ダウンロード数 : ?
ファイル
言語
英語
著者
千貫 祐子 医学部
内容記述(抄録等)
Cetuximab, the IgG1 subclass chimeric mouse-human monoclonal antibody biologic that targets the epidermal growth factor receptor (EGFR), is used worldwide for the treatment of EGFR-positive unresectable progressive/recurrent colorectal cancer and head and neck cancer. Research has shown that the principal cause of cetuximab-induced anaphylaxis is anti-oligosaccharide IgE antibodies specific for galactose-α-1,3-galactose (α-Gal) oligosaccharide present on the mouse-derived Fab portion of the cetuximab heavy chain. Furthermore, it has been revealed that patients who are allergic to cetuximab also develop an allergic reaction to mammalian meat containing the same α-Gal oligosaccharide owing to cross-reactivity, and the presumed cause of sensitization is tick bites: Amblyomma in the United States, Ixodes in Australia and Europe, and Haemaphysalis in Japan. The α-Gal-specific IgE test (bovine thyroglobulin-conjugated ImmunoCAP) or CD63-expression-based basophil activation test may be useful to identify patients with IgE to α-Gal in order to predict risk for cetuximab-induced anaphylactic shock. Investigations of cetuximab-related anaphylaxis have revealed three novel findings that improve our understanding of immediate-type allergy: 1) oligosaccharide can serve as the main IgE epitope of anaphylaxis; 2) because of the oligosaccharide epitope, a wide range of cross-reactivity with mammalian meats containing α-Gal similar to cetuximab occurs; and 3) tick bites are a crucial factor of sensitization to the oligosaccharide. Nonetheless, taking a medical history of tick bites and beef allergy may be insufficient to prevent cetuximab-induced anaphylaxis, and therefore blood testing with an α-Gal-specific IgE test, with high sensitivity and specificity, is necessary to detect sensitization to α-Gal.
主題
Anaphylaxis
Cetuximab
Galactose-α-1
3-galactose
Red meat allergy
Tick bites
掲載誌名
Allergology International
68
3
開始ページ
296
終了ページ
300
ISSN
1323-8930
ISSN(Online)
1440-1592
発行日
2019/07/12
DOI
出版者
一般社団法人日本アレルギー学会
出版者ヨミ
イッパン シャダン ホウジン ニホン アレルギー ガッカイ
出版者別表記
Japanese Society of Allergology
資料タイプ
学術雑誌論文
ファイル形式
PDF
関連情報
権利関係
表示 - 非営利 - 改変禁止 4.0 国際 (CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
著者版/出版社版
出版社版
業績ID
e38190
部局
医学部
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