Adult anaphylaxis: A state-of-the-art review

Rossi, Carlo Maria; Lenti, Marco Vincenzo

doi:10.1016/j.ejim.2022.03.003

Cited by 15 publications

(7 citation statements)

References 63 publications

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“…These results seem to suggest that the hypertensive response can be considered a pseudoallergy, while, in the case of stronger stimuli caused by zymosan and CVF leading to hypotensive shock, is an anaphylactoid response. This distribution of allergy in the mouse is similar to the general practice in humans, as anaphylaxis is considered to be the most severe acute allergic disease [ 4 ]. The hypertensive effect was due to C activation with C3a release and binding to C3aR, as the blood level of the anaphylatoxin paralleled the rise of MABP [ 2 ].…”

Section: Introductionmentioning

confidence: 85%

The Hypertensive Effect of Amphotericin B-Containing Liposomes (Abelcet) in Mice: Dissecting the Roles of C3a and C5a Anaphylatoxins, Macrophages and Thromboxane

et al. 2022

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Liposomal amphotericin B (Abelcet) can cause infusion (anaphylactoid) reactions in patients whose mechanism is poorly understood. Here, we used mice to investigate the role of complement (C) receptors and the cellular sources of vasoactive mediators in these reactions. Anesthetized male NMRI and thromboxane prostanoid receptor (TP) or cyclooxygenase-1 (COX-1)-deficient and wild type C57Bl6/N mice were intravenously injected with Abelcet at 30 mg/kg. Mean arterial blood pressure (MABP) and heart rate (HR) were measured. In untreated mice, Abelcet caused a short (15 min) but large (30%) increase in MABP. C depletion with cobra venom factor (CVF) and inhibition of C5a receptors with DF2593A considerably prolonged, while C3aR inhibition with SB290157 significantly decreased the hypertensive effect. Likewise, the hypertensive response was abolished in COX-1- and TP-deficient mice. CVF caused a late hypertension in TP-deficient mice. Both macrophage depletion with liposomal clodronate and blockade of platelet GPIIb/IIIa receptors with eptifibatide prolonged the hypertensive effect. The early phase of the hypertensive effect is COX-1- and TP-receptor-dependent, partly mediated by C3aR. In contrast, the late phase is under the control of vasoactive mediators released from platelets and macrophages subsequent to complement activation and C5a binding to its receptor.

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Section: Introductionmentioning

confidence: 85%

The Hypertensive Effect of Amphotericin B-Containing Liposomes (Abelcet) in Mice: Dissecting the Roles of C3a and C5a Anaphylatoxins, Macrophages and Thromboxane

et al. 2022

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“…Super-antigens produced by bacteria such as Streptococcus species and Staphylococcus aureus bind with the MHC and T-cell receptors, resulting in T-cell stimulation and concurrent release of cytokines which culminate into toxic shock syndrome [ 126 ]. These super antigens are strong T-cell mitogens, capable of causing fever, shock, and death at doses as low as 0.1 pg/ml [ 119 ].…”

Section: Types Of Pulmonary Cytokine Stormmentioning

confidence: 99%

The critical impacts of cytokine storms in respiratory disorders

Riyaz Tramboo,

Elkhalifa,

Quibtiya

et al. 2024

Heliyon

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“…In some patients, multiple allergens were suspected; therefore, the total number of all patients per trigger categories exceeds the total number of patients. The percentages refer to the respective category of suspected triggers 1 Various medications 2 Fruits including ananas (3x), kiwi (2x), strawberry (1x), banana (1x), mandarine (1x), orange (1x), melon (1x), cherry (1x), Yackfruit (1x), fruit juice (1x) 3 Spices including curry (3x), curcuma (3x), paprica (1x) 4 Other including almonds (2x), carrots (2x), mushrooms (2x), sage (1x), sesame (1x) 5 In the unclear cases, no exact food trigger or a combination of food triggers were suspected, for example, a meal was eaten with subsequent allergic reaction…”

Section: Table 2 Suspected Triggers Of Anaphylaxis N = 531mentioning

confidence: 99%

“…Anaphylaxis represents the most severe clinical condition of an acute systemic reaction comprising two or more organ systems due to the activation of mast cells, basophils, and other immune cells with release of various mediators [1,2]. Recent studies show a worldwide incidence between 50 and 112 occurrences per 100,000 person-years, while the estimated lifetime prevalence is 0.3-5.1% [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Anaphylaxis in a Swiss university emergency department: clinical characteristics and supposed triggers

Ehrhard,

Eyb,

Gautschi

et al. 2024

Allergy Asthma Clin Immunol

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Background Anaphylaxis is the most severe form of acute systemic and potentially life-threatening reactions triggered by mast and basophilic cells. Recent studies show a worldwide incidence between 50 and 112 occurrences per 100,000 person-years. The most identified triggers are food, medications, and insect venoms. We aimed to analyze triggers and clinical symptoms of patients presenting to a Swiss university emergency department for adults. Methods Six-year retrospective analysis (01/2013 to 12/2018) of all patients (> 16 years of age) admitted with moderate or severe anaphylaxis (classification of Ring and Messmer ≥ 2) to the emergency department. Patient and clinical data were extracted from the electronic medical database of the emergency department. Results Of the 531 includes patients, 53.3% were female, the median age was 38 [IQR 26–51] years. The most common suspected triggers were medications (31.8%), food (25.6%), and insect stings (17.1%). Organ manifestations varied among the different suspected triggers: for medications, 90.5% of the patients had skin symptoms, followed by respiratory (62.7%), cardiovascular (44.4%) and gastrointestinal symptoms (33.7%); for food, gastrointestinal symptoms (39.7%) were more frequent than cardiovascular symptoms (36.8%) and for insect stings cardiovascular symptoms were apparent in 63.8% of the cases. Conclusions Average annual incidence of moderate to severe anaphylaxis during the 6-year period in subjects > 16 years of age was 10.67 per 100,000 inhabitants. Medications (antibiotics, NSAID and radiocontrast agents) were the most frequently suspected triggers. Anaphylaxis due to insect stings was more frequently than in other studies. Regarding clinical symptoms, gastrointestinal symptoms need to be better considered, especially that initial treatment with epinephrine is not delayed.

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Adult anaphylaxis: A state-of-the-art review

Cited by 15 publications

References 63 publications

The Hypertensive Effect of Amphotericin B-Containing Liposomes (Abelcet) in Mice: Dissecting the Roles of C3a and C5a Anaphylatoxins, Macrophages and Thromboxane

The Hypertensive Effect of Amphotericin B-Containing Liposomes (Abelcet) in Mice: Dissecting the Roles of C3a and C5a Anaphylatoxins, Macrophages and Thromboxane

The critical impacts of cytokine storms in respiratory disorders

Anaphylaxis in a Swiss university emergency department: clinical characteristics and supposed triggers

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