title: Towards a specific marker for acute bradykinin-mediated angioedema attacks: a literature review.
abstract: BACKGROUND
  Bradykinin-mediated angioedema (AE) is a rare disease characterised by recurrent angioedema linked to acquired (e.g. angiotensin converting enzyme inhibitor induced AE) or hereditary disorders (e.g. AE type I or II). As the clinical picture can be misleading, diagnosis of this disease is sometimes difficult. A bradykinin-mediated AE attack may be a therapeutic emergency which requires access to effective, but expensive, treatments. Their prescription must therefore be justified. No specific marker of acute bradykinin-mediated AE attacks has yet been identified to facilitate the therapeutic decision but it has been sought in many studies.
  
  
  OBJECTIVE
  This article reviews the literature on this type of biomarker, comparing candidate bradykinin-mediated AE markers to candidate markers of mast cell activation.
  
  
  CONCLUSIONS
  The most interesting biomarkers are those linked to endothelial stress (VE cadherin, E-selectin, endothelin-1, von Willebrand factor and its activity) which is significantly increased during an AE attack. All these markers must now be validated by prospective studies to determine their specificity and utility in diagnosis.
authors.affiliation: Internal Medicine Department,, Centre national de référence des angiœdèmes (CREAK).
authors.forename: Alban
authors.initials: A
authors.lastname: Deroux
authors.affiliation: Universités des Alpes-Grenoble 1, 38041 Grenoble, France, CEA, DSV/iRTSV,, INSERM, Unité 1036, Biologie du cancer et de l'infection, 17, rue des Martyrs, 38054 Grenoble, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vilgrain
authors.affiliation: Centre national de référence des angiœdèmes (CREAK),, Universités des Alpes-Grenoble 1, 38041 Grenoble, France, Immunology Department, Grenoble University Hospital, 38000 Grenoble, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Dumestre-Pérard
authors.affiliation: Internal Medicine Department,, Centre national de référence des angiœdèmes (CREAK).
authors.forename: Isabelle
authors.initials: I
authors.lastname: Boccon-Gibod
authors.affiliation: Internal Medicine Department,, Centre national de référence des angiœdèmes (CREAK),, Universités des Alpes-Grenoble 1, 38041 Grenoble, France, CEA, DSV/iRTSV,, INSERM, Unité 1036, Biologie du cancer et de l'infection, 17, rue des Martyrs, 38054 Grenoble, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bouillet
mesh_terms: D000799:Angioedema / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001920:Bradykinin / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D050718:Complement C1 Inhibitor Protein / Q000378:metabolism*; D019040:E-Selectin / Q000097:blood; D019332:Endothelin-1 / Q000097:blood; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006632:Histamine / Q000097:blood / Q000652:urine; D006801:Humans; D007378:Interleukins / Q000097:blood; D008407:Mast Cells / Q000378:metabolism
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D050718:Complement C1 Inhibitor Protein; D019040:E-Selectin; D019332:Endothelin-1; D005338:Fibrin Fibrinogen Degradation Products; D007378:Interleukins; C036309:fibrin fragment D; D006632:Histamine; D002097:C-Reactive Protein; D001920:Bradykinin
keywords: C1 inhibitor; VE cadherin; biomarkers; endothelial dysfunction; hereditary angioedema; vascular permeability