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Characterization of a monoclonal antibody against latex protein associated with latex allergy

Kurup VP, Kumar A, Kelly KJ, Fink JN

J Allergy Clin Immunol, 1993 Nov;92(5):638-43.
PMID: 8227854 DOI: 10.1016/0091-6749(93)90005-z

Several hybridomas were produced against antigens extracted from the latex sap of Hevea brasiliensis. One of the monoclonal antibodies (LA-E3) reacted with antigens demonstrating binding to patient sera on crossed enzyme immunoelectrophoresis. This monoclonal antibody reacted with 2 of 10 glove extracts studied and with both Malaysian and Indian latex plant extracts. The antigens purified with monoclonal antibody affinity chromatography demonstrated specific IgE in the sera of patients with latex allergy as determined by ELISA. This monoclonal antibody can thus be utilized to obtain reliable antigens useful in the diagnosis of latex sensitivity, although additional antigens will likely be necessary to enhance sensitivity and specificity.

Matched MeSH terms: Anaphylaxis/immunology
Plasma and urine metabolite profiling reveals the protective effect of Clinacanthus nutans in an ovalbumin-induced anaphylaxis model: 1H-NMR metabolomics approach

Khoo LW, Audrey Kow SF, Maulidiani M, Lee MT, Tan CP, Shaari K, et al.

J Pharm Biomed Anal, 2018 Sep 05;158:438-450.
PMID: 29957507 DOI: 10.1016/j.jpba.2018.06.038

The present study sought to identify the key biomarkers and pathways involved in the induction of allergic sensitization to ovalbumin and to elucidate the potential anti-anaphylaxis property of Clinacanthus nutans (Burm. f.) Lindau water leaf extract, a Southeast Asia herb in an in vivo ovalbumin-induced active systemic anaphylaxis model evaluated by 1H-NMR metabolomics. The results revealed that carbohydrate metabolism (glucose, myo-inositol, galactarate) and lipid metabolism (glycerol, choline, sn-glycero-3-phosphocholine) are the key requisites for the induction of anaphylaxis reaction. Sensitized rats treated with 2000 mg/kg bw C. nutans extract before ovalbumin challenge showed a positive correlation with the normal group and was negatively related to the induced group. Further 1H-NMR analysis in complement with Kyoto Encyclopedia of Genes and Genomes (KEGG) reveals the protective effect of C. nutans extract against ovalbumin-induced anaphylaxis through the down-regulation of lipid metabolism (choline, sn-glycero-3-phosphocholine), carbohydrate and signal transduction system (glucose, myo-inositol, galactarate) and up-regulation of citrate cycle intermediates (citrate, 2-oxoglutarate, succinate), propanoate metabolism (1,2-propanediol), amino acid metabolism (betaine, N,N-dimethylglycine, methylguanidine, valine) and nucleotide metabolism (malonate, allantoin). In summary, this study reports for the first time, C. nutans water extract is a potential anti-anaphylactic agent and 1H-NMR metabolomics is a great alternative analytical tool to explicate the mechanism of action of anaphylaxis.

Matched MeSH terms: Anaphylaxis/blood; Anaphylaxis/immunology; Anaphylaxis/prevention & control*; Anaphylaxis/urine
Anti-allergic activity of 2,4,6-trihydroxy-3-geranylacetophenone (tHGA) via attenuation of IgE-mediated mast cell activation and inhibition of passive systemic anaphylaxis

Tan JW, Israf DA, Harith HH, Md Hashim NF, Ng CH, Shaari K, et al.

Toxicol Appl Pharmacol, 2017 03 15;319:47-58.
PMID: 28167223 DOI: 10.1016/j.taap.2017.02.002

