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Title: Neutrophil activation during acute human anaphylaxis: analysis of MPO and sCD62L.
Austin Authors: Francis, A;Bosio, E;Stone, S F;Fatovich, D M;Arendts, G;Nagree, Y;Macdonald, S P J;Mitenko, H;Rajee, M;Burrows, S;Brown, S G A
Affiliation: Emergency Department, Royal Hobart Hospital, Hobart, TAS, Australia
Emergency Department, South West Health Campus, Bunbury, WA, Australia
Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia
School of Medicine & Pharmacology, University of Western Australia, Perth, WA, Australia
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, WA, Australia
Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, WA, Australia
Emergency Department, Royal Perth Hospital, Perth, WA, Australia
Emergency Department, Fiona Stanley Hospital, Murdoch, WA, Australia
Emergency Department, Fremantle Hospital, Fremantle, WA, Australia
Emergency Department, Armadale Kelmscott Memorial Hospital, Mount Nasura, WA, Australia
Issue Date: Mar-2017
Date: 2017-01-13
Publication information: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2017; 47(3): 361-370
Abstract: The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Patients presenting to the emergency department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time-points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP, respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell tryptase positive. At enrolment, myeloperoxidase concentrations were 2.9- (95% CI: 1.3, 6.5) and 5.0- (95% CI: 2.4, 10.5) fold higher in moderate and severe patients, respectively, compared with healthy controls, and remained stable over the first 5 h following symptom onset. At enrolment, soluble CD62L was 29% (95% CI: 19, 38) and 31% (95% CI: 22, 40) lower in moderate and severe patients, respectively, than healthy controls, and was stable over the first 5 h. There were no associations between myeloperoxidase or soluble CD62L concentrations and either histamine or mast cell tryptase concentrations. These results provide compelling evidence for the involvement of neutrophils during acute human anaphylaxis, suggesting they are activated early in the reaction, regardless of mast cell activation. This important finding increases our understanding of the basic mechanisms of anaphylaxis, a necessary precursor to improving treatment and prevention.
DOI: 10.1111/cea.12868
ORCID: 0000-0002-4356-7686
Journal: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
PubMed URL: 27906487
Type: Journal Article
Subjects: anaphylaxis
basic mechanisms
clinical immunology
peripheral blood leucocyte
Appears in Collections:Journal articles

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