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VA Varney,1,2 A Nicholas,2 A Warner,2 N Sumar2 1Department of Medicine, St Helier Hospital, Carshalton, Surrey SM5 1AA, UK; 2Department of Allergy and Immunology, St Helier Hospital, Carshalton, Surrey SM5 1AA, UKCorrespondence: VA VarneyDepartment of Medicine, St Helier Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, UKTel +44 20 8296 2401Email veronica.varney@btinternet.comBackground: The renin-angiotensin system (RAS) protects the circulation against sudden falls in systemic blood pressure via generation of angiotensin II (AII). Previously, we demonstrated that patients with anaphylaxis involving airway angioedema and cardiovascular collapse (AACVS) had significantly increased “I” gene polymorphisms of the angiotensin-converting-enzymes (ACE). This is associated with lower serum ACE and AII levels and was not seen in anaphylaxis without collapse nor atopics and healthy controls.Objectives: To examine the angiotensinogen (AGT-M235T) and chymase gene (CMA-1 A1903G) polymorphisms in these original subjects.Method: 122 patients with IgE-mediated anaphylaxis, 119 healthy controls and 52 atopics had polymorphisms of the AGT gene and chymase gene examined by polymerase chain reactions and gel electrophoresis. Their previous ACE genotypes were included for the analysis.Results: AGT-MM genes (associated with low AGT levels) were significantly increased in anaphylaxis (Terr’s classification). When combined with ACE, anaphylaxis showed increased MM/II gene pairing (p |
