angiotensin-i and Anaphylaxis

Topics: Adenine Nucleotides; Amines; Anaphylaxis; Angiotensin I; Angiotensin II; Animals; Bradykinin; Cytochrome P-450 Enzyme System; Epoxide Hydrolases; Glucuronosyltransferase; Histamine Release; Humans; Inactivation, Metabolic; Lung; NADP; Neurotransmitter Agents; Physical Stimulation; Prostaglandins; SRS-A; Stimulation, Chemical

Insect venom allergy (IVA) is present in 1-3% of the population. A group of patients with high specific IgE do not react to stings. In contrast, a proportion of patients with IVA have low specific IgE levels. These findings indicate that factors other than specific IgE may also be involved in IVA. Dysfunction of the renin-angiotensin system (RAS) has been described as a potential factor in IVA. The objective of this study was to determine the prevalence of angiotensin AGT p.M235T and angiotensin-converting enzyme ACE I/D, I/I, D/D gene polymorphisms in patients with IVA and to relate the presence of these gene variants to the course of IVA and the safety of treatment.. A total of 107 patients with IVA and 113 controls were studied. AGT p.M235T and ACE (ID, I/I, D/D) gene polymorphisms were examined, and angiotensin I levels were measured by immunoassay.. The frequency of the AGT MM M235T variant was significantly higher in IVA patients (29.9%) than in controls (17%, p = 0.02). The presence of the MM M235T genotype increased the risk of grade IV reactions (odds ratio = 2.5 and 95% confidence interval 1.04-6.08). There were no differences in the prevalence of the ACE I/D polymorphism and angiotensin I levels between control groups and patients with different grades of anaphylactic reactions or patients with side effects of venom immunotherapy.. The AGT M235T MM variant may be responsible for severe anaphylactic reactions to insect venom allergens in some patients.

Topics: Adolescent; Adult; Aged; Allergens; Anaphylaxis; Angiotensin I; Angiotensinogen; Animals; Arthropod Venoms; Bee Venoms; Female; Humans; Hymenoptera; Male; Middle Aged; Peptidyl-Dipeptidase A; Polymorphism, Genetic

It has been discussed in several studies that non-immunologic factors, such as renin angiotensin aldosterone system (RAAS) may play a role in the pathophysiology of anaphylaxis. This study aimed to determine whether RAAS plays a part in the fall in blood pressure during drug reactions or not. Twenty patients who experienced hypotension during drug reaction and 15 healthy volunteers were enrolled in this study. None of the patients in the study or control groups were under treatment with any drug that was capable of influencing to RAAS. Serum levels of angiotensin-I (A-I), angiotensin-II (A-II), angiotensin converting enzyme (ACE) and aldosterone were measured in both study and control groups. The Mann-Whitney U test was used to compare the results of the groups. There were no statistically significant differences between the groups with respect to A-I, A-II, ACE and aldosterone levels. It was concluded that a fall in blood pressure during drug reaction must be the result of mast cell mediator effects on the vascular wall rather than RAAS impairment.

Topics: Adolescent; Adult; Aldosterone; Anaphylaxis; Angiotensin I; Angiotensin II; Cohort Studies; Drug Hypersensitivity; Female; Humans; Hypotension; Male; Middle Aged; Peptidyl-Dipeptidase A; Renin-Angiotensin System; Statistics, Nonparametric

Patients with a history of anaphylactic reactions to hymenoptera venom who tolerated the hyposensitization and the sting provocation without problems (n = 10) had angiotensin I (ANG I), angiotensin II (ANG II), angiotensinogen and renin similar to the values found in healthy nonallergic controls (n = 11). In contrast, patients who repeatedly experienced anaphylactic reactions during hyposensitization and who displayed anaphylactic reactions to sting provocation with a living insect (n = 6) showed significantly lower renin (p < 0.05), angiotensinogen (p < 0.05), ANG I (p < 0.05) and ANG II (p < 0.05) plasma levels as compared to healthy nonallergic controls (n = 11). Sting provocation with a living insect induced clinical symptoms of anaphylaxis in all of the 6 patients. A decrease in ANG I was found in 4 of the patients (67%) after provocation as compared to the concentration before the sting challenge. Angiotensinogen decreased in 3 of the patients (50%) whereas renin activity decreased in 2 of the patients (29%). In all cases a decrease in ANG II was noticed (100%). It is concluded that patients at high risk of developing anaphylactic reactions possess a dysfunctional renin-angiotensin system (RAS) which is not stimulated and does not respond appropriately. These findings point to an important role of the RAS as a defense mechanism in response to anaphylactic reactions.

