Fw: [iodine] Fw: Iodine allergy

[Guest guest]

LOL

I'd like to thank Chuck for making me aware of this series of Japanese articles

on iodine allergy. I've included abstracts below and added them to our links

here:

Links > 10 Clinical Pearls > Iodine Allergies > Allergy Research

iodine/links/Clinical_Pearls_001138891653/I\

odine_Allergies_001138752470/Allergy_Research_001145573253/

I'd be curious how the radiology group from UCSF in the link below would respond

to those articles.

Iodine Allergy and Contrast Administration

" Our purpose is to show that iodine does not confer a specific cross-reactivity

between iodine-rich substances, that the cross-reactivity that does exist is

nonspecific, and that the concept of iodine allergy is fallacious and may result

in the inappropriate nonuse of IV contrast material in patients intolerant of

antiseptics or seafood that contain iodine. "

http://www.radiology.ucsf.edu/instruction/abdominal/ab_handbook/04-IodineAllergy\

..html

I don't know where Chuck got the following idea: " Inorganic iodine (I2) or

iodide ion, thus _become_ organic as soon as

they are taken internally. " I have been trying to find good information on what

happens to iodine/iodide once they are taken internally. The best information I

have been able to find has been by Thrall, et al, and their work is very

preliminary. I would be interested in Chuck's sources on this.

Thanks for posting this, Gracia.

Zoe

*******************************************************

Studies on experimental iodine allergy: 1. Antigen recognition of guinea pig

anti-iodine antibody.

Shionoya H, Sugihara Y, Okano K, Sagami F, Mikami T, Katayama K.. Japan. 2004.

Article.

" It has generally been thought that iodine allergy is cross-sensitive to various

iodine-containing chemicals. However, this concept seems to deviate from the

immunological principle that immune recognition is specific. To solve this

contradiction, we hypothesize that iodine allergy is an immunological reaction

to iodinated autologous proteins produced in vivo by iodination reaction from

various iodine-containing chemicals. Antisera to iodine were obtained from

guinea pigs immunized subcutaneously with iodine-potassium iodide solution

emulsified in complete Freund's adjuvant (CFA). The specificity of guinea pig

anti-iodine antiserum was determined by enzyme-linked immunosorbent assay

(ELISA) inhibition experiments using microplates coated with iodinated guinea

pig serum albumin (I-GSA). Antibody activities were inhibited by I-GSA,

diiodo-L-tyrosine, and thyroxine, but not by potassium iodide,

monoiodo-L-tyrosine, 3,5,3'-triiodothyronine, monoiodo-L-histidine, or

diiodo-L-histidine, or by ionic or non-ionic iodinated contrast media. The

results that antigen recognition of anti-iodine antibody is specific to

iodinated protein support our hypothesis. While protein iodination usually takes

place both at histidine residues as well as at tyrosine residues, only iodinated

tyrosine acted as an antigenic determinant and no antibody activities to

iodinated histidine were detected in our experimental iodine allergy model. "

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=15206581 & query_hl=2 & itool=pubmed_docsum

Studies on experimental iodine allergy: 2. Iodinated protein antigens and their

generation from inorganic and organic iodine-co

[iodine-containing chemicals.] Shionoya H, Sugihara Y, Okano K, Sagami F, Mikami

T, Katayama K., Japan. 2004. Article.

" We hypothesize that iodine allergy is an immune response to iodinated

autologous proteins generated in vivo from iodine-containing organic and

inorganic chemicals. In this report, effects of protein iodination on

elicitogenic activity in guinea pig iodine allergy model and iodinated protein

antigen generation in vitro from iodine-containing chemicals were investigated.

Active cutaneous anaphylaxis (ACA) and delayed-type hypersensitivity (DTH) tests

were performed in guinea pigs immunized with iodine. The amount of iodine (I2)

reacted to proteins for giving them an eliciting activity of ACA was > or = 0.15

micromol for 1 mg of albumin. DTH reactions were provoked by intradermal

injection of 10(6) PECs reacted with > or = 0.075 micromol of I2. I2 was

generated from a potassium iodide (KI) solution or iodinated contrast media by

UV light irradiation. X-ray irradiation of KI and iodinated contrast media in

the presence of protein resulted in the generation of iodinated protein

antigens. The generation of iodinated protein antigens was inhibited in the

presence of reducing agents. Therefore, it is noteworthy that iodine allergy of

the present hypothesis is dependent on reactive oxygens. By presenting these ex

vivo and in vitro data, we discuss the possibilities for the generation of

iodinated protein antigens in vivo. "

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5206582 & dopt=Abstract

Studies on experimental iodine allergy: 3. Low molecular weight elicitogenic

antigens of iodine allergy.

Sugihara Y, Shionoya H, Okano K, Sagami F, Mikami T, Katayama K.. Japan. 2004.

Article.

