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Toxic response following latex drain implantation.
Shriver ET; Nicolaysen P; Hubbs A; Weissman D; Siegel P; Meade BJ
Toxicologist 2001 Mar; 60(1):324
These studies were initiated to investigate the potential role of implanting latex surgical drains on the development of latex allergy. Protein and allergen levels of 5 different brands of Penrose drains were quantified by the Lowry method and an immunoassay. Protein values ranged from 44 to 2566 ng/mg drain material, and latex allergen ranged from 70 to 4528 pg/mg. Drain material (200 mg) was implanted subcutaneously in anesthetized female BALB/c or B6C3F1 mice 6-8 weeks old (N = 5/group). Serum was collected by tail-bleed prior to implantation and weekly, thereafter. Exposure to drain brand (A) induced significant elevation in total IgE (5748 ng/ml VS. 347 ng/ml for the sham control) by day 21. No elevation in IgE or systemic toxicity was observed with brand (B). IgE was not measured for mice implanted with brand (C) due to systemic toxicity within 14 hours. In a dose response study, implants of 10, 100 and 200 mg of brand (C) drain material produced dose dependent clinical signs (severe vasodilatation, hypothermia, and ataxia) and clevations in serum alanine amino-transferase, blood urea nitrogen, and creatinine. Kidney and liver weights were decreased in the 200 mg group. The principal histopathologic alteration in the 200 mg group was acute, fibrinosuppurative dermatitis with suppurative vasculitis of dermal venules. No bacteria were seen in tissue sections. Hepatic changes were consistent with glycogen depletion. Endotoxin levels in the drain material were < 1 EU/mg. Leaching drain material for 24 hours in methanol or acidic water reduced the toxic effects of brand (C), but leaching in sterile phosphate buffered saline, water and alkaline water had no effect on the toxicity of the material. In summary, responses other than latex sensitization that ranged from no effect to acute toxicity occurred after implantation of various Penrose drains.
Allergic-reactions; Allergens; Laboratory-animals; Animals; Animal-studies; Kidneys; Kidney-toxins; Liver; Liver-tissue; Endotoxins; Toxins; Toxic-effects
Issue of Publication
The Toxicologist. Society of Toxicology 40th Annual Meeting, March 25-29, 2001, San Francisco, California