tHGA, a geranyl acetophenone compound originally isolated from a local shrub called Melicope ptelefolia, has been previously reported to prevent ovalbumin-induced allergic airway inflammation in a murine model of allergic asthma by targeting cysteinyl leukotriene synthesis. Mast cells are immune effector cells involved in the pathogenesis of allergic diseases including asthma by releasing cysteinyl leukotrienes. The anti-asthmatic properties of tHGA could be attributed to its inhibitory effect on mast cell degranulation. As mast cell degranulation is an important event in allergic responses, this study aimed to investigate the anti-allergic effects of tHGA in cellular and animal models of IgE-mediated mast cell degranulation. For in vitro model of IgE-mediated mast cell degranulation, DNP-IgE-sensitized RBL-2H3 cells were pre-treated with tHGA before challenged with DNP-BSA to induce degranulation. For IgE-mediated passive systemic anaphylaxis, Sprague Dawley rats were sensitized by intraperitoneal injection of DNP-IgE before challenged with DNP-BSA. Both in vitro and in vivo models showed that tHGA significantly inhibited the release of preformed mediators (β-hexosaminidase and histamine) as well as de novo mediators (interleukin-4, tumour necrosis factor-α, prostaglandin D2 and leukotriene C4). Pre-treatment of tHGA also prevented IgE-challenged RBL-2H3 cells and peritoneal mast cells from undergoing morphological changes associated with mast cell degranulation. These findings indicate that tHGA possesses potent anti-allergic activity via attenuation of IgE-mediated mast cell degranulation and inhibition of IgE-mediated passive systemic anaphylaxis. Thus, tHGA may have the potential to be developed as a mast cell stabilizer for the treatment of allergic diseases in the future.

Matched MeSH terms: Passive Cutaneous Anaphylaxis/drug effects*; Passive Cutaneous Anaphylaxis/physiology
The Potential use of Honey as a Remedy for Allergic Diseases: A Mini Review

Aw Yong PY, Islam F, Harith HH, Israf DA, Tan JW, Tham CL

Front Pharmacol, 2020;11:599080.
PMID: 33574752 DOI: 10.3389/fphar.2020.599080

Honey has been conventionally consumed as food. However, its therapeutic properties have also gained much attention due to its application as a traditional medicine. Therapeutic properties of honey such as anti-microbial, anti-inflammatory, anti-cancer and wound healing have been widely reported. A number of interesting studies have reported the potential use of honey in the management of allergic diseases. Allergic diseases including anaphylaxis, asthma and atopic dermatitis (AD) are threatening around 20% of the world population. Although allergic reactions are somehow controllable with different drugs such as antihistamines, corticosteroids and mast cell stabilizers, modern dietary changes linked with allergic diseases have prompted studies to assess the preventive and therapeutic merits of dietary nutrients including honey. Many scientific evidences have shown that honey is able to relieve the pathological status and regulate the recruitment of inflammatory cells in cellular and animal models of allergic diseases. Clinically, a few studies demonstrated alleviation of allergic symptoms in patients after application or consumption of honey. Therefore, the objective of this mini review is to discuss the effectiveness of honey as a treatment or preventive approach for various allergic diseases. This mini review will provide insights into the potential use of honey in the management of allergic diseases in clinical settings.

Matched MeSH terms: Anaphylaxis
Cutaneous immune reaction: its usefulness in the evaluation of small-pox immunity in dark races

Doraisingham M

Journal of the Malaya Branch of the British Medical Association, 1940;4:314-18.

1. Observations made on groups of light and dark skinned individuals indicate that the percentage of dark skinned people who can be recognized as immune by their reaction to vaccination is considerably lower than in the case of people with a lesser skin pigmentation.
2. It is suggested that the reading of "immune reaction" is influenced considerably by the intensity of skin pigment found in the individual.
3. It would appear that while the usefulness of immune reaction readings in light-skinned peope is very great, its value is limited when applied to those with dark skins.

Matched MeSH terms: Passive Cutaneous Anaphylaxis
Ten years of lipoprotein apheresis for familial hypercholesterolemia in Malaysia: A creative approach by a cardiologist in a developing country

Khoo KL, Page MM, Liew YM, Defesche JC, Watts GF

J Clin Lipidol, 2016 05 13;10(5):1188-94.
PMID: 27678436 DOI: 10.1016/j.jacl.2016.05.006

