The anaphylaxis hypothesis of sudden infant death syndrome (SIDS): mast cell degranulation in cot death revealed by elevated concentrations of tryptase in serum.
A series of cases of sudden unexpected post-neonatal deaths from two centres in the UK have been investigated for evidence of mast cell activation using the biochemical markers tryptase and 9 alpha,11 beta-PGF2. Tryptase was selected as a possible marker because it is a component of mast cell secretory granules and, unlike histamine, it is not released from basophils. The prostaglandin 9 alpha,11 beta-PGF2 is an initial and pharmacologically active metabolite of PGD2, the major mast cell-derived cyclooxygenase product. This prostaglandin was chosen to serve as a marker of newly generated mediator release. In the study, unexplained infant deaths were associated with a higher concentration of tryptase in serum compared with cases of unexpected, but subsequently explained death. However, 9 alpha,11 beta-PGF2 was found to be an unsuitable post mortem marker in this situation. These results provide direct evidence that mast cell degranulation, possibly as a result of anaphylaxis, may be occurring around the time of death in some cases of cot death.
Holgate
S T
ST
University Medicine, Southampton General Hospital, UK.
Walters
C
C
Walls
A F
AF
Lawrence
S
S
Shell
D J
DJ
Variend
S
S
Fleming
P J
PJ
Berry
P J
PJ
Gilbert
R E
RE
Robinson
C
C
D000707:Anaphylaxis / Q000201:enzymology* / Q000503:physiopathology; D000911:Antibodies, Monoclonal; D015415:Biomarkers; D015550:Cell Degranulation; D002675:Child, Preschool; D053818:Chymases; D015237:Dinoprost / Q000097:blood; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007231:Infant, Newborn; D008407:Mast Cells / Q000502:physiology*; D012697:Serine Endopeptidases / Q000097:blood*; D013398:Sudden Infant Death / Q000097:blood* / Q000209:etiology; D053802:Tryptases
D000911:Antibodies, Monoclonal; D015415:Biomarkers; D015237:Dinoprost; D012697:Serine Endopeptidases; C083294:chymase 2; D053818:Chymases; D053802:Tryptases