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Personalized diagnostic approach and indirect quantification of extravasation in human anaphylaxis
Author(s) -
NuñezBorque Emilio,
Betancor Diana,
PastorVargas Carlos,
FernándezBravo Sergio,
MartinBlazquez Ariadna,
CasadoNavarro Natalia,
LópezDomínguez David,
GómezLópez Alicia,
Rodriguez del Rio Pablo,
Tramón Paloma,
Beitia Juan María,
MorenoAguilar Carmen,
GonzálezdeOlano David,
Goikoetxea María José,
IbáñezSandín María Dolores,
Laguna José Julio,
CuestaHerranz Javier,
Esteban Vanesa
Publication year - 2023
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.15443
Subject(s) - anaphylaxis , extravasation , medicine , tryptase , acute phase protein , human serum albumin , allergy , gastroenterology , immunology , mast cell , inflammation , chemistry , chromatography
Background Anaphylaxis is the most acute and life‐threatening manifestation of allergic disorders. Currently, there is a need to improve its medical management and increase the understanding of its molecular mechanisms. This study aimed to quantify the extravasation underlying human anaphylactic reactions and propose new theragnostic approaches. Methods Molecular determinations were performed in paired serum samples obtained during the acute phase and at baseline from patients presenting with hypersensitivity reactions. These were classified according to their severity as Grades 1, 2 and 3, the two latter being considered anaphylaxis. Tryptase levels were measured by ImmunoCAP, and serum protein concentration was quantified by Bradford assay. Human serum albumin (HSA) and haemoglobin beta subunit (HBB) levels were determined by Western blot and polyacrylamide gel electrophoresis, respectively. Results A total of 150 patients were included in the study. Of them, 112 had experienced anaphylaxis (83 and 29 with Grade 2 and 3 reactions, respectively). Tryptase diagnostic efficiency substantially improved when considering patients' baseline values (33%–54%) instead of the acute value threshold (21%). Serum protein concentration and HSA significantly decreased in anaphylaxis ( p < .0001). HSA levels dropped with the severity of the reaction (6% and 15% for Grade 2 and 3 reactions, respectively). Furthermore, HBB levels increased during the acute phase of all hypersensitivity reactions ( p < .0001). Conclusions For the first time, the extravasation underlying human anaphylaxis has been evaluated based on the severity of the reaction using HSA and protein concentration measurements. Additionally, our findings propose new diagnostic and potential therapeutic approaches for this pathological event.