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Rydz A, Lange M, Ługowska-Umer H, Sikorska M, Nowicki RJ, Morales-Cabeza C, Alvarez-Twose I. Diffuse Cutaneous Mastocytosis: A Current Understanding of a Rare Disease. Int J Mol Sci 2024; 25:1401. [PMID: 38338679 DOI: 10.3390/ijms25031401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/06/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Mastocytosis is a heterogeneous disease characterized by the expansion and accumulation of neoplastic mast cells in various tissues. Diffuse cutaneous mastocytosis (DCM) is a rare and most severe form of cutaneous mastocytosis, which typically occurs in childhood. There have been reports of a familial DCM with specific gene mutations, indicating both sporadic and hereditary factors involved in its pathogenesis. DCM is associated with severe MC mediator-related symptoms and an increased risk of anaphylaxis. The diagnosis is based on the appearance of skin lesions, which typically show generalized thickening, erythroderma, blistering dermographism, and a positive Darier's sign. Recognition, particularly in infants, is challenging due to DCMs resemblance to other bullous skin disorders. Therefore, in unclear cases, a skin biopsy is crucial. Treatment focuses on symptom management, mainly including antihistamines and mast cell stabilizers. In extremely severe cases, systemic steroids, tyrosine kinase inhibitors, phototherapy, or omalizumab may be considered. Patients should be equipped with an adrenaline autoinjector. Herein, we conducted a comprehensive review of literature data on DCM since 1962, which could help to better understand both the management and prognosis of DCM, which depends on the severity of skin lesions, intensity of mediator-related symptoms, presence of anaphylaxis, and treatment response.
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Affiliation(s)
- Agnieszka Rydz
- Student's Scientific Circle Practical and Experimental Dermatology, Medical University of Gdansk, 80-211 Gdańsk, Poland
| | - Magdalena Lange
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Hanna Ługowska-Umer
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Monika Sikorska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Cristina Morales-Cabeza
- Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast)-Spanish Reference Center for Mastocytosis, Hospital Virgen del Valle-Complejo Hospitalario Universitario de Toledo, 45071 Toledo, Spain
| | - Iván Alvarez-Twose
- Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast)-Spanish Reference Center for Mastocytosis, Hospital Virgen del Valle-Complejo Hospitalario Universitario de Toledo, 45071 Toledo, Spain
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Polivka L, Madrange M, Bulai-Livideanu C, Barete S, Ballul T, Neuraz A, Greco C, Agopian J, Brenet F, Dubreuil P, Burdet C, Lemal R, Tournilhac O, Terriou L, Launay D, Bouillet L, Gourguechon C, Damaj G, Frenzel L, Meni C, Bouktit H, Collange AF, Gaudy-Marqueste C, Gousseff M, Le Mouel E, Hamidou M, Neel A, Ranta D, Jaussaud R, Guilpain P, Canioni D, Molina TJ, Bruneau J, Lhermitte L, Garcelon N, Javier RM, Pelletier F, Castelain F, Retornaz F, Cabrera Q, Zunic P, Gourin MP, Wierzbicka-Hainaut E, Viallard JF, Lavigne C, Hoarau C, Durieu I, Heiblig M, Dimicoli-Salazar S, Torregrosa-Diaz JM, Soria A, Arock M, Lortholary O, Bodemer C, Hermine O, Rossignol J. Pathophysiologic implications of elevated prevalence of hereditary alpha-tryptasemia in all mastocytosis subtypes. J Allergy Clin Immunol 2024; 153:349-353.e4. [PMID: 37633651 DOI: 10.1016/j.jaci.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/22/2023] [Accepted: 08/08/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Mastocytosis and monoclonal mast cell (MC) activation syndrome (MMAS) are heterogeneous conditions characterized by the accumulation of atypical MCs. Despite the recurrent involvement of KIT mutations, the pathophysiologic origin of mastocytosis and MMAS is unclear. Although hereditary α-tryptasemia (HαT, related to TPSAB1 gene duplication) is abnormally frequent in these diseases, it is not known whether the association is coincidental or causal. OBJECTIVE We evaluated the prevalence of HαT in all mastocytosis subtypes and MMAS and assessed the pathophysiologic association with HαT. METHODS Clinical data, laboratory data, KIT mutations, TPSAB1 duplication (assessed by droplet digital PCR), and HαT prevalence were retrospectively recorded for all patients with mastocytosis and MMAS registered in the French national referral center database and compared to a control cohort. To increase the power of our analysis for advanced systemic mastocytosis (advSM), we pooled our cohort with literature cases. RESULTS We included 583 patients (27 with MMAS and 556 with mastocytosis). The prevalence of HαT in mastocytosis was 12.6%, significantly higher than in the general population (5.7%, P = .002) and lower than in MMAS (33.3%, P = .02). HαT+ patients were more likely to have anaphylactic reactions and less likely to have cutaneous lesions than HαT- patients (43.0% vs 24.4%, P = .006; 57.7% vs 75.6%, respectively, P = .006). In the pooled analysis, the prevalence of HαT was higher in advSM (11.5%) than in control cohorts (5.2%, P = .01). CONCLUSION Here we confirm the increase incidence of anaphylaxis in HαT+ mastocytosis patients. The increased prevalence of HαT in all subtypes of systemic mastocytosis (including advSM) is suggestive of pathophysiologic involvement.
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Affiliation(s)
- Laura Polivka
- Department of Dermatology, Reference Center for Genodermatoses (MAGEC), AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Marine Madrange
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | | | - Stéphane Barete
- CEREMAST, the Department of Dermatology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Thomas Ballul
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Antoine Neuraz
- Department of Bioinformatics, Necker-Children's Hospital, AP-HP, Paris Centre University, Imagine Institute, INSERM U1163, Paris, France
| | - Celine Greco
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Pain and Palliative Care Unit, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Julie Agopian
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France; Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Fabienne Brenet
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France; Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Patrice Dubreuil
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, Marseille, France; Association Française pour les Initiatives de Recherche sur le Mastocyte et les Mastocytoses (AFIRMM), Marseille, France
| | - Charles Burdet
- Centre d'Investigation Clinique, INSERM CIC 1425, AP-HP, Bichat Hospital, Paris Centre University, Paris, France
| | - Richard Lemal
- Histocompatibility Laboratory, EA 7453, Université Clermont Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Olivier Tournilhac
- CEREMAST, the Adult Clinical Hematology, CHU Clermont-Ferrand, INSERM CIC501, EA 7453, Clermont Auvergne University, Clermont-Ferrand, France
| | - Louis Terriou
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, Claude Huriez Hospital, CHRU Lille, Lille, France
| | - David Launay
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, Claude Huriez Hospital, CHRU Lille, Lille, France; Lille University, INSERM U995 LIRIC, CHU Lille, and Referral Center for Rare Systemic Autoimmune Diseases North and North-west of France, Lille, France
| | - Laurence Bouillet
- CEREMAST, the Clinical Immunology/Internal Medicine Department, National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
| | | | - Ghandi Damaj
- CEREMAST, the Haematology Institute, Normandy University School of Medicine, Caen, France
| | - Laurent Frenzel
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Cécile Meni
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Hassiba Bouktit
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Anne Florence Collange
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Caroline Gaudy-Marqueste
- CEREMAST, the Department of Dermatology, Aix-Marseille University, CHU Timone, Marseille, France
| | - Marie Gousseff
- Department of Internal Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Edwige Le Mouel
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Mohamed Hamidou
- CEREMAST, the Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Antoine Neel
- CEREMAST, the Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Dana Ranta
- Department of Haematology, Nancy University Hospital, Nancy, France
| | - Roland Jaussaud
- Department of Internal Medicine and Clinical Immunology, Vandoeuvre-lès-Nancy, France
| | - Philippe Guilpain
- CEREMAST, the Department of Internal Medicine-Multi-organ Diseases, Saint-Eloi University Hospital, Montpellier University, Montpellier, France
| | - Danielle Canioni
- CEREMAST, the Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Thierry Jo Molina
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Julie Bruneau
- CEREMAST, the Department of Pathology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
| | - Ludovic Lhermitte
- CEREMAST, the Laboratory of Onco-hematology, Necker Children's Hospital, AP-HP, Paris, France
| | - Nicolas Garcelon
- Paris Centre University, Imagine Institute, Data Science Platform, INSERM UMR 1163, F-75015, Paris, France
| | - Rose-Marie Javier
- CEREMAST, the Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Fabien Pelletier
- CEREMAST, the Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Florence Castelain
- CEREMAST, the Department of Dermatology, Allergology Unit, University Hospital of Besançon, Besançon, France
| | - Frederique Retornaz
- Unité de soins et de recherche en médecine interne et maladies infectieuses, European Hospital, Marseille, France
| | - Quentin Cabrera
- Department of Haematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | - Patricia Zunic
- Department of Haematology, Sud Reunion University Hospital, Saint Pierre, La Réunion, France
| | | | | | - Jean François Viallard
- Department of Internal Medicine and Infectious Diseases, Haut-Lévêque Hospital, CHRU Bordeaux, Bordeaux University, Bordeaux, France
| | - Christian Lavigne
- CEREMAST, the Department of Internal Medicine and Clinical Immunology, University Hospital, Angers, France
| | - Cyrille Hoarau
- CEREMAST, the Service d'Immunologie Clinique et d'Allergologie, Centre Hospitalier Régional Universitaire, Tours, France
| | - Isabelle Durieu
- CEREMAST, the Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
| | - Maël Heiblig
- CEREMAST, the Department of Hematology, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | - Angèle Soria
- CEREMAST, the Department of Dermatology and Allergy, Tenon Hospital, Sorbonne University, Paris, France
| | - Michel Arock
- CEREMAST, the Laboratory of Hematology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Olivier Lortholary
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Christine Bodemer
- Department of Dermatology, Reference Center for Genodermatoses (MAGEC), AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France
| | - Olivier Hermine
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France.
| | - Julien Rossignol
- CEREMAST, the Imagine Institute, INSERM U1163, AP-HP, Necker-Children's Hospital, Paris Centre University, Paris, France; CEREMAST, the Department of Hematology, Necker-Children's Hospital, AP-HP, Paris Centre University, Paris, France
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Elesela S, Arzola-Martínez L, Rasky A, Ptaschinski C, Hogan SP, Lukacs NW. Mucosal IgA immune complex induces immunomodulatory responses in allergic airway and intestinal T H2 disease. J Allergy Clin Immunol 2023; 152:1607-1618.e1. [PMID: 37604310 DOI: 10.1016/j.jaci.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND IgA is the most abundant immunoglobulin at the mucosal surface and although its role in regulating mucosal immunity is not fully understood, its presence is associated with protection from developing allergic disease. OBJECTIVE We sought to determine the role of IgA immune complexes for therapeutic application to mucosal allergic responses. METHODS Trinitrophenol (TNP)-specific IgA immune complexes were applied, using TNP-coupled ovalbumin (OVA), to airway and gut mucosal surfaces in systemically sensitized allergic animals to regulate allergen challenge responses. Animals were assessed for both pathologic and immune-mediated responses in the lung and gut, respectively, using established mouse models. RESULTS The mucosal application of IgA immune complexes in the lung and gut with TNP-OVA regulated TH2-driven allergic response in the lung and gut, reducing TH2 cytokines and mucus (lung) as well as diarrhea and temperature loss (gut), but increasing IL-10 and the number of regulatory T cells. The IgA-OVA immune complex did not alter peanut-induced anaphylaxis, indicating antigen specificity. Using OVA-specific DO.11-green fluorescent protein IL-4 reporter mouse-derived TH2-skewed cells in a transfer model demonstrated that mucosal IgA immune complex treatment reduced TH2-cell expansion and increased the number of regulatory T cells. To address a potential mechanism of action, TGF-β and IL-10 were induced in bone marrow-derived dendritic cells when they were exposed to IgA immune complex, suggesting a regulatory phenotype induced in dendritic cells that also led to an altered primary T-cell-mediated response in in vitro OVA-specific assays. CONCLUSIONS These studies highlight one possible mechanism of how allergen-specific IgA may provide a regulatory signal to reduce the development of allergic responses in the lung and gut.
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Affiliation(s)
- Srikanth Elesela
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich; Mary H. Weiser Food Allergy Center, Ann Arbor, Mich
| | - Llilian Arzola-Martínez
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich; Mary H. Weiser Food Allergy Center, Ann Arbor, Mich
| | - Andrew Rasky
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich
| | - Catherine Ptaschinski
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich; Mary H. Weiser Food Allergy Center, Ann Arbor, Mich
| | - Simon P Hogan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich; Mary H. Weiser Food Allergy Center, Ann Arbor, Mich
| | - Nicholas W Lukacs
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich; Mary H. Weiser Food Allergy Center, Ann Arbor, Mich.
