title: Current pharmacotherapy of bradykinin-mediated angioedema.
abstract: BACKGROUND
  Bradykinin-mediated angioedema is characterized by subcutaneous and/or submucosal edema formation without wheals and pruritus. It is linked to bradykinin-enhanced vascular permeability and, therefore, it does not respond to conventional measures, but requires specific therapy.
  
  
  METHODS
  This summary briefly reviews the different types of bradykinin-mediated angioedema and its remedies. Therapy focuses on relieving edema, as well as on decreasing its incidence and severity. The modes of the actions of attenuated androgens and antifibrinolytics are not precisely known - these agents have been introduced on an empirical basis. Contemporary treatments, by contrast, have been purposely developed to inhibit bradykinin. Most experience pertains to angioedema resulting from C1-inhibitor deficiency, and the controlled studies have focused on the hereditary form of this disease type (HAE). The pathomechanisms of HAE with normal C1-inhibitor activity, as well as of angiotensin-converting enzyme inhibitor-releated, and of non-histaminergic idiopathic sporadic angioedemas are largely unknown. Appropriate laboratory methods for the diagnosis, or specific interventions for the therapy of these conditions are not available or only available off-label.
  
  
  CONCLUSIONS
  In this case, diagnosis and management are challenging. The range of targeted therapeutic options has increased in recent years and includes measures to handle emergencies, prevent edematous episodes and manage additional types of bradykinin-mediated angioedema.
authors.affiliation: Semmelweis University, 3rd Department of Internal Medicine, Faculty of Medicine, H-1125 Budapest, Kútvölgyiút 4, Hungary. farkash@kut.sote.hu
authors.forename: Henriette
authors.initials: H
authors.lastname: Farkas
mesh_terms: D000728:Androgens / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001920:Bradykinin / Q000037:antagonists & inhibitors* / Q000378:metabolism; D065168:Bradykinin Receptor Antagonists; D002199:Capillary Permeability / Q000187:drug effects; D050718:Complement C1 Inhibitor Protein / Q000627:therapeutic use*; D056828:Hereditary Angioedema Type III / Q000188:drug therapy / Q000378:metabolism; D056829:Hereditary Angioedema Types I and II / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D018002:Receptors, Bradykinin / Q000378:metabolism; D011994:Recombinant Proteins / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D000933:Antifibrinolytic Agents; D065168:Bradykinin Receptor Antagonists; D050718:Complement C1 Inhibitor Protein; D018002:Receptors, Bradykinin; D011994:Recombinant Proteins; D001920:Bradykinin