Quinolone immediate hypersensitivity due to topical ophthalmic preparations: a case report and review of literature

Ajima, Sayaka; Sano, Yusuke; Hashizume, Hideo

doi:10.1111/1346-8138.15669

Cited by 2 publications

(1 citation statement)

References 14 publications

(16 reference statements)

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“…Fluoroquinolone antibiotics, such as ciprofloxacin, moxifloxacin, and norfloxacin, are commonly used broad-spectrum antibiotics [ 143 , 145 ]. In a recent case report, the authors reported an MRGPRX2-linked hypersensitivity reaction from a topical fluoroquinolone ophthalmic preparation [ 110 ]. Evidence has been reported on fluoroquinolone-induced MC activation via MRGPRX2 [ 72 , 111 ].…”

Section: Pharmacology Of Mas-related G Protein-coupled Receptors X 2 (Mrgprx2)mentioning

confidence: 99%

Unlocking the Non-IgE-Mediated Pseudo-Allergic Reaction Puzzle with Mas-Related G-Protein Coupled Receptor Member X2 (MRGPRX2)

Kumar

Duraisamy

Chow

2021

Cells

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Mas-related G-protein coupled receptor member X2 (MRGPRX2) is a class A GPCR expressed on mast cells. Mast cells are granulated tissue-resident cells known for host cell response, allergic response, and vascular homeostasis. Immunoglobulin E receptor (FcεRI)-mediated mast cell activation is a well-studied and recognized mechanism of allergy and hypersensitivity reactions. However, non-IgE-mediated mast cell activation is less explored and is not well recognized. After decades of uncertainty, MRGPRX2 was discovered as the receptor responsible for non-IgE-mediated mast cells activation. The puzzle of non-IgE-mediated pseudo-allergic reaction is unlocked by MRGPRX2, evidenced by a plethora of reported endogenous and exogenous MRGPRX2 agonists. MRGPRX2 is exclusively expressed on mast cells and exhibits varying affinity for many molecules such as antimicrobial host defense peptides, neuropeptides, and even US Food and Drug Administration-approved drugs. The discovery of MRGPRX2 has changed our understanding of mast cell biology and filled the missing link of the underlying mechanism of drug-induced MC degranulation and pseudo-allergic reactions. These non-canonical characteristics render MRGPRX2 an intriguing player in allergic diseases. In the present article, we reviewed the emerging role of MRGPRX2 as a non-IgE-mediated mechanism of mast cell activation in pseudo-allergic reactions. We have presented an overview of mast cells, their receptors, structural insight into MRGPRX2, MRGPRX2 agonists and antagonists, the crucial role of MRGPRX2 in pseudo-allergic reactions, current challenges, and the future research direction.

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