" We hypothesize that iodine allergy is an immune response to iodinated self

proteins produced in vivo from various iodine-containing chemicals. Since an

antigenic determinant of experimental iodine allergy is diiodotyrosine (DIT), we

designed low molecular weight DIT derivatives having provocative antigenicity

without sensitizing immunogenicity. Tetraiododityrosine and hexaiodotrityrosine

provoked dose-dependent skin reactions in guinea pigs previously immunized with

iodine. No guinea pigs immunized with hexaiodotrityrosine showed anaphylactic

reaction by i.v. challenge with hexaiodotrityrosine and none of their antisera

showed positive passive cutaneous anaphylaxis (PCA) reaction in guinea pigs,

indicating the non-immunogenic nature of the compound. Erythrosine, one of the

color additives having a structure common with DIT, was assessed for its

immunological property. Enzyme-linked immunosorbent assay (ELISA) inhibition

studies on erythrosine revealed that the inhibitory activity of erythrosine was

stronger than that of DIT. Furthermore, erythrosine provoked a PCA reaction in

animals sensitized with anti-iodine antisera. In conclusion, hexaiodotrityrosine

is thought to be useful for skin testing of iodine allergy without any fear of

sensitization to the allergen. Erythrosine was shown to provoke an experimental

iodine allergy and, also, the relationships between the new concept of iodine

allergy and features of clinical findings of adverse effects by iodocontrast

media are discussed. "

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=15206583 & query_hl=2 & itool=pubmed_docsum

[iodine] Fw: Iodine allergy

can someone help me here?

gracia

Gracia wrote:

>

>

>

> the thing to realize is that this reaction is to the kind of iodine used

> in the dyes (which is organic) as opposed to the kind of iodine our

> bodies use (which is inorganic).

No it is not. The inorganic iodine (or iodide) react with proteins in

the victim, making an allergen out of the person's own chemistry.

Inorganic iodine (I2) or iodide ion, thus _become_ organic as soon as

they are taken internally. The distinction is rather moot except to

indicate that the iodine is not already compounded with some other

molecule, which might be even more problematic. People that react to

iodide contrast agents will typically be even more sensitive to high

molality dyes, but that is simply because the concentration of elemental

iodine in them is higher. The source form is largely immaterial.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5206582 & dopt=Abstract

Chuck

------------------------------------------------------------------------------

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.1.408 / Virus Database: 268.13.6/486 - Release Date: 10/19/2006

------------------------------------------------------------------------------

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.1.408 / Virus Database: 268.13.6/486 - Release Date: 10/19/2006

----------

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.1.408 / Virus Database: 268.13.9/490 - Release Date: 10/20/2006

[Guest guest]

Gracia,

You wrote:

>

> ... I'd be curious how the radiology group from UCSF in the link below would

> respond to those articles....

Their position does not contradict what I, or those articles, said

before. I quite agreed that allergy to proteins in seafood does not

imply an allergy to iodine. However, sensitivity to iodine is well

documented, and people who have the anaphylactoid (anaphylactic-like)

sensitivity reaction to iodine WILL react to the iodine in seafood,

kelp, or supplements. The many sources I cited already also said that

since the reaction to iodine is not mediated by lymphocytes in a

specific antigen-antibody interaction, it should more properly be called

a sensitivity or nonspecific immune response. However, it still causes

the exact same constellation of anaphylactoid symptoms, some of which

can be life threatening.

>

> I don't know where Chuck got the following idea: " Inorganic iodine (I2)

> or iodide ion, thus _become_ organic as soon as

> they are taken internally. " ...

The UCSF article you just cited explains the formation of hapten-carrier

complexes:

" Simple atoms or molecules such as iodine or contrast material do not

have the complexity required for antigenicity, although theoretically

they might act as haptens. Haptens are agents that are too small to act

as antigens by themselves but that, by binding to larger carrier

molecules, provoke an antibody response to the hapten-carrier complex. "

Since iodine is a member of the highly reactive halogen family, it binds

readily to digestive enzymes, proteins, and other complex molecules that

it encounters. It is classed as a hapten. This is introductory

chemistry, although we teach much more about it in the upper level

biochemistry classes.

Stomach acid also tends to turn elemental iodine into iodide ions, but

these too are reactive and will bind to form hapten-complexes, to which

some people evidently respond. UCSF says " theoretically " because no one

has yet isolated the specific complexes that provoke the sensitivity.

The reason the organic based contrast agents cause more sensitivity

reactions is simply that they carry a higher concentration of iodine. It

has nothing to do with the organic or inorganic state of the iodine to

begin with.

