Rifampicin specific antibodies

Burgess K,Lopez A,GaudryLE, Chong BH Rifampicin-dependent antibodies bind a similar or identical epitope to glycoprotein IX-specific quinine-dependent antibodies. Blood 2000 95 1988-92. 

Initially, display of a peptide libraiy on prokaiyotic polysomes in the E. cdi S30 system was described (6, 7). To produce a population of stalled polysomes, agents such as rifampicin or chloramphenicol, which block prokaiyotic translation, were used. (The term stalled implies that the process of translation has been interrupted such that the ribosome, mRNA, and nascent protein remain associated.) The main example was of screening a large peptide libraiy with 10 members and selection of epitopes by a specific antibody. Peptide libraries have also been expressed and selected in the wheat germ system (8). 

Hemolytic anemia associated with rifampicin was hypothesized to be hapten mediated, as the patient s serum fixed complement in the presence of rifampicin. However, subsequent studies identified circulating erythrocyte-specific antibodies in the serum with specificity for both the Lutheran (Lu) and I antigens. The presence of the I antigen on the surface of leukocytes, platelets, and renal tubular epithelial cells may have accounted for the hemolysis, thrombocytopenia, and renal failure with acute tubular damage observed in the first patient. 

This child developed halothane hepatitis after her first vapor anesthetic but she had susceptibility factors of obesity, female sex, and previous exposure to isoiuazid and rifampicin, albeit 4 years before. Isoiuazid induces CYP2E1 and therefore increases the metabolism of halothane, perhaps placing her at increased risk. Although there is no defined diagnostic test for halothane hepatitis, most experts feel that the presence of hepatitis, eosinophUia, CYP2E1 or ERp58 autoantibodies, or trifluoroacetyl chloride specific IgG antibodies after the exclusion of infection increases the probabUity. 

Two examples of renal toxicity occurring in Chinese individuals were reported by Chan et al. (28 ). In both these patients antibodies to rifampicin were demonstrated and the histological picture from a renal biopsy was compatible with immunological damage to the kidney although no specific IgM could be demonstrated by immunofluorescence techniques. A brief Italian report (29 ) stated that in biopsies of patients with acute renal failure following rifampicin, evidence of an immunological... 

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