Immunoglobulin Class and Subclass Distribution of Dextran‐Reactive Antibodies in Human Reactors and Non Reactors to Clinical Dextran

Kraft, Dietrich; Hedin, H.; Richter, Wolfgang; Scheiner, Otto; Rumpold, Helmut; Devey, M. E.

doi:10.1111/j.1398-9995.1982.tb02331.x

Cited by 80 publications

(33 citation statements)

References 21 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, allergen-specific IgG antibodies rather than IgE antibodies were detected in individuals who manifested systemic anaphylaxis against medical reagents, such as protamine, dextran and recombinant IgG, including anti-tumour necrosis factor-a (Kraft et al, 1982;Weiss et al, 1989;Adourian et al, 1993;Cheifetz et al, 2003). Vadas et al (2008) investigated the roles of PAF and PAF acetylhydrolase, the enzyme that inactivates PAF, in anaphylaxis in humans.…”

Section: Food Allergensmentioning

confidence: 99%

Current Understanding of Allergic Transfusion Reactions: Incidence, Pathogenesis, Laboratory Tests, Prevention and Treatment

文也¹

2013

JJTC

View full text Add to dashboard Cite

SummaryNon-haemolytic transfusion reactions are the most common type of transfusion reaction and include transfusion-related acute lung injury, transfusion-associated circulatory overload, allergic reactions, febrile reactions, post-transfusion purpura and graft-versus-host disease. Although life-threatening anaphylaxis occurs rarely, allergic reactions occur most frequently. If possible, even mild transfusion reactions should be avoided because they add to patients' existing suffering. During the last decade, several new discoveries have been made in the field of allergic diseases and transfusion medicine. First, mast cells are not the only cells that are key players in allergic diseases, particularly in the murine immune system. Second, it has been suggested that immunologically active undigested or digested food allergens in a donor's blood may be transferred to a recipient who is allergic to these antigens, causing anaphylaxis. Third, washed platelets have been shown to be effective for preventing allergic transfusion reactions, although substantial numbers of platelets are lost during washing procedures, and platelet recovery after transfusion may not be equivalent to that with unwashed platelets. This review describes allergic transfusion reactions, including the above-mentioned points, and focusses on their incidence, pathogenesis, laboratory tests, prevention and treatment.

show abstract

Section: Food Allergensmentioning

confidence: 99%

Current Understanding of Allergic Transfusion Reactions: Incidence, Pathogenesis, Laboratory Tests, Prevention and Treatment

文也¹

2013

JJTC

View full text Add to dashboard Cite

show abstract

“…ICs are known to mediate type 3 HSRs in a small subset of people receiving dextran infusions. In these cases, ICs are formed and mediate severe reactions in patients with high antidextran IgG antibody levels (Bircher, Hedin, and Berglund 1995;Hedin et al 1980;Hedin and Richter 1982;Kraft et al 1982;Ljungstrom et al 1983Ljungstrom et al , 1988.…”

Section: Infusion Reactions and Generalized Type 3 Hsrsmentioning

confidence: 99%

Formation, Clearance, Deposition, Pathogenicity, and Identification of Biopharmaceutical-related Immune Complexes

et al. 2014

View full text Add to dashboard Cite

Vascular inflammation, infusion reactions, glomerulopathies, and other potentially adverse effects may be observed in laboratory animals, including monkeys, on toxicity studies of therapeutic monoclonal antibodies and recombinant human protein drugs. Histopathologic and immunohistochemical (IHC) evaluation suggests these effects may be mediated by deposition of immune complexes (ICs) containing the drug, endogenous immunoglobulin, and/or complement components in the affected tissues. ICs may be observed in glomerulus, blood vessels, synovium, lung, liver, skin, eye, choroid plexus, or other tissues or bound to neutrophils, monocytes/macrophages, or platelets. IC deposition may activate complement, kinin, and/or coagulation/fibrinolytic pathways and result in a systemic proinflammatory response. IC clearance is biphasic in humans and monkeys (first from plasma to liver and/or spleen, second from liver or spleen). IC deposition/clearance is affected by IC composition, immunomodulation, and/or complement activation. Case studies are presented from toxicity study monkeys or rats and indicate IHC-IC deposition patterns similar to those predicted by experimental studies of IC-mediated reactions to heterologous protein administration to monkeys and other species. The IHC-staining patterns are consistent with findings associated with generalized and localized IC-associated pathology in humans. However, manifestations of immunogenicity in preclinical species are generally not considered predictive to humans.

show abstract

“…13 This could also be the case for hirudin, because we could demonstrate hightiter anti-hirudin antibodies of the IgG class but no IgE antibodies in 1 of the patients. This is in line with a report by Bircher et al 7 on a volunteer who received several uneventful intravenous injections of the r-hirudin desirudin.…”

Section: Discussionmentioning

confidence: 72%

Anaphylactic and Anaphylactoid Reactions Associated With Lepirudin in Patients With Heparin-Induced Thrombocytopenia

2003

View full text Add to dashboard Cite

Background— Lepirudin (Refludan) is a hirudin derivative. It is a direct thrombin inhibitor obtained by recombinant technology from the medicinal leech and is approved for treatment of heparin-induced thrombocytopenia complicated by thrombosis. Because 3 cases of fatal anaphylaxis possibly associated with use of lepirudin have been reported, we initiated an investigation of putative lepirudin-associated anaphylaxis. Methods and Results— Aided by the manufacturer (Schering AG, Berlin, Germany), we used the lepirudin study databases to identify all patients in whom possible anaphylaxis/severe allergy was recorded from 1994 to September 2002. The 26 possible cases identified were reviewed independently by 2 investigators. After excluding patients with mild skin reactions, reactions likely caused by concomitant medications, poorly documented cases, and reactions that did not correspond temporally with lepirudin use, there remained 9 patients judged to have had severe anaphylaxis in close temporal association with lepirudin. All reactions occurred within minutes of intravenous lepirudin administration, with 4 fatal outcomes (3 acute cardiorespiratory arrests, 1 hypotension-induced myocardial infarction). In these 4 cases, a previous uneventful treatment course with lepirudin was identified (1 to 12 weeks earlier). We recorded high-titer IgG-anti-lepirudin antibodies in an additional patient with anaphylaxis. Because lepirudin has been used in ≈35 000 patients, the risk of anaphylaxis is ≈0.015% (5 of 32 500) on first exposure and 0.16% (4 of 2500) in reexposed patients (7.5% estimated reexposures). Conclusion— Lepirudin can cause fatal anaphylaxis, particularly in patients who are treated within 3 months of a previous exposure. The overall risk/benefit assessment of lepirudin as a treatment for heparin-induced thrombocytopenia remains favorable.

show abstract

Immunoglobulin Class and Subclass Distribution of Dextran‐Reactive Antibodies in Human Reactors and Non Reactors to Clinical Dextran

Cited by 80 publications

References 21 publications

Current Understanding of Allergic Transfusion Reactions: Incidence, Pathogenesis, Laboratory Tests, Prevention and Treatment

Current Understanding of Allergic Transfusion Reactions: Incidence, Pathogenesis, Laboratory Tests, Prevention and Treatment

Formation, Clearance, Deposition, Pathogenicity, and Identification of Biopharmaceutical-related Immune Complexes

Anaphylactic and Anaphylactoid Reactions Associated With Lepirudin in Patients With Heparin-Induced Thrombocytopenia

Contact Info

Product

Resources

About