Topics: Adolescent; Adult; Aged; Anaphylaxis; Angiotensin I; Angiotensin II; Angiotensinogen; Animals; Arthropod Venoms; Child; Desensitization, Immunologic; Female; Humans; Hymenoptera; Immunotherapy; Insect Bites and Stings; Male; Middle Aged; Radioallergosorbent Test; Renin; Renin-Angiotensin System

Immunoreactive angiotensin I (ANG I) and angiotensin II (ANG II) were measured in human urine, after purification on octadecasilyl-silica cartridges. The total daily excretion of ANG I and II in healthy volunteers was 292.2 +/- 62.5 and 12.2 +/- 2.5 pmol/24 h (mean +/- SEM; n = 14). No differences in the concentrations of ANG I or II were detected between females and males. Although lower levels of ANG I and II were found during the nighttime, no clear-cut circadian rhythm in the excretion of the peptides was found. ANG II was not degraded in acidified urine which shows the effective inhibition of ANG-II-degrading enzymes. Oral provocation tests (OPT) in patients with a history of anaphylactoid reactions (AR) to drugs, foods and food additives were associated with elevated ANG I and II concentrations when symptoms of anaphylaxis occurred. The excretion of ANG I increased by a factor of 7.8 +/- 2.4 and the excretion of ANG II by a factor of 6.1 +/- 1.6 (mean +/- SEM; n = 15). In patients with negative OPT and no clinical symptoms of anaphylaxis, the levels of ANG I and II remained unchanged (n = 26). It is concluded that angiotensin peptides play a role during the events of AR. The peptides may be considered as counteracting factors which stabilize cardiovascular functions.

Topics: Adolescent; Adult; Aged; Anaphylaxis; Angiotensin I; Angiotensin II; Child; Child, Preschool; Drug Hypersensitivity; Female; Food Hypersensitivity; Humans; Male; Middle Aged; Renin-Angiotensin System

Angiotensin I (ANG I) and angiotensin II (ANG II) were measured radioimmunologically in human leukocytes extracted with a mixture of acetone, 1N HCl and water (40:1:10 vol). The analytical recoveries of 125I-ANG I and 125I-ANG II, which were added prior to extraction, were 92.00 +/- 3.10 and 99.19 +/- 0.91% (mean +/- SEM; n = 12). The concentration of ANG I- and ANG II-like material in leukocytes from healthy volunteers was 32.04 +/- 3.64 and 13.05 +/- 1.26 fmol/mg protein (n = 24). The immunoreactive material could be characterized on HPLC as Ile5-ANG I, Ile5-ANG II and angiotensin metabolites such as Ile4-ANG III, Ile3-ANG II hexapeptide, Ile2-ANG II pentapeptide and Ile1-ANG II tetrapeptide. From the ANG I-immunoreactive material determined in the extracts, 26% could be characterized on HPLC as Ile5-ANG I. The ANG II-immunoreactive material present in the extracts could be separated on HPLC into 44% Ile5-ANG II, 14% Ile4-ANG III, 7% Ile3-ANG II hexapeptide, 4% Ile2-ANG II pentapeptide and 8% Ile1-ANG II tetrapeptide. Patients with a history of anaphylactic reactions to bee or wasp venom showed significantly reduced ANG II concentrations in their leukocytes as compared to controls (6.76 +/- 0.76 fmol ANG II/mg protein, n = 22, vs. 13.05 +/- 1.26 fmol ANG II/mg protein, n = 24; p < 0.05). A significant correlation between the severity of clinical symptoms and the ANG II levels was found for grade I and II reactions (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Anaphylaxis; Angiotensin I; Angiotensin II; Animals; Arthropod Venoms; Chromatography, High Pressure Liquid; Female; Humans; Hymenoptera; Leukocytes; Male; Middle Aged; Radioimmunoassay

The plasma concentrations of arginine vasopressin, oxytocin, angiotensin I and II were studied in patients with hymenoptera venom anaphylaxis (n = 50) and healthy volunteers (n = 25). There was no difference in arginine vasopressin: 5.52 +/- 0.45 fmol/ml vs. 3.99 +/- 0.41 fmol/ml or oxytocin: 28.10 +/- 1.13 fmol/ml vs. 26.24 +/- 1.80 fmol/ml between patients and controls. No correlation between the severity of clinical symptoms and the plasma levels of arginine vasopressin and oxytocin was found in patients. However, patients with a history of hymenoptera venom anaphylaxis showed significantly reduced angiotensin I and angiotensin II plasma levels as compared to controls (ANG I: 9.51 +/- 0.61 fmol/ml vs. 22.91 +/- 1.73 fmol/ml; ANG II: 2.84 +/- 0.16 fmol/ml vs. 6.95 +/- 0.33 fmol/ml). A significant inverse correlation between the severity of clinical symptoms and the plasma levels of angiotensin I and angiotensin II was observed; the lower the concentrations the more severe the clinical symptoms. Oxytocin immunoreactivity eluted from the HPLC column as a single peak with the same retention time as synthetic oxytocin. The vasopressin immunoreactive material could be characterized on HPLC as arginine-vasopressin and two other peptides of unknown nature which crossreacted with the vasopressin antibody. These findings suggest a possible role of angiotensin I and angiotensin II in hymenoptera venom anaphylaxis while arginine vasopressin and oxytocin are most likely not involved.

