- Title
- Elevated serum cytokines during human anaphylaxis: identification of potential mediators of acute allergic reactions
- Creator
- Stone, Shelley F.; Cotterell, Claire; Isbister, Geoffrey K.; Holdgate, Anna; Brown, Simon G. A.; Emergency Department Anaphylaxis Investigators
- Relation
- Journal of Allergy and Clinical Immunology Vol. 124, Issue 4, p. 786-792
- Publisher Link
- http://dx.doi.org/10.1016/j.jaci.2009.07.055
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2009
- Description
- Background: Anaphylaxis is generally unanticipated and requires emergency management. Therefore, the biological mediators in human beings have been difficult to define. Objective: Our aim was to identify cytokines and chemokines whose concentrations increase during anaphylaxis in human beings and to determine how each correlates with severity. Methods: We measured the concentrations of potential mediators, including cytokines, chemokines, mast cell tryptase (MCT), and histamine, over 3 time points in 76 patients presenting to emergency departments with anaphylaxis and correlated these with a global severity scale, hypotension, and hypoxia. Results: IL-2, IL-6, IL-10, TNF receptor 1, MCT, and histamine were significantly elevated in patients with severe reactions (n = 36) compared with moderate reactions (n = 40) and healthy controls. Histamine levels peaked at emergency department arrival, whereas other mediators peaked later. IL-4, IL-5, IL-13, IFN-γ, and TNF-α were marginally elevated in severe reactions compared with healthy controls but did not correlate with reaction severity. Severe reactions tended to be either hypotensive (n = 19) or hypoxemic (n = 12). Levels of IL-6, IL-10, TNF receptor 1, MCT, and histamine correlated with hypotension. No mediator correlated with hypoxemia or other respiratory features. Conclusion: This study confirms that the concentrations of a number of cytokines are elevated in blood during anaphylaxis in human beings and that some correlate with the presence of hypotension. Others were only marginally elevated within a concentration range that available assays do not reliably detect. During respiratory reactions, mediators may be largely confined to the airways so that blood concentrations do not reflect activity.
- Subject
- anaphylaxis; cytokines; chemokines; IL-10; IL-6; IL-2; TNFRI; histamine; mast cell tryptase
- Identifier
- uon:7164
- Identifier
- http://hdl.handle.net/1959.13/806599
- Identifier
- ISSN:0091-6749
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