Platelet-activating factor as an endogenous cofactor of food anaphylaxis

Anaphylaxis is a severe, acute, life-threatening generalized or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing worldwide, with medications and food contributing to most cases. Physical exercise, acute infections, drugs, alcohol, and menstruation are the external cofactors associated with more severe systemic reaction. The aim of this review is to show that platelet-activating factor contributes to the development of severe anaphylactic reaction, and even to anaphylactic shock.

Mast Cells and Basophils in IgE-Independent Anaphylaxis

Anaphylaxis is a life-threatening or even fatal systemic hypersensitivity reaction. The incidence of anaphylaxis has risen at an alarming rate in the past decades in the majority of countries. Generally, the most common causes of severe or fatal anaphylaxis are medication, foods and Hymenoptera venoms. Anaphylactic reactions are characterized by the activation of mast cells and basophils and the release of mediators. These cells express a variety of receptors that enable them to respond to a wide range of stimulants. Most studies of anaphylaxis focus on IgE-dependent reactions. The mast cell has long been regarded as the main effector cell involved in IgE-mediated anaphylaxis. This paper reviews IgE-independent anaphylaxis, with special emphasis on mast cells, basophils, anaphylactic mediators, risk factors, triggers, and management.

Anti-SARS-CoV-2 IgG against the S Protein: A Comparison of BNT162b2, mRNA-1273, ChAdOx1 nCoV-2019 and Ad26.COV2.S Vaccines

BACKGROUND

COVID-19 vaccines induce a differentiated humoral and cellular response, and one of the comparable parameters of the vaccine response is the determination of IgG antibodies.

MATERIALS AND METHODS

Concentrations of IgG anti-SARS-CoV-2 antibodies were analyzed at three time points (at the beginning of May, at the end of June and at the end of September). Serum samples were obtained from 954 employees of the Nicolaus Copernicus University in Toruń (a total of three samples each were obtained from 511 vaccinated participants). IgG antibody concentrations were determined by enzyme immunoassay. The statistical analysis included comparisons between vaccines, between convalescents and COVID-19 non-patients, between individual measurements and included the gender, age and blood groups of participants.

RESULTS

There were significant differences in antibody levels between mRNA and vector vaccines. People vaccinated with mRNA-1273 achieved the highest levels of antibodies, regardless of the time since full vaccination. People vaccinated with ChAdOx1 nCoV-2019 produced several times lower antibody levels compared to the mRNA vaccines, while the antibody levels were more stable. In the case of each of the vaccines, the factor having the strongest impact on the level and stability of the IgG antibody titers was previous SARS-CoV-2 infection. There were no significant correlations with age, gender and blood type.

SUMMARY

mRNA vaccines induce a stronger humoral response of the immune system with the fastest loss of antibodies over time.

Differences in the Concentration of Anti-SARS-CoV-2 IgG Antibodies Post-COVID-19 Recovery or Post-Vaccination

At the end of 2020, population-based vaccination programs with new generation mRNA-based vaccines began almost all over the world. The aim of the study was to evaluate the titer of anti-SARS-CoV-2 IgG antibodies against the S1 subunit of the virus's spike protein as a marker of the humoral response in 477 patients and the concentration of interferon-gamma as an indicator of cellular response in 28 individuals. In our studies, we used serological enzyme-linked immunosorbent assays. IgG was measured in weeks 2 and 3 after the first dose and 1-5 weeks after the second dose of an mRNA vaccine in seropositive and seronegative individuals as well as in symptomatic and asymptomatic convalescents. High levels of antibodies were observed in 98% of our vaccinated cohort, and the presence of protective T cells was confirmed in the blood samples of all participants. The humoral immune response is diversified and is visible as early as 2-3 weeks after the first dose of the mRNA vaccine. The level of protection increased significantly after the second dose, with the increase being much greater in pre-vaccine healthy subjects and less in convalescents. In the second and third weeks after the second dose, the concentration of IgG antibodies was the highest, and in the following weeks, it decreased gradually. Regular serological measurements on eight subjects show that antibody titers are lower four months after vaccination than before the second dose.

