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Immunologic reactions to drugs.

The clinical finding by Eisner and Shahidi (page 376) that a metabolite of a drug but not the drug itself can be responsible for an immunologic reaction was anticipated by the basic studies of Landsteiner 50 years ago. Landsteiner found that antigenic organic compounds (especially those containing benzene rings) could be modified by attachment of simple inorganic radicals (e.g., sulfate) to produce new antigens that elicited non-cross-reacting antibodies.1 Two of the chemical analogues that he used, p-aminobenzoic acid and p-aminobenzene sulfonic acid, are remarkably similar in structure to the drug (acetylated p-amino-hydroxybenzene) and metabolite (the sulfate ester) involved in the . . .