Literature DB >> 16364156

Pholcodine stimulates a dramatic increase of IgE in IgE-sensitized individuals. A pilot study.

E Florvaag1, S G O Johansson, H Oman, T Harboe, A Nopp.   

Abstract

BACKGROUND: A previous study showed a relation between pholcodine (PHO) consumption, prevalence of IgE-sensitization to PHO, morphine (MOR) and suxamethonium (SUX) and anaphylaxis to neuromuscular blocking agents (NMBA). The purpose of this pilot study was to explore the effect on IgE production, in IgE-sensitized and nonsensitized individuals, of exposure to cough syrup and environmental chemicals containing PHO, MOR and SUX related allergenic structures.
METHODS: Serum concentrations of IgE and IgE antibodies to PHO, MOR and SUX allergens measured by ImmunoCAP (Pharmacia Diagnostics, Uppsala, Sweden) were followed after intake of cough syrup, or exposure to confectionary and other household chemicals containing various amounts of substances cross-reacting with PHO, MOR and SUX.
RESULTS: Cough syrup containing PHO gave, in sensitized individuals, within 1-2 weeks, an increase of IgE of 60-105 times and of IgE antibodies to PHO, MOR and SUX in the order of 30-80 times. The tested confectionary did not have any similar stimulating effect but seemed to counteract the expected decrease of IgE. No effect was seen in nonsensitized individuals. The PHO stimulated IgE showed a nonspecific binding to ImmunoCAP with common allergens and glycine background ImmunoCAP that was up to 10-fold higher than that of monomeric myeloma-IgE at twice the concentration.
CONCLUSIONS: It seems as cough syrups containing PHO have a most remarkable IgE boostering effect in persons IgE-sensitized to PHO, MOR and SUX related allergens. Household chemicals containing such allergenic epitopes seem capable of some, minor, stimulation.

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Year:  2006        PMID: 16364156     DOI: 10.1111/j.1398-9995.2005.00933.x

Source DB:  PubMed          Journal:  Allergy        ISSN: 0105-4538            Impact factor:   13.146


  10 in total

1.  IgE-mediated anaphylactic reactions to neuromuscular blocking agents: can they be prevented?

Authors:  E Florvaag; S G O Johansson
Journal:  Curr Allergy Asthma Rep       Date:  2008-09       Impact factor: 4.806

2.  Instantaneous rigor after fatal pholcodine intoxication.

Authors:  Pierre Esnault; Bertrand Prunet; Guillaume Lacroix; Erwan D'Aranda; Yvan Gaillard; Henry Boret
Journal:  Br J Clin Pharmacol       Date:  2014-03       Impact factor: 4.335

Review 3.  Perioperative anaphylaxis: what should be known?

Authors:  Pascale Dewachter; Claudie Mouton-Faivre; David L Hepner
Journal:  Curr Allergy Asthma Rep       Date:  2015-05       Impact factor: 4.806

Review 4.  Exploring the link between pholcodine exposure and neuromuscular blocking agent anaphylaxis.

Authors:  Anna M Brusch; Russell C Clarke; Peter R Platt; Elizabeth J Phillips
Journal:  Br J Clin Pharmacol       Date:  2014-07       Impact factor: 4.335

5.  Omalizumab decreases IgE production in patients with allergic (IgE-mediated) asthma; PKPD analysis of a biomarker, total IgE.

Authors:  Philip J Lowe; Didier Renard
Journal:  Br J Clin Pharmacol       Date:  2011-08       Impact factor: 4.335

Review 6.  Reclassifying Anaphylaxis to Neuromuscular Blocking Agents Based on the Presumed Patho-Mechanism: IgE-Mediated, Pharmacological Adverse Reaction or "Innate Hypersensitivity"?

Authors:  David Spoerl; Haig Nigolian; Christoph Czarnetzki; Thomas Harr
Journal:  Int J Mol Sci       Date:  2017-06-07       Impact factor: 5.923

Review 7.  In Vitro Diagnosis of Immediate Drug Hypersensitivity Anno 2017: Potentials and Limitations.

Authors:  I I Decuyper; E A Mangodt; A L Van Gasse; K Claesen; A Uyttebroek; M Faber; V Sabato; C H Bridts; C Mertens; M M Hagendorens; L S De Clerck; Didier G Ebo
Journal:  Drugs R D       Date:  2017-06

8.  Expertise in allergy and immunology can aid other medical specialties.

Authors:  S Gunnar O Johansson
Journal:  World Allergy Organ J       Date:  2009-09       Impact factor: 4.084

9.  The Pholcodine Case. Cough Medicines, IgE-Sensitization, and Anaphylaxis: A Devious Connection.

Authors:  E Florvaag; S G O Johansson
Journal:  World Allergy Organ J       Date:  2012-07       Impact factor: 4.084

10.  Pholcodine consumption and immunoglobulin E-sensitization in atopics from Australia, Korea, and Japan.

Authors:  Constance H Katelaris; Motohiro Kurosawa; Hee-Bom Moon; Magnus Borres; Erik Florvaag; Stig Gunnar Olof Johansson
Journal:  Asia Pac Allergy       Date:  2014-04-29
  10 in total

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