Contributions to the study of the favouring role of chronic urinary infections in inducing and starting drug-allergic-type reactions.

Medecine interne Pub Date : 1990-01-01
I B Iamandescu
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Abstract

A randomized study in a group of 87 patients with drug-allergic-type reactions (DAtR) manifested by urticaria and or angioedema, revealed in 55 patients (63.2%) the presence of chronic urinary infections (CUI), significantly different (p less than 0.001) from the control group (80 patients without DAtR) in which the incidence of CUI was only 20% (16 patients). Among the drugs observed to induce allergic-type reactions were substances such as penicillins and aspirin which are not used in CUI. It was therefore assumed that it is not their frequent use in CUI (as is the case with antibacterial drugs and contrast iodide substances) that leads to DAtR but rather more the CUI proper. The assumption that CUI are risk factors for the occurrence of DAtR is discussed and the following mechanisms are suggested in support of this assumption: enhancement of IgE secretion (by the drugs as allergens--complete or haptens--or by the inhibiting effects of some antibiotics on the T suppressor cells): nonimmunological mast cell degranulation (by the bacterial wall products--lectins and proteoglycans--or by the endotoxines with complement activation generating anaphylatoxines C3a and C5a): neurovegetative changes induced by infectious diseases.

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对慢性尿路感染在诱导和开始药物过敏型反应中的有利作用的研究贡献。
一项针对87例以荨麻疹和/或血管性水肿为表现的药物过敏型反应(DAtR)患者的随机研究显示,55例(63.2%)患者存在慢性尿路感染(CUI),与对照组(80例无DAtR患者)(CUI发生率仅为20%(16例))有显著差异(p < 0.001)。在观察到引起过敏型反应的药物中,有青霉素和阿司匹林等未在CUI中使用的物质。因此,人们认为,导致DAtR的不是它们在CUI中的频繁使用(就像抗菌药物和对比碘化物物质的情况一样),而是CUI本身。讨论了CUI是发生DAtR的危险因素的假设,并提出了以下机制来支持这一假设:增强IgE分泌(通过药物作为过敏原-完全或半抗原-或通过某些抗生素对T抑制细胞的抑制作用);非免疫性肥大细胞脱肉芽(由细菌壁产物——凝集素和蛋白聚糖——或由补体激活产生过敏素C3a和C5a的内毒素):由传染病引起的神经营养改变。
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