J Korean Med Sci.  2012 Nov;27(11):1292-1299. 10.3346/jkms.2012.27.11.1292.

Identifying Genetic Susceptibility to Sensitization to Cephalosporins in Health Care Workers

• Nam YH
• Kim JE
• Kim SH
• Jin HJ
• Hwang EK
• Shin YS
• Ye YM
• Park HS

• KMID: 2157937
• DOI: http://doi.org/10.3346/jkms.2012.27.11.1292

Abstract

Exposure to cephalosporins could cause occupational allergic diseases in health care workers (HCWs). We evaluated the prevalence of serum specific IgE and IgG antibodies to cephalosporin-human serum albumin (HSA) conjugate and to identify potential genetic risk factors associated with sensitization to cephalosporins in exposed HCWs. The study population consisted of 153 HCWs who had been exposed to antibiotics in a single university hospital and 86 unexposed healthy controls. A questionnaire survey of work-related symptoms (WRS) was administered. A skin-prick test (SPT) was performed, and serum-specific IgE and IgG antibodies to 3 commonly prescribed cephalosporins were measured by ELISA. Four single-nucleotide polymorphisms of the candidate genes related to IgE sensitization were genotyped. The prevalence of WRS to cephalosporins was 2.6%. The prevalence rates of serum-specific IgE and IgG antibodies to cephalosporins were 20.3% and 14.7%, respectively. The FcepsilonR1beta-109T > C polymorphism was significantly associated with IgE sensitization to cephalosporins in HCWs (P = 0.036, OR = 3.553; CI, 1.324-9.532). The in vitro functional assay demonstrated that the T allele of FcepsilonR1beta-109T had greater promoter activity than did the C allele (P < 0.001). The FcepsilonR1beta-109T > C polymorphism may be a potential genetic risk factor for increased IgE sensitization to cephalosporins.

Keyword

Cephalosporins; FcepsilonR1beta Gene; IgE; IgG; Single-Nucleotide Polymorphism

MeSH Terms

Adult
Alleles
Anti-Bacterial Agents/analysis/*immunology
Cephalosporins/analysis/*immunology
Enzyme-Linked Immunosorbent Assay
Female
Genetic Predisposition to Disease
Health Personnel
Humans
Hypersensitivity/*diagnosis/epidemiology
Immunoglobulin E/blood
Immunoglobulin G/blood
Male
Occupational Diseases/*chemically induced/epidemiology
Occupational Exposure
Odds Ratio
Questionnaires
Receptors, IgE/genetics
Skin Tests
Young Adult
Anti-Bacterial Agents
Cephalosporins
Immunoglobulin G
Receptors, IgE
Immunoglobulin E

Figure

• 

  Fig. 1 Serum-specific IgE levels in response to cephalosporin-human serum albumin (HSA) conjugates in health care workers (●) and unexposed nonatopic healthy controls (○): (A) cefotiam-HSA conjugates, (B) ceftriaxone-HSA conjugates, (C) ceftizoxime-HSA conjugates. The horizontal line represents the positive cutoff value derived from the mean + 3 SD of the absorbance value of the controls.

• 

  Fig. 2 Effects of FcεR1β-109T>C polymorphism on transcriptional activity in HMC-1 cells. Luciferase activity assay was performed in four independent experiments (total n = 12). Relative luciferase activity is represented as the ratio relative to luciferase activity in cells transfected with the empty control vector pGL3-basic.

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