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Jiang M, Yu H, Luo L, Zhang L, Xiong A, Wang J, Wang Q, Liu Y, Liu S, Xiong Y, Yang P, Chang C, Zhang J, He X, Li G. Single cell characteristics of patients with vaccine-related adverse reactions following inactivated COVID-19 vaccination. Hum Vaccin Immunother 2023; 19:2246542. [PMID: 37614152 PMCID: PMC10453975 DOI: 10.1080/21645515.2023.2246542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/26/2023] [Accepted: 08/06/2023] [Indexed: 08/25/2023] Open
Abstract
A good safety and immunogenicity profile was reported in Phase I and II clinical trials of inactivated SARS-CoV-2 vaccines. Here, we report two cases associated with vaccine-associated adverse events, including one patient with fever and another with anaphylactic shock resulting from inactivated SARS-CoV-2 vaccination. Cell sub-types and the importance of genetic characteristics were assessed using single-cell mRNA sequencing and machine learning. Overall, the patient with fever showed a significant increase in the numbers of cytotoxic CD8 T cells and MKI67high CD8 T cells. A potential concurrent infection with the Epstein-Barr virus enhanced interferon type I responses to vaccination against the virus. STAT1, E2F1, YBX1, and E2F7 played a key role in the transcription regulation of MKI67high CD8 T cells. In contrast, the patient with allergic shock displayed predominant increases in the numbers of S100A9high monocytes, activated CD4 T cells, and PPBPhigh megakaryocytes. The decision tree showed that LYZ and S100A8 in S100A9high monocytes contributed to the degranulation of neutrophils and activation of neutrophils involved in allergic shock. PPBP and PF4 were major contributors to platelet degranulation. These findings highlight the diversity of adverse reactions following inactivated SARS-CoV-2 vaccination and show the emerging role of cellular subtypes and central genes in vaccine-associated adverse reactions.
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Affiliation(s)
- Manling Jiang
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Haiqiong Yu
- Department of Pulmonary and Critical Care Medicine, The Eight Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Li Luo
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Lei Zhang
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Anying Xiong
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Junyi Wang
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Qianhui Wang
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Yao Liu
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Shengbin Liu
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Ying Xiong
- Department of Pulmonary and Critical Care Medicine, Sichuan friendship hospital, Chengdu, China
| | - Pingchang Yang
- Institute of Allergy & Immunology, Shenzhen University School of Medicine, State Key Laboratory of Respiratory Disease Allergy Division at Shenzhen University, Shenzhen, China
| | - Christopher Chang
- Division of Immunology, Allergy and Rheumatology, Joe DiMaggio Children’s Hospital, Memorial Healthcare System, Hollywood, FL, USA
| | - Jianquan Zhang
- Department of Pulmonary and Critical Care Medicine, The Eight Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Xiang He
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Guoping Li
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu Third People’s Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
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Lee H, Kwon JW, Jeong YW, Lee C, Lee J. Pilot Project of Special Emergency Medical Service Team for Anaphylaxis in Gangwon-do, Korea: Results from an Online Questionnaire Survey. J Korean Med Sci 2021; 36:e258. [PMID: 34725975 PMCID: PMC8560315 DOI: 10.3346/jkms.2021.36.e258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Early recognition and prompt intramuscular epinephrine administration are critical for the treatment of anaphylaxis. The special emergency medical service team (SEMST) is a reorganization plan that incorporates first-level emergency medical technicians (EMTs) and nurses from Korea to give the authority to administer epinephrine. This study evaluates the experience of SEMST and aims to investigate further needs in the pre-hospital management of anaphylaxis. METHODS An online survey of 29 questions on the Gangwon-do 119 EMST was conducted. IBM SPSS Statistics ver. 20.0 (IBM Co., Armonk, NY, USA) and R ver.4.0.3. were used for statistical analysis. RESULTS A total of 428 (44.6%) participants responded to the questionnaire, and 55.6% (238/428) experienced anaphylaxis. The common presumed cause was insect sting/animal bites at 84.5% (201/238), followed by food (7.6%, 18/238), and drugs (6.3%, 15/238). The frequency of occurrence was highest for tourist attractions (58.6%, 167/285), followed by homes (31.9%, 91/285) and workplace (3.5%, 10/285). Among 136 medical personnel (31.8%) who were currently active or had been active as the SEMST, 95 (70.0%) experienced anaphylaxis, and 58 (61.1%) used epinephrine, which was significantly lower in the non-SEMST group (n = 36, 25.2%). The biggest difficulty in pre-hospital treatment was the limitation of drug administration authority (23.4%, 22/95). The lack of experience and tricky treatment are the chief difficulties in pediatric anaphylaxis. The percentage of correct answers regarding anaphylaxis awareness was significantly higher in the educated (n = 374) than in the non-educated group (n = 54), both for diagnosis (24.9% vs. 11.1%) and treatment (73.5% vs. 37.0%). CONCLUSION Proper administration of epinephrine is particularly important for pre-hospital anaphylaxis management in rural areas. Expanding SEMST and conducting periodic education using virtual experiences is necessary.
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Affiliation(s)
- Hyeonseung Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae-Woo Kwon
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Yong Whi Jeong
- Department of Information and Statistics, Yonsei University, Wonju, Korea
| | - Changhoon Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jeongmin Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Castells MC. Mast cell disorders: A framework of allergy and hematology symptoms leading to personalized treatments. Ann Allergy Asthma Immunol 2021; 127:403-404. [PMID: 34593102 DOI: 10.1016/j.anai.2021.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/20/2023]
Affiliation(s)
- Mariana C Castells
- Drug Hypersensitivity and Desensitization Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Mastocytosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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Fukunaga K, Chinuki Y, Hamada Y, Fukutomi Y, Sugiyama A, Kishikawa R, Fukunaga A, Oda Y, Ugajin T, Yokozeki H, Harada N, Suehiro M, Hide M, Nakagawa Y, Noguchi E, Nakamura M, Matsunaga K, Yagami A, Morita E, Mushiroda T. Genome-wide association study reveals an association between the HLA-DPB1 ∗02:01:02 allele and wheat-dependent exercise-induced anaphylaxis. Am J Hum Genet 2021; 108:1540-1548. [PMID: 34246321 PMCID: PMC8387458 DOI: 10.1016/j.ajhg.2021.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/15/2021] [Indexed: 12/27/2022] Open
Abstract
Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a life-threatening food allergy triggered by wheat in combination with the second factor such as exercise. The identification of potential genetic risk factors for this allergy might help high-risk individuals before consuming wheat-containing food. We aimed to identify genetic variants associated with WDEIA. A genome-wide association study was conducted in a discovery set of 77 individuals with WDEIA and 924 control subjects via three genetic models. The associations were confirmed in a replication set of 91 affected individuals and 435 control individuals. Summary statistics from the combined set were analyzed by meta-analysis with a random-effect model. In the discovery set, a locus on chromosome 6, rs9277630, was associated with WDEIA in the dominant model (OR = 3.95 [95% CI, 2.31-6.73], p = 7.87 × 10-8). The HLA-DPB1∗02:01:02 allele displayed the most significant association with WDEIA (OR = 4.51 [95% CI, 2.66-7.63], p = 2.28 × 10-9), as determined via HLA imputation following targeted sequencing. The association of the allele with WDEIA was confirmed in replication samples (OR = 3.82 [95% CI, 2.33-6.26], p = 3.03 × 10-8). A meta-analysis performed in the combined set revealed that the HLA-DPB1∗02:01:02 allele was significantly associated with an increased risk of WDEIA (OR = 4.13 [95% CI, 2.89-5.93], p = 1.06 × 10-14). Individuals carrying the HLA-DPB1∗02:01:02 allele have a significantly increased risk of WDEIA. Further validation of these findings in independent multiethnic cohorts is needed.
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Affiliation(s)
- Koya Fukunaga
- Laboratory for Pharmacogenomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Yuko Chinuki
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane 693-0021, Japan
| | - Yuto Hamada
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa 252-0392, Japan
| | - Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa 252-0392, Japan
| | - Akiko Sugiyama
- Department of Allergology, National Hospital Organization Fukuoka National Hospital, Fukuoka 810-0062, Japan
| | - Reiko Kishikawa
- Department of Allergology, National Hospital Organization Fukuoka National Hospital, Fukuoka 810-0062, Japan
| | - Atsushi Fukunaga
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshiko Oda
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Tsukasa Ugajin
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Naoe Harada
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Masataka Suehiro
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Michihiro Hide
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Yukinobu Nakagawa
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Emiko Noguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Masashi Nakamura
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya 454-8509, Japan; General Research and Development Institute, Hoyu, Nagakute 454-8509, Japan
| | - Kayoko Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya 454-8509, Japan
| | - Akiko Yagami
- Department of Allergology, Fujita Health University School of Medicine, Nagoya 454-8509, Japan; Fujita Health University General Allergy Center in Bantane Hospital, Nagoya 454-8509, Japan
| | - Eishin Morita
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane 693-0021, Japan.
| | - Taisei Mushiroda
- Laboratory for Pharmacogenomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan.
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Zhang Y, Liu JY, Shao JW, Luo QQ, Zhang YQ, Song G, Wang CY, Zhao SY, Wan C, Du XH, Xu LZ. Effective Model of Food Allergy in Mice Sensitized with Ovalbumin and Freud's Adjuvant. Bull Exp Biol Med 2021; 171:352-356. [PMID: 34297293 DOI: 10.1007/s10517-021-05226-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Indexed: 12/29/2022]
Abstract
To better explore the pathophysiology of FA and its therapy, we aimed to establish a simple and practicable FA model with Freund's adjuvant and introduce an easy and reliable laboratory evaluation method for assessment of inflammation in intestinal segments at different anatomical locations. BALB/c mice were sensitized with ovalbumin combined with Freund's adjuvant. Complete Freund's adjuvant was chosen for the first sensitization and two weeks later incomplete Freund's adjuvant was used for a second sensitization. Two weeks later, the sensitized mice were challenged with 50 mg ovalbumin every other day. After the 6 challenge, all mice were assessed for systemic anaphylaxis, and then sacrificed for sample collection. All sensitized mice showed anaphylactic symptoms and markedly increased levels of serum ovalbumin-specific IgE and IgG1. The activity of mast cell protease-1 (mMCPT-1) was significantly increased in the serum and interstitial fluid of the duodenum, jejunum, ileum, and colon. A successful FA model was established, of which inflammation occurred in the duodenum, jejunum, ileum, and colon. This model provides a reliable and simple tool for analysis of the mechanism of FA and methods of immunotherapy. Moreover, combined detection of ovalbumin-specific antibody and local mMCPT-1 levels could potentially be used as the major indicator for assessment of food allergy.
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Affiliation(s)
- Y Zhang
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - J Y Liu
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - J W Shao
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - Q Q Luo
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - Y Q Zhang
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - G Song
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - C Y Wang
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - S Y Zhao
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - C Wan
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - X H Du
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - L Z Xu
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China.
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9
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Nguyen SMT, Rupprecht CP, Haque A, Pattanaik D, Yusin J, Krishnaswamy G. Mechanisms Governing Anaphylaxis: Inflammatory Cells, Mediators, Endothelial Gap Junctions and Beyond. Int J Mol Sci 2021; 22:ijms22157785. [PMID: 34360549 PMCID: PMC8346007 DOI: 10.3390/ijms22157785] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022] Open
Abstract
Anaphylaxis is a severe, acute, life-threatening multisystem allergic reaction resulting from the release of a plethora of mediators from mast cells culminating in serious respiratory, cardiovascular and mucocutaneous manifestations that can be fatal. Medications, foods, latex, exercise, hormones (progesterone), and clonal mast cell disorders may be responsible. More recently, novel syndromes such as delayed reactions to red meat and hereditary alpha tryptasemia have been described. Anaphylaxis manifests as sudden onset urticaria, pruritus, flushing, erythema, angioedema (lips, tongue, airways, periphery), myocardial dysfunction (hypovolemia, distributive or mixed shock and arrhythmias), rhinitis, wheezing and stridor. Vomiting, diarrhea, scrotal edema, uterine cramps, vaginal bleeding, urinary incontinence, dizziness, seizures, confusion, and syncope may occur. The traditional (or classical) pathway is mediated via T cells, Th2 cytokines (such as IL-4 and 5), B cell production of IgE and subsequent crosslinking of the high affinity IgE receptor (FcεRI) on mast cells and basophils by IgE-antigen complexes, culminating in mast cell and basophil degranulation. Degranulation results in the release of preformed mediators (histamine, heparin, tryptase, chymase, carboxypeptidase, cathepsin G and tumor necrosis factor alpha (TNF-α), and of de novo synthesized ones such as lipid mediators (cysteinyl leukotrienes), platelet activating factor (PAF), cytokines and growth factors such as vascular endothelial growth factor (VEGF). Of these, histamine, tryptase, cathepsin G, TNF-α, LTC4, PAF and VEGF can increase vascular permeability. Recent data suggest that mast cell-derived histamine and PAF can activate nitric oxide production from endothelium and set into motion a signaling cascade that leads to dilatation of blood vessels and dysfunction of the endothelial barrier. The latter, characterized by the opening of adherens junctions, leads to increased capillary permeability and fluid extravasation. These changes contribute to airway edema, hypovolemia, and distributive shock, with potentially fatal consequences. In this review, besides mechanisms (endotypes) underlying IgE-mediated anaphylaxis, we also provide a brief overview of IgG-, complement-, contact system-, cytokine- and mast cell-mediated reactions that can result in phenotypes resembling IgE-mediated anaphylaxis. Such classifications can lead the way to precision medicine approaches to the management of this complex disease.
