Immunoglobulin E: Pathogenic Relevance in Urticaria and Eczema
Ana M. Giménez-Arnau, Howard I. Maibach in Contact Urticaria Syndrome, 2014
Acute urticaria can be triggered by multiple factors: allergens (type I hypersensitivity reaction), acute inflections (hepatitis virus B and C, Streptococcus sp., Anisakis), and histamine-releasing factors such as some drugs (nonsteroidal anti-inflammatory drugs, opioids, polymyxin, vancomycin) or certain foods (e.g., tomato, alcohol). However, in 50% of cases, the triggering factor cannot be determined.[53] The type I hypersensitivity reaction is an IgE-mediated allergy that can be clinically manifested by a wide variety of symptoms, ranging from mild symptoms to anaphylaxis reaction. It is characterized by the presence of a specific IgE that binds to an environmental allergen; this can be demonstrated by skin prick test or immunoassay of serum antigen-specific IgE. Increased concentrations of serum antigen-specific IgE and the size of the skin prick test wheal are generally associated with increased likelihood of a clinical reaction, but they are never predictive of reaction severity.[54–60] The most frequent allergens related to this type I hypersensitivity reaction of acute urticaria are food (e.g., peanuts, peach), drugs (e.g., penicillin), as well as, other proteins also involved in CUS (e.g., latex, seafood).[8,61,62]
Effects
Frank A. Barile in Barile’s Clinical Toxicology, 2019
Antigens involved in type I reactions are generally airborne pollens, including mold spores and ragweed, as well as food ingredients. Ambient factors, such as heat and cold, drugs (opioids and antibiotics), and metals (silver and gold), precipitate chemical allergies of the type I nature. Because of their small molecular weight, the majority of drugs and chemicals, as single entities, generally circulate undetected by immune surveillance systems. Consequently, to initiate the sensitization phase of an antigenic response, chemicals are immunologically handled as haptens.* Some examples of type I hypersensitivity syndromes are described in Table 6.6, and typical effects of chemical allergies are listed in Table 6.7. The effects of Type I chemical allergies are usually acute and appear quickly, as compared with other Types II-IV hypersensitivity reactions.
Overview of hypersensitivity
Gabriel Virella in Medical Immunology, 2019
Most frequently, human type I hypersensitivity has a localized expression, such as the bronchoconstriction and bronchial edema that characterize bronchial asthma, the mucosal edema in hay fever, and the skin rash and subcutaneous edema that define urticaria (hives). The factor(s) involved in determining the target organs that will be affected in different types of immediate hypersensitivity reactions are not well defined, but the route of exposure to the challenging antigen seems an important factor. For example, allergic (extrinsic) asthma and hay fever are usually associated with inhaled antigens, while urticaria is seen as a frequent manifestation of food allergy. However, the manifestations of food allergy are very diverse, and, in addition to hives, can include a variety of symptoms affecting different organs and systems (Table 20.2).
Cross-reactivity between halogenated platinum salts in an immediate-type respiratory hypersensitivity model
Published in Inhalation Toxicology, 2018
David M. Lehmann, Wanda C. Williams
Asthma is a condition associated with narrowing of the airways leading to bouts of chest tightness, wheezing, coughing and shortness of breath. Occupational asthma is the most common occupational lung disease, accounting for up to 15% of asthma cases in the United States (ALA, 2008; Balmes et al., 2003; Blanc & Toren, 1999). Asthmatic reactions can be triggered by exposure to high concentrations of irritants (e.g. hydrochloric acid, sulfur dioxide, ammonia, smoke) or through the development of a type I hypersensitivity response (e.g. isocyanates, metals). Unlike irritant-induced asthmatic reactions which occur immediately after first exposure, type I hypersensitivity reactions occur after repeated work-related exposure to an allergy-inducing substance resulting in activation of an adaptive immune system response. Continued exposure to occupational asthmagens can intensify symptoms and lead to the development of lifelong asthma. Occupational asthma has the potential to not only adversely impact worker productivity, but to also decrease the quality of life for affected individuals. Consequently, identification and characterization of occupational asthmagens is paramount.
Safety of the current drug treatments for vitiligo
Published in Expert Opinion on Drug Safety, 2020
Torello Lotti, Komal Agarwal, Indrashis Podder, Francesca Satolli, Martin Kassir, Robert A Schwartz, Uwe Wollina, Stephan Grabbe, Alexander A Navarini, Simon M Mueller, Mohamad Goldust
Intravenous immunoglobulin is a sterile highly purified IgG preparation made from pooled human plasma and contains more than 95% of unmodified IgG and trace amounts of IgA or IgM. The adverse effects are mostly self-limiting and disappear if the infusion is discontinued or the rate is lowered [21]. Certain reactions like headache, chills, flushing, fever, myalgia, hypertension, etc. are related to the rate of infusion rather than the dose. Serious reactions like deep vein thrombosis, stroke, and renal failure may also occur. Renal failure is more common when IVIG preparation contains sucrose [21]. Injection site erythema, purpura, eczematous reaction, and phlebitis may occur. Cutaneous adverse effects include petechiae, purpura, urticaria, lichenoid reaction, and leukocytoclastic vasculitis. Anaphylaxis secondary to previous infusions of IVIG is an absolute contraindication, whereas relative contraindications include congestive heart failure, renal failure, and rheumatoid arthritis [21]. Pregnancy is not a contraindication to IVIG therapy. IgA-deficient patients can react with type I hypersensitivity and should be skin tested before administration.
Evaluation of the reported rates of hypersensitivity reactions associated with iron dextran and ferric carboxymaltose based on global data from VigiBase™ and IQVIA™ MIDAS® over a ten-year period from 2008 to 2017
Published in Expert Review of Hematology, 2020
Darshana Durup, Philip Schaffalitzky de Muckadell, Claes Christian Strom
Descriptive statistics were used to evaluate exposure and reported rates of HSRs. Data were aggregated across all countries. The number of unique spontaneously reported HSRs was determined for eight different categories of HSR, based on the groups defined above: 1. SMQ Anaphylactic reaction (Group A–D combined, primary analysis); 2. Group A; 3. Group B; 4. Group C; 5. Group D; 6. Type I–IV hypersensitivity terms; 7. Anaphylactic/anaphylactoid reaction terms; 8. Death. Additionally, the type I–IV hypersensitivity terms were evaluated excluding reactions coded as ‘hypersensitivity’ without specification of type, and also excluding ‘type I hypersensitivity’ to create a set of type II–IV hypersensitivity terms. A sensitivity analysis included only the HSR events that had a time to onset within 24 hours of IV iron administration. To investigate geographic variability, the share of exposure and HSR events were also determined by region.
Related Knowledge Centers
- Allergen
- Type II Hypersensitivity
- Type III Hypersensitivity
- Type IV Hypersensitivity
- Hypersensitivity
- Allergy
- Inhalation
- Ingestion
- Antigen
- Type II Hypersensitivity
- Type III Hypersensitivity
- Type IV Hypersensitivity
- Injection