Differentiating the cellular and humoral components of neuromuscular blocking agent-induced anaphylactic reactions in patients undergoing anaesthesia
| Autor: | Rob C. Aalberse, F. Leynadier, W. Paulij, M. W. Hollmann, S. O. Stapel, I. Kleine Budde, M. Mulder |
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| Přispěvatelé: | Landsteiner Laboratory, ACS - Amsterdam Cardiovascular Sciences, AII - Amsterdam institute for Infection and Immunity, Anesthesiology |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Allergy Serum albumin Basophil Degranulation Test Anesthesia General Basophil Immunoglobulin E Histamine Release chemistry.chemical_compound Radioallergosorbent Test Antibody Specificity Humans Medicine Androstanols Rocuronium Intraoperative Complications Anaphylaxis Aged Skin Tests medicine.diagnostic_test biology business.industry Radioallergosorbent test Middle Aged medicine.disease Anesthesiology and Pain Medicine medicine.anatomical_structure chemistry Anesthesia Immunology biology.protein Female business Histamine Neuromuscular Nondepolarizing Agents medicine.drug |
| Zdroj: | British journal of anaesthesia, 106(5), 665-674. Oxford University Press |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aer028 |
| Popis: | Background. The significance of IgE antibodies to neuromuscular blocking agent (NMBA)-induced anaphylactic reactions during anaesthesia is unclear. We investigated the relevance of IgE to rocuronium using an in vitro technique. Methods. Serum samples from 61 patients with anaphylactic reactions during anaesthesia were investigated. On the basis of clinical history, allergy to NMBA was considered likely in 48 patients, further assessed using intradermal skin tests for several commonly used NMBAs, including rocuronium, vecuronium, and succinylcholine. To determine the presence of rocuronium IgE in human serum, a rocuronium-human serum albumin (rocHSA) conjugate was coupled to a solid phase and a radioallergosorbent test performed. The biological effects of patient serum NMBA-IgE on histamine release were investigated using in vitro sensitized basophils from healthy blood donors. Results. IgE to rocuronium was found in 23 of 48 serum samples (48%) with NMBA allergy, although only two of these were able to sensitize basophils to release histamine in response to rocHSA. IgE-responsiveness in the basophil test was only observed with conjugated rocHSA and not with unconjugated rocuronium or the other NMBAs evaluated. However, unconjugated rocuronium inhibited the histamine release induced by rocHSA. Correlation between skin-test reactivity to rocuronium and IgE to rocHSA was low (P > 0.1). In contrast, striking correlation between IgE to rocuronium and skin-test reactivity to succinylcholine was found (P |
| Databáze: | OpenAIRE |
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