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Anaphylaxis pathophysiology

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https://www.readbyqxmd.com/read/28780941/the-pathophysiology-of-anaphylaxis
#1
REVIEW
Laurent L Reber, Joseph D Hernandez, Stephen J Galli
Anaphylaxis is a severe systemic hypersensitivity reaction that is rapid in onset; characterized by life-threatening airway, breathing, and/or circulatory problems; and usually associated with skin and mucosal changes. Because it can be triggered in some persons by minute amounts of antigen (eg, certain foods or single insect stings), anaphylaxis can be considered the most aberrant example of an imbalance between the cost and benefit of an immune response. This review will describe current understanding of the immunopathogenesis and pathophysiology of anaphylaxis, focusing on the roles of IgE and IgG antibodies, immune effector cells, and mediators thought to contribute to examples of the disorder...
August 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28684600/frontline-science-corticotropin-releasing-factor-receptor-subtype-1-is-a-critical-modulator-of-mast-cell-degranulation-and-stress-induced-pathophysiology
#2
Saravanan Ayyadurai, Amelia J Gibson, Susan D'Costa, Elizabeth L Overman, Laura J Sommerville, Ashwini C Poopal, Emily Mackey, Yihang Li, Adam J Moeser
Life stress is a major risk factor in the onset and exacerbation of mast cell-associated diseases, including allergy/anaphylaxis, asthma, and irritable bowel syndrome. Although it is known that mast cells are highly activated upon stressful events, the mechanisms by which stress modulates mast cell function and disease pathophysiology remains poorly understood. Here, we investigated the role of corticotropin-releasing factor receptor subtype 1 (CRF1) in mast cell degranulation and associated disease pathophysiology...
July 6, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28675997/cold-induced-anaphylaxis-the-case-of-a-9-year-old-child-and-review-of-the-literature
#3
Paolo Romita, Paola Mascia, Gianfranco Calogiuri, Caterina Foti
BACKGROUND AND OBJECTIVE: The present review investigated cold-induced anaphylaxis, a potentially life-threatening condition that occurs after exposure to cold stimuli and is characterized by respiratory distress and/or hypotension. Anaphylaxis is rarely associated to cold-induced urticarial (CU), a particular form of physical urticaria that is difficult to diagnose and manage. The incidence of cold-induced urticaria has been estimated at about 0.05%, higher in colder regions and in women; its pathological mechanisms are still unknown...
July 3, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28577270/hidden-causes-of-anaphylaxis
#4
REVIEW
Vivian C Nanagas, James L Baldwin, Keerthi R Karamched
PURPOSE OF REVIEW: This study aimed to review important hidden causes of anaphylaxis in ingestants, non-ingestants, and uncommon settings. RECENT FINDINGS: Multiple new and elusive causes of anaphylaxis have been described over the past 35 years. Further research is required to identify the epidemiology, pathophysiology, and clinical impact of these hidden causes. Although these culprits should be considered in the appropriate clinical scenarios, many remain exceedingly rare...
July 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28570220/effects-of-rupatadine-on-platelet-activating-factor-induced-human-mast-cell-degranulation-compared-with-desloratadine-and-levocetirizine-the-maspaf-study
#5
R Munoz-Cano, E Ainsua-Enrich, I Torres-Atencio, M Martin, J Sánchez-Lopez, J Bartra, C Picado, J Mullol, A Valero
BACKGROUND AND OBJECTIVE: Platelet-activating factor (PAF) is a lipid mediator involved in the pathophysiology of several allergic diseases, for example, in the amplification of mast cell (MC) activation in anaphylaxis. Rupatadine is an antihistamine with a demonstrated anti-PAF effect, although its capacity to inhibit PAF-induced MC degranulation has not been fully evaluated. Objectives: To compare the ability of rupatadine to inhibit PAF-induced MC degranulation with that of desloratadine and levocetirizine and to confirm the dual anti-H1 and anti-PAF activity of rupatadine...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#6
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28362039/in-response-to-anaphylaxis-during-cardiac-surgery-for-hypetrophic-cardiomyopathy-pathophysiologic-and-therapeutic-considerations
#7
Marcin Wąsowicz, Kevin Fu Hong Yee
No abstract text is available yet for this article.
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28346234/outstanding-animal-studies-in-allergy-i-from-asthma-to-food-allergy-and-anaphylaxis
#8
Erika Jensen-Jarolim, Isabella Pali-Schöll, Franziska Roth-Walter
PURPOSE OF REVIEW: Animal models published within the past 18 months on asthma, food allergy and anaphylaxis, all conditions of rising public health concern, were reviewed. RECENT FINDINGS: While domestic animals spontaneously develop asthma, food allergy and anaphylaxis, in animal models, divergent sensitization and challenge routes, dosages, intervals and antigens are used to induce asthmatic, food allergic or anaphylactic phenotypes. This must be considered in the interpretation of results...
