Mechanisms of IgE-Mediated Allergic Reactions

2004 ◽  
pp. 90-109
Keyword(s):  
Allergic Reactions ◽  
Ige Mediated

IgE-Mediated Allergic Reactions after the First Administration of Glatiramer Acetate in Patients with Multiple Sclerosis

2014 ◽  
Vol 165 (4) ◽  
pp. 244-246 ◽  
Author(s):  
Mercè Corominas ◽  
Idoia Postigo ◽  
Victoria Cardona ◽  
Ramon Lleonart ◽  
Lucía Romero-Pinel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Allergic Reactions ◽  
Ige Mediated

scholarly journals Neo-antigens for the serological diagnosis of IgE-mediated drug allergic reactions to antibiotics cephalosporin, carbapenem and monobactam

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Edurne Peña-Mendizabal ◽  
Sergi Morais ◽  
Ángel Maquieira
Keyword(s):  
Drug Allergy ◽  
High Sensitivity ◽  
Specific Ige ◽  
In Vitro Tests ◽  
Allergic Reactions ◽  
Serum Samples ◽  
Lactam Ring ◽  
Specific Igg ◽  
Ige Mediated

Abstract New antigens deriving from -lloyl and -llanyl, major and minor determinants, respectively, were produced for β-lactam antibiotics cefuroxime, cefotaxime, ceftriaxone, meropenem and aztreonam. Twenty β-lactam antigens were produced using human serum albumin and histone H1 as carrier proteins. Antigens were tested by multiplex in vitro immunoassays and evaluated based on the detection of specific IgG and IgE in the serum samples. Both major and minor determinants were appropriate antigens for detecting specific anti-β-lactam IgG in immunised rabbit sera. In a cohort of 37 allergic patients, we observed that only the minor determinants (-llanyl antigens) were suitable for determining specific anti-β-lactam IgE antibodies with high sensitivity (< 0.01 IU/mL; 24 ng/L) and specificity (100%). These findings reveal that not only the haptenisation of β-lactam antibiotics renders improved molecular recognition events when the 4-member β-lactam ring remains unmodified, but also may contribute to develop promising minor antigens suitable for detecting specific IgE-mediated allergic reactions. This will facilitate the development of sensitive and selective multiplexed in vitro tests for drug-allergy diagnoses to antibiotics cephalosporin, carbapenem and monobactam.

scholarly journals Sesame as a major cause of severe IgE-mediated food allergic reactions among infants and children in Israel

2002 ◽  
Vol 109 (1) ◽  
pp. S217-S217 ◽  
Author(s):  
Han Dalal ◽  
Inga Binson ◽  
Ram Reifen ◽  
Ami Ballin ◽  
Eli Somekh
Keyword(s):  
Infants And Children ◽  
Allergic Reactions ◽  
Ige Mediated

scholarly journals Improvement of the Elevated Tryptase Criterion to Discriminate IgE- From Non–IgE-Mediated Allergic Reactions

2018 ◽  
Vol 127 (2) ◽  
pp. 414-419 ◽  
Author(s):  
Gabriel Gastaminza ◽  
Alberto Lafuente ◽  
Maria Jose Goikoetxea ◽  
Carmen M. D’Amelio ◽  
Amalia Bernad-Alonso ◽  
...  
Keyword(s):  
Allergic Reactions ◽  
Ige Mediated

scholarly journals Tespa1 negatively regulates FcεRI-mediated signaling and the mast cell–mediated allergic response

2014 ◽  
Vol 211 (13) ◽  
pp. 2635-2649 ◽  
Author(s):  
Di Wang ◽  
Mingzhu Zheng ◽  
Yuanjun Qiu ◽  
Chuansheng Guo ◽  
Jian Ji ◽  
...  
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
Cell Activation ◽  
Cytokine Production ◽  
Adaptor Protein ◽  
Mast Cell Activation ◽  
Allergic Reactions ◽  
Proinflammatory Cytokine Production ◽  
Increased Sensitivity ◽  
Ige Mediated

