Antibody-mediated drug hypersensitivity

Types II and III Hypersensitivity. No simple animal models are currently available to assess Type II (antibody-mediated cytotoxicity) hypersensitivity reactions. IgE antibodies and immune complexes in the sera of exposed animals can be assayed using ELISA or RIA techniques that require the use of specific antibodies to the drug. 

The adaptive immune system is responsible for the occurrence of drug allergies after applying certain chemicals for example to the skin. Symptoms of such allergic hypersensitivities are observed only in the elicitation phase and not in the preceding sensitization phase, as only the second exposure to the causative drug results in T cell- or antibody-mediated adverse effects. 

Type in hypersensitivity is mediated by soluble immune complexes mostly involving IgG antibodies. Drug-induced serum sickness-like reaction is the prototype example of type III drug hypersensitivity. Hypersensitivity vascu-Ms is another example of a type III hypersensitivity response induced by drugs. 

The chemically similar teicoplanin, not approved in the USA, is not inferior to vancomycin with regard to efficiency of treating grampositive infections. It shows a lower rate of adverse reactions, particularly nephrotoxicity and, as already discussed, is used as a substitute for vancomycin in red man syndrome. When hypersensitivity reactions do occur with teicoplanin they are generally of the delayed type, but there are a few documented cases of apparent IgE antibody-mediated reactions implicated, for example, by an immediate wheal and flare skin reaction to the drug or by teicoplanin-induced histamine release from a patient s basophils. Despite the chemical and pharmacological... 

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