Anaphylaxis to protamine sulfate mediated by a complement-dependent IgG antibody

Enhanced IgE and IgG Anti‐Melittin Antibody Formation Induced by Heparin‐Melittin Complexes in Mice

“…Einally, we should like to mention an interesting clinical case (14) which illustrates the possible consequences of the binding of heparin to cationic proteins in vivo. An individual was given heparin prior to donating blood and then was injected with protamine after blood donation in order to neutralize the injected heparin.…”

“…All materials were dissolved or diluted in physiologic saline. IgG (YI) antibodies were determined by 2 h passive cutaneous anaphylaxis (PCA) reactions in CFW mice (14) and IgE titres were measured by PCA reactions in the skin of 200 g male Sprague-Dahli rats (19). The next day the precipitates were washed twice in cold saline, and resuspended in 1 ml of saline.…”

Noncardiogenic pulmonary oedema following cardiopulmonary bypass: report of two cases and review of the literature

“…No immunological studies were done. Lakin, however, documented anaphylaxis to protamine sulphate 7 It was surmised that the anaphylactoid reaction to protamine administration was secondary to nonimmunological mast cell degranulation and/or complement consumption mediated by protamine or protamine-heparin complexes. He presented evidence that the reaction is mediated by a complement-dependent IgG skin-sensitizing antibody.…”

Mast cell chymase in complex with heparin proteoglycan is regulated by protamine

“…Other reports have shown that protamine can interact directly with mast cells (MC), causing non-immunological histamine release [4,5]. In addition, inhibition of plasma carboxypeptidase N [6] and activation of the complement system [7,8] by protamine have been reported.…”