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Affiliation(s)
| | | | - Aaisha Haque
- The Bill Hefner VA Medical Center, Salisbury, NC 27106, USA;
| | - Debendra Pattanaik
- Division of Allergy and Immunology, UT Memphis College of Medicine, Memphis, TN 38103, USA;
| | - Joseph Yusin
- The Division of Allergy and Immunology, Greater Los Angeles VA Medical Center, Los Angeles, CA 90011, USA;
| | - Guha Krishnaswamy
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27106, USA;
- The Bill Hefner VA Medical Center, Salisbury, NC 27106, USA;
- Correspondence:
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Taketomi Y, Endo Y, Higashi T, Murase R, Ono T, Taya C, Kobayashi T, Murakami M. Mast Cell-Specific Deletion of Group III Secreted Phospholipase A 2 Impairs Mast Cell Maturation and Functions. Cells 2021; 10:1691. [PMID: 34359862 PMCID: PMC8303318 DOI: 10.3390/cells10071691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
Tissue-resident mast cells (MCs) have important roles in IgE-associated and -independent allergic reactions. Although microenvironmental alterations in MC phenotypes affect the susceptibility to allergy, understanding of the regulation of MC maturation is still incomplete. We previously reported that group III secreted phospholipase A2 (sPLA2-III) released from immature MCs is functionally coupled with lipocalin-type prostaglandin D2 (PGD2) synthase in neighboring fibroblasts to supply a microenvironmental pool of PGD2, which in turn acts on the PGD2 receptor DP1 on MCs to promote their proper maturation. In the present study, we reevaluated the role of sPLA2-III in MCs using a newly generated MC-specific Pla2g3-deficient mouse strain. Mice lacking sPLA2-III specifically in MCs, like those lacking the enzyme in all tissues, had immature MCs and displayed reduced local and systemic anaphylactic responses. Furthermore, MC-specific Pla2g3-deficient mice, as well as MC-deficient KitW-sh mice reconstituted with MCs prepared from global Pla2g3-null mice, displayed a significant reduction in irritant contact dermatitis (ICD) and an aggravation of contact hypersensitivity (CHS). The increased CHS response by Pla2g3 deficiency depended at least partly on the reduced expression of hematopoietic PGD2 synthase and thereby reduced production of PGD2 due to immaturity of MCs. Overall, our present study has confirmed that MC-secreted sPLA2-III promotes MC maturation, thereby facilitating acute anaphylactic and ICD reactions and limiting delayed CHS response.
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Affiliation(s)
- Yoshitaka Taketomi
- Center for Disease Biology and integrative Medicine, Laboratory of Microenvironmental and Metabolic Health Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.T.); (T.H.)
- Lipid Metabolism Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; (Y.E.); (R.M.)
| | - Yuki Endo
- Lipid Metabolism Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; (Y.E.); (R.M.)
- Department of Biology, Faculty of Science, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan;
| | - Takayoshi Higashi
- Center for Disease Biology and integrative Medicine, Laboratory of Microenvironmental and Metabolic Health Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.T.); (T.H.)
| | - Remi Murase
- Lipid Metabolism Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; (Y.E.); (R.M.)
| | - Tomio Ono
- Center for Basic Technology Research, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; (T.O.); (C.T.)
| | - Choji Taya
- Center for Basic Technology Research, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; (T.O.); (C.T.)
| | - Tetsuyuki Kobayashi
- Department of Biology, Faculty of Science, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan;
| | - Makoto Murakami
- Center for Disease Biology and integrative Medicine, Laboratory of Microenvironmental and Metabolic Health Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.T.); (T.H.)
- Lipid Metabolism Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; (Y.E.); (R.M.)
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11
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Kadali RAK, Janagama R, Peruru S, Gajula V, Madathala RR, Chennaiahgari N, Malayala SV. Non-life-threatening adverse effects with COVID-19 mRNA-1273 vaccine: A randomized, cross-sectional study on healthcare workers with detailed self-reported symptoms. J Med Virol 2021; 93:4420-4429. [PMID: 33822361 PMCID: PMC8250701 DOI: 10.1002/jmv.26996] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 12/16/2022]
Abstract
There are concerns regarding the side effects of the new coronavirus disease 2019 (COVID-19) mRNA-1273 vaccine among healthcare workers (HCWs) in the United States. The objective of the study was to investigate the side effects of the mRNA-1273 vaccine with detailed review of organ systems. A randomized, cross-sectional study using an independent online survey questionnaire was conducted to collect responses from HCWs. Of all participants, 87.8% (1116/1271) provided complete responses. Of them, 38.7% (432/1116) received the mRNA-1273 vaccine, among which, 89.35% were females; 425 of these 432 mRNA-1273 vaccine recipients (98.34%) reported at least one or more symptoms. The results were classified based on the frequency of symptoms reported postvaccination. Of these, 254/432 (58.8%) were able to continue their daily routine activities. 108/432 (25%) temporarily had trouble to perform daily activities, 120/432 (27.78%) required transient time off from work, 17/432 (3.94%) required help from an outpatient provider, 1/432 (0.23%) required help from emergency department, and none of them were hospitalized. Despite the wide array of self-reported symptoms, 97.02% of the HCWs did not intend to skip the second dose of vaccine. Among all the symptoms reported, localized pain, generalized weakness, headache, myalgia, chills, fever, nausea, joint pains, sweating, localized swelling at the injection site, dizziness, itching, rash, decreased appetite, muscle spasm, decreased sleep quality, and brain fogging were the most commonly reported symptoms (in descending order of occurrence). Most of the symptoms reported were nonlife threatening. Despite the wide array of self-reported symptoms, there appears to be a higher acceptance for this vaccine.
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Affiliation(s)
- Renuka Ananth Kalyan Kadali
- Department of Internal Medicine, Harnett Health SystemAffiliated with Cape Fear Valley Health SystemLillingtonNorth CarolinaUSA
- Department of Internal MedicineCampbell University Jerry M. Wallace School of Osteopathic MedicineLillingtonNorth CarolinaUSA
| | | | - Sharanya Peruru
- Department of StatisticsNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Viswanath Gajula
- Department of Pediatrics, Division of Pediatric Critical Care MedicineUniversity of Mississippi Medical CenterJacksonMississippiUSA
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12
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Affiliation(s)
- S Moein Moghimi
- School of Pharmacy, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
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13
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Dolence JJ. Induction of Peanut Allergy Through Inhalation of Peanut in Mice. Methods Mol Biol 2021; 2223:19-35. [PMID: 33226584 PMCID: PMC10497096 DOI: 10.1007/978-1-0716-1001-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Peanut (PN) allergy is a common life-threatening disease; however, our knowledge on the immunological mechanisms remains limited. Here, we describe the first mouse model of inhalation-driven peanut allergy. We administered PN flour intranasally to naïve wild-type mice twice a week for 4 weeks, followed by intraperitoneal challenge with PN extract. Exposure of mice to PN flour sensitized them without addition of adjuvants, and mice developed PN-specific IgE, IgG1, and IgG2a. After challenge, mice displayed lower body temperature and other clinical signs of anaphylaxis. This inhalation model is an ideal system to allow for future examination of immunological mechanisms critical for the development of PN allergy.
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Affiliation(s)
- Joseph J Dolence
- Department of Biology, University of Nebraska at Kearney, Kearney, NE, USA.
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14
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Yamani A, Wu D, Ahrens R, Waggoner L, Noah TK, Garcia-Hernandez V, Ptaschinski C, Parkos CA, Lukacs NW, Nusrat A, Hogan SP. Dysregulation of intestinal epithelial CFTR-dependent Cl - ion transport and paracellular barrier function drives gastrointestinal symptoms of food-induced anaphylaxis in mice. Mucosal Immunol 2021; 14:135-143. [PMID: 32576925 DOI: 10.1038/s41385-020-0306-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/20/2020] [Accepted: 05/01/2020] [Indexed: 02/04/2023]
Abstract
Food-triggered anaphylaxis can encompass a variety of systemic and intestinal symptoms. Murine-based and clinical studies have revealed a role for histamine and H1R and H2R-pathway in the systemic response; however, the molecular processes that regulate the gastrointestinal (GI) response are not as well defined. In the present study, by utilizing an IgE-mast cell (MC)-dependent experimental model of oral antigen-induced anaphylaxis, we define the intestinal epithelial response during a food-induced anaphylactic reaction. We show that oral allergen-challenge stimulates a rapid dysregulation of intestinal epithelial transcellular and paracellular transport that was associated with the development of secretory diarrhea. Allergen-challenge induced (1) a rapid intestinal epithelial Cftr-dependent Cl- secretory response and (2) paracellular macromolecular leak that was associated with modification in epithelial intercellular junction proteins claudin-1, 2, 3 and 5, E-cadherin and desmosomal cadherins. OVA-induced Cftr-dependent Cl- secretion and junctional protein degradation was rapid occurring and was sustained for 72 h following allergen-challenge. Blockade of both the proteolytic activity and Cl- secretory response was required to alleviate intestinal symptoms of food-induced anaphylaxis. Collectively, these data suggest that the GI symptom of food-induced anaphylactic reaction, secretory diarrhea, is a consequence of CFTR-dependent Cl- secretion and proteolytic activity.
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Affiliation(s)
- Amnah Yamani
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229-3026, USA
| | - David Wu
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229-3026, USA
| | - Richard Ahrens
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229-3026, USA
| | - Lisa Waggoner
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229-3026, USA
| | - Taeko K Noah
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229-3026, USA
| | - Vicky Garcia-Hernandez
- Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
| | - Catherine Ptaschinski
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
| | - Charles A Parkos
- Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
| | - Nicholas W Lukacs
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
- Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
| | - Asma Nusrat
- Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA
| | - Simon P Hogan
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA.
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229-3026, USA.
- Department of Pathology, Michigan Medicine, University of Michigan, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA.
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15
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Lv Y, Fu J, Jia Q, Dong H, Han S, Li L, He L. Liquid Chromatography Tandem Mass Spectrometry Based Label-Free Quantification Method for Assessment of Allergen-Induced Anaphylactoid Reactions. J Am Soc Mass Spectrom 2020; 31:856-863. [PMID: 32125841 DOI: 10.1021/jasms.9b00104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Mast cells are essential in mediating inflammatory processes. When activated, mast cells can rapidly release characteristic granules and various mediators into the interstitium. Tryptase (TPS) and β-hexosaminidase (HEXB) are typical protease mediators stored in granules and released upon activation. They have been recognized as important biomarkers of anaphylaxis, and the released level is associated with the severity of allergic reactions. In this study, a sensitive, accurate, and selective liquid chromatography tandem mass spectrometry (LC-MS/MS) method for simultaneously quantifying the two biomarkers was developed and validated in LAD2 cell culture supernatant, and P14R was used as internal standard. Good linearity was observed in the range of 50-2500 ng/mL for TPS and 10-2000 ng/mL for HEXB both with R2 > 0.99. The matrix effect and recovery were both within acceptable limits. We quantified TPS and HEXB released from Laboratory of Allergic Disease 2 (LAD2) mast cells treated with several potential allergens, and the results demonstrate that the method can be used to investigate TPS and HEXB levels in LAD2 mast cell model during allergy research. We anticipate our approach to be a robust and sensitive assessment method for more biomarkers with similar kinetics characteristics and to be a major tool of allergic drug assessment or antiallergic drug development in research.