BACKGROUND: Familial hypercholesterolemia (FH) leads to premature coronary artery disease and aortic stenosis, with undertreated severe forms causing death at a young age. Lipoprotein apheresis (LA) is often required for lowering low-density lipoprotein cholesterol levels in severe FH.
OBJECTIVES: The objective of this study was to present the first experiences with LA in Malaysia, between 2004 and 2014.
METHODS: We retrospectively collected data from patient records to assess the effectiveness, adverse effects, patient quality of life, and costs associated with an LA service for genetically confirmed homozygous and heterozygous FH.
RESULTS: We treated 13 women and 2 men aged 6 to 59 years, 10 with homozygous and 5 with heterozygous FH, all on maximally tolerated cholesterol-lowering drug therapy, for a total of 65 patient-years. Acute lowering of low-density lipoprotein cholesterol post apheresis was 56.3 ± 7.2%, with time-averaged mean lowering of 34.9 ± 13.9%. No patients experienced any cardiovascular events during the period of receiving LA. Patients receiving LA experienced few side effects and enjoyed reasonable quality of life, but inability to continue treatment was frequent because of cost.
CONCLUSION: LA for severe FH can be delivered effectively in the short term in developing nations, but costs are a major barrier to sustaining this mode of treatment for this high-risk group of patients. New drug therapies for FH, such as the proprotein convertase subtilisin/kexin type 9 inhibitors, microsomal triglyceride transfer protein inhibitors, and apolipoprotein-B100 antisense oligonucleotides may allow improved care for these patients, but costs and long-term safety remain as issues to be addressed.

Matched MeSH terms: Anaphylaxis/etiology
Immunochemical characterization of edible bird's nest allergens

Goh DL, Chua KY, Chew FT, Liang RC, Seow TK, Ou KL, et al.

J Allergy Clin Immunol, 2001 Jun;107(6):1082-7.
PMID: 11398089

BACKGROUND: We have previously described anaphylaxis induced by edible bird's nest (BN) and demonstrated that this condition is IgE mediated.
OBJECTIVES: This study aimed at describing the immunochemical properties of the BN allergens. Comparative studies between 3 commercially available sources (according to the country of origin) of BN were also made.
METHODS: Crude extracts of commercially available processed BN from Sarawak (Malaysia), Thailand, and Indonesia and fresh unprocessed BN from the caves of Sarawak were obtained by means of aqueous extraction. Specific IgE toward these sources were determined by using fluorescence allergosorbent tests (FASTs). Cross-reactivity studies between the 3 sources of commercially available processed BN were carried out by means of FAST inhibition. Immunochemical characterization by means of IgE immunoblot, periodate treatment, and heat stability studies were carried out on fresh unprocessed BN from Sarawak.
RESULTS: Serum from allergic patients showed differences in IgE binding to the 3 sources of commercially available BN, with the highest levels of specific IgE recorded with the Sarawak source (P

Matched MeSH terms: Anaphylaxis/etiology
Penicillin allergy 1976: a review of reactions, detection and current management

Fellner MJ

Int J Dermatol, 1976 Sep;15(7):497-504.
PMID: 134974
Matched MeSH terms: Anaphylaxis/chemically induced
Fulltext Acute myocardial infarction following ingestion of a non-selective non-steroidal anti-inflammatory drug

Mahmod M, Nor IF, Maskon O

BMJ Case Rep, 2010;2010.
PMID: 22448190 DOI: 10.1136/bcr.02.2009.1549

While selective non-steroidal anti-inflammatory drugs, namely cyclo-oxygenase-2 (COX 2) inhibitors, are known to be associated with acute myocardial infarction, little is known about the cardiovascular safety of the non-selective non-steroidal anti-inflammatory drugs. We report the case of a 44-year-old man who developed anaphylactic reaction and acute inferior myocardial infarction following ingestion of a non-selective anti-inflammatory drug, diclofenac sodium. Coronary angiography revealed a large thrombus in the right coronary artery which was partially removed by intracoronary catheter aspiration. Complete resolution of the remaining thrombus was achieved after treatment with an oral anticoagulant.

Matched MeSH terms: Anaphylaxis
Fulltext Supraventricular Tachycardia: An Unusual Side Effects of Cefuroxime

Yeap, Boon Tat, Yeoh, Boon Seng, Rajesh Kumar Muniandy

Borneo Journal of Medical Sciences, 2019;13(2):35-38.
MyJurnal

Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.

