{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:49:07Z","timestamp":1790084947409,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,4,29]],"date-time":"2013-04-29T00:00:00Z","timestamp":1367193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Enzyme replacement therapy (<jats:styled-content style=\"fixed-case\">ERT<\/jats:styled-content>) with recombinant human idursulfase is effective for the treatment of Hunter syndrome, mucopolysaccharidosis (<jats:styled-content style=\"fixed-case\">MPS<\/jats:styled-content>) type<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>. However, various adverse events can occur by the infusion of idursulfase. The purpose was to evaluate the occurrence of infusion\u2010related allergic reactions, including anaphylaxis, to idursulfase in patients with<jats:styled-content style=\"fixed-case\">MPS II<\/jats:styled-content>receiving<jats:styled-content style=\"fixed-case\">ERT<\/jats:styled-content>and to elucidate its possible mechanism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 34 patients with<jats:styled-content style=\"fixed-case\">MPS II<\/jats:styled-content>were enrolled to receive<jats:styled-content style=\"fixed-case\">ERT<\/jats:styled-content>with Elaprase<jats:sup>\u00ae<\/jats:sup>at a dose of 0.5\u00a0mg\/kg intravenously once a week. Information regarding the symptoms, frequency, and timing of anaphylaxis during treatment was analyzed. Presence of anti\u2010idursulfase<jats:styled-content style=\"fixed-case\">IgE<\/jats:styled-content>antibody was assessed by skin prick test (<jats:styled-content style=\"fixed-case\">SPT<\/jats:styled-content>) and enzyme\u2010linked immunosorbent assay (<jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content>). Western blotting was performed to confirm the reaction between idursulfase and specific<jats:styled-content style=\"fixed-case\">IgE<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three patients (8.8%) showed anaphylaxis by infusion of idursulfase. No deaths occurred during the study. Anti\u2010idursulfase<jats:styled-content style=\"fixed-case\">IgE<\/jats:styled-content>antibody was detected by<jats:styled-content style=\"fixed-case\">SPT<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content>. Immunoblotting with patients\u2019 sera and Elaprase<jats:sup>\u00ae<\/jats:sup>showed a single band of specific<jats:styled-content style=\"fixed-case\">IgE<\/jats:styled-content>binding to the protein around 70\u00a0kD, and idursulfase did not display amino acid sequence homology to known allergens. SPT with idursulfase demonstrated positive results in all patients with anaphylaxis. However, we failed to reveal any risk factors for the development of infusion\u2010related immediate\u2010type allergic reactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anaphylaxis related to infusion of idursulfase is mediated by anti\u2010idursulfase<jats:styled-content style=\"fixed-case\">IgE<\/jats:styled-content>antibody, which might be produced by de novo synthesis. SPT is useful in predicting the occurrence of anti\u2010idursulfase<jats:styled-content style=\"fixed-case\">IgE<\/jats:styled-content>\u2010mediated anaphylaxis during infusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12155","type":"journal-article","created":{"date-parts":[[2013,4,29]],"date-time":"2013-04-29T11:35:43Z","timestamp":1367235343000},"page":"796-802","source":"Crossref","is-referenced-by-count":24,"title":["<scp>IgE<\/scp>\u2010mediated anaphylaxis and allergic reactions to idursulfase in patients with<scp>H<\/scp>unter syndrome"],"prefix":"10.1111","volume":"68","author":[{"given":"J.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"},{"name":"The Environmental Health Center for Atopic Diseases Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"},{"name":"The Environmental Health Center for Atopic Diseases Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"},{"name":"The Environmental Health Center for Atopic Diseases Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. O.","family":"Lee","sequence":"additional","affiliation":[{"name":"The Environmental Health Center for Atopic Diseases Samsung Medical Center Seoul Korea"},{"name":"The Samsung Biomedical Research Institute Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. H.","family":"Maeng","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Y.","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Han","sequence":"additional","affiliation":[{"name":"The Environmental Health Center for Atopic Diseases Samsung Medical Center Seoul Korea"},{"name":"The Samsung Biomedical Research Institute Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"},{"name":"The Environmental Health Center for Atopic Diseases Samsung Medical Center Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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