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Affiliation(s)
- Yanni Lv
- School of Pharmacy, Xi'an Jiaotong University, 76# Yanta West Road, Xi'an 710061, China
- School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, Wisconsin 53705, United States
| | - Jia Fu
- School of Pharmacy, Xi'an Jiaotong University, 76# Yanta West Road, Xi'an 710061, China
| | - Qianqian Jia
- School of Pharmacy, Xi'an Jiaotong University, 76# Yanta West Road, Xi'an 710061, China
| | - Hengtao Dong
- Shimadzu (China) Co., Ltd., 56# Jinye First Road, Xi'an 710000, China
| | - Shengli Han
- School of Pharmacy, Xi'an Jiaotong University, 76# Yanta West Road, Xi'an 710061, China
| | - Lingjun Li
- School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, Wisconsin 53705, United States
| | - Langchong He
- School of Pharmacy, Xi'an Jiaotong University, 76# Yanta West Road, Xi'an 710061, China
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Kumar M, Singh K, Duraisamy K, Allam AA, Ajarem J, Kwok Chong CHOW B. Protective Effect of Genistein against Compound 48/80 Induced Anaphylactoid Shock via Inhibiting MAS Related G Protein-Coupled Receptor X2 (MRGPRX2). Molecules 2020; 25:molecules25051028. [PMID: 32106575 PMCID: PMC7179155 DOI: 10.3390/molecules25051028] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022] Open
Abstract
Anaphylactoid shock is a fatal hypersensitivity response caused by non-IgE mediated mast cell activation. These reactions are mediated by a family of G protein-coupled receptors (GPCRs) known as Mas related GPCRX2 (MRGPRX2). Several US FDA approved drugs which are used in day to day life have been reported to cause anaphylactoid shock. Surprisingly, no therapeutic drugs are available which can directly target MRGPRX2 for treatment of anaphylactoid shock. Genistein is a non-steroidal polyphenol known for its diverse physiological and pharmacological activities. In recent studies, Genistein has been reported for its anti-inflammatory activity on mast cells. However, the effects and mechanistic pathways of Genistein on anaphylactoid reaction remain unknown. In the present study, we designed a battery of in-vitro, in-silico and in-vivo experiments to evaluate the anti-anaphylactoid activity of Genistein in order to understand the possible molecular mechanisms of its action. The in-vitro results demonstrated the inhibitory activity of Genistein on MRGPRX2 activation. Further, a mouse model of anaphylactoid shock was used to evaluate the inhibitory activity of Genistein on blood vessel leakage and hind paw edema. Taken together, our findings have demonstrated a therapeutic potential of Genistein as a lead compound in the treatment of anaphylactoid shock via MRGPRX2.
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Affiliation(s)
- Mukesh Kumar
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong, China; (M.K.); (K.S.); (K.D.)
| | - Kailash Singh
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong, China; (M.K.); (K.S.); (K.D.)
| | - Karthi Duraisamy
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong, China; (M.K.); (K.S.); (K.D.)
| | - Ahmed A. Allam
- Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef 62511, Egypt;
| | - Jamaan Ajarem
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Billy Kwok Chong CHOW
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong, China; (M.K.); (K.S.); (K.D.)
- Correspondence: ; Tel.: +852-2299-0850; Fax: +852-2559-9114
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Abe N, Ito T, Kobayashi T, Egusa C, Maeda T, Okubo Y, Tsuboi R. A case of anaphylaxis due to fish collagen in a gummy candy. Allergol Int 2020; 69:146-147. [PMID: 31262631 DOI: 10.1016/j.alit.2019.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Namiko Abe
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Tomonobu Ito
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
| | - Tomoko Kobayashi
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Chizu Egusa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Maeda
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Ryoji Tsuboi
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
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Martini M, Mistrello G, Amato S, Bilò MB, Agolini S, Corsi A, Tontini A, Antonicelli L. Anaphylaxis to baobab fruit: the paradox of "natural healthy food". Eur Ann Allergy Clin Immunol 2019; 51:282-284. [PMID: 31686469 DOI: 10.23822/eurannaci.1764-1489.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M Martini
- Allergy Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | | | - S Amato
- Lofarma SpA, R and D Dept, Milano, Italy
| | - M B Bilò
- Allergy Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - S Agolini
- Allergy Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - A Corsi
- Allergy Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - A Tontini
- Allergy Unit, Department of Internal Medicine, AOU Ospedali Riuniti, Ancona, Italy
| | - L Antonicelli
- Allergy Unit, Department of Internal Medicine, AOU Ospedali Riuniti, Ancona, Italy
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19
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Abstract
Anaphylaxis is a sudden onset, immediate reaction that implies a risk of death. Think of a "rule of 2s" for anaphylaxis, which implies that reactions usually begin within 2 minutes to 2 hours after injection, infusion, ingestion, contact, or inhalation. Fatalities can be from asphyxiation from laryngeal or oropharyngeal swelling, collapse from hypotensive shock, cardiac arrest, or acute severe bronchoconstriction that causes respiratory failure and arrest. When there is activation of mast cells and basophils in anaphylaxis, chemical mediators are detectable. The preformed mediators from mast cells include histamine, tryptase, carboxypeptidase A, and proteoglycans (heparin, chondroitin sulfates). Newly synthesized mediators include prostaglandin D₂, leukotriene D₄, and platelet activating factor. Crucial actions of the mediators include an abrupt increase in vascular permeability, vascular smooth muscle relaxation, and bronchial smooth muscle contraction. Anaphylaxis can be classified into immunologic, nonimmunologic, or idiopathic based on the associated mechanism. For example, immunologic causes of anaphylaxis are those mediated by immunoglobulin E (IgE) antibodies acting through the FcεR I (foods, insect venom, 32 β-lactam antibiotics), whereas non-IgE immunologic anaphylaxis is mediated without the presence of anti-allergen IgE antibodies or via FcεRI activation (radiographic contrast material). Nonimmunologic anaphylaxis involves mast cell mediator release such as occurs with exercise or with cold temperature exposure, or from medications such as opioids or vancomycin. Idiopathic anaphylaxis involves mast cell activation (acutely elevated urine histamine or serum tryptase) and activated lymphocytes. Because anaphylaxis is a medical emergency, the drug of choice is epinephrine, not H1 antihistamines or H₂ receptor antagonists.
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Kozma GT, Mészáros T, Vashegyi I, Fülöp T, Örfi E, Dézsi L, Rosivall L, Bavli Y, Urbanics R, Mollnes TE, Barenholz Y, Szebeni J. Pseudo-anaphylaxis to Polyethylene Glycol (PEG)-Coated Liposomes: Roles of Anti-PEG IgM and Complement Activation in a Porcine Model of Human Infusion Reactions. ACS Nano 2019; 13:9315-9324. [PMID: 31348638 DOI: 10.1021/acsnano.9b03942] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Polyethylene glycol (PEG)-coated nanopharmaceuticals can cause mild to severe hypersensitivity reactions (HSRs), which can occasionally be life threatening or even lethal. The phenomenon represents an unsolved immune barrier to the use of these drugs, yet its mechanism is poorly understood. This study showed that a single i.v. injection in pigs of a low dose of PEGylated liposomes (Doxebo) induced a massive rise of anti-PEG IgM in blood, peaking at days 7-9 and declining over 6 weeks. Bolus injections of PEG-liposomes during seroconversion resulted in anaphylactoid shock (pseudo-anaphylaxis) within 2-3 min, although similar treatments of naı̈ve animals led to only mild hemodynamic disturbance. Parallel measurement of pulmonary arterial pressure (PAP) and sC5b-9 in blood, taken as measures of HSR and complement activation, respectively, showed a concordant rise of the two variables within 3 min and a decline within 15 min, suggesting a causal relationship between complement activation and pulmonary hypertension. We also observed a rapid decline of anti-PEG IgM in the blood within minutes, increased binding of PEGylated liposomes to IgM+ B cells in the spleen of immunized animals compared to control, and increased C3 conversion by PEGylated liposomes in the serum of immunized pigs. These observations taken together suggest rapid binding of anti-PEG IgM to PEGylated liposomes, leading to complement activation via the classical pathway, entailing anaphylactoid shock and accelerated blood clearance of liposome-IgM complexes. These data suggest that complement activation plays a causal role in severe HSRs to PEGylated nanomedicines and that pigs can be used as a hazard identification model to assess the risk of HSRs in preclinical safety studies.
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Affiliation(s)
- Gergely Tibor Kozma
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
- SeroScience Ltd. , Budapest 1125, Hungary, and Cambridge , Massachusetts 02138 , United States
| | - Tamás Mészáros
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
| | - Ildikó Vashegyi
- SeroScience Ltd. , Budapest 1125, Hungary, and Cambridge , Massachusetts 02138 , United States
| | - Tamás Fülöp
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
| | - Erik Örfi
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
| | - László Dézsi
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
| | - László Rosivall
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
- SeroScience Ltd. , Budapest 1125, Hungary, and Cambridge , Massachusetts 02138 , United States
- Department of Pathophysiology, International Nephrology Research and Training Center , Semmelweis University , Budapest 1089 , Hungary
| | - Yaelle Bavli
- Laboratory of Membrane and Liposome Research, IMRIC , Hebrew University-Hadassah Medical School , Jerusalem 9112102 , Israel
| | - Rudolf Urbanics
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
- SeroScience Ltd. , Budapest 1125, Hungary, and Cambridge , Massachusetts 02138 , United States
| | - Tom Eirik Mollnes
- Department of Immunology , Oslo University Hospital , Rikshospitalet , Oslo 0372 , Norway
- Research Laboratory, Nordland Hospital Bodø, and Faculty of Health Sciences and TREC , University of Tromsø , Tromsø 9019 , Norway
- Centre of Molecular Inflammation Research , Norwegian University of Science and Technology , Trondheim 7012 , Norway
| | - Yechezkel Barenholz
- Laboratory of Membrane and Liposome Research, IMRIC , Hebrew University-Hadassah Medical School , Jerusalem 9112102 , Israel
| | - János Szebeni
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1089 , Hungary
- SeroScience Ltd. , Budapest 1125, Hungary, and Cambridge , Massachusetts 02138 , United States
- Department of Nanobiotechnology and Regenerative Medicine, Faculty of Health , Miskolc University , Miskolc 3515 , Hungary
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Sharma S, Tomar S, Dharne M, Ganesan V, Smith A, Yang Y, Waggoner L, Wang YH, Hogan SP. Deletion of ΔdblGata motif leads to increased predisposition and severity of IgE-mediated food-induced anaphylaxis response. PLoS One 2019; 14:e0219375. [PMID: 31369572 PMCID: PMC6675080 DOI: 10.1371/journal.pone.0219375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/21/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Previous studies have revealed an important role for the transcription factor GATA-1 in mast cell maturation and degranulation. However, there have been conflicting reports with respect to the requirement of GATA-1 function in mast cell dependent inflammatory processes. Herein, we examine the requirement of GATA-1 signaling in mast cell effector function and IgE-mast cell-dependent anaphylaxis. OBJECTIVE To study the requirement of GATA-1 dependent signaling in the development and severity of IgE-mast cell-dependent anaphylaxis in mice. METHODS Wild type (Balb/c) and mutant ΔdblGata (Balb/c) mice were employed to study the role of GATA-1 signaling in in vitro IgE-mediated activation of bone marrow derived mast cells (BMMCs). Murine models of passive IgE-mediated and oral antigen-induced IgE-mediated anaphylaxis were employed in mice. Frequency of steady state mast cells in various tissues (duodenum, ear, and tongue), peritoneal cavity, and clinical symptoms (diarrhea, shock, and mast cell activation) and intestinal Type 2 immune cell analysis including CD4+ Th2 cells, type 2 innate lymphoid cells (ILC2), and IL-9 secreting mucosal mast cells (MMC9) were assessed. RESULTS In vitro analysis revealed that ΔdblGata BMMCs exhibit a reduced maturation rate, decreased expression of FcεRIα, and degranulation capacity when compared to their wildtype (WT) counterparts. These in vitro differences did not impact tissue resident mast cell numbers, total IgE, and susceptibility to or severity of IgE-mediated passive anaphylaxis. Surprisingly, ΔdblGata mice were more susceptible to IgE-mast cell-mediated oral antigen induced anaphylaxis. The increased allergic response was associated with increased Type 2 immunity (antigen-specific IgE, and CD4+ TH2 cells), MMC9 cells and small intestine (SI) mast cell load. CONCLUSION Diminished GATA-1 activity results in reduced in vitro mast cell FcεRIα expression, proliferation, and degranulation activity. However, in vivo, diminished GATA-1 activity results in normal homeostatic tissue mast cell levels and increased antigen-induced CD4+ Th2 and iMMC9 cell levels and heightened IgE-mast cell mediated reactions.