The effect of hymenoptera venom immunotherapy on neutrophils, interleukin 8 (IL-8) and interleukin 17 (IL-17)

OBJECTIVES

Venom immunotherapy (VIT) is an effective treatment method and is addressed to patients with a history of an anaphylactic reaction to Hymenoptera stings. However, the immunological mechanisms of protection have not been explained yet. The objective of this study was to analyze neutrophils, interleukin 8 (IL-8) and interleukin 17 (IL-17) before and after the initial phase of the immunotherapy.

MATERIAL AND METHODS

Overall, 40 individuals, including 20 wasp venom sensitized and 20 bee venom sensitized patients, were included in the study. The patients had had a history of severe allergic reactions type III and IV according to Mueller's classification. An ultra-rush VIT protocol was used in this study. The concentration of serum IL-8 and IL-17A was determined using the ELISA enzymatic method.

RESULTS

The authors demonstrated a significant rise in the IL-8 level after the immunotherapy, compared to baseline (14.9 vs. 24.7, p < 0.05). The rise in the neutrophils level was also noticeable but proved to be barely out of the range of statistical significance (4.3 vs. 5.0, p = 0.06). The shift in IL-17A was negligent and not statistically significant in the paired samples t-test (1.6 vs. 1.5, p = 0.34).

CONCLUSIONS

Venom immunotherapy induces neutrophils and IL-8 activity after 2 days. After the desensitization, the level of IL-17A did not change. Int J Occup Med Environ Health. 2020;33(6):811-7.

ABO blood groups, Rhesus factor, and anaphylactic reactions due to Hymenoptera stings

INTRODUCTION

Numerous publications indicate that the prevalence of some infectious, neoplastic and immunological diseases are associated with ABO blood groups.

OBJECTIVE

The aim of this study was to verify whether ABO and Rh blood groups are associated with severe anaphylactic reactions after Hymenoptera stings.

MATERIAL AND METHODS

A study was undertaken of 71,441 Caucasian subjects living in the same geographic area. The study group included 353 patients with diagnosed systemic anaphylaxis to Hymenoptera venom. Control group included 71,088 healthy blood donors. Frequencies of ABO and Rhesus groups in the study and control groups were compared using univariate and multivariate analyses.

RESULTS

No statistically significant interactions were observed between the ABO blood group and anaphylactic reactions to Hymenoptera.

Anaphylaxis as a cause of hospitalization--a single academic centre experience

INTRODUCTION

In recent years, more and more often the increase in incidence of allergies is observed. According to the WHO, they are getting the fourth position amongst the most frequent diseases after cancers, cardiovascular diseases and AIDS. Anaphylaxis is a severe, life-threatening, systemic or generalised immediate hypersensitivity reaction. The analysis of the causes and the clinical picture of anaphylaxis in patients treated at single academic hospital centre was the purpose of the study.

MATERIAL AND METHODS

The study was based on retrospective analysis of case records of the patients hospitalised at the Chair and Department of Allergology, Clinical Immunology and Internal Diseases, the Jan Biziel University Hospital in Bydgoszcz in the years 2005-2010. 132 patients, in whom anaphylactic reaction appeared, were analysed. The examined population included 70 men and 62 women at 16-95 years of age.

RESULTS

The conducted examinations allowed to obtain information about the causes and the course of anaphylactic reactions. The problem of hypersensitivity to substances of various origin (biological or synthetic) can concern everyone irrespective of sex and age. Nevertheless, the phenomenon of anaphylaxis more often occurred in the examined men than women. Most cases of anaphylactic reactions were reported in the 26-50 age range. Based on the presented results, no regularity was observed in anaphylaxis clinical picture and its causative factor.

CONCLUSIONS

It is difficult to forecast the course of the reaction based on the causative factor, for anaphylactic reaction is characterised by a great individual changeability and intensity of the first symptoms.