June 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28342911/basophils-high-affinity-ige-receptors-and-ccl2-in-human-anaphylaxis
#9
Peter Korosec, Paul J Turner, Mira Silar, Peter Kopac, Mitja Kosnik, Bernhard F Gibbs, Mohamed H Shamji, Adnan Custovic, Matija Rijavec
BACKGROUND: The role of basophils in anaphylaxis is unclear. OBJECTIVE: We sought to investigate whether basophils have an important role in human anaphylaxis. METHODS: In an emergency department study we recruited 31 patients with acute anaphylaxis, predominantly to Hymenoptera venom. We measured expression of basophil activation markers (CD63 and CD203c); the absolute number of circulating basophils; whole-blood FCER1A, carboxypeptidase A3 (CPA3), and L-histidine decarboxylase (HDC) gene expression; and serum markers (CCL2, CCL5, CCL11, IL-3, and thymic stromal lymphopoietin) at 3 time points (ie, during the anaphylactic episode and in convalescent samples 7 and 30 days later)...
March 22, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28144845/gastric-vascular-and-motor-responses-to-anaphylactic-hypotension-in-anesthetized-rats-in-comparison-to-those-with-hemorrhagic-or-vasodilator-induced-hypotension
#10
Yuhichi Kuda, Toshishige Shibamoto, Tao Zhang, Wei Yang, Mamoru Tanida, Yasutaka Kurata
Anaphylactic shock is life-threatening, but pathophysiology of the stomach lesion remains unclear. We determined gastric hemodynamics and gastric functions during anaphylactic hypotension, as compared to hypotension induced by hemorrhage or sodium nitroprusside (SNP) in anesthetized and ovalbumin-sensitized Sprague-Dawley rats. Systemic arterial pressure, portal venous pressure, and gastric arterial blood flow were measured, and gastric vascular resistance (GVR) was determined. Separately, the intragastric pressure (IGP) and gastric effluent, as a measure of gastric flux, were continuously measured...
January 31, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/27895892/sexual-dimorphism-in-the-mast-cell-transcriptome-and-the-pathophysiological-responses-to-immunological-and-psychological-stress
#11
Emily Mackey, Saravanan Ayyadurai, Calvin S Pohl, Susan D' Costa, Yihang Li, Adam J Moeser
BACKGROUND: Biological sex plays a prominent role in the prevalence and severity of a number of important stress-related gastrointestinal and immune-related diseases including IBS and allergy/anaphylaxis. Despite the establishment of sex differences in these diseases, the underlying mechanisms contributing to sex differences remain poorly understood. The objective of this study was to define the role of biological sex on mast cells (MCs), an innate immune cell central to the pathophysiology of many GI and allergic disorders...
2016: Biology of Sex Differences
https://www.readbyqxmd.com/read/27822074/diagnosis-of-exercise-induced-anaphylaxis-current-insights
#12
REVIEW
Valerio Pravettoni, Cristoforo Incorvaia
Exercise-induced anaphylaxis (EIAn) is defined as the occurrence of anaphylactic symptoms (skin, respiratory, gastrointestinal, and cardiovascular symptoms) after physical activity. In about a third of cases, cofactors, such as food intake, temperature (warm or cold), and drugs (especially nonsteroidal anti-inflammatory drugs) can be identified. When the associated cofactor is food ingestion, the correct diagnosis is food-dependent EIAn (FDEIAn). The literature describes numerous reports of FDEIAn after intake of very different foods, from vegetables and nuts to meats and seafood...
2016: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/27758758/effects-of-rupatadine-on-platelet-activating-factor-induced-human-mast-cell-degranulation-compared-with-desloratadine-and-levocetirizine-the-maspaf-study
#13
R Munoz-Cano, E Ainsua-Enrich, I Torres-Atencio, M Martin, J Sánchez-Lopez, J Bartra, C Picado, J Mullol, A Valero
BACKGROUND AND OBJECTIVE: Platelet-activating factor (PAF) is a lipid mediator involved in the pathophysiology of several allergic diseases, for example, in the amplification of mast cell (MC) activation in anaphylaxis. Rupatadine is an antihistamine with a demonstrated anti-PAF effect, although its capacity to inhibit PAF-induced MC degranulation has not been fully evaluated. Objectives: To compare the ability of rupatadine to inhibit PAF-induced MC degranulation with that of desloratadine and levocetirizine and to confirm the dual anti-H1 and anti-PAF activity of rupatadine...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/27745988/adverse-reactions-to-contrast-material-a-canadian-update
#14
REVIEW
Alexander Morzycki, Anuj Bhatia, Kieran J Murphy
Imaging techniques frequently employ contrast agents to improve image resolution and enhance pathology detection. These gadolinium- and iodine-based media, although generally considered safe, are associated with a number of adverse effects ranging from mild to severe. Reactions are classified as either anaphylactoid ("anaphylaxis-like") or nonanaphylactoid, depending on a number of elements that will be reviewed. Herein, we have summarized predisposing risk factors for adverse events resulting from the use of contrast, their associated pathophysiological mechanisms as well as known prophylaxis for the antitreatment of high-risk patients...