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Affiliation(s)
- Sribava Sharma
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
- Immunobiology graduate program, Division of Immunobiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Sunil Tomar
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Mayuri Dharne
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Varsha Ganesan
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Andrew Smith
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Yanfen Yang
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Lisa Waggoner
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Yui-Hsi Wang
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Simon P. Hogan
- Division of Allergy and Immunology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
- Mary H Weiser Food Allergy Center, Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States of America
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22
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Vasconcelos MJ, Badas J, Bartolomé B, Coimbra A, Silva D. Beer allergy: When malt is the culprit. Ann Allergy Asthma Immunol 2019; 123:211-213.e1. [PMID: 31108182 DOI: 10.1016/j.anai.2019.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/04/2019] [Accepted: 05/11/2019] [Indexed: 11/19/2022]
Affiliation(s)
| | - Jenny Badas
- Serviço de Imunoalergologia, Centro Hospitalar de São João E.P.E., Porto, Portugal
| | | | - Alice Coimbra
- Serviço de Imunoalergologia, Centro Hospitalar de São João E.P.E., Porto, Portugal
| | - Diana Silva
- Serviço de Imunoalergologia, Centro Hospitalar de São João E.P.E., Porto, Portugal; Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
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23
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Al-Salam S, Aburawi EH, Al-Hammadi S, Dhanasekaran S, Shafiuallah M, Yasin J, Sudhadevi M, Awwad A, Alper SL, Kazzam EE, Bellou A. Cellular and Immunohistochemical Changes in Anaphylactic Shock Induced in the Ovalbumin-Sensitized Wistar Rat Model. Biomolecules 2019; 9:biom9030101. [PMID: 30871269 PMCID: PMC6468713 DOI: 10.3390/biom9030101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 11/24/2022] Open
Abstract
Anaphylactic shock (AS) is a life-threatening, multisystem disorder arising from sudden release of mast cell- and basophil-derived mediators into the circulation. In this study, we have used a Wistar rat model to investigate AS-associated histopathologic changes in various organs. Rats were sensitized with ovalbumin (1 mg s.c), and AS was induced by intravenous injection of ovalbumin (1 mg). Experimental groups included nonallergic rats (n = 6) and allergic rats (n = 6). Heart rate and blood pressure were monitored during one hour. Organs were harvested at the end of the experiment and prepared for histologic and immunohistochemical studies. Lung, small bowel mucosa and spleen were found to undergo heavy infiltration by mast cells and eosinophils, with less prominent mast cell infiltration of cardiac tissue. The mast cells in lung, small bowel and spleen exhibited increased expression of tryptase, c-kit and induced nitric oxide synthase (iNOS). Increased expression of endothelial nitric oxide synthase (eNOS) by vascular endothelial cells was noted principally in lung, heart and small bowel wall. The Wistar rat model of AS exhibited accumulation of mast cells and eosinophils in the lung, small bowel, and spleen to a greater extent than in the heart. We conclude that lung and gut are principal inflammatory targets in AS, and likely contribute to the severe hypotension of AS. Targeting nitric oxide (NO) production may help reduce AS mortality.
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Affiliation(s)
- Suhail Al-Salam
- Department of Pathology, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | - Elhadi H Aburawi
- Department of Paediatrics, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | - Suleiman Al-Hammadi
- Department of Paediatrics, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | | | - Mohamed Shafiuallah
- Department of Pharmacology, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | - Javed Yasin
- Department of Internal Medicine, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | - Manjusha Sudhadevi
- Department of Pathology, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | - Aktham Awwad
- Department of Laboratory Medicine, Tawam Hospital, AlAin 15258, Abu Dhabi, UAE.
| | - Seth L Alper
- Division of Nephrology and Vascular Biology Research Center, Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA.
| | - Elsadig E Kazzam
- Department of Internal Medicine, College of Medicine & Health Sciences, United Arab Emirates University, AlAin 17666, Abu Dhabi, UAE.
| | - Abdelouahab Bellou
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
- Global HealthCare Network & Research Innovation Institute, Brookline, MA 02446, USA.
- International Board of Medicine and Surgery, Tampa, FL 34677, USA.
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24
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Farrell A, Judge C, Redenbaugh V, Awad H, Conlon N. Food-dependent exercise-induced reactions: lessons from a 15-year retrospective study. Ir J Med Sci 2019; 188:815-819. [PMID: 30661174 DOI: 10.1007/s11845-019-01965-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Food-dependent exercise-induced anaphylaxis (FDEIA) is a life-threatening disorder in which the signs and symptoms of anaphylaxis occur if physical exertion occurs within a few hours of exposure to a food. AIMS The aim of this study was to characterise patients diagnosed with FDEIA and related disorders. METHODS A retrospective review of electronic clinical data from 2001 to 2016 was carried out. Fifty-seven cases were identified and analysed to establish clinical features, triggering factors and sensitisation patterns. RESULTS The number of patients per annum diagnosed with FDEIA or related reactions increased from 1 in 2001 to 18 patients in 2016. Sixty-nine percent reported systemic symptoms consistent with anaphylaxis, and 31% had skin manifestations only. In 33% of cases, the level of triggering exercise was mild. Forty-four percent of patients were sensitised to the omega-5-gliadin fraction of wheat. CONCLUSIONS FDEIA is an increasingly recognised serious allergic disease. The clinical diagnosis is supported by targeted sensitisation testing and molecular-based allergy diagnostics. These tools allow implementation of effective dietary and lifestyle modifications that mitigate against future serious reactions. Given the limited access to physicians with specialist allergy training in Ireland, increased awareness of this condition amongst sports medicine specialists and general physicians is required.
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Affiliation(s)
- Aisling Farrell
- Department of Immunology, St. James's Hospital, Dublin, Ireland.
| | - Ciaran Judge
- Department of Immunology, St. James's Hospital, Dublin, Ireland
| | | | - Hanna Awad
- Department of Immunology, St. James's Hospital, Dublin, Ireland
| | - Niall Conlon
- Department of Immunology, St. James's Hospital, Dublin, Ireland
- Department of Immunology, Trinity College Dublin, Dublin, Ireland
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25
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Mukai K, Kuda Y, Shibamoto T, Tanida M, Kurata Y, Yokoyama H. Renal response to anaphylaxis in anesthetized rats and isolated perfused rat kidneys: roles of nitric oxide. J Physiol Sci 2018; 68:689-697. [PMID: 29209891 PMCID: PMC10717926 DOI: 10.1007/s12576-017-0583-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 11/24/2017] [Indexed: 11/30/2022]
Abstract
We determined the renal responses to anaphylaxis and the effects of a nitric oxide synthesis inhibitor, L-NAME, in anesthetized rats and isolated perfused rat kidneys. After the ovalbumin antigen injection, the sensitized rats showed transient and substantial decreases in mean blood pressure and renal blood flow and an increase in renal vascular resistance. Creatinine clearance, a measure of renal function, decreased to 53% baseline at 2 h after antigen. L-NAME pretreatment significantly enhanced the antigen-induced renal vasoconstriction and renal dysfunction. Moreover, plasma creatinine levels significantly increased only in the L-NAME pretreated rats. Separately, in isolated perfused kidneys, we observed the antigen-induced renal vasoconstriction and its augmentation by L-NAME. In conclusion, the renal vascular response to the antigen is vasoconstriction, which is enhanced by L-NAME in both isolated perfused rat kidneys and anesthetized rats; it is accompanied by renal dysfunction, which is also augmented by L-NAME.
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Affiliation(s)
- Kiyotaka Mukai
- Department of Nephrology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Yuhichi Kuda
- Department of Physiology II, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Toshishige Shibamoto
- Department of Physiology II, Kanazawa Medical University, Ishikawa, 920-0293, Japan.
| | - Mamoru Tanida
- Department of Physiology II, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Yasutaka Kurata
- Department of Physiology II, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Hitoshi Yokoyama
- Department of Nephrology, Kanazawa Medical University, Ishikawa, 920-0293, Japan
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26
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Galli SJ. Mary Hewitt Loveless, MD: The origin of venom immunotherapy. Ann Allergy Asthma Immunol 2018; 121:268-271. [PMID: 29964225 DOI: 10.1016/j.anai.2018.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/20/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Stephen J Galli
- Department of Pathology, Department of Microbiology and Immunology, Stanford University School of Medicine, Center for Clinical Sciences Research, Stanford, California.
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27
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Guendouz M, Haddi A, Grar H, Kheroua O, Saidi D, Kaddouri H. Preventive effects of royal jelly against anaphylactic response in a murine model of cow's milk allergy. Pharm Biol 2017; 55:2145-2152. [PMID: 28982287 PMCID: PMC6130715 DOI: 10.1080/13880209.2017.1383487] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/15/2017] [Indexed: 06/07/2023]
Abstract
CONTEXT Royal jelly (RJ) has long been used to promote human health. OBJECTIVE The current study investigated the preventive effects of RJ against the development of a systemic and intestinal immune response in mice allergic to cow's milk proteins. MATERIALS AND METHODS Balb/c mice treated orally for seven days with RJ at doses of 0.5, 1 and 1.5 g/kg were sensitized intraperitoneally with β-lactoglobulin (β-Lg). Serum IgG and IgE anti-β-Lg were determined by an enzyme-linked immunosorbent assay (ELISA). Plasma histamine levels, symptom scores and body temperature were determined after in vivo challenge to β-Lg. Jejunums were used for assessment of local anaphylactic responses by an ex vivo study in Ussing chambers and morphologic changes by histological analysis. RESULTS RJ significantly decreased serum IgG (31.15-43.78%) and IgE (64.28-66.6%) anti-β-Lg and effectively reduced plasma histamine level (66.62-67.36%) (p < 0.001) at all the doses tested. Additionally, no clinical symptoms or body temperature drops were observed in RJ-pretreated mice. Interestingly, RJ significantly reduced (p < 0.001) intestinal dysfunction by abolishing the secretory response (70.73-72.23%) induced by sensitization and prevented length aberrations of jejunal villi by 44.32-59.01% (p < 0.001). DISCUSSION AND CONCLUSIONS We speculate that using RJ may help prevent systemic and anaphylactic response in allergic mice. These effects may be related to its inhibitory effects on the degranulation of mast cells.
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Affiliation(s)
- Malika Guendouz
- Laboratory of Physiology of the Nutrition and Food Safety, Department of Biology, Faculty of Natural and Life Sciences, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Abir Haddi
- Laboratory of Physiology of the Nutrition and Food Safety, Department of Biology, Faculty of Natural and Life Sciences, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Hadria Grar
- Laboratory of Physiology of the Nutrition and Food Safety, Department of Biology, Faculty of Natural and Life Sciences, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Omar Kheroua
- Laboratory of Physiology of the Nutrition and Food Safety, Department of Biology, Faculty of Natural and Life Sciences, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Djamel Saidi
- Laboratory of Physiology of the Nutrition and Food Safety, Department of Biology, Faculty of Natural and Life Sciences, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Hanane Kaddouri
- Laboratory of Physiology of the Nutrition and Food Safety, Department of Biology, Faculty of Natural and Life Sciences, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
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Kassas-Guediri A, Coudrat J, Pacreau E, Launay P, Monteiro RC, Blank U, Charles N, Benhamou M. Phospholipid scramblase 1 amplifies anaphylactic reactions in vivo. PLoS One 2017; 12:e0173815. [PMID: 28282470 PMCID: PMC5345872 DOI: 10.1371/journal.pone.0173815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/27/2017] [Indexed: 02/07/2023] Open
Abstract
Mast cells are critical actors of hypersensitivity type I (allergic) reactions by the release of vasoactive and proinflammatory mediators following their activation by aggregation of the high-affinity receptor for immunoglobulin E (FcεRI). We have previously identified Phospholipid Scramblase 1 (PLSCR1) as a new molecular intermediate of FcεRI signaling that amplifies degranulation of the rat mast cell line RBL-2H3. Here we characterized primary mast cells from Plscr1-/- mice. The absence of PLSCR1 expression did not impact mast cell differentiation as evidenced by unaltered FcεRI expression, general morphology, amount of histamine stored and expression of FcεRI signal effector molecules. No detectable mast cell deficiency was observed in Plscr1-/- adult mice. In dose-response and time-course experiments, primary cultures of mast cells (bone marrow-derived mast cells and peritoneal cell-derived mast cells) generated from Plscr1-/- mice exhibited a reduced release of β-hexosaminidase upon FcεRI engagement as compared to their wild-type counterparts. In vivo, Plscr1-/- mice were protected in a model of passive systemic anaphylaxis when compared to wild-type mice, which was consistent with an observed decrease in the amounts of histamine released in the serum of Plscr1-/- mice during the reaction. Therefore, PLSCR1 aggravates anaphylactic reactions by increasing FcεRI-dependent mast cell degranulation. PLSCR1 could be a new therapeutic target in allergy.
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Affiliation(s)
- Asma Kassas-Guediri
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Julie Coudrat
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Emeline Pacreau
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Pierre Launay
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Renato C. Monteiro
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Ulrich Blank
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Nicolas Charles
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
| | - Marc Benhamou
- INSERM U1149, Faculté de Médecine Xavier Bichat, Paris, France
- University Paris-Diderot, Sorbonne Paris Cité, Laboratoire d’excellence INFLAMEX, DHU FIRE, Paris, France
- * E-mail:
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Ghazali H, Gammoudi M, Yahmadi A, Chaaebeni G, Souyah A, Souissi S. Anaphylaxis in an emergency department: Epidemiology, clinical features and management. Tunis Med 2017; 95:45-52. [PMID: 29327768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Studies report that anaphylaxis was under-diagnosed in emergency department (ED) and emergency management was often in disagreement with international recommendations. AIM OF THE STUDY The aim of this study was to describe the epidemiology, clinical features, management and outcome of patients with anaphylaxis presenting to an ED. METHODS Prospective, observational study over four years (June 2010 to May 2014). INCLUSION CRITERIA patients (> 14 years of age) presenting consecutively to the ED with the diagnosis of anaphylaxis. Collection of epidemiological, clinical and therapeutic parameters Results: During the study, 239 patients were enrolled. Mean age = 40±15 years. Sex-ratio=0.8. History of anaphylaxis was reported in 40% of cases. Clinical features n (%): cutaneous features 229 (96), cardiovascular features 124 (52), respiratory features 127 (53), gastrointestinal features 48 (20) and neurologic features 4 (10). Most common allergens: drugs 62%, food 24% and insects 4%. No causes were apparent in 8% of cases. An anaphylactic shock was recorded in 73 patients (31%). Adrenaline was used in 83%of patients, intravenously in 31%. Corticosteroids and histamine H1 antagonist were prescribed in 98 and 51% respectively. Biphasic reactions were reported in three patients. There was no death cases registered. CONCLUSION Our results showed that the prevalence of anaphylaxis was low.This demonstrates that anaphylaxis is a situation which remains underestimated. It is therefore imperative to conduct prospective multicenter studies in emergency services for better determination of its impact and its risk factors.
