Paul Ehrlich’s Mastzellen: A Historical Perspective of Relevant Developments in Mast Cell Biology

Ghably, Jack G.; Saleh, Hana; Vyas, Harsha; Peiris, Emma; Misra, Niva; Krishnaswamy, Guha

doi:10.1007/978-1-4939-1568-2_1

Cited by 14 publications

(12 citation statements)

References 41 publications

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“…H1 and H2 receptors are primarily responsible for the swelling that leads to angioedema 1,4,5. Histamine-mediated angioedema, such as anaphylaxis, occurs rapidly after an allergen exposure (type I hypersensitivity reaction) 5,25–30. Histamine-mediated angioedema and anaphylaxis present similarly, as they are along the same clinical spectrum, although diagnosis of anaphylaxis requires specific clinical criteria 1–5.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Angioedema in the Emergency Department

Long

Koyfman

Gottlieb

2019

WestJEM

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Angioedema is defined by non-dependent, non-pitting edema that affects several different sites and is potentially life-threatening due to laryngeal edema. This narrative review provides emergency physicians with a focused overview of the evaluation and management of angioedema. Two primary forms include histamine-mediated and bradykinin-mediated angioedema. Histamine-mediated forms present similarly to anaphylaxis, while bradykinin-mediated angioedema presents with greater face and oropharyngeal involvement and higher risk of progression. Initial evaluation and management should focus on evaluation of the airway, followed by obtaining relevant historical features, including family history, medications, and prior episodes. Histamine-mediated angioedema should be treated with epinephrine intramuscularly, antihistaminergic medications, and steroids. These medications are not effective for bradykinin-mediated forms. Other medications include C1-INH protein replacement, kallikrein inhibitor, and bradykinin receptor antagonists. Evidence is controversial concerning the efficacy of these medications in an acute episode, and airway management is the most important intervention when indicated. Airway intervention may require fiberoptic or video laryngoscopy, with preparation for cricothyrotomy. Disposition is dependent on patient’s airway and respiratory status, as well as the sites involved.

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Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Angioedema in the Emergency Department

Long

Koyfman

Gottlieb

2019

WestJEM

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“…Richet termed the condition "anaphylaxis" as opposed to prophylaxis and was awarded the Nobel Prize in Medicine for this work in 1913. 5 e- Table 1 provides a historical perspective of events leading to our current understanding of anaphylaxis.…”

mentioning

confidence: 99%

Anaphylaxis

LoVerde

Iweala

Eginli

et al. 2018

Chest

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Anaphylaxis is a systemic, life-threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or nonallergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal, and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest, resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting; however, these conditions can be severe enough to warrant evaluation of the patient in the ED and in some cases, hospitalization, and management in an ICU. Reports suggest that underdiagnosis and undertreatment of anaphylaxis are common. Several new syndromes have been described recently including bird-egg, pork-cat, delayed allergy to mammalian meat and a diverse group of mast cell activation disorders. Conditions such as postural orthostatic tachycardia syndrome, carcinoid syndrome, Munchausen stridor, and factitious anaphylaxis can present similarly and need to be included in the differential diagnosis. Anaphylaxis is a clinical diagnosis, but plasma tryptase and urinary histamine levels are often elevated, allowing diagnostic confirmation; however, diagnostic testing should not delay treatment as results may not be immediately available. The sine qua non of treatment is avoidance of any known triggers and epinephrine, which should never be delayed if this disorder is suspected. Secondary treatments include fluids, bronchodilators, antihistamines, and glucocorticoids. Patients with cardiopulmonary arrest or airway or vascular compromise require mechanical ventilation, vasopressors, and other advanced life support in the ICU.

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“…MCs are perivascularly located tissue-resident cells of hematopoietic origin recognized as effectors in inflammation and immunity due to their role in a range of processes including atopic diseases, parasitic infections, hematologic malignancies, autoimmune and autoinflammatory diseases, as well as connective tissue remodeling and repair [1, 2]. In humans, they originate in the bone marrow from CD34+/CD117+ pluripotent progenitor cells, then circulate in the blood as committed precursors, and complete their differentiation in peripheral tissues where they reside and are maintained by local cytokines including stem cell factor [3, 4].…”

Section: Mast Cellsmentioning

confidence: 99%

The Role of Mast Cells in Intracerebral Hemorrhage

Yehya

Torbey

2017

Neurocrit Care

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Mast cells are first responders to intracerebral hemorrhage. They release potent mediators that can disrupt the blood-brain barrier promoting injury, vasogenic edema formation, and hematoma exacerbation. Also, mast cells recruit other inflammatory cells that maintain and amplify brain damage. Given their early role in the cascade of events in intracerebral hemorrhage, mast cells may offer an alternative target for antichemotactic interventions.

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Paul Ehrlich’s Mastzellen: A Historical Perspective of Relevant Developments in Mast Cell Biology

Cited by 14 publications

References 41 publications

Evaluation and Management of Angioedema in the Emergency Department

Evaluation and Management of Angioedema in the Emergency Department

Anaphylaxis

The Role of Mast Cells in Intracerebral Hemorrhage

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