Basal platelet-activating factor acetylhydrolase: Prognostic marker of severe Hymenoptera venom anaphylaxis

Pravettoni, Valerio; Piantanida, Marta; Primavesi, Laura; Forti, Stella; Pastorello, Elide A.

doi:10.1016/j.jaci.2013.10.033

Cited by 42 publications

(49 citation statements)

References 10 publications

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“…21,31,42 Several studies have independently confirmed that PAF-AH deficiency predisposes to severe anaphylaxis, and more rapid rates of inactivation of PAF result in milder allergic manifestations. 21,23,39 Basal PAF-AH levels studied in patients with Hymenoptera venom allergy showed that patients with grade III or IV anaphylaxis had the lowest basal enzyme activity, 49 confirming earlier published findings 21,30 showing that low PAF-AH levels are a risk factor for severe anaphylaxis. Factors affecting PAF-AH levels have been studied, including stability of precursor molecules, 50 susceptibility to oxidant attack 51 and clearance rate from plasma.…”

Section: Role Of Paf-ah and Pafr Antagonists In Patients With Anaphylsupporting

confidence: 76%

Platelets in the immune response: Revisiting platelet-activating factor in anaphylaxis

Gill

Jindal

Jagdis

et al. 2015

Journal of Allergy and Clinical Immunology

106

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Anaphylaxis is an acute, severe, life-threatening multisystem allergic reaction resulting from the sudden systemic release of biochemical mediators and chemotactic substances. Release of both preformed granule-associated mediators and newly generated lipid-derived mediators contributes to the amplification and prolongation of anaphylaxis. Platelet-activating factor (PAF) is a potent phospholipid-derived mediator the central role of which has been well established in experimental models of both immune-mediated and non-immune mediated anaphylaxis. It is produced and secreted by several types of cells, including mast cells, monocytes, tissue macrophages, platelets, eosinophils, endothelial cells, and neutrophils. PAF is implicated in platelet aggregation and activation through release of vasoactive amines in the inflammatory response, resulting in increased vascular permeability, circulatory collapse, decreased cardiac output, and various other biological effects. PAF is rapidly hydrolyzed and degraded to an inactive metabolite, lysoPAF, by the enzyme PAF acetylhydrolase, the activity of which has shown to correlate inversely with PAF levels and predispose to severe anaphylaxis. In addition to its role in anaphylaxis, PAF has also been implicated as a mediator in both allergic and nonallergic inflammatory diseases, including allergic rhinitis, sepsis, atherosclerotic disease, and malignancy, in which PAF signaling has an established role. The therapeutic role of PAF antagonism has been investigated for several diseases, with variable results thus far. Further investigation of its role in pathology and therapeutic modulation is highly anticipated because of the pressing need for more selective and targeted therapy for the management of severe anaphylaxis.

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Section: Role Of Paf-ah and Pafr Antagonists In Patients With Anaphylsupporting

confidence: 76%

Platelets in the immune response: Revisiting platelet-activating factor in anaphylaxis

Gill

Jindal

Jagdis

et al. 2015

Journal of Allergy and Clinical Immunology

106

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“…The use of peptide inhibitors to block HRF/IgE interaction inhibited HRF/IgE mast cell activation and cutaneous anaphylaxis and airway inflammation . In a study of 169 patients with hymenoptera venom anaphylaxis, basal PAF acetylhydrolase level was associated with clinical severity of anaphylaxis . In a small study, elevated chymase was associated with anaphylaxis‐related death .…”

Section: Precision Medicine In Anaphylaxismentioning

confidence: 99%

Precision medicine in allergic disease—food allergy, drug allergy, and anaphylaxis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology

Muraro¹,

Lemanske

Castells

et al. 2017

Allergy

166

128

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This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology, which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying the disease. Although significant progress has been made in defining endotypes for asthma, definitions of endotypes for food and drug allergy or for anaphylaxis lag behind. Progress has been made in discovery of biomarkers to guide a precision medicine approach to treatment of food and drug allergy, but further validation and quantification of these biomarkers are needed to allow their translation into practice in the clinical management of allergic disease.

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“…Recently, Pravettoni et al [39] have established a significant correlation between basal PAF acetylhydrolase activity and the grade of anaphylaxis in patients with venom allergy. These results may provide a plausible background to make an assertion that ‘low' OPN levels or a possible metabolic pathway related to OPN could be a predictor of the risk for severe sting anaphylaxis, analogous to PAF and PAF acetylhydrolase.…”

Section: Discussionmentioning

confidence: 99%

Increased Osteopontin Levels in Children Undergoing Venom Immunotherapy May Serve as a Marker of Clinical Efficacy

Yavuz¹,

Soyer²,

Şekerel³

et al. 2014

Int Arch Allergy Immunol

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Background: Venom immunotherapy (VIT) has its effect by modulating various mediators resulting in immune tolerance. The aim of this study was to measure changes in plasma osteopontin (OPN) and serum basal tryptase (sBT) levels over the course of 1 year of VIT in children with venom allergy. Methods: Children who suffered from a large local reaction (LLR) or a systemic reaction (SR) after insect stings were included along with control subjects. Measurements were performed before the initiation of VIT and 6 and 12 months after it had been started. Results: A total of 58 children (24 with SR, 18 with LLR and 16 control subjects) with a median age of 9.5 years (range 6.7-12.8) were enrolled. The plasma OPN levels of patients with LLR [median 1,477 ng/ml, interquartile range (IQR) 1,123-1,772] were significantly higher than patients with SR (882 ng/ml, 579-1,086; p < 0.001) and healthy control subjects (1,015 ng/ml, 815-1,203; p = 0.002). A significant increase in plasma OPN levels in children was determined after the 1-year VIT. The sBT levels of children with SR (4.1 ng/ml, 3.6-5.8) were significantly higher than children with LLR (3.1 ng/ml, 2.5-4.0) and control subjects (3.0 ng/ml, 2.9-3.8; p = 0.001). There was no significant change in the sBT levels of the patients after the 1-year VIT. Conclusions: The results of our study showed higher baseline levels of OPN in children with LLR compared to control subjects and children with SR. In children with SR, OPN levels were increased after the 1-year VIT. Our results may suggest a possible association between OPN and successful VIT in children.

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Basal platelet-activating factor acetylhydrolase: Prognostic marker of severe Hymenoptera venom anaphylaxis

Cited by 42 publications

References 10 publications

Platelets in the immune response: Revisiting platelet-activating factor in anaphylaxis

Platelets in the immune response: Revisiting platelet-activating factor in anaphylaxis

Precision medicine in allergic disease—food allergy, drug allergy, and anaphylaxis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology

Increased Osteopontin Levels in Children Undergoing Venom Immunotherapy May Serve as a Marker of Clinical Efficacy

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