Effect of Locally Administered Heparins on Delayed-Type Hypersensitivity Reactions

1990 ◽  
Vol 93 (4) ◽  
pp. 300-307 ◽  
Author(s):  
A.M. Kakakios ◽  
J. Ryan ◽  
C.L. Geczy
Keyword(s):  
Delayed Type Hypersensitivity ◽  
Hypersensitivity Reactions

Molecular weight determines the frequency of delayed type hypersensitivity reactions to heparin and synthetic oligosaccharides

2005 ◽  
Vol 94 (12) ◽  
pp. 1265-1269 ◽  
Author(s):  
Susanne Alban ◽  
Roland Kaufmann ◽  
Edelgard Lindhoff-Last ◽  
Wolf-Henning Boehncke ◽  
Ralf J. Ludwig ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Heparin Therapy ◽  
Delayed Type Hypersensitivity ◽  
Published Data ◽  
Low Molecular Weight ◽  
Hypersensitivity Reactions ◽  
Type Iv ◽  
Total Data ◽  
The Individual

SummaryEczematous lesions, resulting from type IV sensitizations are well-known and relatively frequent cutaneous adverse effects of s.c. heparin therapy. If anticoagulation is further required intravenous heparin, heparinoids or lepirudin may be used as a substitute. However, these alternatives are not optimal in terms of practicability and/or safety-profiles. As molecular weight of different heparin preparations has repetitively been implied to determine the frequency of sensitization, we hypothesized, that due to its low molecular weight the pentasaccharide fondaparinux may provide a practicable and safe anticoagulant therapy in patients with delayed type hypersensitivity reactions (DTH) to heparin and other oligosaccharides. To test this concept, patients referred for diagnosis of cutaneous reactions after s.c. anticoagulant treatment underwent a series of in vivo skin allergyand challenge-tests with unfractionated heparin, a series of low molecular weight heparins (nadroparin, dalteparin, tinzaparin, enoxaparin and certoparin), the heparinoid danaparoid and the synthetic pentasaccharide fondaparinux. In total, data from twelve patients was evaluated. In accordance with previously published data, we report a high crossreactivity among heparins and heparinoids. In contrast – and in support of our initial hypothesis – sensitization towards the synthetic pentasaccharide fondaparinux was rarely observed. Plotting the cumulative incidence against the determined molecular weight of the individual anticoagulant preparations, shows that molecular weight generally is a key determinant of sensitization towards heparins and other oligosaccharides (r2=0.842, p=0.009). Hence, fondaparinux may be used as a therapeutic alternative in patients with cutaneous DTH relations towards heparin and other polysaccharides.

Clozapine Induced Rash: Case Report of Successful Desensitization

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
R. Singh ◽  
K. Raju ◽  
J. Southern ◽  
J. Darroch
Keyword(s):  
Side Effects ◽  
Drug Hypersensitivity ◽  
Effective Means ◽  
Drug Dose ◽  
Delayed Type Hypersensitivity ◽  
Psychotic Symptoms ◽  
Hypersensitivity Reactions ◽  
Treatment Resistant ◽  
Drug Of Choice ◽  
Cutaneous Hypersensitivity

Aim:Clozapine is the drug of choice for patients with treatment-resistant schizophrenia. However a minority of them have been unable to continue with Clozapine due to side-effects, for example rash. This report looks at the use of graded desensitization in a patient who developed cutaneous reactions to Clozapine.Method:This report describes the management of a patient with treatment resistant-schizophrenia, mild learning disabilities and epilepsy, following a cutaneous reaction to Clozapine. Having been maintained on Clopixol depot until 4 years ago, he required a change in antipsychotics following a relapse of psychotic symptoms. He was then treated unsuccessfully with various anti-psychotics, before starting Clozapine, to which he showed a good response. Unfortunately he developed an eczematous rash on two separate occasions when the drug was introduced. Again he was tried on other anti-psychotics, to which he also developed a rash. He was then put on a graded desensitization regimen of liquid Clozapine.Results:Graded desensitization, using incremental increases in drug dose, allowed maintenance treatment with therapeutic doses of Clozapine to be achieved in the absence of cutaneous hypersensitivity reactions. the patient's previously treatment-resistant psychotic symptoms were improved by this method.Conclusion:We should be aware of possibilities for the management of both the common and uncommon side-effects associated with Clozapine, as the result might vastly improve the patients’ quality of life. Desensitisation regimens can be an effective means of overcoming drug hypersensitivity but should be used with great caution, especially when patients exhibit delayed-type hypersensitivity reactions.

Increased and prolonged inflammation and angiogenesis in delayed-type hypersensitivity reactions elicited in the skin of thrombospondin-2–deficient mice

Blood ◽  
2002 ◽  
Vol 99 (2) ◽  
pp. 538-545 ◽  
Author(s):  
Bernhard Lange-Asschenfeldt ◽  
Wolfgang Weninger ◽  
Paula Velasco ◽  
Themis R. Kyriakides ◽  
Ulrich H. von Andrian ◽  
...  
Keyword(s):  
Inflammatory Diseases ◽  
Angiogenesis Inhibitor ◽  
Dermal Fibroblasts ◽  
Delayed Type Hypersensitivity ◽  
Hypersensitivity Reactions ◽  
Wild Type ◽  
Edema Formation ◽  
Inflammatory Infiltration ◽  
Deficient Mice

Abstract Angiogenesis and enhanced microvascular permeability are hallmarks of a large number of inflammatory diseases. Although up-regulation of proangiogenic factors such as vascular endothelial growth factor and interleukin-8 have been previously reported in inflamed tissue, the biologic role of endogenous inhibitors of angiogenesis in inflammation has remained unclear. To investigate the biologic role of the potent angiogenesis inhibitor thrombospondin-2 (TSP-2) in the control of cutaneous inflammation, delayed-type hypersensitivity reactions were elicited in the ear skin of wild-type and TSP-2–deficient mice by topical sensitization and challenge with oxazolone. Cutaneous TSP-2 expression was up-regulated in the inflamed skin of wild-type mice, predominantly in dermal fibroblasts and microvessels. Lack of TSP-2 resulted in a significantly enhanced inflammatory response with increased angiogenesis, edema formation, and inflammatory infiltration. Ear swelling and inflammation persisted for more than 2 weeks in TSP-2–deficient mice, as compared with 1 week in wild-type mice. Although baseline vascular permeability was unchanged, significantly enhanced microvascular leakage was found in the inflamed skin of TSP-2–deficient mice. Moreover, the fraction of rolling leukocytes was significantly increased in the untreated skin of TSP-2–deficient mice. These results reveal an important role of TSP-2 in limiting the extent and the duration of edema formation, angiogenesis, and inflammatory cell infiltration during acute and chronic inflammation.

scholarly journals Cysteine-type cathepsins promote the effector phase of acute cutaneous delayed-type hypersensitivity reactions

Theranostics ◽  
2019 ◽  
Vol 9 (13) ◽  
pp. 3903-3917 ◽  
Author(s):  
Johannes Schwenck ◽  
Andreas Maurer ◽  
Birgit Fehrenbacher ◽  
Roman Mehling ◽  
Philipp Knopf ◽  
...  
Keyword(s):  
Delayed Type Hypersensitivity ◽  
Hypersensitivity Reactions ◽  
Effector Phase
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