Antigen-mediated cross-linking of IgE on mast cells triggers a signaling cascade that results in their degranulation and proinflammatory cytokine production, which are key effectors in allergic reactions. We show that the activation of mast cells is negatively regulated by the newly identified adaptor protein Tespa1. Loss of Tespa1 in mouse mast cells led to hyper-responsiveness to stimulation via FcεRI. Mice lacking Tespa1 also displayed increased sensitivity to IgE-mediated allergic responses. The dysregulated signaling in KO mast cells was associated with increased activation of Grb2-PLC-γ1-SLP-76 signaling within the LAT1 (linker for activation of T cells family, member 1) signalosome versus the LAT2 signalosome. Collectively, these findings show that Tespa1 orchestrates mast cell activation by tuning the balance of LAT1 and LAT2 signalosome assembly.

scholarly journals 143. Use of First-Generation Cephalosporins in Patients with Serious Penicillin Allergies

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S86-S87
Author(s):  
Sydney E McNeill ◽  
Shauna Junco ◽  
Janessa Smith ◽  
Mallory C Cowart ◽  
Alejandro Jordan Villegas ◽  
...  
Keyword(s):  
Allergic Reaction ◽  
First Generation ◽  
Generation Cephalosporin ◽  
Delayed Hypersensitivity ◽  
Antibiotic Administration ◽  
Allergic Reactions ◽  
Hypersensitivity Reactions ◽  
Airway Compromise ◽  
Ige Mediated ◽  
Antibiotic Dose

Abstract Background Penicillin allergies have a negative impact on patient outcomes due to utilization of second-line agents. Newer data suggests cephalosporins are well tolerated in penicillin allergies; however, none have solely evaluated anaphylactic penicillin allergies with first-generation cephalosporins. The purpose of this study was to evaluate the risk of any allergic reaction to first-generation cephalosporins compared to aztreonam in patients reporting anaphylaxis to an agent in the penicillin class. Methods This was a retrospective cohort study with patients who reported “anaphylaxis” to a penicillin agent and received cefazolin, cephalexin, or aztreonam. The final analysis included 220 patients: aztreonam (n=81), cefazolin (n=81), and cephalexin (n=58) (Figure 1). IgE-mediated reactions (within six hours of antibiotic administration) were defined as any one of the following: anaphylaxis, angioedema, urticarial rash, hypotension, immediate airway compromise, or receipt of epinephrine, hydrocortisone, or diphenhydramine. Non-IgE mediated reactions (within thirty days of antibiotic administration) included delayed hypersensitivity reactions and other dermatologic reactions. Figure 1: Patient Enrollment Patients admitted between January 1, 2013 to September 1, 2020 with a reported allergy of “anaphylaxis” to an agent in the penicillin class who received at least one dose of cefazolin, cephalexin, or aztreonam were screened for inclusion. Patients were excluded if the allergy was deleted from the electronic health record prior to antibiotic administration. All first-generation cephalosporin patients were included. Aztreonam patients were included in chronological order and limited to the number of included cefazolin patients. Results There were less allergic reactions in the first-generation cephalosporin group compared to the aztreonam group, but this was not statistically significant (7% vs. 14%, p=0.077). There were fewer IgE-mediated reactions in the cephalosporin group (6% vs. 14%, p=0.046). No difference in allergic reactions was observed when comparing those who received a single antibiotic dose versus multiple doses within the cephalosporin and aztreonam groups, respectively (3% vs. 11%, p=0.082, 20% vs. 12%, p=0.451). Because cephalexin has a similar R1 side chain to aminopenicillins, five patients with an aminopenicillin allergy who received cephalexin were evaluated separately; none had an allergic reaction (Table 1, Table 2, Figure 2). Table 1: Baseline Characteristics The median age was higher in the aztreonam group, and the majority of patients were female and Caucasian. There were significantly more pregnant females in the cephalosporin group, and the majority of patients reported a natural penicillin allergy. Table 2: Outcomes There were less allergic reactions (IgE or non-IgE mediated) in the first-generation cephalosporin group compared to the aztreonam group, but this was not statistically significant. Also, there were fewer IgE-mediated reactions in the cephalosporin group. There was no difference in allergic reactions in patients with two or more reported drug allergies compared to less than two drug allergies. No difference in allergic reactions was observed when comparing those who received a single antibiotic dose versus multiple doses within the cephalosporin and aztreonam groups. Of the five patients who received cephalexin and reported an aminopenicillin anaphylactic allergy, none had an allergic reaction. Additionally, there were not any patients readmitted within 30 days for delayed hypersensitivity reactions and no antibiotics were discontinued due to other documented adverse reactions. Figure 2: Occurrence of Allergic Reactions Of the patients who had allergic reactions in the cephalosporin and aztreonam groups, these included immediate airway compromise, hypotension with one patient in the aztreonam group receiving vasopressors within the pre-defined time frame, receipt of the non-standing rescue medication of diphenhydramine, and drug rash. Conclusion There was no difference in the incidence of allergic reactions between the aztreonam and first-generation cephalosporin group, and fewer serious allergic reactions occurred in the cephalosporin group. This study suggests that cefazolin and cephalexin can safely be used in patients who report anaphylaxis to an agent in the penicillin class. Disclosures Janessa Smith, PharmD, Merck & Co. (Employee)