Expression of IL-17A concentration and effector functions of peripheral blood neutrophils in food allergy hypersensitivity patients

Lymphocytes Th17 and other types of immune system cells produce IL17. By induction of cytokines and chemokines, the IL17 cytokine is involved in mechanisms of allergic reaction with participation of neutrophil granulocytes. It affects activation, recruitment, and migration of neutrophils to the tissues, regulating inflammatory reaction intensity. Excited neutrophils secrete inter alia elastase and reactive oxygen species (ROS)--significant mediators of inflammation process responsible for tissues damage.The aim of the study was to evaluate the concentrations of serum interleukin 17A, serum neutrophil elastase, and ROS production by neutrophils in patients with food allergy.The study included 30 patients with food allergy diagnosed based on interview, clinical symptoms, positive SPT, placebo controlled double-blind oral provocation trial, and the presence of asIgE in blood serum against selected food allergens using fluoro-immuno-enzymatic method FEIA UNICap 100. The control group consisted of 10 healthy volunteers. The concentrations of IL17A were determined in all patients using ELISA method with eBioscience kits, and elastase using BenderMed Systems kits. Chemiluminescence of non-stimulated neutrophils was evaluated using luminol-dependent kinetic method for 40 min on Luminoskan (Labsystems luminometer).The results of serum IL-17A concentrations and the values of chemiluminescence obtained by non-activated neutrophils, as well as elastase concentrations, were higher in patients with food allergic hypersensitivity compared to healthy volunteers.This study demonstrates a significance of IL-17A and activated neutrophil granulocytes in the course of diseases with food allergic hypersensitivity.

Platelet activating factor in allergies

The platelet-activating factor (PAF) produced and released by mast cells, basophils, neutrophils, eosinophils, fibroblasts, platelets, endothelial cells, and even cardiac muscle cells plays an important role in inflammatory and thrombotic diseases. PAF has been shown to be an important mediator in anaphylaxis. Serum level of the factor correlates with the severity of systemic reactions. PAF is also involved in asthamatic patients' bronchoconstriction, mucus hypersecretion, and inflammation of bronchi. Furthermore, increased plasma levels of PAF have been reported in patients with urticarial. Studies have shown that PAF increases the permeability of skin's capillaries and indices the development of wheals, flare, and inflammatory reactions in the skin.This review focuses on the actions of the PAF on the eosinophiles and mast cells. Following that pathophysiological mechanism of the PAF in anaphylaxis bronchial asthma and urticaria was discussed.

Angiogenesis in bronchial asthma

Bronchial asthma is a chronic inflammatory disease characterised by airflow obstruction that may be reversed spontaneously or in response to treatment. The airway inflammation can lead to structural changes and remodelling consisting of subepithelial layer thickening, airway smooth muscle hyperplasia and angiogenesis. Subepithelial hypervascularity and angiogenesis in the airways are part of the structural airway wall in asthma. Increased vascularity of bronchial mucosa is closely related to the expression of angiogenic factors like vascular endothelial growth factor (VEGF), angiopoietin and hypoxia-inducible factor (HIF). The scope of the present review is to summarise the roles of anagiogenic factors and treatment in vascular development.

Snake (Vipera berus) bite: The cause of severe anaphylactic shock and hepatocellular injury

Vipera berus bites lead to a variety of clinical manifestations. Local swelling, coagulopathy, nephrotoxicity, cardiac effects and myotoxicity are known to be associated with envenoming by a viper bite. Although a variety of clinical manifestations have been reported in viper bite cases, anaphylactic reactions and liver injury events have not been described. We report a unique case of an anaphylaxis and transitional liver cell injury due to a Vipera berus bite in the case of a 58-year-old man with no past history suggestive of allergy and liver disease. These observations need to be further explored with laboratory studies to identify the venom components which could have pre-disposed the patient to the development of these complications.

[Antimicrobial peptides in asthma pathogenesis]

Antimicrobial peptides exhibit activity against bacteria, viruses, fungi, and parasites. They have been described not only as endogenous antibiotics but also as immune modulators with an impact on innate and adaptive immune functions. Asthma is one of the most common diseases, characterized by chronic airway inflammation, bronchial hyperreactivity and asthma attacks. Airway inflammation in asthma is characterized by allergic phenotypes, such as dense infiltration of eosinophils, mast cells, Th 2 lymphocytes and monocytes. Viral infections are often the cause of asthma exacerbation. This review highlights recent observations on the role of antimicrobial peptides in asthma pathogenesis.

