Drug-Induced Anaphylaxis: An Update on Epidemiology and Risk Factors

Regateiro, Frederico S.; Marques, Maria Luís; Gomes, Eva

doi:10.1159/000507445

Cited by 43 publications

(50 citation statements)

References 46 publications

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“…Kreisel et al examined the relationship between prophylactic antibiotic therapy and the development of clostridium difficile toxin positivity and reported a five-fold greater risk of positivity with inappropriate prophylaxis [ 16 ]. Antibiotics are also the most common class of medications implicated in drug allergy and anaphylaxis [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Prophylaxis in Clean Pediatric Surgical Procedures: A Necessity or Redundancy?

Syed

Faqeeh

Othman

et al. 2020

Cureus

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Background The clinical utility of antimicrobial prophylaxis in clean pediatric surgical cases remains enigmatic. The present study aims to evaluate the prevalence of surgical site infections in instances where antibiotic prophylaxis is not employed prior to clean pediatric surgical procedures. Methods A retrospective cross-sectional study that included data of all pediatric clean surgical procedures from January 2018 till January 2020 was conducted. All children undergoing clean surgical procedures who did not receive antibiotics at least two weeks prior to the procedure were included in the study. The exclusion criteria included patients with congenital heart disease, ventriculoperitoneal shunt, nephrotic syndrome, immunodeficiency, and prior administration of antimicrobial prophylaxis. All patients were followed for two to four weeks for any signs of surgical site infections. Results Of the 178 patients included, 119 were male and 59 were female, with the mean age hovering at 8.19 ± 2.87 years. Orchidopexy and herniotomy were the most commonly performed surgical procedures, and were performed in 56 (31.46%) and 54 (30.33%) patients, respectively. Only one case of postoperative surgical site wound infection was reported, accounting for a prevalence rate of 0.56%. Conclusion In clean pediatric surgical procedures, the risk of surgical site infections is exceedingly low. The unnecessary use of antibiotics in children can cause deleterious adverse effects and promote antimicrobial resistance. In a carefully selected pediatric population, administration of antibiotic prophylaxis might confer no added benefit.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Prophylaxis in Clean Pediatric Surgical Procedures: A Necessity or Redundancy?

Syed

Faqeeh

Othman

et al. 2020

Cureus

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“…Anaphylaxis, from the Greek ( ana meaning against; phylax meaning guard or protection), is defined as a serious and complex allergic reaction that involves respiratory and cardiovascular symptoms and may be life-threatening specially if not treated [ 1 ]. Different triggers can cause anaphylactic reactions, the most common include drugs [ 2 ], insect venom [ 3 ], and food allergies; the last with a higher prevalence in children [ 4 ]. Sometimes anaphylaxis co-exists in patients with asthma, urticaria, mastocytosis, and atopic dermatitis (AD) [ 5 ].…”

Section: Anaphylaxis a General Overview: Definition Effector Cells And Mechanismsmentioning

confidence: 99%

Anaphylaxis: Focus on Transcription Factor Activity

Guo

Proaño-Pérez

Muñoz-Cano

et al. 2021

IJMS

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Anaphylaxis is a severe allergic reaction, rapid in onset, and can lead to fatal consequences if not promptly treated. The incidence of anaphylaxis has risen at an alarming rate in past decades and continues to rise. Therefore, there is a general interest in understanding the molecular mechanism that leads to an exacerbated response. The main effector cells are mast cells, commonly triggered by stimuli that involve the IgE-dependent or IgE-independent pathway. These signaling pathways converge in the release of proinflammatory mediators, such as histamine, tryptases, prostaglandins, etc., in minutes. The action and cell targets of these proinflammatory mediators are linked to the pathophysiologic consequences observed in this severe allergic reaction. While many molecules are involved in cellular regulation, the expression and regulation of transcription factors involved in the synthesis of proinflammatory mediators and secretory granule homeostasis are of special interest, due to their ability to control gene expression and change phenotype, and they may be key in the severity of the entire reaction. In this review, we will describe our current understanding of the pathophysiology of human anaphylaxis, focusing on the transcription factors’ contributions to this systemic hypersensitivity reaction. Host mutation in transcription factor expression, or deregulation of their activity in an anaphylaxis context, will be updated. So far, the risk of anaphylaxis is unpredictable thus, increasing our knowledge of the molecular mechanism that leads and regulates mast cell activity will enable us to improve our understanding of how anaphylaxis can be prevented or treated.

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“…There is compelling evidence of a global increase in anaphylaxis rates in recent years (2). Several epidemiological studies show that drug-induced anaphylaxis (DIA) has increased dramatically in the last decade (3,4). Indeed, DIA is one of the leading causes of fatal anaphylaxis in adults, the most common triggers being antibiotics and non-steroidal anti-inflammatory drugs (NSAID) (5,6).…”

Section: Introductionmentioning

confidence: 99%

Proteomic and Biological Analysis of an In Vitro Human Endothelial System in Response to Drug Anaphylaxis

et al. 2021

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Anaphylaxis is a life-threatening systemic hypersensitivity reaction. During anaphylaxis, mediator release by effector cells causes endothelial barrier breakdown, increasing vascular permeability and leakage of fluids, which may lead to tissue edema. Although endothelial cells (ECs) are key players in this context, scant attention has been paid to the molecular analysis of the vascular system, and further analyses of this cell type are necessary, especially in humans. The protein expression pattern of human microvascular ECs was analyzed in response to sera from anaphylactic patients (EC-anaphylaxis) and sera from non-allergic subjects (EC-control) after 2 hours of contact. Firstly, a differential quantitative proteomic analysis of the protein extracts was performed by mass spectrometry using an isobaric labeling method. Second, the coordinated behavior of the identified proteins was analyzed using systems biology analysis (SBA). The proteome of the EC-anaphylaxis system showed 7,707 proteins, of which 1,069 were found to be significantly altered between the EC-control and EC-anaphylaxis groups (p-value < 0.05). Among them, a subproteome of 47 proteins presented a high rate of change (|ΔZq| ≥ 3). This panel offers an endothelial snapshot of the anaphylactic reaction. Those proteins with the highest individual changes in abundance were hemoglobin subunits and structural support proteins. The interacting network analysis of this altered subproteome revealed that the coagulation and complement systems are the main biological processes altered in the EC-anaphylactic system. The comprehensive SBA resulted in 5,512 functional subcategories (biological processes), 57 of which were significantly altered between EC-control and EC-anaphylaxis. The complement system, once again, was observed as the main process altered in the EC system created with serum from anaphylactic patients. Findings of the current study further our understanding of the underlying pathophysiological mechanisms operating in anaphylactic reactions. New target proteins and relevant signaling pathways operating in the in vitro endothelial-serum system have been identified. Interestingly, our results offer a protein overview of the micro-EC-anaphylaxis environment. The relevance of the coagulation, fibrinolytic, contact and complement systems in human anaphylaxis is described. Additionally, the untargeted high-throughput analysis used here is a novel approach that reveals new pathways in the study of the endothelial niche in anaphylaxis.

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Drug-Induced Anaphylaxis: An Update on Epidemiology and Risk Factors

Cited by 43 publications

References 46 publications

Antimicrobial Prophylaxis in Clean Pediatric Surgical Procedures: A Necessity or Redundancy?

Antimicrobial Prophylaxis in Clean Pediatric Surgical Procedures: A Necessity or Redundancy?

Anaphylaxis: Focus on Transcription Factor Activity

Proteomic and Biological Analysis of an In Vitro Human Endothelial System in Response to Drug Anaphylaxis

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