May 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/27719658/aspirin-intolerance-experimental-models-for-bed-to-bench
#15
Masamichi Yamashita
Aspirin is the oldest non-steroidal anti-inflammatory drug (NSAID), and it sometimes causes asthma-like symptoms known as aspirin-exacerbated respiratory disease (AERD), which can be serious. Unwanted effects of aspirin (aspirin intolerance) are also observed in patients with food-dependent exercise-induced anaphylaxis, a type I allergy disease, and aspirin-induced urticaria (AIU). However the target and the mechanism of the aspirin intolerance are still unknown. There is no animal or cellular model of AERD, because its pathophysiological mechanism is still unknown, but it is thought that inhibition of cyclooxygenase by causative agents leads to an increase of free arachidonic acid, which is metabolized into cysteinyl leukotrienes (cysLTs) that provoke airway smooth muscle constriction and asthma symptoms...
2016: Current Drug Targets
https://www.readbyqxmd.com/read/27692840/clinical-mimics-an-emergency-medicine-focused-review%C3%A2-of%C3%A2-sepsis-mimics
#16
Brit Long, Alex Koyfman
BACKGROUND: Sepsis is a common clinical condition, and mortality and morbidity may be severe. The current definition of sepsis involves systemic inflammatory response syndrome (SIRS) criteria, which is met by many conditions. OBJECTIVE: This review evaluates the SIRS continuum, signs and symptoms of sepsis, mimics of sepsis, and an approach to management for sepsis mimics. DISCUSSION: The current emergency medicine definition of sepsis includes SIRS, a definition that may be met by many conditions...
January 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27689430/anaphylaxis-and-cardiac-surgery-for-hypertrophic-obstructive-cardiomyopathy-a-case-report-and-review-of-anaesthetic-management
#17
Kevin Fu Hong Yee, Marcin Wasowicz
BACKGROUND: The aim of this paper is to describe clinical management in a situation where patient has experienced anaphylaxis while undergoing surgical septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM). CASE REPORT: A 40-yr-old female was scheduled to undergo surgical septal myectomy for the treatment of HOCM. After induction, the patient developed refractory hypotension that did not respond to escalating doses of vasopressors and volume therapy...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27621657/reslizumab-in-the-management-of-poorly-controlled-asthma-the-data-so-far
#18
REVIEW
Diego Jose Maselli, Maria Ines Velez, Linda Rogers
Interleukin-5, an important cytokine in the pathophysiology of asthma, participates in terminal maturation and increases chemotaxis, endothelial adhesion, and activation of eosinophils. Blockade of interleukin-5 activity with monoclonal antibodies have been successful in decreasing eosinophil counts. Reslizumab, a monoclonal antibody that targets interleukin-5, has been studied for the treatment of severe asthma. Several studies have shown that reslizumab can effectively treat severe asthma with an eosinophilic phenotype...
2016: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/27591544/diagnosis-of-anaphylactic-death-in-forensics-review-and-future-perspectives
#19
REVIEW
Rossana Cecchi
The diagnosis of anaphylaxis in a pre- or post-mortal phase involves the formulation of problems not yet solved by the international scientific literature, due to the complexity of pathogenic factors and pathophysiological processes that characterizes it. For forensic autopsies, further problems of differential diagnosis arise and often leave the forensic pathologist unable to express an opinion of certainty, as a result of lack of case history, circumstantial and autoptical-histopathological data. Nevertheless, in routine cases the postmortem diagnosis of anaphylactic death continues to be based on exclusion and circumstantial evidence...
September 2016: Legal Medicine
https://www.readbyqxmd.com/read/27545856/ischemic-stroke-after-wasp-sting
#20
Ashish Kulhari, Ashley Rogers, Han Wang, Vishakhadatta Mathur Kumaraswamy, Wei Xiong, Michael DeGeorgia
BACKGROUND: Despite the common occurrence of hymenopteran stings worldwide, primary neurologic manifestations including stroke are rare. We report a case of a healthy male who developed a right middle cerebral artery (MCA) territory ischemic stroke after getting stung by a wasp. CASE REPORT: A 44-year-old man with hypertension presented to the hospital with sudden-onset left hemiparesis, left facial weakness, and dysarthria after being stung by a wasp. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) scans of the brain revealed a right MCA territory infarct and a lack of flow in the distal right internal carotid artery and MCA...
October 2016: Journal of Emergency Medicine
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