Dress Syndrome Induced by Sulphasalazine

DRESS syndrome (Drug rash with eosinophilia and systemic symptoms) is a severe drug-induced hypersensitivity syndrome characterized by diffuse skin rash, fever, eosinophilia, atypical lymphocytes and organ involvement. We report a case of drug reaction with eosinophilia and systemic symptoms (DRESS) to sulphasalazine. A 54-year-old woman developed a widespread papulovesicular rash after treatment with sulphasalazine (1000 mg daily). She was successfully treated with systemic corticosteroids.

[Gene and environmental interactions of food allergy]

Food allergy is now looming as a major health issue with significant implications. In westernized countries, recent reports show a rise in allergic diseases, in particular food allergy. It affects approximately 5-8% of children and 1-5% of adults. Despite this, our current understanding of the immunological and biological mechanisms of food allergy is still incomplete. It is generally believed that food allergy is determined by both genetic and environmental factors. There is some evidence that epigenetic modifications may affect the prevalence of food allergies. This paper discusses the current state of knowledge regarding genetic, epigenetic and environmental factors of food allergy.

Celery--cause of severe anaphylactic shock

BACKGROUND

We present a case of anaphylactic shock induced by celery ingestion in a 28-year old woman with pollinosis during allergen (50% birch, 50% grass) immunotherapy.

CASE REPORT

A female patient, aged 28 was admitted to the clinic due to a serious anaphylactic reaction. The event took place 15 min after ingesting fresh celery. She recovered after routine treatment with adrenaline, corticosteroids and antazoline.

CONCLUSIONS

Our case shows the possibility of simultaneous occurrence of hypersensitivity to inhaled allergens and food. In such cases, it is considered part of cross-reactivity We discuss the importance of cross- reactivity associated with sensitization to pollen and vegetable foods.

Komórki Dendrytyczne a Alergie

Komórki dendrytyczne odgrywają kluczową rolę w regulacji aktywności układu immunologicznego. Celem pracy jest przedstawienie aktualnych poglądów na pochodzenie, biologię komórek dendrytycznych oraz znaczenie tych komórek w astmie oskrzelowej i immunoterapii.

[Dendritic cells and allergy]

Dendritic cells (DC) are pivotal regulator of immune reactivity and immune tolerance. The aim of this paper is to present the current knowledge on the dendritic cell development, biology and their role in asthma and immunotherapy.

[Severe hyponatremia in patient with tumor of mediastinum]

Hyponatremia is the most common electrolyte derangement occurring in hospitalized patients. The study presents a case of severe hyponatremia (range 93.2 mEq/l) in 67-year-old women presented weakness and neurological abnormalities. Laboratory tests showed additional electrolyte abnormalities such as hypokaliemia, hypomphosphatemia and hypomagnesemia. The cause of syndrome of inadequate antidiuretic hormone secretion (SIADH) in reported patient was lung carcinoma.

[Alternations of bronchial smooth muscle and effect of therapy on remodeling in asthma]

Alternations in airway wall architecture, particularly increased smooth muscle mass are associated with pathogenesis of asthma. Muscle fiber hyperplasia and hypertrophy is a major contributor to the increase in smooth muscle mass. Airway smooth muscle was traditionally considered to have only contractile and proliferative functions and has little attention with regard to its ability to express and release inflammatory mediators. Airway smooth muscle cells have been shown to release cytokines such as: GM-CSF, IL-11, IL-6, IL-1, IL-5, IL-8, PGs and NO. Airway remodeling has been shown to respond to some degree anti-inflammatory therapy. Several study results indicate that steroid can positively influence progressive airflow limitation. Combined use of a beta2-agonist and steroid can reduced the remodeling progression.

[Remodeling of the basement membrane and airway epithelium in patients with asthma]

Chronic inflammation is recognized as a primary factor in the development of asthma, and its role in the induction of the remodeling of the airways has recently been emphasized. Changes in airway structure such as thickening of the airway wall are common findings in cases of asthma. Thickening of the epithelial reticular basement membrane has been reported to show a positive correlation with airway hyperresponsiveness, the frequency of asthma attacks, and the numbers of fibroblasts and myofibroblasts that lie external and adjacent to it. Studies on the pathology of asthma showed changes of airway epithelium. The most common of these changes are squamous cell metaplasia, goblet cell hyperplasia and damage and shedding of airway surface epithelium.