Suspected anaphylaxis

2018 ◽  
Author(s):  
Siraj Misbah
Keyword(s):  
Allergic Reaction ◽  
Histamine Release ◽  
Acute Onset ◽  
Type I ◽  
Allergic Reactions ◽  
Systemic Allergic Reaction ◽  
Ige Mediated

A type I IgE-mediated systemic allergic reaction is characterized by a constellation of symptoms which are due to widespread histamine release and which comprise acute-onset urticaria, angioedema, bronchospasm, and hypotension. While a mild reaction may be limited to localized urticaria and/or angioedema, a full-blown allergic reaction associated with systemic features is best described as anaphylaxis. The term ‘anaphylactoid’, previously used to denote non-IgE-mediated systemic allergic reactions, is no longer recommended for use.

scholarly journals Use of levocetrizine in the management of type IV hypersensitivity to lidocaine: a case report

2021 ◽  
Vol 10 (12) ◽  
pp. 1424
Author(s):  
Mansi Dey ◽  
Bibhu Prasad Mishra ◽  
Abhijeeta Sahoo
Keyword(s):  
Adverse Effect ◽  
Allergic Rhinitis ◽  
Hypersensitivity Reaction ◽  
Local Anesthetic ◽  
Symptomatic Treatment ◽  
Chronic Idiopathic Urticaria ◽  
Allergic Reactions ◽  
Type Iv ◽  
Ige Mediated ◽  
Alternative Drugs

Lidocaine is a commonly used local anesthetic in the field of dentistry. It has been known to cause allergic reactions, mainly immunoglobulin (IgE)-mediated and T-cell –mediated type IV reactions, which require the use of alternative drugs without adverse effects.  Here we present the case of a 29 year old female patient who developed Type IV hypersensitivity reaction in the vicinity of the injection site after the administration of lidocaine local anesthetic for performing exodontia. Levocetrizine tablet was prescribed in order to relieve the symptoms of the reaction. Levocetrizine is a selective, potent, oral histamine H(1) receptor antagonist that is used for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria. It has been reported to be effective and generally well tolerated by the patients. In our case also it was able to cure Type IV hypersensitivity reaction to lidocaine without producing any adverse events. Apart from curing allergic rhinitis and urticaria, levocetrizine is a wonderful option for treating Type IV hypersensitivity reaction to a local anesthetic, and it hardly produces any adverse effect. More cases are required to be reported in the future in order to support this article.

