IgE‐mediated anaphylaxis to Thiomucase®, a mucopolyssacharidase: allergens and cross‐reactivity

• Published in: Allergy (Copenhagen) Vol. 57; no. 3; pp. 254 - 257
• Main Authors: Caballero, T., Alonso, A., De Miguel, S., Martín‐Esteban, M., Varga, B., Pascual, C. Y., López‐Serrano, M. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science, Ltd 01-03-2002; Blackwell
• Subjects: allergens; anaphylaxis; Anaphylaxis - etiology; animals; Biological and medical sciences; Bsa; Cross Reactions; cross‐reactivity; Drug toxicity and drugs side effects treatment; Echinococcus granulosus; Glucuronidase - immunology; Humans; IgE; Immunoglobulin E - immunology; Lyases - immunology; Medical sciences; Miscellaneous (drug allergy, mutagens, teratogens...); Molecular Weight; mucopolysaccharidase; Pharmacology. Drug treatments; Thiomucase; Human; Drug; Immunopathology; Allergy; Prick test; Specific IgE; Plathelmintha; Male; Cestoda; Intramuscular administration; Case study; Anaphylaxis; Animal; Cross reaction; Helmintha; Diagnosis; Invertebrata; Allergen; Echinococcus granulosus; Skin test
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1034/j.1398-9995.2002.03322.x

Background: Thiomucase® is a mucopolysaccharidase obtained from ovine tissues mainly used to facilitate the diffusion of local anaesthetics and in the treatment of cellulitis. A patient with an anaphylaxis in relation to the intramuscular administration of Thiomucase® is reported.
Objective: To investigate Thiomucase® allergens and their possible relationship with dander allergens and animal albumins.
Material and methods: Skin prick tests (SPT) and serum‐specific IgE were performed with Thiomucase® and danders. Thiomucase® SDS‐PAGE immunoblotting was performed in order to study allergens. RAST/CAP inhibition and SDS‐PAGE immunoblotting inhibition were carried out to study the cross‐reactivity.
Results: Skin prick tests (SPT) were positive to Thiomucase®, animal dander (cat, dog, sheep, other), bovine serum albumin (BSA), and echinococcus. Specific IgE was also positive to Thiomucase®, animal dander (cat, dog, sheep, other), BSA and echinococcus. In the RAST‐CAP inhibition assays BSA was nearly completely inhibited by Thiomucase®, Thiomucase® was partially inhibited by BSA and cat and Echinococcus granulosus was partially inhibited by sheep and Thiomucase®. In the Thiomucase® SDS‐PAGE immunoblotting several proteins fixed IgE, ranging from 20 kDa to > 94 kDa, the strongest with 43 kDa. The IgE fixation to BSA, cat and sheep in the SDS‐PAGE immunoblotting was completely inhibited by the preincubation of the serum with Thiomucase®.
Conclusions: An IgE‐mediated anaphylaxis to Thiomucase® is documented. Multiple allergens are recognized in Thiomucase® by the patient serum, the main with 43 kDa. Partial cross‐reactivity with BSA, cat dander and sheep dander is documented.