UCSF also cited the statistics I gave before: " Evidence exists of a

nonspecific cross-reactivity between contrast material sensitivity and

allergy to seafood, as well as other foods. In a large review, 5% of

112,003 cases of intravascular ionic contrast administration resulted in

a reaction. The relative risk of a reaction in patients with seafood

allergy (diagnostic criteria unspecified) was 3.0, compared with 2.9 for

those with allergy to eggs, milk, or chocolate; 2.6 for those with

allergy to fruit and strawberries; and 2.2 for those with asthma. "

[shehadi WH. Adverse reactions to intravascularly administered contrast

media. AJR 1975;24: 145-152]

You might want to consult some of the other citations in the UCSF

posting that confirm all this. At least note the titles.

Nilsson R, Ehrenberg L, Fedorcsak I. Formation of potential antigens

from radiographic contrast media. Acta Radiol 1987; 28:473-77

Stejkal V, Nilson R, Grepe A. Immunologic basis for adverse reactions to

radiographic contrast media. Acta Radial 1990; 31:605-612

Van Ketel WG, van den Berg WHHW. Sensitization to povidone-iodine.

Dermatol din 1990;8: 107-109

Waran KD, Munsick RA. Anaphylaxis from povidone-iodine (letter). Lancet

1995;345: 1506

Here are more titles to read from the WebMD site I gave you before:

http://www.emedicine.com/radio/topic864.htm

Bush WH, Swanson DP: Acute reactions to intravascular contrast media:

types, risk factors, recognition, and specific treatment. AJR Am J

Roentgenol 1991 Dec; 157(6): 1153-61.

Caro JJ, Trindade E, McGregor M: The risks of death and of severe

nonfatal reactions with high- vs low- osmolality contrast media: a

meta-analysis. AJR Am J Roentgenol 1991 Apr; 156(4): 825-32.

Cohan RH, Ellis JH, Dunnick NR: Use of low-osmolar agents and

premedication to reduce the frequency of adverse reactions to

radiographic contrast media: a survey of the Society of Uroradiology.

Radiology 1995 Feb; 194(2): 357-64.

Foord KD, Kaye B, J, Cumberland DC: Comparison of the

side-effects of low-osmolar contrast media in intravenous urography.

Clin Radiol 1985 Jul; 36(4): 379-80.

Greenberger PA, R, Radin RC: Two pretreatment regimens for

high-risk patients receiving radiographic contrast media. J Allergy Clin

Immunol 1984 Oct; 74(4 Pt 1): 540-3.

Katayama H, Yamaguchi K, Kozuka T, et al: Adverse reactions to ionic and

nonionic contrast media. A report from the Japanese Committee on the

Safety of Contrast Media. Radiology 1990 Jun; 175(3): 621-8.

Kinnison ML, Powe NR, Steinberg EP: Results of randomized controlled

trials of low-versus high-osmolality contrast media. Radiology 1989 Feb;

170(2): 381-9.

Lasser EC, Berry CC, Talner LB, et al: Pretreatment with corticosteroids

to alleviate reactions to intravenous contrast material. N Engl J Med

1987 Oct 1; 317(14): 845-9.

Marshall GD Jr, Lieberman PL: Comparison of three pretreatment protocols

to prevent anaphylactoid reactions to radiocontrast media. Ann Allergy

1991 Jul; 67(1): 70-4.

Memolo M, Dyer R, Zagoria RJ: Extravasation injury with nonionic

contrast material. AJR Am J Roentgenol 1993 Jan; 160(1): 203-4.

Panto PN, Davies P: Delayed reactions to urographic contrast media. Br J

Radiol 1986 Jan; 59(697): 41-4.

Shehadi WH: Contrast media adverse reactions: occurrence, recurrence,

and distribution patterns. Radiology 1982 Apr; 143(1): 11-7.

Tepel, M, Zidek, W: Acetylcysteine and contrast media nephropathy. Curr

Opin Nephrol Hypertens 2002; 11(5): 503-6.

vanSonnenberg E, Neff CC, Pfister RC: Life-threatening hypotensive

reactions to contrast media administration: comparison of pharmacologic

and fluid therapy. Radiology 1987 Jan; 162(1 Pt 1): 15-9.

Wolf GL, Arenson RL, Cross AP: A prospective trial of ionic vs nonionic

contrast agents in routine clinical practice: comparison of adverse

effects. AJR Am J Roentgenol 1989 May; 152(5): 939-44.

Chuck

[Guest guest]

Have a question to anyone that might know the answer..

Can hypo people that are being treated all of a sudden get an allergy

to iodine??

I'm asking because in Sept. I went to Red Lobster to eat and ate sea

food (lobster, crab legs ect.) and by the time I got home I had a rash

on my wrist and stomach that was very itchy.... I put hydocortisone on

it and took benedyl and was ok the next morning. I haven't eaten any

since...

any comments???

Bev

[Guest guest]

Bev,

You wrote:

> Can hypo people that are being treated all of a sudden get an allergy

> to iodine??

> ... Red Lobster ... and by the time I got home I had a rash ...

The statistics say it is more likely that you are allergic to seafood

rather than the iodine, but both are possible.

Chuck