The renin-angiotensin system in patients with repeated anaphylactic reactions during hymenoptera venom hyposensitization and sting challenge.
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.
Hermann
K
K
Dermatologische Klinik und Poliklinik, Technische Universität München, Deutschland.
Ring
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000209:etiology*; D000803:Angiotensin I / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D000808:Angiotensinogen / Q000097:blood; D000818:Animals; D001180:Arthropod Venoms / Q000276:immunology*; D002648:Child; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D006927:Hymenoptera; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011852:Radioallergosorbent Test; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology*
D001180:Arthropod Venoms; D000808:Angiotensinogen; D000804:Angiotensin II; D000803:Angiotensin I; D012083:Renin