Drugs Chemicals And Delayed Hypersensitivity

A variety of drugs have been reported to alter or cause delayed hypersensitivity reactions (Table 1). Benzocaine, neomycin, and sulfonamides are known sensitizers. In fact, sulfonamides have limited usage in the general population because of the high sensitization rate.

Sulfonamides are unique in that they require metabolism to become sensitizers. Sulfonamides are metabolized by phase II conjugation creating water-soluble molecules. N-hydroxylation creates reactive metabolites that readily complex with proteins to form immunogenic sensitizing complexes.

Metals are known sensitizers. Nickel is a frequent sensitizer in women. Clothing fasteners and costumejewelry (e.g., ear studs) are high in nickel content. Ear studs are usually gold coated over a nickel base. Normal abrasion of the outer coating exposes the nickel base and initiates sensitization.

Workers in paper, cement, and paint factories often develop contact dermatitis as a result of chromium used in the manufacting process. Chromium is also used as a catalyst in electroplating processes (Burrell et al., 1992).

Table 1. Chemicals that Alter Delayed-Type -Hypersensitivity Reactions

Chemical

Species

Effect

Lead

Mouse, rat

1

Selenium

Rat

4

Tetrachlorodibenzofuran

Guinea pig

I

Polychlorinated biphenyl

Rabbit

i

Methylcholanthrene

Mouse

l

Carbofuran

Rabbit

I

2,4-Dichlorophenol

Rat

l

Sodium hypochloride

Rat

Diethylnitrosamine

Mouse

t

Triphenyltin

Rat

Dialkyltin

Mouse

I

Modified from ImmunologyandAllergyPractice, Koller, 1985,1:13-25.

Modified from ImmunologyandAllergyPractice, Koller, 1985,1:13-25.

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