Matched MeSH terms: Anaphylaxis
Fulltext A diagnostic workup of perioperative anaphylaxis reveals a selective type 1 hypersensitivity to cefazolin

Meera Thalayasingam, Shek, Lynette Pei-Chi

International e-Journal of Science, Medicine & Education, 2015;9(2):37-39.
MyJurnal

Anaphylaxis in the operating room although infrequent can be potentially fatal. The diagnosis of perioperative anaphylaxis is complex due to a multitude of factors. Firstly, patients under anesthesia cannot verbalize their complaints, the anesthetic agents themselves can alter vital parameters (e.g. heart rate and blood pressure) and cutaneous signs in a completely draped patient may be missed. Secondly, the differential diagnosis of intraoperative anaphylaxis is wide. Conditions such as asthma exacerbation, arrhythmia, hemorrhage, angioedema, mastocytosis, acute myocardial infarction, drug overdose, pericardial tamponade, pulmonary edema, pulmonary embolus, sepsis, tension pneumothorax, vasovagal reaction, venous air embolism, laryngospasm, blood transfusion reaction and malignant hyperthermia need to be considered. Thirdly, the diagnostic workup is challenging due to the multiple medications administered and other exposures encountered such as latex and chlorhexidene. However, through a timely allergy consultation and a systematic approach, identification of the culprit agent and safe alternatives can be established to prevent future occurrences as illustrated in the case below.

Matched MeSH terms: Anaphylaxis
Fulltext Intravenous iron-sucrose complex for treatment of iron deficiency anaemia in pregnancy - experience in an obstetric day care clinic in a tertiary hospital

Tan, AE, Siti, S.A.

Medicine & Health, 2008;3(2):288-293.
MyJurnal

A cross-sectional study was undertaken to evaluate if outpatient administration of in-travenous iron sucrose complex (Venofer) was a sensible option in treating iron defi-ciency anaemia during pregnancy and puerperium. A total of 120 patients with iron deficiency anaemia were recruited from the Obstetric Day Care Clinic at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over 18 months from March 2003 to August 2004. The main outcome measures were haemoglobin increment, patients’ compliance, adverse effects and saving from hospitalization fees. The pre-treatment haemoglobin (Hb) level was 8.5+0.85g/dl for the antenatal patient and 7.6+0.80 g/dl in the post-partum group. The mean post-treatment haemoglobin increment at day four-teenth was 3.52+0.75g/dl. One patient developed skin rash while another had low-grade pyrexia. Seven patients experienced mild metallic taste. There were no serious side effects or anaphylactic reactions. Ten patients (8.3%) did not complete their ther-apy - eight delivered before completion of treatment; another two defaulted following delivery. The average number of Venofer used was seven ampoules i.e. 700mg per person, most of them required three sessions to complete the course. Outpatient treatment allows each patient to save hospitalization fees of RM45 per day, which to-talled up to RM135 for a 3-days ward stay. An estimation of RM16,200 hospitalization fees for the 120 patients was avoided during the study period. In conclusion, outpatient treatment of anaemia in pregnancy and post-partum period using Venofer was safe and feasible, with high patient compliant and cost-savings from hospitalization fees.
Study site: Obstetric Day Care Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Anaphylaxis
Fulltext Allergens derived from shrimp

Mary Margaret, P.D.S., Jinap, S., Ahmad Faizal, A.R.

International Food Research Journal, 2015;22(5):1751-1754.
MyJurnal

Allergy caused by food is usually type 1 allergy of four types of allergic reactions. One of the most widespread allergic is those that are caused by crustacean shellfish. Crustaceans are classified among arthropods which include crab, crayfish, lobster, prawn and shrimp. Shrimp which are broadly consumed as nutritional food is one of the most important food that contribute to allergy. Thus, reducing the allergenicity of shrimp allergen will be helpful to individuals who are sensitive to shrimp and for this reason the characteristics of each allergen need to be studied. Those sensitized individuals can develop urticaria, angiodema, laryngospasm, asthma and life threatening anaphylaxis. To date, four main allergens contribute to allergic reactions. They are tropomyosin (TM), a highly conserved and heat stable myofibrillar protein of 35-38 kDa followed by arginine kinase (AK) which is also known as Pen m 2 or Lit v 2 with 40 kDa. Two other contributing allergens are sarcoplasmic calcium-binding protein (SCP) also known as Lit v 4 with 22 kDa and myosin light chain (MLC) which is also termed as Lit v 3 with 20 kDa. This mini-review will provide a better understanding of each allergen derived from shrimp which subsequently will help to reduce the allergenicity.

Matched MeSH terms: Anaphylaxis
Anaphylaxis to Malaysian meat loaf

Moritz KB, Kopp T, Stingl G, Bublin M, Breiteneder H, Wöhrl S

Allergol Immunopathol (Madr), 2011 Jul-Aug;39(4):244-5.
PMID: 21741147 DOI: 10.1016/j.aller.2010.06.010
Matched MeSH terms: Anaphylaxis

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