A case report of carboxymethylcellulose allergy: exploring tolerance based on administration route.

IF 3 4区医学 Q3 IMMUNOLOGY Immunopharmacology and Immunotoxicology Pub Date : 2025-04-01 Epub Date: 2025-02-20 DOI:10.1080/08923973.2025.2469214

Anays Piotin, Anh Poirot, Maxence Wurm, Celine Lutz, Naji Khayath, Frédéric de Blay, Carine Metz-Favre

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Abstract

Background: The management of hypersensitivity to excipients and food additives remains a significant issue for healthcare professionals and patients. Avoiding carboxymethylcellulose (CMC) can be a considerable challenge for patients allergic to CMC due to its widespread use. We assessed the tolerance of CMC through different route of administration in a patient with a confirmed CMC allergy. We conducted a literature review to analyze all relevant cases of patients allergic to CMC, focusing on tolerance through non-injectable routes.

Methods: Skin tests, basophil activation tests, oral and nasal provocation tests with CMC were performed to evaluate patient's hypersensitivity.

Results: Skin tests and basophil activation tests with CMC were positive and confirmed IgE-mediated hypersensitivity to CMC in the patient. While the patient tolerated oral administration of CMC and CMC-containing eye drops, nasal provocation test resulted in asthma exacerbation and rhinitis.

Conclusion: Tolerance of CMC appears to be route-dependent. Provocation tests with CMC through various routes of administration are essential for assessing tolerance and providing appropriate recommendations for patients with CMC allergy.

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羧甲基纤维素过敏病例报告：根据给药途径探索耐受性。

背景：对辅料和食品添加剂过敏的管理仍然是卫生保健专业人员和患者的一个重要问题。由于羧甲基纤维素的广泛使用，避免对羧甲基纤维素过敏的患者是一个相当大的挑战。我们通过不同给药途径评估了一位确诊CMC过敏的患者对CMC的耐受性。我们进行文献回顾，分析所有相关的CMC过敏病例，重点关注非注射途径的耐受性。方法：采用皮肤试验、嗜碱性粒细胞活化试验、口腔及鼻腔CMC激发试验评价患者的超敏反应。结果：皮肤试验和嗜碱性粒细胞活化试验阳性，证实患者对CMC有ige介导的超敏反应。患者口服CMC和含CMC滴眼液耐受，鼻腔激发试验导致哮喘加重和鼻炎。结论：CMC的耐受性具有通路依赖性。通过各种给药途径进行CMC激发试验对于评估CMC耐受性和为CMC过敏患者提供适当建议至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Immunopharmacology and Immunotoxicology 医学-毒理学

CiteScore

5.40

自引率

0.00%

发文量

133

审稿时长

4-8 weeks

期刊介绍： The journal Immunopharmacology and Immunotoxicology is devoted to pre-clinical and clinical drug discovery and development targeting the immune system. Research related to the immunoregulatory effects of various compounds, including small-molecule drugs and biologics, on immunocompetent cells and immune responses, as well as the immunotoxicity exerted by xenobiotics and drugs. Only research that describe the mechanisms of specific compounds (not extracts) is of interest to the journal. The journal will prioritise preclinical and clinical studies on immunotherapy of disorders such as chronic inflammation, allergy, autoimmunity, cancer etc. The effects of small-drugs, vaccines and biologics against central immunological targets as well as cell-based therapy, including dendritic cell therapy, T cell adoptive transfer and stem cell therapy, are topics of particular interest. Publications pointing towards potential new drug targets within the immune system or novel technology for immunopharmacological drug development are also welcome. With an immunoscience focus on drug development, immunotherapy and toxicology, the journal will cover areas such as infection, allergy, inflammation, tumor immunology, degenerative disorders, immunodeficiencies, neurology, atherosclerosis and more. Immunopharmacology and Immunotoxicology will accept original manuscripts, brief communications, commentaries, mini-reviews, reviews, clinical trials and clinical cases, on the condition that the results reported are based on original, clinical, or basic research that has not been published elsewhere in any journal in any language (except in abstract form relating to paper communicated to scientific meetings and symposiums).