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Ang WG, Church AM, Kulis M, Choi HW, Burks AW, Abraham SN. Mast cell desensitization inhibits calcium flux and aberrantly remodels actin. J Clin Invest 2016; 126:4103-4118. [PMID: 27669462 PMCID: PMC5096925 DOI: 10.1172/jci87492] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/16/2016] [Indexed: 11/17/2022] Open
Abstract
Rush desensitization (DS) is a widely used and effective clinical strategy for the rapid inhibition of IgE-mediated anaphylactic responses. However, the cellular targets and underlying mechanisms behind this process remain unclear. Recent studies have implicated mast cells (MCs) as the primary target cells for DS. Here, we developed a murine model of passive anaphylaxis with demonstrated MC involvement and an in vitro assay to evaluate the effect of DS on MCs. In contrast with previous reports, we determined that functional IgE remains on the cell surface of desensitized MCs following DS. Despite notable reductions in MC degranulation following DS, the high-affinity IgE receptor FcεRI was still capable of transducing signals in desensitized MCs. Additionally, we found that displacement of the actin cytoskeleton and its continued association with FcεRI impede the capacity of desensitized MCs to evoke the calcium response that is essential for MC degranulation. Together, these findings suggest that reduced degranulation responses in desensitized MCs arise from aberrant actin remodeling, providing insights that may lead to improvement of DS treatments for anaphylactic responses.
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Affiliation(s)
- W.X. Gladys Ang
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Alison M. Church
- GlaxoSmithKline, Rare Diseases Unit, Research Triangle Park, North Carolina, USA
| | - Mike Kulis
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - A. Wesley Burks
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Soman N. Abraham
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina, USA
- Department of Pathology and
- Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA
- Program in Emerging Infectious Diseases, Duke–National University of Singapore, Singapore
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Sterzik V, Wild V, Tatschner T, Babel B, Bohnert M. Fatal visit to the general practitioner. Arch Kriminol 2016; 238:120-127. [PMID: 29870175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 31-year-old female asthmatic patient received an infusion of metamizole and tramadol for chronic pain at a GP surgery. After a few minutes, the patient developed breaing difficulties and died in spite of resuscitation measures. The general practitioner was suspected of medical malpractice. Medico-legal investigations confirmed the assumption that death was caused by anaphylacitic shock. In spite of temporary intubation into the oesophagus no evidence of medical malpractice was found, however.
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Ventura MT, Sanapo F, Calogiuri GF, Satriano F. Anaphylaxis Induced by Intramuscular Betamethasone Disodium Phosphate: Reflections on a Clinical Case. Int J Immunopathol Pharmacol 2016; 20:387-91. [PMID: 17624252 DOI: 10.1177/039463200702000220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Glucocorticoids could be responsible for allergic symptoms correlated to an Ig-E mediated hypersensitivity mechanism. We describe the case of an anaphylactic reaction in a professional nurse, occurring after an intramuscular administration of Betamethasone. After performing skin prick tests, intramuscular tests and patch tests we concluded that the patient had Ig-E mediated sensitization. She was prescribed oral Prednisone and Deflazacort and shows good tolerance of these drugs. This demonstrates that in these patients it is possible to administrate glucocorticoids without the changes in the sites indicated by Wilkinson. Nevertheless, our patient showed a negative allergy test for Dexamethasone disodium phosphate, and in those patients sensitized to fluorinated glucocorticoids, tolerance to other glucocorticoids is not so easily predictable as in patients with hypersensitivity to first generation steroids or in corticosteroid contact dermatitis, according to the four patterns of cross-reactivity proposed by Coopman and Dooms-Goossens.
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Affiliation(s)
- M T Ventura
- Cattedra di Allergologia ed Immunologia Clinica, Università degli Studi di Bari, Italy.
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Guo XJ, Wang YY, Zhang HY, Jin QQ, Gao CR. Mast cell tryptase and carboxypeptidase A expression in body fluid and gastrointestinal tract associated with drug-related fatal anaphylaxis. World J Gastroenterol 2015; 21:13288-13293. [PMID: 26715811 PMCID: PMC4679760 DOI: 10.3748/wjg.v21.i47.13288] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 07/09/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the expression of mast cell tryptase and carboxypeptidase A in drug-related fatal anaphylaxis.
METHODS: The expression of mast cell tryptase and carboxypeptidase A in 15 autopsy cases of drug-related fatal anaphylaxis and 20 normal autopsy cases were detected. First, the expression of mast cell tryptase was determined in stomach, jejunum, lung, heart, and larynx by immunofluorescence. Different tissues were removed and fixed in paraformaldehyde solution, then paraffin sections were prepared for immunofluorescence. Using specific mast cell tryptase and carboxypeptidase A antibodies, the expression of tryptase and carboxypeptidase A in gastroenterology tract and other tissues were observed using fluorescent microscopy. The postmortem serum and pericardial fluid were collected from drug-related fatal anaphylaxis and normal autopsy cases. The level of mast cell tryptase and carboxypeptidase A in postmortem serum and pericardial fluid were measured using fluor enzyme linked immunosorbent assay (FEIA) and enzyme linked immunosorbent assay (ELISA) assay. The expression of mast cell tryptase and carboxypeptidase A was analyzed in drug-related fatal anaphylaxis cases and compared to normal autopsy cases.
RESULTS: The expression of carboxypeptidase A was less in the gastroenterology tract and other tissues from anaphylaxis-related death cadavers than normal controls. Immunofluorescence revealed that tryptase expression was significantly increased in multiple organs, especially the gastrointestinal tract, from anaphylaxis-related death cadavers compared to normal autopsy cases (46.67 ± 11.11 vs 4.88 ± 1.56 in stomach, 48.89 ± 11.02 vs 5.21 ± 1.34 in jejunum, 33.72 ± 5.76 vs 1.30 ± 1.02 in lung, 40.08 ± 7.56 vs 1.67 ± 1.03 in larynx, 7.11 ± 5.67 vs 1.10 ± 0.77 in heart, P < 0.05). Tryptase levels, as measured with FEIA, were significantly increased in both sera (43.50 ± 0.48 μg/L vs 5.40 ± 0.36 μg/L, P < 0.05) and pericardial fluid (28.64 ± 0.32 μg/L vs 4.60 ± 0.48 μg/L, P < 0.05) from the anaphylaxis group in comparison with the control group. As measured by ELISA, the concentration of carboxypeptidase A was also increased more than 2-fold in the anaphylaxis group compared to control (8.99 ± 3.91 ng/mL vs 3.25 ± 2.30 ng/mL in serum, 4.34 ± 2.41 ng/mL vs 1.43 ± 0.58 ng/mL in pericardial fluid, P < 0.05).
CONCLUSION: Detection of both mast cell tryptase and carboxypeptidase A could improve the forensic identification of drug-related fatal anaphylaxis.
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Abstract
Acute toxic nephropathy may be produced by a variety of poisons and drugs. Cellular poisons, such as mercuric bichloride, produce tubular necrosis. Many drugs induce an immunologically mediated response presenting as interstitial nephritis, glomerulonephritis or angiitis. Substances, which are not primarily nephrotoxic but induce dehydration, shock, hemolysis, rhabdomyolysis and/or electrolyte disturbances may also lead to secondary acute renal failure. Reduced renal blood flow, suppressed glomerular filtration, increased tubular pressure due to obstruction, and tubular leakage are responsible for the functional breakdown. In addition, specific tubular functions may be impaired. Complete or incomplete recovery is the rule.
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Shumakova AA, Shipelin VA, Trushina EN, Mustaphina OK, Gmoshinsky IV, Khanferyan RA, Khotimchenko SA, Tutelyan VA. [Toxicological assessment of nanostructured silica. IV. Immunological and allergological indices in animals sensitized with food allergen and final discussioin]. Vopr Pitan 2015; 84:102-111. [PMID: 29364614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This paper is the final in a series of publications on the assessment of subacute oral toxicity of nanostructured silica (SiO2). Preparation studied was a commercial nanopowder of SiO2, obtained by hydrolysis of tetrachlorosilane in the gaseous phase with the size of primary nanoparticles (NPs) of 5–30 nm. The experiment was conducted in 95 male Wistar rats weighing 150–180 g, divided into 6 groups numbering 25 (group 1), 26 (group 2), 11 (groups 3–6) of animals. The aqueous dispersion of SiO2 after sonication was administered to animals of groups 2, 4 and 6 for 28 days by intragastric gavage at a dose of 100 mg/kg of body weight per day. Animals of groups 1, 3, and 5 were treated with deionized water. On the 1st, 3d, 5th and 21st day of experiment the rats of groups 1, 2, 3 and 4 were sensitized intraperitoneally with hen’s egg ovalbumin (OVA) adsorbed to aluminum hydroxide. Intravenous administration of the challenge dose OVA to rats in groups 1 and 2 was carried out on the 29th day. In the same period animals of groups 3–6 were bled for analysis of cellular immunity. There were evaluated the severity of systemic anaphylaxis reaction, the level of specific IgG antibodies to OVA in sensitized animals, state of erythrocytes, platelets and leukocytes of peripheral blood using standard methods. Using flow cytometry there were measured contents of lymphocyte populations of B-lymphocytes (CD45RA+), total T-lymphocytes (CD3+), T-helper cells (CD4+), T-cytotoxic cells (CD8+), NKcells (CD161a+), phagocytic activity of polymorphonuclear leukocytes in respect of latex particles. Serum levels of TNFα and IL-10 cytokines were determined by ELISA. The result showed that NPs SiO2, at dose of 100 mg/kg body weight had no any marked effect on severity of active anaphylactic shock and level of specific antibodies. The changes in cellular immunity under the influence of nanomaterial had similar direction in sensitized and non-sensitized animals and were more pronounced in the latter. Based on the discussion of the results, together with data from previous publications it was concluded that oral maximum level without observable adverse effect (NOAEL) of nanostructured SiO2 is located below 100 mg/kg body weight.
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Abstract
Mast cells are central effector cells in allergic asthma and are augmented in the airways of asthma patients. Attenuating mast cell degranulation and with it the early asthmatic response is an important intervention point to inhibit bronchoconstriction, plasma exudation and tissue oedema formation. To validate the efficacy of novel pharmacological interventions, appropriate and practicable in vivo models reflecting mast cell-dependent mechanisms in the lung, are missing. Thus, we developed a novel model of passive pulmonary anaphylaxis in rats. Rats were passively sensitized by concurrent intratracheal and intradermal (ear) application of an anti-DNP IgE antibody. Intravenous application of the antigen, DNP-BSA in combination with Evans blue dye, led to mast cell degranulation in both tissues. Quantification of mast cell degranulation in the lung was determined by (1) mediator release into bronchoalveolar lavage, (2) extravasation of Evans blue dye into tracheal and bronchial lung tissue and (3) invasive measurement of antigen-induced bronchoconstriction. Quantification of mast cell degranulation in the ear was determined by extravasation of Evans blue dye into ear tissue. We pharmacologically validated our model using the SYK inhibitor Fostamatinib, the H1-receptor antagonist Desloratadine, the mast cell stabilizer disodium cromoglycate (DSCG) and the β2-adrenergic receptor agonist Formoterol. Fostamatinib was equally efficacious in lung and ear. Desloratadine effectively inhibited bronchoconstriction and ear vascular leakage, but was less effective against pulmonary vascular leakage, perhaps reflecting the differing roles for histamine receptor sub-types. DSCG attenuated both vascular leakage in the lung and bronchoconstriction, but with a very short duration of action. As an inhaled approach, Formoterol was more effective in the lung than in the ear. This model of passive pulmonary anaphylaxis provides a tissue relevant readout of early mast cell activity and pharmacological benchmarking broadly reflects responses observed in patients with asthma.
