaction induced by binding of allergen specific IgE antibodies to its high affinity receptor on mast cells (MC) resulting in antigen/allergen specific MC degranulation in pre-sensitized persons. | The reaction starts quickly, may be strong and fade quickly. It manifests as allergic rhinoconjunctivitis, allergic asthma or generalized urticaria or other organ manifestations. |
Anaphylaxis | Anaphylaxis is simply the maximum variant of type-I allergy with systemic manifestation. | Anaphylaxis may begin within minutes or even seconds of exposure, can progress rapidly to airway constriction, generalized urticaria, intestinal and cardiovascular involvement. Without acute treatment it may end lethally. |
Anaphylactoid reactions | Anaphylactoid reactions have no immunologic background and occur in a more dose-depend manner but require some individual predisposition too. | The clinical symptoms are similar to type-I reaction and therefore difficult to differentiate from IgE mediated Type I reactions. |
Drug idiosyncrasy | Idiosyncrasy is an individual drug induced non-immunologic reaction and applies to genetically inherited enzyme defects involved in drug metabolism. | Idiosyncratic reactions occur therefore also in pre-disposed persons and may have similar features to allergic reactions. |
Humoral Factors | Anaphylactoid Reaction | Anaphylactic Reaction | Inflammatory Reaction |
---|---|---|---|
5-HT | + | + | − |
SC5b-9 | + | − | + |
IL-6 | − | + | + |
Bb | + | − | − |
C4d | − | − | + |
C3a | + | + | + |
histamine | + | + | + |
Sample Name | Reaction Time (s) | Coefficient of Variation (%) | Recovery (%) | Contained (EU/mL) |
---|---|---|---|---|
4% SHL injection | 2708 | - | 75.85 | <0.01 |
2729 | ||||
20% SHL injection | 2139 | 0.36 | 114.34 | 0.0103 |
2128 | ||||
100% SHL injection | 1766 | 1.31 | 132.60 | 0.0274 |
1799 | ||||
4% YXC injection | 2698 | - | 109.78 | <0.01 |
2675 | ||||
20% YXC injection | 2098 | 4.41 | 75.85 | 0.0095 |
2233 | ||||
100% YXC injection | 1714 | 1.75 | 114.34 | 0.0317 |
1757 | ||||
4% paclitaxel injection | 2757 | - | 120.69 | <0.01 |
2729 | ||||
20% paclitaxel injection | 2478 | - | 114.54 | <0.01 |
2491 | ||||
100% paclitaxel injection | 2209 | 1.68 | 93.93 | 0.0091 |
2157 | ||||
4% levofloxacin injection | 2641 | - | 105.88 | <0.01 |
2673 | ||||
20% levofloxacin injection | 2765 | - | 84.25 | <0.01 |
2770 | ||||
100% levofloxacin injection | 2174 | 1.08 | 117.77 | 0.0097 |
2141 | ||||
4% diammonium glycyrrhizinate injection | 2575 | - | 77.06 | <0.01 |
2589 | ||||
20% diammonium glycyrrhizinate injection | 2187 | 2.20 | 78.62 | 0.0098 |
2120 | ||||
100% diammonium glycyrrhizinate injection | 1944 | 2.22 | 83.81 | 0.0157 |
2006 | ||||
4% toad venom injection | 1880 | 1.74 | 109.76 | 0.0195 |
1926 | ||||
20% toad venom injection | 2029 | 3.37 | 94.97 | 0.0162 |
1934 | ||||
100% toad venom injection | 2001 | 1.94 | 85.83 | 0.0141 |
2056 | ||||
4% amiodarone hydrochloride injection | 2209 | 1.98 | 118.82 | <0.01 |
2272 | ||||
20% amiodarone hydrochloride injection | 2019 | 2.46 | 87.18 | 0.0133 |
2090 | ||||
100% amiodarone hydrochloride injection | 2069 | - | 88.96 | 0.0097 |
2329 |
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Wang, F.; Weng, Z.; Li, C.; Peng, G. A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs. Molecules 2016, 21, 1352. https://doi.org/10.3390/molecules21101352
Wang F, Weng Z, Li C, Peng G. A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs. Molecules. 2016; 21(10):1352. https://doi.org/10.3390/molecules21101352
Chicago/Turabian StyleWang, Fang, Zebin Weng, Cunyu Li, and Guoping Peng. 2016. "A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs" Molecules 21, no. 10: 1352. https://doi.org/10.3390/molecules21101352
APA StyleWang, F., Weng, Z., Li, C., & Peng, G. (2016). A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs. Molecules, 21(10), 1352. https://doi.org/10.3390/molecules21101352