Basophil activation through ASGM1 stimulation triggers PAF release and anaphylaxis-like shock in mice

Penicillin causes non-allergic anaphylaxis by activating the contact system

Immediate hypersensitivity reaction (IHR) can be divided into allergic- and non-allergic-mediated, while “anaphylaxis” is reserved for severe IHR. Clinically, true penicillin allergy is rare and most reported penicillin allergy is “spurious”. Penicillin-initiated anaphylaxis is possible to occur in skin test- and specific IgE-negative patients. The contact system is a plasma protease cascade initiated by activation of factor XII (FXII). Many agents with negative ion surface can activate FXII to drive contact system. Our data showed that penicillin significantly induced hypothermia in propranolol- or pertussis toxin-pretreated mice. It also caused a rapid and reversible drop in rat blood pressure, which did not overlap with IgE-mediated hypotension. These effects could be countered by a bradykinin-B2 receptor antagonist icatibant, and consistently, penicillin indeed increased rat plasma bradykinin. Moreover, penicillin not only directly activated contact system FXII-dependently, but also promoted bradykinin release in plasma incubated-human umbilical vein endothelial cells. In fact, besides penicillin, other beta-lactams also activated the contact system in vitro. Since the autoactivation of FXII can be affected by multiple-factors, plasma from different healthy individuals showed vastly different amidolytic activity in response to penicillin, suggesting the necessity of determining the potency of penicillin to induce individual plasma FXII activation. These results clarify that penicillin-initiated non-allergic anaphylaxis is attributed to contact system activation, which might bring more effective diagnosis options for predicting penicillin-induced fatal risk and avoiding costly and inappropriate treatment clinically.

Basophils have emerged as a key player in immunity

Basophils had long been neglected in immunological studies, because of their paucity and phenotypic similarity with tissue-resident mast cells. However, recent development of analytical tools has cast new light on this neglected minority, and revealed previously unappreciated roles of basophils, distinct from those of mast cells, in various immune responses. Primary function of basophils appears to be the protection against infections with parasites, including ticks and helminths. This is why basophils are evolutionally conserved well in many animal species, albeit a small number. Nevertheless, basophils sometimes exert host-deleterious functions in immunological disorders such as allergy. Here we summarize recent advance in our understanding of basophil ontogeny and their in vivo roles under physiological and pathological conditions.