[Bronchial asthma and menopause]

The existing literature suggests that asthmatic women suffer from an increase in asthma symptoms just before and during menstruation. Many investigators speculated that estrogen and progesterone plays a modulating role in asthma features. Estradiol administration was associated with improvement in symptoms, dyspnea index scores, pulmonary function, and decrease in corticosteroid requirement. It is established that estrogen deficiency plays an important role in the pathogenesis of post-menopausal osteoporosis particularly in women with steroid-dependent asthma. This article provides an overview of the mechanisms of beneficial effects of in estrogen and progesterone therapy in asthmatic post- menopausal women.

[Eosinophil apoptosis and asthma]

Eosinophils play an important role in airway inflammation in asthma. Eosinophils are believed through the release of their mediators to develop the irreversible structural airway changes. Dysregulation of apoptosis can lead to pathological accumulation of eosinophils in bronchial tissue. Apoptosis (programmed cell death) leads to the characteristic morphologic changes including reduction of the cellular volume, blebbing of the membrane, condensation of the nuclear chromatin, DNA laddering, mitochondrial dysregulation and finally to apoptotic bodies. Apoptosis can be induced by oncogenes, specific ligands and some cytokines. On the other hand IL-5, IL-3 and GM-CSF (granulocyte-macrophage-colony stimulating factor) dramatically increase the life span of eosinophils. Glucocorticoids promote eosinophil apoptosis and totally reverse the delayed death cased by beta2-agonists.

[Role of neurotrophin and neuropeptides in bronchial asthma]

Asthma represents a chronic inflammatory process of the airways. The neurothrophin (NGF) and neuropeptides such as substance P (SP), neurokinin A (NKA), and calcitonin gene-related peptide (CGRP) play important role in stimulation of airways inflammation in asthmatics. NGF stimulates the differentiation and the migration of mast cells to bronchi epithelium. Furthermore, NGF stimulates mast cell degranulation and mediator upregulation and release. It also influences activity of basophils, eosinophils, neurophils, macrophages and T-cells. In addition, its important role in releasing of hyperresponsiveness has been proved. Neuropeptides such as CGRP and SP stimulate migration and degranulation of eosinophils and influence on airway responsiveness in asthmatics. This review article discusses the neuropeptides and NGF actions and mechanisms in the pathogenesis of asthma.

[Assessment of serum levels of some angiogenic factors in healthy children]

Angiogenesis is defined as a development of new blood vessels. This process is required for many physiological and pathological conditions. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are the most important cytokines stimulating angiogenesis. The purpose of this work was to evaluate serum levels of VEGF and bFGF in healthy children. 39 girls and 31 boys aged 3-18 years were included in the study.

[Thalidomide--new prospective therapy in oncology]

Thalidomide was first produced in Germany in the 1950s. The drug was promoted as a safe sedative and was found to be useful as an antiemetic during pregnancy. In late 1960s, reports of teratogenic actions resulted in the withdrawal of thalidomide from world markets. Thalidomide has multiple actions, including anti-inflammatory and anti-angiogenic ones. This article reviews the pharmacology and clinical trials of the drug for the treatment of various cancers including multiple myeloma. Furthermore, in preliminary studies, thalidomide has been found to be effective in several syndromes related to advanced cancer, such as the cancer cachexia, chronic nausea and pain.

[Thalidomide--a new prospective therapy in rheumatology and transplantation]

This review article discusses the thalidomide therapy of diseases such as systemic sclerosis, rheumatoid arthritis, Behçet syndrome, lupus erythematosus disseminatus and graft-versus-host disease. The main mechanism of action of thalidomide in these diseases is probably based on the suppression of tumor necrosis factor-alpha and the modulation of interleukins.

[Risk factors and pathogenesis of occupational asthma]

Workplace exposure may be an important cause of both new-onset occupational asthma and exacerbations of preexisting disease. In the paper, the risk factors and mechanisms of occupational asthma development are discussed.

