tetano
Editor, Senior Moderator
Vaccine
. 2023 Jun 15;S0264-410X(23)00714-4.
doi: 10.1016/j.vaccine.2023.06.039. Online ahead of print. Hypersensitivity reactions to anti-SARS-CoV-2 vaccines: Basophil reactivity to excipients
Patrizia Pignatti[SUP] 1 [/SUP], Giuseppe Alvise Ramirez[SUP] 2 [/SUP], Marco Russo[SUP] 3 [/SUP], Paolo Marraccini[SUP] 4 [/SUP], Serena Nannipieri[SUP] 5 [/SUP], Chiara Asperti[SUP] 5 [/SUP], Fabrizio Della Torre[SUP] 6 [/SUP], Antonio Tiri[SUP] 7 [/SUP], Beatrice Maria Gatti[SUP] 8 [/SUP], Antonella Gurrado[SUP] 1 [/SUP], Antonio Meriggi[SUP] 9 [/SUP], Giovanni Benanti[SUP] 5 [/SUP], Maria Bernadette Cilona[SUP] 5 [/SUP], Paolo Pigatto[SUP] 10 [/SUP], Samuele E Burastero[SUP] 5 [/SUP], Lorenzo Dagna[SUP] 5 [/SUP], Mona-Rita Yacoub[SUP] 11 [/SUP]
Affiliations
Basophil activation test (BAT) can tackle multiple mechanisms underlying acute and delayed hypersensitivity to drugs and vaccines and might complement conventional allergy diagnostics but its role in anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-related hypersensitivity is ill-defined. Therefore, 89 patients with possible hypersensitivity (56 % with delayed mucocutaneous manifestations) to anti-SARS-CoV-2 vaccines were tested with BAT for Macrogol 3350, DMG-PEG 2000, PEG 20000, polysorbate-80 and trometamol and compared to 156 subjects undergoing pre-vaccine BAT. A positive BAT was associated with delayed reaction onset (p = 0.010) and resolution (p = 0.011). BAT was more frequently positive to DMG-PEG 2000 than to other excipients in both groups (p < 0.001). DMG-PEG 2000 reactivity was less frequent in vaccine-naïve (6 %) than vaccinated subjects (35 %, p < 0.001) and associated with mRNA-1273 vaccination. DMG-PEG 2000 BAT might therefore have a diagnostic role in subjects with delayed hypersensitivity reactions. Natural immunity might be a key player in basophil activation.
Keywords: Adverse reaction; Allergy; Basophil activation test; COVID-19; Hypersensitivity; Polyethylene glycol; SARS-CoV-2; Vaccine.
. 2023 Jun 15;S0264-410X(23)00714-4.
doi: 10.1016/j.vaccine.2023.06.039. Online ahead of print. Hypersensitivity reactions to anti-SARS-CoV-2 vaccines: Basophil reactivity to excipients
Patrizia Pignatti[SUP] 1 [/SUP], Giuseppe Alvise Ramirez[SUP] 2 [/SUP], Marco Russo[SUP] 3 [/SUP], Paolo Marraccini[SUP] 4 [/SUP], Serena Nannipieri[SUP] 5 [/SUP], Chiara Asperti[SUP] 5 [/SUP], Fabrizio Della Torre[SUP] 6 [/SUP], Antonio Tiri[SUP] 7 [/SUP], Beatrice Maria Gatti[SUP] 8 [/SUP], Antonella Gurrado[SUP] 1 [/SUP], Antonio Meriggi[SUP] 9 [/SUP], Giovanni Benanti[SUP] 5 [/SUP], Maria Bernadette Cilona[SUP] 5 [/SUP], Paolo Pigatto[SUP] 10 [/SUP], Samuele E Burastero[SUP] 5 [/SUP], Lorenzo Dagna[SUP] 5 [/SUP], Mona-Rita Yacoub[SUP] 11 [/SUP]
Affiliations
- PMID: 37349223
- DOI: 10.1016/j.vaccine.2023.06.039
Basophil activation test (BAT) can tackle multiple mechanisms underlying acute and delayed hypersensitivity to drugs and vaccines and might complement conventional allergy diagnostics but its role in anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-related hypersensitivity is ill-defined. Therefore, 89 patients with possible hypersensitivity (56 % with delayed mucocutaneous manifestations) to anti-SARS-CoV-2 vaccines were tested with BAT for Macrogol 3350, DMG-PEG 2000, PEG 20000, polysorbate-80 and trometamol and compared to 156 subjects undergoing pre-vaccine BAT. A positive BAT was associated with delayed reaction onset (p = 0.010) and resolution (p = 0.011). BAT was more frequently positive to DMG-PEG 2000 than to other excipients in both groups (p < 0.001). DMG-PEG 2000 reactivity was less frequent in vaccine-naïve (6 %) than vaccinated subjects (35 %, p < 0.001) and associated with mRNA-1273 vaccination. DMG-PEG 2000 BAT might therefore have a diagnostic role in subjects with delayed hypersensitivity reactions. Natural immunity might be a key player in basophil activation.
Keywords: Adverse reaction; Allergy; Basophil activation test; COVID-19; Hypersensitivity; Polyethylene glycol; SARS-CoV-2; Vaccine.