New Biomarkers in Anaphylaxis (Beyond Tryptase)

Galvan-Blasco, Paula; Gil-Serrano, J.; Sala‐Cunill, Anna

doi:10.1007/s40521-022-00326-1

Cited by 10 publications

(5 citation statements)

References 86 publications

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“…It was previously demonstrated that C4a levels in ME/CFS patients were in general lower than in healthy control participants but elevated after exercise challenge and correlating with PEMassociated symptoms [34][35][36]. Interestingly, the rise in C4a levels was not observable one hour after being physically challenged [34][35][36] but only after six hours [36] and returned almost to baseline 24 hours post exercise. This suggests C4a as a potential PEM-associated biomarker and a pathophysiological marker in ME/CFS.…”

Section: Discussionmentioning

confidence: 89%

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Rohrhofer,

Hauser,

Lettenmaier

et al. 2023

Preprint

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease characterized by profound fatigue, post-exertional malaise (PEM), and neurocognitive dysfunction. Immune dysregulation and gastrointestinal symptoms are commonly observed in ME/CFS patients. Despite affecting approximately 0.89% of the general population, the underlying pathophysiological mechanisms remain poorly understood. This study aimed to elucidate the relationship between immunological characteristics and intestinal barrier function in ME/CFS patients. ME/CFS patients were stratified into two groups based on their immune competence. After documentation of detailed medical records, serum and plasma samples were collected for assessment of inflammatory immune mediators and biomarkers for intestinal barrier integrity by ELISA. We found reduced complement protein C4a levels in immunodeficient ME/CFS patients suggesting a sub-group specific innate immune dysregulation. ME/CFS patients without immunodeficiencies exhibit a mucosal barrier leakage, as indicated by elevated levels of Lipopolysaccharide-binding protein (LBP). Stratifying ME/CFS patients based on immune competence enabled the distinction of two subgroups with different pathophysiological patterns. The study highlights the importance of emphasizing precise patient stratification in ME/CFS, particularly in the context of defining suitable treatment strategies. Given the substantial health and socioeconomic burden associated with ME/CFS, urgent attention and research efforts are needed to define causative treatment approaches.

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Section: Discussionmentioning

confidence: 89%

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Rohrhofer,

Hauser,

Lettenmaier

et al. 2023

Preprint

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“…As chronic mast cell activation is difficult to determine, due to the acute nature and short half-life of the major mediators tryptase and histamine [ 24 ], we aimed to measure the serum levels of ECP and EDN. The measurement of ECP did not reveal differences between the test groups of the study cohort and thus is not shown.…”

Section: Resultsmentioning

confidence: 99%

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Rohrhofer,

Hauser,

Lettenmaier

et al. 2024

JCM

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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease characterized by profound fatigue, post-exertional malaise (PEM), and neurocognitive dysfunction. Immune dysregulation and gastrointestinal symptoms are commonly observed in ME/CFS patients. Despite affecting approximately 0.89% of the general population, the underlying pathophysiological mechanisms remain poorly understood. This study aimed to elucidate the relationship between immunological characteristics and intestinal barrier function in ME/CFS patients. ME/CFS patients were stratified into two groups based on their immune competence. After documentation of detailed medical records, serum and plasma samples were collected for the assessment of inflammatory immune mediators and biomarkers for intestinal barrier integrity by ELISA. We found reduced complement protein C4a levels in immunodeficient ME/CFS patients suggesting a subgroup-specific innate immune dysregulation. ME/CFS patients without immunodeficiencies exhibit a mucosal barrier leakage, as indicated by elevated levels of Lipopolysaccharide-binding protein (LBP). Stratifying ME/CFS patients based on immune competence enabled the distinction of two subgroups with different pathophysiological patterns. The study highlights the importance of emphasizing precise patient stratification in ME/CFS, particularly in the context of defining suitable treatment strategies. Given the substantial health and socioeconomic burden associated with ME/CFS, urgent attention and research efforts are needed to define causative treatment approaches.

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“…This is especially true for patients with food-induced anaphylaxis [31,32], in which only a 30% increase in tryptase seems to suffice [33]. It is possible that other mediators such as platelet-activating factor (PAF), prostaglandin D2, leukotriene E4, histamine, or other cytokines might be more sensitive in these patients [34][35][36][37]. Note that even when MCA is depicted, no conclusion can be drawn about the mechanism (IgE-mediated or non-IgE-mediated) responsible for MC degranulation [38,39].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders

Beyens,

Toscano,

Ebo

et al. 2023

Diagnostics

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Tryptase has proven to be a very useful and specific marker to demonstrate mast cell activation and degranulation when an acute (i.e., within 4 h after the event) and baseline value (i.e., at least 24 h after the event) are compared and meet the consensus formula (i.e., an increase of 20% + 2). The upper limit of normal determined by the manufacturer is 11.4 ng/mL; however, this boundary has been the subject of debate. According to ECNM and AIM experts, the normal range of baseline tryptase should be 1 to 15 ng/mL. A genetic trait, hereditary alpha tryptasemia, characterized by an increased alpha coding TPSAB1 copy number is associated with a baseline value above 8 ng/mL. Elevated tryptase can also be found in chronic kidney disease, obesity, and hematological neoplasms. A tryptase > 20 ng/mL serves as a minor criterion to diagnose systemic mastocytosis and an increase in tryptase > 20% + 2 during an acute event is a required criterion in the diagnosis of mast cell activation syndrome. The goal of this review is to demonstrate the (in)significance of tryptase using some clinical vignettes and to provide a practical guide on how to manage and interpret an elevated tryptase level.

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New Biomarkers in Anaphylaxis (Beyond Tryptase)

Cited by 10 publications

References 86 publications

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Immunological Patient Stratification in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders

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