Allergo Journal International

, Volume 23, Issue 2, pp 60–66

Human heart as a shock organ in anaphylaxis

  • Gianni Marone
  • Arturo Genovese
  • Gilda Varricchi
  • Francescopaolo Granata
Review Article

Summary

Anaphylaxis is a potentially fatal, immediate hypersensitivity reaction. Mast cells and basophils, by elaborating vasoactive mediators and cytokines, are the main primary effector cells of anaphylaxis. Mast cells have been identified in human heart between myocardial fibers, perivascularly, in the adventitia, and in the arterial intima. Mast cells isolated from human heart tissue (HHMC) of patients undergoing cardiac transplantation express high affinity immunglobulin E (IgE) receptors (FcεRI), C3a, C5a, and kit receptors (KIT). Anti-IgE, anti-FcεRI, and immunoglobulin superallergens induce in vitro secretion of preformed mediators (histamine, tryptase, chymase, and renin) and the de novo synthesis of cysteinyl leukotriene C4 (LTC4) and prostaglandin D2 (PGD2) from HHMC. Complement is activated and anaphylatoxin forms during anaphylaxis. C5a and C3a cause the in vitro release of histamine and tryptase from HHMC. Therapeutic (general anesthetics, protamine, etc.) and diagnostic agents (radio contrast media, etc.), which can cause anaphylactoid reactions, activate HHMC in vitro. Low concentrations of histamine and cysteinyl leukotrienes given to subjects undergoing diagnostic catheterisation caused significant systemic and coronary hemodynamic effects. These data indicate that human heart mast cells and their mediators play a role in severe anaphylactic reactions.

Keywords

Anaphylaxis heart histamine leukotrienes mast cells tryptase 

Abbreviations

C3aR

C3a receptor

C5aR

C5a receptor

CH

Control heart

CBF

Coronary blood flow

CVR

Coronary vascular resistance

CysLT2

Cysteinyl leukotriene receptor 2

CysLT1

Cysteinyl leukotriene receptor 1

DCM

Dilated cardiomyopathy

ECP

Eosinophil cationic protein

FcɛRI

High affinity immunglobulin E receptors

HHMC

Mast cells isolated from human heart tissue

ICM

Ischemic cardiomyopathy

IgE

Immunglobulin E

LTC4

Cysteinyl leukotriene C4

LTD4

Cysteinyl leukotriene D4

LV

Left ventricular

MBP

Major basic protein

PAF

Platelet-activating factor

PGD2

Prostaglandin D2

SCF

Stem cell factor

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Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  • Gianni Marone
    • 1
    • 2
    • 3
  • Arturo Genovese
    • 1
    • 2
  • Gilda Varricchi
    • 1
  • Francescopaolo Granata
    • 1
  1. 1.Department of Translational Medical SciencesUniversity of Naples Federico IINaplesItaly
  2. 2.Center for Basic and Clinical Immunology Research (CISI)University of Naples Federico IINaplesItaly
  3. 3.Department of Translational Medical SciencesUniversity of Naples Federico IINapoliItaly

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