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目的:探讨青霉素过敏患者外周血T淋巴细胞识别抗原的特异性。方法:采用四甲基偶氮唑蓝(MTT)比色法测定16例青霉素类抗生素过敏患者外周血T淋巴细胞,用4种青霉素类药物(青霉素G,青霉素V,氨苄西林和阿莫西林)及其侧链和6-氨基青霉烷酸刺激后的增殖情况。采用放射过敏原吸附试验(RAST)测定5例患者血清中8种特异性IgE抗体(青霉素G,青霉素V,氨苄西林和阿莫西林的主要、次要抗原决定簇)。结果:T淋巴细胞总增殖阳性率为93.75%(15/16)。4例患者(26.67%)T细胞仅对一种刺激物发生特异性增殖;2例患者(13.33%)对一种青霉素类药物及其侧链发生增殖;9例患者(60.00%)的T细胞同时对多种刺激物发生增殖反应。5例过敏患者中有4例血清中IgE抗体阳性。结论:T细胞在青霉素过敏反应中占重要地位,根据识别特性可分T细胞系为特异性和交叉反应性两类。
Objective: To investigate the specificity of T lymphocyte antigen recognition in peripheral blood of patients with penicillin allergy. Methods: T lymphocytes from peripheral blood of 16 patients with penicillin antibiotic allergy were detected by MTT assay. Four kinds of penicillins (penicillin G, penicillin V, ampicillin and amoxicillin) And its side chain and 6-amino penicillanic acid stimulation of proliferation. Eight specific IgE antibodies (the major and minor epitopes of penicillin G, penicillin V, ampicillin and amoxicillin) were measured in the sera of five patients using the radiolabeled antigen adsorption assay (RAST). Results: The positive rate of T lymphocyte proliferation was 93.75% (15/16). T cells from 4 patients (26.67%) proliferated exclusively for one stimulus; 2 patients (13.33%) proliferated against one penicillin and its side chains; T cells from 9 patients (60.00%) At the same time on a variety of stimuli proliferative response. Serum IgE antibodies were positive in 4 of 5 allergic patients. Conclusion: T cells play an important role in the allergic reaction of penicillin. T cell lines can be classified as specific and cross-reactive according to their recognition characteristics.