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Affiliation(s)
- Eva Wex
- Respiratory Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
- * E-mail:
| | - Eva Thaler
- Respiratory Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - Sylvia Blum
- Respiratory Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - David Lamb
- Respiratory Diseases Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
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Schrøder MA, Kirketerp-Møller K, Winther L. [Suspected anaphylaxis by wound treatment with polyhexanide derivate wound products]. Ugeskr Laeger 2014; 176:V02120094. [PMID: 25497633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Only four cases of anaphylaxis triggered by polyhexanide have been reported in the literature. We report a case of anaphylaxis in a Danish patient treated with polyhexanide derivate (Prontosan) wound products. We emphasise the importance of intramuscular injection of adrenaline as part of the treatment protocol in the initial phase of anaphylaxis and stress the importance of being aware of polyhexanide as a potential trigger of anaphylaxis.
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Affiliation(s)
- Morten A Schrøder
- Pædiatrisk Afdeling, Hvidovre Hospital, Kettegårds Alle 30, 2650 Hvidovre.
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Kim MH, Lee SY, Lee SE, Yang MS, Jung JW, Park CM, Lee W, Cho SH, Kang HR. Anaphylaxis to iodinated contrast media: clinical characteristics related with development of anaphylactic shock. PLoS One 2014; 9:e100154. [PMID: 24932635 PMCID: PMC4059752 DOI: 10.1371/journal.pone.0100154] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/22/2014] [Indexed: 11/22/2022] Open
Abstract
Objective Anaphylaxis is the most severe form of radiocontrast media (RCM) induced hypersensitivity and can be life-threatening if profound hypotension is combined. With increased use of iodine based RCM, related hypersensitivity is rapidly growing. However, the clinical characteristics and risk factors of RCM induced anaphylaxis accompanied by hypotension (anaphylactic shock) are not clearly defined. This study was performed to investigate the risk factors of RCM induced anaphylactic shock and the clinical value of RCM skin testing to identify causative agents in affected patients. Methods We analyzed the data of RCM induced anaphylaxis monitored by an inhospital pharmacovigilance center at a tertiary teaching hospital from January 2005 to December 2012 and compared the clinical features and skin test results according to the accompanying hypotension. Results Among total of 104 cases of RCM induced anaphylaxis, 34.6% of patients, developed anaphylaxis on their first exposure to RCM. Anaphylactic patients presenting with shock were older (57.4 vs. 50.1 years, p = 0.026) and had a history of more frequently exposure to RCM (5.1±7.8 vs. 1.9±3.3, p = 0.004) compared to those without hypotension. Among RCMs, hypotension was more frequent in anaphylaxis related to iopromide compared to other agents (85.0% vs. 61.4%, p = 0.011). Skin tests were performed in 51 patients after development of RCM induced anaphylaxis. Overall skin test positivity to RCM was 64.7% and 81.8% in patients with anaphylactic shock. Conclusion RCM induced anaphylactic shock is related to multiple exposures to RCM and most patients showed skin test positivity to RCM.
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Affiliation(s)
- Min-Hye Kim
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Seoul National University Hospital Regional Pharmacovigilance Center, Seoul, Republic of Korea
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Seung-Eun Lee
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Min-Suk Yang
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Jae-Woo Jung
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Chang Min Park
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Whal Lee
- Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang-Heon Cho
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Seoul National University Hospital Regional Pharmacovigilance Center, Seoul, Republic of Korea
| | - Hye-Ryun Kang
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Seoul National University Hospital Regional Pharmacovigilance Center, Seoul, Republic of Korea
- * E-mail:
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Commins SP, James HR, Stevens W, Pochan SL, Land MH, King C, Mozzicato S, Platts-Mills TAE. Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose. J Allergy Clin Immunol 2014; 134:108-15. [PMID: 24656556 DOI: 10.1016/j.jaci.2014.01.024] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 01/15/2014] [Accepted: 01/18/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND In 2009, we reported a novel form of delayed anaphylaxis to red meat related to serum IgE antibodies to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal). Although patients were remarkably consistent in their description of a 3- to 6-hour delay between eating mammalian meat and the appearance of symptoms, this delay has not been demonstrated under observed studies. OBJECTIVES We sought to formally document the time course of clinical symptoms after the ingestion of mammalian meat in subjects with IgE to alpha-gal and to monitor ex vivo for the appearance of markers of an allergic reaction. METHODS Open food challenges were performed with mammalian meat in 12 subjects with a history of severe urticarial reactions 3 to 6 hours after eating beef, pork, or lamb, as well as in 13 control subjects. Blood samples were taken hourly during each challenge. RESULTS Ten of 12 subjects with IgE to alpha-gal had clinical evidence of a reaction during the food challenge (vs none of the control subjects, P < .001). The reactions occurred 3 to 7 hours after the initial ingestion of mammalian meat and ranged from urticaria to anaphylaxis. Tryptase levels were positive in 3 challenges. Basophil activation, as measured by increased expression of CD63, correlated with the appearance of clinical symptoms. CONCLUSION The results presented provide clear evidence of an IgE-mediated food allergy that occurs several hours after ingestion of the inciting allergen. Moreover, here we report that in vivo basophil activation during a food challenge occurs in the same time frame as clinical symptoms and likely reflects the appearance of the antigen in the bloodstream.
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Affiliation(s)
- Scott P Commins
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va.
| | - Hayley R James
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Whitney Stevens
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Shawna L Pochan
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Michael H Land
- Duke Asthma, Allergy and Airway Center, Duke University, Durham, NC
| | - Carol King
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Susan Mozzicato
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, Department of Medicine, University of Virginia, Charlottesville, Va
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Lieberman P, Schwartz LB. Anaphylactic reaction to white-faced hornet sting and elevated baseline (asymptomatic) serum tryptase. J Allergy Clin Immunol Pract 2014; 1:315. [PMID: 24565497 DOI: 10.1016/j.jaip.2012.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 10/10/2012] [Indexed: 11/19/2022]
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Heger K, Fierens K, Vahl JC, Aszodi A, Peschke K, Schenten D, Hammad H, Beyaert R, Saur D, van Loo G, Roers A, Lambrecht BN, Kool M, Schmidt-Supprian M. A20-deficient mast cells exacerbate inflammatory responses in vivo. PLoS Biol 2014; 12:e1001762. [PMID: 24453940 PMCID: PMC3891641 DOI: 10.1371/journal.pbio.1001762] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 11/26/2013] [Indexed: 12/13/2022] Open
Abstract
Mast cells, best known as effector cells in pathogenic immunoglobulin-mediated responses, can sense a variety of “danger” signals; if manipulated to enhance their resulting inflammatory responses, they also exacerbate inflammatory diseases such as arthritis and lung inflammation. Mast cells are implicated in the pathogenesis of inflammatory and autoimmune diseases. However, this notion based on studies in mast cell-deficient mice is controversial. We therefore established an in vivo model for hyperactive mast cells by specifically ablating the NF-κB negative feedback regulator A20. While A20 deficiency did not affect mast cell degranulation, it resulted in amplified pro-inflammatory responses downstream of IgE/FcεRI, TLRs, IL-1R, and IL-33R. As a consequence house dust mite- and IL-33-driven lung inflammation, late phase cutaneous anaphylaxis, and collagen-induced arthritis were aggravated, in contrast to experimental autoimmune encephalomyelitis and immediate anaphylaxis. Our results provide in vivo evidence that hyperactive mast cells can exacerbate inflammatory disorders and define diseases that might benefit from therapeutic intervention with mast cell function. Mast cells mediate allergic and anaphylactic immune reactions. They are also equipped with innate pattern recognition, cytokine, and alarmin receptors, which induce inflammatory responses. Correlative studies in human patients hinted at roles for mast cells in autoimmune and inflammatory diseases. However, studies using mast cell-deficient mice have yielded contradictory results in this context. In this study we determined that A20, the negative feedback regulator, restricts inflammation downstream of the mast cell antigen (allergen) receptor module, innate pattern recognition receptors, and the alarmin receptor IL-33R. By mast cell–specific ablation of A20 we established a mouse model for exaggerated inflammatory but normal anaphylactic mast cell signaling. With these mice we evaluated the impact of increased mast cell-mediated inflammation under experimental conditions aimed at mimicking several inflammatory human diseases. Our results demonstrated that the lack of A20 from mast cells exacerbated disease in mouse models for rheumatoid arthritis and innate forms of asthma, but did not impact disease progression in a mouse model for multiple sclerosis. Our data provide direct evidence that enhanced inflammatory mast cell responses can contribute to disease pathology and do so via sensing and amplifying local inflammatory reactions driven by “danger” stimuli and/or tissue damage that leads to the release of alarmins.
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MESH Headings
- Anaphylaxis/chemically induced
- Anaphylaxis/immunology
- Anaphylaxis/metabolism
- Anaphylaxis/pathology
- Animals
- Arthritis, Experimental/chemically induced
- Arthritis, Experimental/immunology
- Arthritis, Experimental/metabolism
- Arthritis, Experimental/pathology
- Collagen Type II/administration & dosage
- Cysteine Endopeptidases
- DNA-Binding Proteins/deficiency
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/immunology
- Dinitrophenols/administration & dosage
- Encephalomyelitis, Autoimmune, Experimental/chemically induced
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Encephalomyelitis, Autoimmune, Experimental/metabolism
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Gene Expression
- Immunoglobulin E/genetics
- Immunoglobulin E/immunology
- Interleukin-1 Receptor-Like 1 Protein
- Interleukin-33
- Interleukins/genetics
- Interleukins/immunology
- Intracellular Signaling Peptides and Proteins/deficiency
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/immunology
- Lung/immunology
- Lung/metabolism
- Lung/pathology
- Male
- Mast Cells/immunology
- Mast Cells/metabolism
- Mast Cells/pathology
- Mice
- Mice, Transgenic
- Myelin-Oligodendrocyte Glycoprotein/administration & dosage
- NF-kappa B/genetics
- NF-kappa B/immunology
- Peptide Fragments/administration & dosage
- Pneumonia/chemically induced
- Pneumonia/immunology
- Pneumonia/metabolism
- Pneumonia/pathology
- Pyroglyphidae/immunology
- Receptors, IgE/genetics
- Receptors, IgE/immunology
- Receptors, Interleukin/genetics
- Receptors, Interleukin/immunology
- Receptors, Interleukin-1/genetics
- Receptors, Interleukin-1/immunology
- Serum Albumin, Bovine/administration & dosage
- Toll-Like Receptors/genetics
- Toll-Like Receptors/immunology
- Tumor Necrosis Factor alpha-Induced Protein 3
- Ubiquitin-Protein Ligases/deficiency
- Ubiquitin-Protein Ligases/genetics
- Ubiquitin-Protein Ligases/immunology
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Affiliation(s)
- Klaus Heger
- Molecular Immunology and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany
| | - Kaat Fierens
- Laboratory of Immunoregulation, Department of Pulmonary Medicine, University Hospital Ghent, Ghent, Belgium
- Department for Molecular Biomedical Research, Vlaams Instituut voor Biotechnologie, Ghent, Belgium
| | - J. Christoph Vahl
- Molecular Immunology and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany
| | - Attila Aszodi
- Department of Surgery, Ludwig Maximilians Universität, Munich, Germany
| | - Katrin Peschke
- Institute for Immunology, Technische Universität Dresden, Dresden, Germany
| | - Dominik Schenten
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Hamida Hammad
- Laboratory of Immunoregulation, Department of Pulmonary Medicine, University Hospital Ghent, Ghent, Belgium
- Department for Molecular Biomedical Research, Vlaams Instituut voor Biotechnologie, Ghent, Belgium
| | - Rudi Beyaert
- Department for Molecular Biomedical Research, Vlaams Instituut voor Biotechnologie, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Dieter Saur
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Geert van Loo
- Department for Molecular Biomedical Research, Vlaams Instituut voor Biotechnologie, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Axel Roers
- Institute for Immunology, Technische Universität Dresden, Dresden, Germany
| | - Bart N. Lambrecht
- Laboratory of Immunoregulation, Department of Pulmonary Medicine, University Hospital Ghent, Ghent, Belgium
- Department for Molecular Biomedical Research, Vlaams Instituut voor Biotechnologie, Ghent, Belgium
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mirjam Kool
- Laboratory of Immunoregulation, Department of Pulmonary Medicine, University Hospital Ghent, Ghent, Belgium
- Department for Molecular Biomedical Research, Vlaams Instituut voor Biotechnologie, Ghent, Belgium
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marc Schmidt-Supprian
- Molecular Immunology and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany
- * E-mail:
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Tada R, Yamanaka D, Nagi-Miura N, Adachi Y, Ohno N. Vasculitis and anaphylactoid shock induced in mice by cell wall extract of the fungus Candida metapsilosis. Pol J Microbiol 2014; 63:223-230. [PMID: 25115117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
To investigate whether cell wall mannan from Candida metapsilosis induces vasculitis similar to that in Kawasaki syndrome and anaphylactoid shock in mice, we examined the pathogenic effects of C. metapsilosis cell wall extracts. Our results show that intraperitoneal injection of cell wall extracts induced severe coronary arteritis, and intravenous injection induced acute anaphylactoid shock similar to extracts from Candida albicans (C. albicans). Structural analysis of cell wall mannan from C. metapsilosis using NMR spectroscopy showed it to contain only a-mannan, indicating that a-mannan might be contributing to Candida pathogenicity by inducing coronary arteritis and acute shock.
