Penicilloyl-polylysine intradermal testing for penicillin hypersensitivity.

The immunochemical mechanisms involved in penicillin allergy have been the subject of numerous investigations during the past 10 years. Considerable progress in understanding how patients become sensitized to penicillin has been made since the publications by Levine (1960) and Weck and Eisen (1960) on various antigenic determinants involved in contact hypersensitivity to penicillin as well as the immunological properties of penicillanic acid, an antigenic derivative of penicillin. Also noteworthy have been the independent investigations of Levine and Ovary (1961), Parker, Weck, Kern, and Eisen (1962a), Parker, Shapiro, Kern, and Eisen (1962c), and Weck (1962a) in establishing the penicilloyl group as the major antigenic determinant involved in hypersensitivity to penicillin. These investigators have shown that rabbits immunized with penicillin form anti-penicilloyl antibodies, which are detectable by precipitation, passive cutaneous anaphylaxis, and haemagglutination. Levine and Ovary (1961) reported specific skin reactions to the intradermal injections of penicilloyl-human gamma globulin conjugate in three out of six patients with histories of penicillin allergy. The specificity of these skin reactions was confirmed by their inhibition with an excess of penicilloyl-epsilonaminocaproate. Parker and others (1962c), Weck (1962b), and Weck and Blum (1963) shortly thereafter reported similar results, using penicilloyl-polylysine conjugates as the test material in a large number of patients.