Enzyme activation and inhibition induced by cold provocation in a patient with cold urticaria.
A 33-year-old female patient with acquired cold urticaria, together with her 8-year-old healthy daughter, was subjected to a brief period of cold exposure. The effect of this treatment upon a number of key factors of the plasma coagulation, kallikrein and complement systems was investigated. Cold air provocation caused increased fibrinolysis, together with a measurable consumption of the protease inhibitors alpha1-antitrypsin (alpha1AT), alpha2-macroglobulin (alpha2M) and C1Inactivator (C1INA). Kaolin activation of the patient's plasma elaborated exceptionally high levels of esterolytic activity, both before and after cold exposure, indicating pre-enzyme lability. Both subjects had abnormally high serum ratios alpha2M/alpha AT. Impressive leucocytosis was observed in the symptomless child.
D000328:Adult; D002648:Child; D003080:Cold Temperature / Q000009:adverse effects*; D003165:Complement System Proteins; D004950:Esterases / Q000037:antagonists & inhibitors / Q000097:blood*; D005260:Female; D005337:Fibrin / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008259:Macroglobulins / Q000032:analysis; D013917:Thrombin / Q000378:metabolism; D014361:Trypsin Inhibitors / Q000097:blood*; D014581:Urticaria / Q000097:blood / Q000201:enzymology* / Q000209:etiology
D008259:Macroglobulins; D014361:Trypsin Inhibitors; D005337:Fibrin; D005340:Fibrinogen; D003165:Complement System Proteins; D004950:Esterases; D007610:Kallikreins; D013917:Thrombin