Basophil histamine release. A study in allergy to suxamethonium

Evaluation of histamine-releasing property of propofol in whole blood in vitro

We examined the property of emulsion form of propofol (ICI 35 868) to release histamine in whole blood in vitro. Heparinized whole blood from 10 healthy volunteers were incubated with medium and propofol at the final concentration of 0, 1, 10 and 100 microg.ml(-1). The concentration of histamine in supernatant fluid after incubation was measured by radioimmunoassay. Histamine release was expressed as the percentage of the concentration of histamine released into supernatant fluid relative to the total cellular histamine content, which was yielded by destroying cell components in the whole blood. Histamine release in the presence of propofol at the concentrations of 1, 10 and 100 microg.ml(-1) were almost the same as histamine release in the absence of propofol. We conclude that emulsion form of propofol has no property to release histamine in whole blood in vitro.

Histamine release by morphine and diamorphine in man

Intravenous morphine and diamorphine are routinely used for postoperative analgesia but the relative histamine releasing abilities of these drugs have not been compared in man. Thirty-eight patients were randomly allocated to receive morphine (0.16 mg.kg-1) or diamorphine (0.08 mg.kg-1) after abdominal surgery. Blood samples for histamine were taken before, and at timed intervals after, opioid administration and analysed by an isotopic radioenzymatic technique. Haemodynamic parameters and pain scores were recorded before and after analgesic administration, and a series of eight basophil histamine release studies was also performed. Significant histamine release (plasma concentration > 2 ng.ml-1 or rise of > 700% baseline) occurred in 23.5% of the morphine group and 21.1% of the diamorphine group. Histamine was released earlier in those receiving diamorphine, but no significant change in haemodynamic parameters occurred, and no histamine release was demonstrated in the basophil histamine release studies. These findings suggest that morphine and diamorphine release histamine from mast cells rather than basophils.

Clinical evaluation of in vitro leukocyte histamine release in allergy to muscle relaxant drugs

We have evaluated the in vitro leukocyte histamine release tests for the diagnosis of allergy to muscle relaxant drugs in 40 patients (Group A) and a control group of 44 subjects with negative leukocyte histamine release (Group B). Non-IgE dependent histamine release, expressed as a percentage of the total blood histamine, was 3.94% +/- 0.49 in Group B. The upper limit of positivity was estimated to be 5% (mean + 2 SD). Leukocyte histamine release tests were positive in 65% of the patients from Group A. The concordance between LHR and QAS-RIA was 64%. The maximal histamine release was observed at dilutions of 10(-2)-10(-4) in 20 of the 26 positive cases. The maximal histamine release was 43.8% +/- 23.3. The spontaneous histamine release was as low as 1.7% +/- 1.1. Cross-reactivity among the 5 different muscle relaxant drugs has been investigated and compared by intradermal testing. The muscle relaxant drugs which gave the lower skin reaction (M2) and the drug responsible for shock (M1) were selected for the study of in vitro leukocyte histamine release. Of 20 M2. All of the 10 cases had negative ID tests with M2. Three of these patients subsequently underwent general anesthesia with the muscle relaxant chosen as harmless (M2) without any clinical reaction.

Basophil histamine release studies in the evaluation of a new anaesthetic agent

Propofol (2,6-diisopropylphenol) has recently been introduced into clinical practice as an induction agent. This study evaluated the effect of propofol on basophil histamine release in 13 healthy subjects. No release was demonstrated in 11 subjects. Two subjects released histamine at the highest drug concentration, one also releasing at lower concentrations. Both subjects whose basophils released histamine in response to propofol were anaesthetists using the drug during the course of their practice.