Hypersensitivity Reactions and Anaphylaxis

2020 ◽  
Author(s):  
Kristopher K. Ford ◽  
Timothy M. Loftus ◽  
Joseph J. Moellman
Keyword(s):  
Mast Cells ◽  
Clinical Manifestations ◽  
Allergic Reactions ◽  
Hypersensitivity Reactions ◽  
Life Threatening ◽  
Vasopressor Agents ◽  
Ige Mediated ◽  
Criteria For Diagnosis ◽  
Key Words Allergy

Allergic reactions vary in intensity from mild rash or allergic rhinitis to devastating anaphylactic shock. Anaphylaxis, often underrecognized and undertreated, can be a life-threatening syndrome leading to multiorgan dysfunction. This review covers the etiology, pathophysiology, and treatment of severe allergic reactions and anaphylaxis. It is precipitated by exposure to particular allergens—commonly food, medications, insect stings, and environmental exposures—in a previously sensitized individual. Symptoms develop from an IgE-mediated immune response leading to degranulation of mast cells and basophils and the release of preformed mediators, lipid-derived metabolites, and inflammatory cytokines. First-line treatment for anaphylaxis involves epinephrine. Secondary treatments are antihistamines and corticosteroids. Further treatments for patients refractory to standard therapies involve vasopressor agents, nebulized albuterol, and glucagon. Frequency and duration of biphasic reactions are variable, limiting the development of consensus guidelines for monitoring of anaphylactic reactions. Figures show the immune activity and inflammatory pathways in allergic responses, mast cell degranulation, and a depiction of common organs involved and corresponding clinical manifestations. Tables list the criteria for diagnosis of anaphylaxis, classification of hypersensitivity reactions, common clinical manifestations, and etiology and mediators of anaphylaxis.  This review contains 4 highly rendered figures, 11 tables, and 43 references. Key words: allergy, anaphylaxis, antihistamine, corticosteroid, epinephrine, mast cells

scholarly journals Transgenic mice expressing the human high-affinity immunoglobulin (Ig) E receptor alpha chain respond to human IgE in mast cell degranulation and in allergic reactions.

1996 ◽  
Vol 183 (1) ◽  
pp. 49-56 ◽  
Author(s):  
W P Fung-Leung ◽  
J De Sousa-Hitzler ◽  
A Ishaque ◽  
L Zhou ◽  
J Pang ◽  
...  
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
Transgenic Mice ◽  
Cell Activation ◽  
Surface Expression ◽  
Mast Cell Activation ◽  
Cell Surface Expression ◽  
Allergic Reactions ◽  
Alpha Chain ◽  
Ige Mediated

The high-affinity receptor for immunoglobulin (Ig) E (Fc epsilon RI) on mast cells and basophils plays a key role in IgE-mediated allergies. Fc epsilon RI is composed of one alpha, one beta, and two gamma chains, which are all required for cell surface expression of Fc epsilon RI, but only the alpha chain is involved in the binding to IgE. Fc epsilon RI-IgE interaction is highly species specific, and rodent Fc epsilon RI does not bind human IgE. To obtain a "humanized" animal model that responds to human IgE in allergic reactions, transgenic mice expressing the human Fc epsilon RI alpha chain were generated. The human Fc epsilon RI alpha chain gene with a 1.3-kb promoter region as a transgene was found to be sufficient for mast cell-specific transcription. Cell surface expression of the human Fc epsilon RI alpha chain was indicated by the specific binding of human IgE to mast cells from transgenic mice in flow cytometric analyses. Expression of the transgenic Fc epsilon RI on bone marrow-derived mast cells was 4.7 x 10(4)/cell, and the human IgE-binding affinity was Kd = 6.4 nM in receptor-binding studies using 125I-IgE. The transgenic human Fc epsilon RI alpha chain was complexed with the mouse beta and gamma chains in immunoprecipitation studies. Cross-linking of the transgenic Fc epsilon RI with human IgE and antigens led to mast cell activation as indicated by enhanced tyrosine phosphorylation of the Fc epsilon RI beta and gamma chains and other cellular proteins. Mast cell degranulation in transgenic mice could be triggered by human IgE and antigens, as demonstrated by beta-hexosaminidase release in vitro and passive cutaneous anaphylaxis in vivo. The results demonstrate that the human Fc epsilon RI alpha chain alone not only confers the specificity in human IgE binding, but also can reconstitute a functional receptor by coupling with the mouse beta and gamma chains to trigger mast cell activation and degranulation in a whole animal system. These transgenic mice "humanized" in IgE-mediated allergies may be valuable for development of therapeutic agents that target the binding of IgE to its receptor.

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