[Role of fibroblasts in bronchial asthma]

The major role of fibroblasts is maintaining integrity, solidity and form of lung tissue. This is achieved by producing a vest variety of extracellular matrix (ECM) components such as collagen, laminin, fibronectin, hyaluronic acid and proteoglycans. Remodeling in the airways as seen in asthma is largely a result of altered fibroblast behavior. Fibroblasts produces a variety of inflammatory cytokines, chemokines and surface molecules which are able to activate and attract that stimulate inflammatory reactions. This paper presents a review of the fibroblast behavior and their interaction in the ongoing inflammatory and remodeling processes of the airway in asthma. Further we discuss the influence of glucocorticoids and long-acting beta 2-agonists on fibroblast in relation to their beneficial clinical effects in asthma therapy.

Influence of quercetin on B16 melanotic melanoma growth in C57BL/6 mice and on activity of some acid hydrolases in melanoma tissue

Quercetin (QC) (5, 7, 3', 4' -tetra oxyflavonolol) is an ubiquitous flavonoid in many plants. The influence of QC on the growth of B16 melanotic melanoma in C57BL/6 mice and activity of some acid hydrolases in the tumor homogenates were investigated. Two series of experiments were carried out: In the first experimental group mice were inoculated s.c. with 10(6) of tumor cells (TC) suspended in 1 ml of saline. TC were obtained from the current serial passages. In the second series of experimental group mice were inoculated with melanoma cells preincubated 15 min. in different concentrations of QC. Mice of both series were divided into three subgroups. Mice of the first series were treated with QC i.p. every second day in a dose of 0.1 mg, 0.5 mg or 1.0 mg (total dose of 1.0 mg, 5.0 mg or 10.0 mg per mice). Animals of the second series did not obtain any treatment. After the nineteenth day of experiment the mice were killed, tumors excised and weighed. Tumor tissue pieces were homogenized for enzyme activity determination. Fragments of tumor tissue were taken for electron microscopy (EM) investigation. In mice injected i.p. with QC mean tumor weight was significantly higher than in control I. The mean tumor weight in the first experimental group was higher than in control from 170% to 196% and in the second experimental group from 69% to 147%. Enzymes activity was also higher in both experimental groups as compared to controls. Arylsulphatase activity in the first group was higher from 102% to 144% and in the second one - from 97% to 115% than in control I. Acid phosphatase activity was higher from 100% to 155% in the first experimental group and from 56% to 161% in the second one. Cathepsin D activity was greater from 133% to 333% and from 113% to 300%, respectively. EM studies revealed the presence of greater number of Golgi structures and primary lysosomes in experimental groups of tumors (mice treated with QC and mice with melanoma preincubated in QC). These results clearly indicate that QC significantly enhances melanotic melanoma growth and increases acid phosphatase and cathepsin D activity in these tumors. The mechanism of QC action on the melanotic melanoma is not fully understood and remains to be defined.

[The role of angiogenesis in rheumatoid arthritis]

The paper presents recent data on the angiogenesis and the angiogenic and angiostatic mediators in rheumatoid arthritis.

The influence of rutin on the weight, metastasis and melanin content of B16 melanotic melanoma in C57BL/6 mice

The influence of rutin on the growth rate and tumor weight of B16 melanoma as well as melanin content and ultrastructure of melanoma cells and metastasis formation was studied in mice. All mice were injected s.c. into the left flank with 0.2 ml of suspension containing 10(6) B16 melanoma cells. The experimental groups were treated with a solution of rutin i.p. every two days with total doses of 1, 5 or 10 mg/mouse. The rutin was dissolved in DMSO. The control groups of mice were injected with 0.2 ml 0.9% NaCl and 0.2 ml DMSO. Increasing doses of rutin 1, 5 or 10 mg per mouse caused augmentation of the tumor mass to 2400 mg, 2600 mg and 2800 mg respectively, whereas the tumor weight of the control group was 980 mg. The median number of lung metastases in the control groups was 12; after treatment with 5 or 10 mg of rutin, the number of lung colonies increased to 19 and 27, respectively. The administration of 10 mg rutin inhibited melanin formation by about 43%. The melanosomes in the experimental groups were in the 2nd or 3rd stage, and the low content of melanin was noticed.