Chemistry of the Neomycins. V. Differentiation of the Neomycin Complex. Identity of Framycetin and Neomycin B. Compounds Obtained from Methyl Neobiosaminide B

Allergy due to topical medications in chronic otitis externa and chronic otitis media

Thirty-four patients suffering from chronic otorrhoea were tested for delayed type contact allergy. Patch testing showed a relevant positive reaction in 19 patients (56%). The most frequent allergens were aminoglycosides with neomycin and framycetin as major offenders. Other antimicrobial agents (clioquinol, polymyxin B), cream bases (lanolin) and corticosteroids (tixocortol) were less common allergens encountered. These results indicate that it is almost obligatory to perform patch testing in any patient with long-standing otitis which does not respond to local therapy. Scoring of the patch tests has to be extended to 7 days, as notably the aminoglycosides and corticosteroids only become positive after such a long interval. Because of the high risk of sensitization, topical preparations containing neomycin and framycetin should not be used routinely. We recommend the use of either a topical antiseptic or a topical antibiotic with low allergenic potential for the initial treatment of otorrhoea.

Mechanism of neomycin stimulation of D-glucose uptake in rabbit intestinal brush border membrane

In order to study the effect of the antibiotic neomycin on the intestinal epithelium, D-glucose was used as a probe molecule and its transport into rabbit brush border membrane vesicles was measured by a rapid filtration method. Treatment of the epithelium with neomycin sulfate prior to the preparation of the brush border membrane enhanced the D-glucose uptake, whereas neutral N-acetylated neomycin did not. This action of neomycin was related to its polycationic character and not to its bactericidal action. No significant difference could be demonstrated between the protein content or disaccharidase-specific activities of the brush border fractions from treated or non-treated intestines. Electrophoretic protein patterns of SDS-solubilized membrane were not significantly different after neomycin treatment. To gain more information on the mechanism involved in the stimulation of D-glucose transport, experiments were conducted on phosphatidyl glycerol artificial membranes and the results compared with those obtained with brush border membrane. At a concentration of 10(-7) M, neomycin decreased the nonactin-induced K+ conductance by a factor of approx. 100. The membrane conductance was linearly dependent on the neomycin concentration and the conductance in 10(-2) M KCl was 10 times that in 10(-3) M KCl. The valence of neomycin was estimated, from the slope of these curves, to be between 6 and 4. In contrast, acetylated neomycin had no effect on the nonactin-induced K+ membrane conductance. Therefore, the effect of neomycin on artificial membrane is related to its 4 to 6 positive charges. It is proposed that the stimulation of sugar transport in brush border membrane is related to screening of the membrane negative charges by the positively-charged neomycin. Accumulation of anions at the membrane surface then occurs and their diffusion into the intravesicular space would increase the transmembrane potential which, in turn, stimulates the entry of D-glucose.

Gentamicins

Gentamicin is a new broad-spectrum antibiotic, basic and water-soluble, produced and developed by Schering Corporation-Bloomfield, New Jersey (1967 and 1968). It is produced by Micromonospora purpurea, a member of a genus of microorganisms from which no other antibiotics have been derived. Paper chromatographic techniques showed the components of gentamicin complex designated as C', C'a, and C2. Gentamicins are bactericidal antibiotics, active in vivo in low concentrations against a wide spectrum of both Gram-positive and Gram-negative organisms. Among the responsive Gram-positive groups of microorganisms are Staphylococcus aureus including many resistant penicillinase producing strains and group A betahemolytic Streptococci. Among the clinically more important species of Gram-positive organisms responsive to gentamicin are both indole-positive and indole-negative Proteus, Pseudomonas, Escherichia coli, Aerobacter, Klebsiella, Salmonella, and Shigella. The production of gentamicins was improved by adding cobalt to the growth medium.

Sensitization potentials and immunologic specificities of neomycins

The use of sensitization indices for expressing allergenic skin reactions in guinea pigs is described. The method is convenient for comparing allergens and cross-reacting substances and permits the use of both irritating and nonirritating challenge concentrations of allergens. It also permits determination of both optimal reading time and challenge concentrations for each experiment. By this technique commercial neomycin complex, neamine (neomycin A), neomycin B, neomycin C, and streptomycin were found to be allergenic in guinea pigs via intradermal (id) and foot-pad (fp) immunizations. The immunizing emulsion consisted of an allergen and an adjuvant containing Mycobacterium butyricum (MB) or Mycobacterium tuberculosis H37Ra (Ra). The adjuvant MB was as effective as Ra by the id route, but inferior to Ra by the fp route. The cross-reactivity of neomycin C was generally greater than neomycin B in guinea pigs sensitized to neamine, neomycin B, neomycin C, or streptomycin. In guinea pigs sensitized to neomycin complex by repeated immunizations, neomycins A, B, and C were effective elicitors of skin reactions, whereas the N-acetylated derivatives of the components failed to cause reactions. This finding is interpreted to mean that the amino groups of the aminoglycosides are the coupling sites to host proteins in the processes of sensitization and elicitation of skin reactions in vivo.