Role of the Side Chain in Penicillin Allergy

The influence of the acyl side chain on the immunological reactivity of penicillins is felt in immunogenicity, in antibody specificity, in degradation pathways and polymerization reactions, and in overall allergenicity. 

Wheal and flare reactions in penicillin-sensitized patients can also be elicited by protein conjugates of phenylacetyl glycine and dimethoxybenzyl glycine (SfflBATA et al. 1968). Using conjugates prepared with various penicillins, the side chain specificity of human skin-sensitizing antibodies has also been evaluated by several groups (Parker and Thiel 1963 Van Dellen et al. 1971). Exclusive or predominant side chain specificity of hypersensitivity may be responsible for the tolerance toward other penicillins of some patients who have been sensitized by penicillin G (Luton 1964). 

---