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Kurihara K, Suzuki T, Unno A, Hatano M. [Case of 5 year-old boy with anaphylaxis due to erythritol with negative prick test and positive intradermal test]. Arerugi 2013; 62:1534-1540. [PMID: 24552764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/05/2013] [Indexed: 06/03/2023]
Abstract
A 5 year-old boy experienced anaphylaxis after eating a jelly product for diet supplement containing erythritol as a major component. Prick test with the jelly product was negative, but the second oral ingestion of the jelly product at home caused another allergic reaction. Prick test with erythritol was negative even at 300 mg/ml, which was almost the solubility limit. Intradermal test was marginally positive at 0.1 mg/ml, and clearly positive at 1 mg/ml or higher concentration. We found subtle dose-response reaction utilizing basophil activation test, examined with 24 hour incubation at the concentration of 40-4000 μg/ml. At the oral challenge test in the hospital, 3 g of erythritol induced remarkable coughing, urticaria, edema, wheezing and hypoxemia. Erythritol is a natural sugar alcohol, with the molecular weight of 122.12, which is recently being widely used for diet supplements, beverages, or drug medicines due to its properties of calorie-free and good-tasting, with easy-to-use physical characteristics. We now have to recognize erythritol as a candidate for food allergen, and to be careful about negative result of prick test.
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Hiragun M, Ishii K, Hiragun T, Shindo H, Mihara S, Matsuo H, Hide M. The sensitivity and clinical course of patients with wheat-dependent exercise-induced anaphylaxis sensitized to hydrolyzed wheat protein in facial soap - secondary publication. Allergol Int 2013; 62:351-8. [PMID: 23880617 DOI: 10.2332/allergolint.13-oa-0553] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 03/25/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Recently, an increasing number of patients with wheat-dependent exercise-induced anaphylaxis (WDEIA) have been reported in Japan. Most of them had developed this condition during or after using hydrolyzed wheat protein (HWP)-containing soap (HWP-WDEIA). METHODS To clarify the relation between WDEIA and HWP-containing soap and their prognosis, we retrospectively studied the patients who visited Hiroshima University Hospital and were diagnosed as WDEIA from January 2010 to June 2011. We took detailed clinical histories, performed skin prick tests, serum immunoassays for antigen-specific IgE and basophil histamine release test, and followed up their clinical courses after the diagnosis. RESULTS Among 36 patients with WDEIA, 30 patients had used only one type of HWP-soap. The patients with HWP-WDEIA were mainly women and had developed facial symptoms and angioedema. They suffered from blood pressure reductions less frequently than patients with conventional WDEIA. The levels of gluten-specific IgE were higher than those of omega-5 gliadin in patients with HWP-WDEIA (P < 0.05, One-way ANOVA). All patients with HWP-WDEIA were positive against HWP in histamine release test. Among the conventional wheat antigens, glutenins induced the highest histamine release from basophils of patients with HWP-WDEIA. The sensitivities of patients against glutens and glutenins were reduced over months along with the discontinuance of HWP-soap. CONCLUSIONS The development of HWP-WDEIA is associated with the use of HWP-soap. The sensitivity to HWP that cross reacts with non-processed wheat may be reduced or possibly cured after the discontinuation of HWP-soap.
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Affiliation(s)
- Makiko Hiragun
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Kanjarawi R, Dy M, Bardel E, Sparwasser T, Dubois B, Mecheri S, Kaiserlian D. Regulatory CD4+Foxp3+ T cells control the severity of anaphylaxis. PLoS One 2013; 8:e69183. [PMID: 23922690 PMCID: PMC3724852 DOI: 10.1371/journal.pone.0069183] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 06/05/2013] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Anaphylaxis is a life-threatening outcome of immediate-type hypersensitivity to allergen, consecutive to mast cell degranulation by allergen-specific IgE. Regulatory T cells (Treg) can control allergic sensitization and mast cell degranulation, yet their clinical benefit on anaphylactic symptoms is poorly documented. Here we investigated whether Treg action during the effector arm of the allergic response alleviates anaphylaxis. METHODS We used a validated model of IgE-mediated passive systemic anaphylaxis, induced by intravenous challenge with DNP-HSA in mice passively sensitized with DNP-specific IgE. Anaphylaxis was monitored by the drop in body temperature as well as plasma histamine and serum mMCP1 levels. The role of Treg was analyzed using MHC class II-deficient (Aβ(°/°)) mice, treatment with anti-CD25 or anti-CD4 mAbs and conditional ablation of Foxp3(+) Treg in DEREG mice. Therapeutic efficacy of Treg was also evaluated by transfer experiments using FoxP3-eGFP knock-in mice. RESULTS Anaphylaxis did not occur in mast cell-deficient W/W(v) mutant mice and was only moderate and transient in mice deficient for histamine receptor-1. Defects in constitutive Treg, either genetic or induced by antibody or toxin treatment resulted in a more severe and/or sustained hypothermia, associated with a rise in serum mMCP1, but not histamine. Adoptive transfer of Foxp3(+) Treg from either naïve or DNP-sensitized donors similarly alleviated body temperature loss in Treg-deficient DEREG mice. CONCLUSION Constitutive Foxp3(+) Treg can control the symptomatic phase of mast cell and IgE-dependent anaphylaxis in mice. This might open up new therapeutic avenues using constitutive rather than Ag-specific Treg for inducing tolerance in allergic patients.
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Affiliation(s)
- Reem Kanjarawi
- CIRI, International Center for Infectiology Research, “Mucosal immunity, Vaccination & Biotherapies” Team, Université de Lyon, Lyon, France
- INSERM, U1111, Lyon, France
- École Normale Supérieure de Lyon, Lyon, France
- Université Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France
- CNRS, UMR5308, Lyon, France
| | - Michel Dy
- CNRS/UMR 8147, université René Descartes, Hôpital Necker, Paris, France
| | - Emilie Bardel
- CIRI, International Center for Infectiology Research, “Mucosal immunity, Vaccination & Biotherapies” Team, Université de Lyon, Lyon, France
- INSERM, U1111, Lyon, France
- École Normale Supérieure de Lyon, Lyon, France
- Université Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France
- CNRS, UMR5308, Lyon, France
| | - Tim Sparwasser
- Institute of Infection Immunology, TWINCORE, Center for Experimental and Clinical Infection Research, Hannover, Germany
| | - Bertrand Dubois
- CIRI, International Center for Infectiology Research, “Mucosal immunity, Vaccination & Biotherapies” Team, Université de Lyon, Lyon, France
- INSERM, U1111, Lyon, France
- École Normale Supérieure de Lyon, Lyon, France
- Université Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France
- CNRS, UMR5308, Lyon, France
| | - Salah Mecheri
- Institut Pasteur, Unité de Biologie des Interactions Hôte Parasites, Paris, France
- Centre National de la Recherche Scientifique, Unité de Recherche Associée 2581, Paris, France
| | - Dominique Kaiserlian
- CIRI, International Center for Infectiology Research, “Mucosal immunity, Vaccination & Biotherapies” Team, Université de Lyon, Lyon, France
- INSERM, U1111, Lyon, France
- École Normale Supérieure de Lyon, Lyon, France
- Université Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France
- CNRS, UMR5308, Lyon, France
- * E-mail:
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Lee S, Hess EP, Nestler DM, Bellamkonda Athmaram VR, Bellolio MF, Decker WW, Li JTC, Hagan JB, Manivannan V, Vukov SC, Campbell RL. Antihypertensive medication use is associated with increased organ system involvement and hospitalization in emergency department patients with anaphylaxis. J Allergy Clin Immunol 2013; 131:1103-8. [PMID: 23453138 DOI: 10.1016/j.jaci.2013.01.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 12/05/2012] [Accepted: 01/10/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Risk factors for increased anaphylaxis severity are poorly understood. Angiotensin-converting enzyme (ACE) inhibitors have been associated with severe anaphylactic reactions in patients with hymenoptera venom allergy. Studies evaluating the association between beta-blockers and severe anaphylaxis have been conflicting. OBJECTIVE To evaluate the association between antihypertensive medication use and increased anaphylaxis severity. METHODS We included emergency department anaphylaxis patients aged 18 years and older. Markers of severe anaphylaxis were defined as (1) syncope, hypotension, or hypoxia; (2) signs and symptoms involving 3 or more organ systems; and (3) hospitalization. Antihypertensive medications evaluated included beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin receptor blockers, and diuretics. Simple and multiple logistic regression analyses were conducted to estimate the association between antihypertensive medication use and markers of increased anaphylaxis severity. RESULTS Among 302 patients with anaphylaxis, 55 (18%) had syncope, hypoxia, or hypotension, 57 (19%) required hospitalization, and 139 (46%) had 3 or more organ system involvement. After adjusting for age, gender, suspected trigger, and preexisting lung disease, beta-blocker, ACE-inhibitor, diuretic, or antihypertensive medication use in aggregate remained associated with both 3 or more organ system involvement and need for hospital admission. The adjusted associations between antihypertensive medication use in aggregate and 3 or more organ system involvement yielded an odds ratio of 2.8 (95% CI, 1.5-5.2; P=.0008) and with hospitalization an odds ratio of 4.0 (95% CI, 1.9-8.4; P=.0001). CONCLUSIONS In emergency department anaphylaxis patients, antihypertensive medication use is associated with increased organ system involvement and increased odds of hospital admission, independent of age, gender, suspected trigger, or preexisting lung disease.
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Affiliation(s)
- Sangil Lee
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Zhou L, Oh SY, Zhou Y, Yuan B, Wu F, Oh MH, Wang Y, Takemoto C, Van Rooijen N, Zheng T, Zhu Z. SHP-1 regulation of mast cell function in allergic inflammation and anaphylaxis. PLoS One 2013; 8:e55763. [PMID: 23390550 PMCID: PMC3563592 DOI: 10.1371/journal.pone.0055763] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 01/04/2013] [Indexed: 11/19/2022] Open
Abstract
Allergic inflammation and severe allergic reactions (anaphylaxis) are important in allergen induced diseases. Bacterial products such as lipopolysaccharide (LPS) are ubiquitous and can facilitate allergen induced Th2 immune responses. Phosphatase SHP-1 is critical in regulating immunological homeostasis and in allergen induced Th2 immune responses in the lung. However, the mechanisms underlying the initiation of allergic inflammation and allergen induced anaphylaxis are still not completely elucidated and it is unclear whether SHP-1 plays any role in LPS-induced airway inflammation and in allergen-induced anaphylaxis. In this study we tested the hypothesis that phosphatase SHP-1 plays an important role in allergic inflammation and anaphylaxis and determined whether its effects are through regulation of mast cell functions. SHP-1 deficient (mev/+ and mev/mev) and mast cell deficient (Kit(W-sh)) mice were examined in their responses to LPS airway stimulation and to ovalbumin (OVA) allergen induced systemic anaphylaxis. Compared to wild type mice, mev/+ mice had significantly enhanced LPS induced airway inflammation and OVA induced anaphylactic responses, including hypothermia and clinical symptoms. These changes were mast cell dependent as Kit(W-sh) mice had reduced responses whereas adoptive transfer of mast cells restored the responses. However, T and B cells were not involved and macrophages did not play a significant role in LPS induced airway inflammation. Interestingly, basophil differentiation from SHP-1 deficient bone marrow cells was significantly reduced. These findings provided evidence that through regulation of mast cell functions SHP-1 plays a critical role as a negative regulator in allergic inflammation and in allergen induced anaphylaxis. In addition, SHP-1 seems to be required for normal basophil development.
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Affiliation(s)
- Li Zhou
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
- Center for Animal Experiment/ABSL-III Laboratory and State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan, P.R. China
| | - Sun Young Oh
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
| | - Yuqi Zhou
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
| | - Baojun Yuan
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
| | - Fan Wu
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
| | - Min Hee Oh
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
| | - Yefu Wang
- Center for Animal Experiment/ABSL-III Laboratory and State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan, P.R. China
| | - Cliff Takemoto
- Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Nico Van Rooijen
- Department of Molecular Cell Biology, VU Medical Center, Amsterdam, The Netherlands
| | - Tao Zheng
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
| | - Zhou Zhu
- Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland, United States of America
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Abstract
Mouse models of systemic anaphylaxis are important tools for the study of mast cell function, for the elucidation of the pathomechanisms of anaphylaxis, and for identifying and characterizing potential therapies for anaphylaxis. Here, we describe two murine models of systemic anaphylaxis that have been a key part of research in these areas. In a passive model, mice are sensitized with antigen-specific IgE antibody 24 h prior to antigen challenge. In an active model, mice are instead sensitized with antigen 18-21 days prior to challenge. Hypothermia serves as the primary quantifiable indicator of anaphylaxis in these models.
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Affiliation(s)
- Elizabeth Doyle
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin, Berlin, Germany
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