Pholcodine consumption and immunoglobulin E-sensitization in atopics from Australia, Korea, and Japan
10.5415/apallergy.2014.4.2.86
- Author:
Constance H KATELARIS
1
;
Motohiro KUROSAWA
;
Hee Bom MOON
;
Magnus BORRES
;
Erik FLORVAAG
;
Stig Gunnar Olof JOHANSSON
Author Information
1. Campbelltown Hospital, University of Western Sydney, Sydney 2560, Australia. Connie.Katelaris@sswahs.nsw.gov.au
- Publication Type:Original Article
- Keywords:
Pholcodine;
IgE;
Anaphylaxis;
General anaesthesia;
Neuromuscular blocking agent
- MeSH:
Ammonium Compounds;
Anaphylaxis;
Australia;
Cough;
European Union;
Immunoassay;
Immunoglobulin E;
Immunoglobulins;
Japan;
Korea;
Morphine;
Neuromuscular Blocking Agents;
Prevalence;
Scandinavian and Nordic Countries;
Succinylcholine
- From:
Asia Pacific Allergy
2014;4(2):86-90
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Accumulating data indicates that pholcodine (PHO)-consuming countries have higher sero-prevalences of immunoglobulin E (IgE)-antibodies to PHO and suxamethonium (SUX) and increased frequencies of IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBAs) than nonconsuming. Withdrawing PHO-containing cough syrups resulted in a significant decrease of cases with anaphylaxis in Scandinavia. Nevertheless, the European Medicines Agency in 2011 advised to continue the unrestricted use throughout the European Union. OBJECTIVE: To extend studies on PHO consumption and prevalence of IgE-sensitization to morphine (MOR), PHO, and SUX to countries representing high (Australia), and low (Korea and Japan), consumers, respectively. METHODS: IgE-antibodies to SUX, MOR, and PHO in atopic subjects were determined by immunoassay and compared with official figures for PHO consumption and reported anaphylaxis to NMBA. RESULTS: The prevalences of IgE-antibodies to PHO, MOR, and SUX were 10%, 8.6%, and 4.3%, respectively, in Australia. The corresponding figures for Japan were 0.8%, 0.8%, and 1.5%, and for Korea 1.0% to PHO and 0.5% to MOR and SUX. Of the SUX-positive sera, 100% were positive to PHO or MOR in Australia and 0% in Japan and Korea. CONCLUSION: The study supports previous findings; exposure to PHO may induce IgE-antibodies to the substituted ammonium ion epitope of NMBAs, thus increasing risk of NMBA-induced anaphylaxis considerably. However, other, still unknown factors occasionally might induce IgE-antibodies to SUX.
