Document Detail


Cross-reactivity patterns of T cells specific for iodinated contrast media.
MedLine Citation:
PMID:  17412404     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Approximately 3% of patients exposed to iodinated contrast media develop delayed hypersensitivity reactions.
OBJECTIVE: We wanted to better understand the molecular basis of contrast media cross-reactivity.
METHODS: Cross-reactivity was assessed by skin testing and measurement of T-cell activation (CD69 upregulation) and proliferation ((3)H-thymidine uptake, 5,6-carboxyfluorescein diacetate succinimidyl ester staining) of PBMCs, T-cell lines, and T-cell clones of 2 patients with delayed hypersensitivity reactions to iohexol and iomeprol, respectively. Thirteen different contrast media and potassium iodide were compared.
RESULTS: Skin testing and analyses of PBMCs, T-cell lines, and clones showed broad cross-reactivity in both patients. Broad as well as more restricted cross-reactivity patterns were found in iohexol-specific and iomeprol-specific CD4(+) T-cell clones, whereas 1 iomeprol-specific CD8(+) T-cell clone showed no cross-reactivity at all. The reactivity to equimolar concentrations of iohexol and its dimer iodixanol was very similar, suggesting that the dimer was not more stimulatory than its monomer. Consistently low reactivity to iobitridol was found in both patients, but never to iodide. A frequency analysis of contrast medium-specific peripheral T cells gave values between 0.6 % (iomeprol) and 0.05 % (iobitridol).
CONCLUSION: Clinically observed cross-reactivity between different contrast media is a result of the presence of contrast media-specific T cells, some of which show a broad cross-reactivity pattern. Iodide ions, known to be present at low concentration in contrast media solutions, do not seem to be the causative moiety.
CLINICAL IMPLICATIONS: Detailed in vitro analysis might help identify noncross-reactive contrast media.
Authors:
Marianne Lerch; Monika Keller; Markus Britschgi; Gisele Kanny; Valerie Tache; Daphne A Schmid; Andreas Beeler; Basil O Gerber; Michael Luethi; Andreas J Bircher; Cathrine Christiansen; Werner J Pichler
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article     Date:  2007-04-06
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  119     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-08     Completed Date:  2007-07-27     Revised Date:  2012-01-11    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1529-36     Citation Subset:  AIM; IM    
Affiliation:
Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, University of Bern, Bern, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cell Line
Clone Cells
Contrast Media / adverse effects*
Female
Humans
Hypersensitivity, Delayed / chemically induced,  immunology*
Iohexol / adverse effects*,  diagnostic use
Iopamidol / adverse effects,  analogs & derivatives*,  diagnostic use
Lymphocyte Activation / drug effects,  immunology
Male
Middle Aged
Skin Tests
T-Lymphocytes / drug effects*,  immunology*
Triiodobenzoic Acids / diagnostic use,  immunology
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Triiodobenzoic Acids; 62883-00-5/Iopamidol; 66108-95-0/Iohexol; 78649-41-9/iomeprol; 92339-11-2/iodixanol
Comments/Corrections
Comment In:
J Allergy Clin Immunol. 2011 Dec;128(6):1356-7   [PMID:  21782229 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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