Topics: Adolescent; Adult; Aged; Anaphylaxis; Angiotensin I; Angiotensin II; Angiotensins; Animals; Arginine Vasopressin; Arthropod Venoms; Child; Chromatography, High Pressure Liquid; Female; Humans; Hymenoptera; Male; Middle Aged; Oxytocin; Radioimmunoassay

Components of the renin angiotensin system, namely renin, angiotensinogen, angiotensin I and II and aldosterone were measured in plasma of patients with hymenoptera venom anaphylaxis (n = 50) and healthy non-allergic controls (n = 25). Patients with a history of anaphylactic reactions to hymenoptera venom who did not undergo immunotherapy showed significantly reduced renin, angiotensinogen, angiotensin I and angiotensin II in plasma as compared with controls (P < 0.05). There was no difference in the aldosterone concentration between patients and controls. Angiotensin I, angiotensin II, renin and angiotensinogen levels were the same in male and female patients. There was also no difference in the angiotensin I, II, renin or angiotensinogen levels between young and older patients. A significant inverse correlation between the severity of clinical symptoms and the plasma levels of renin (r = -0.382, P < 0.001), angiotensinogen (r = -0.567, P < 0.0001), angiotensin I (r = -0.656, P < 0.0001) and angiotensin II (r = 0.0762, P < 0.0001) was found: the lower the levels the more severe the clinical symptoms. No correlation was found for aldosterone. Hymenoptera venom allergic patients with repeated anaphylactic reactions during hyposensitization did not tolerate the sting of a living insect (n = 6). In these patients, renin, angiotensinogen, angiotensin I and II remained significantly lower than in healthy non-allergic controls. Patients with successful immunotherapy (n = 27) who tolerated the sting of a living insect had renin, angiotensin I and II significantly higher than patients without immunotherapy. These findings suggest a possible role of the renin angiotensin system in hymenoptera venom anaphylaxis.

Topics: Adolescent; Adult; Aged; Aldosterone; Anaphylaxis; Angiotensin I; Angiotensin II; Angiotensin III; Angiotensinogen; Bee Venoms; Child; Desensitization, Immunologic; Female; Homeostasis; Humans; Hypotension; Male; Middle Aged; Renin; Renin-Angiotensin System; Severity of Illness Index; Wasp Venoms

Human urine samples, purified on octadecasilyl-silica cartridges, contained immunoreactive angiotensin I, II, arginine vasopressin and oxytocin. The daily excretion of these peptides in healthy volunteers was 190.00 +/- 38.43 (n = 12), 17.48 +/- 3.09 (n = 12), 63.43 +/- 14.84 (n = 8) and 13.52 +/- 1.42 (n = 7) pmol/24 hr, respectively (mean +/- s.e.m.). Patients with a history of anaphylactoid reactions to drugs or food additives showed clinical symptoms such as urticaria, flush, nausea, dizziness and hypotension after oral provocation with cyanocobalamine, propyphenazone, acetylsalicylic acid and sodium benzoate. In five of the seven patients, angiotensin I and II were increased several fold in the urine fractions after symptoms were reported. The average increase in the urine concentration of both peptides was fourfold and 5.5-fold. In three out of five patients, the mean excretion of arginine vasopressin and oxytocin immunoreactive material was also elevated by a factor of 5.7 and 4.4, respectively. Oral provocation with a placebo failed to elicit anaphylactoid symptoms or an increase in the urine levels of angiotensin I or angiotensin II. Angiotensin I and angiotensin II-like immunoreactivity could be characterized on HPLC as Ile5-angiotensin I, Ile5-angiotensin II and angiotensin II metabolites. HPLC characterization of immunoreactive arginine vasopressin and oxytocin in two different gradient systems showed retention times different than the retention times of the corresponding synthetic standard peptides indicating that both peptides are not authentic AVP and OXT. These results suggest that angiotensin I and angiotensin II may be involved in the clinical events observed during some forms of anaphylactoid reactions.

Topics: Adult; Anaphylaxis; Angiotensin I; Angiotensin II; Antipyrine; Arginine Vasopressin; Aspirin; Benzoates; Benzoic Acid; Female; Humans; Male; Middle Aged; Oxytocin; Vitamin B 12

Immunoreactive angiotensin I and angiotensin II were found in human urine that was purified on octadecasilylsilica cartridges. The daily excretion of angiotensin I and II in healthy volunteers was 189.00 (SE 38.36) and 17.54 (SE 3.07) pmol/24 h or 148.09 (SE 32.22) and 12.82 (SE 2.34) pmol/L, respectively (n = 12). No circadian rhythm was observed in the excretion patterns of angiotensin I and II. In vitro degradation of angiotensin I or II could not be detected in acidified urine samples. A marked increase in the excretion of angiotensin I and II could be demonstrated in patients with anaphylactoid reactions to drugs and food additives after oral challenge. Immunoreactive angiotensin I and II could be characterized by HPLC as Ile5-angiotensin I, Ile5-angiotensin II, and angiotensin II metabolites.

Topics: Adult; Anaphylaxis; Angiotensin I; Angiotensin II; Chromatography, High Pressure Liquid; Female; Humans; Male; Middle Aged; Radioimmunoassay

Topics: Adult; Anaphylaxis; Angiotensin I; Angiotensin II; Animals; Bee Venoms; Female; Humans; Male; Renin-Angiotensin System; Wasp Venoms