Food-dependent,exercise-induced anaphylaxis(FDEIA)is a potentially life-threatening disorder that often occurs with exercise,and patients typically have eaten a specific food within hours before disease onset.This dis...Food-dependent,exercise-induced anaphylaxis(FDEIA)is a potentially life-threatening disorder that often occurs with exercise,and patients typically have eaten a specific food within hours before disease onset.This disease is exceedingly rare,with a prevalence of 0.02%.No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly.Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years.As the anaphylactic symptoms had not been controlled after traditional treatments,the patient was given subcutaneous injection of dupilumab seven times within 33 weeks.During dupilumab treatments,the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis.Thus,dupilumab may improve the allergic reactions in FDEIA patients.展开更多
Wheat dependent exercise-induced anaphylaxis（WDEIA） is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life（QOL） is ...Wheat dependent exercise-induced anaphylaxis（WDEIA） is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life（QOL） is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form（FAQLQ-AF） and Food Allergy Independent Measure（FAIM） after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion（26/28）. Symptoms of anaphylaxis included cutaneous（26/28）, respiratory（11/28）, gastro-intestinal（5/28） and cardiovascular manifestations（27/28）. Skin prick tests were positive to salt soluble（89.3%） and salt insoluble wheat allergen extracts（100%）. Positive rate to wheat, gluten and omega-5 gliadin specific Ig E was 64.3%, 92.9% and 92.9% respectively. Specific Ig E to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA（sensitivity： 89.3%; and specificity： 88.9%）. The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin Ig E had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific Ig E to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.展开更多
BACKGROUND The practice of Indian Ayurvedic medicine is spreading in Western countries and Shilajit is one of the most used drugs, for its antioxidant activities and immunomodulatory effects. Albeit Shilajit has showe...BACKGROUND The practice of Indian Ayurvedic medicine is spreading in Western countries and Shilajit is one of the most used drugs, for its antioxidant activities and immunomodulatory effects. Albeit Shilajit has showed a high degree of safety, it can act as cofactor of anaphylaxis, especially in condition at high risk, such as mast cell activation syndrome(MCAS). We reported this case to sensitize practitioners to investigate to the use of complementary and alternative medicine,in case of exercise-induced anaphylaxis(EIAn).CASE SUMMARY A 43-year-old woman, working as a dance teacher, developed urticaria after ingestion of rice, tuna and Shilajit, which did not respond to intramuscular corticosteroids. Subsequently, she developed dyspnoea and hypotension with loss of consciousness that arose 1 h after sexual activity. The patient did not refer personal history of atopy. Specific IgE for main food allergens resulted negative,with total IgE levels of 14 IU/L. Oral provocation test with Shilajit was not perfomed because the patient refused, but we performed prick-by-prick and patch test that resulted negative. Serum tryptase at the time of anaphylaxis was 20.6 μg/L that fell down to of 10.6 μg/L after therapy, but has remained at the high value after two days and during the follow-up. We performed an analysis of the c-KIT gene in peripheral blood, which was negative. We felt the diagnosis consistent with EIAn in a patient with a possible MCAS.CONCLUSION In Western countries the use of drugs from Ayurvedic medicine is more common than in the past. These substances can be cofactors of anaphylaxis in patients with risk factors.展开更多
Background： Wheat-dependent, exercise-induced anaphylaxis （WDEIA） is an allergic reaction induced by intense exercise combined with wheat ingestion. The gold standard for diagnosis of WDEIA is a food exercise chall...Background： Wheat-dependent, exercise-induced anaphylaxis （WDEIA） is an allergic reaction induced by intense exercise combined with wheat ingestion. The gold standard for diagnosis of WDEIA is a food exercise challenge： however, this test is unacceptable for Chinese WDEIA patients and unable to be approved by the Ethics Committee of Chinese hospitals due to substantial risk. There are no diagnostic criteria tbr Chinese WDEIA patients. The aim of present study was to propose new practical diagnosis criteria t＇or Chinese WDE1A patients. Methods： We prospectively included 283 clinically diagnosed WDEIA patients from January 1,2010 to June 30, 2014, and in tile meanwhile, three groups were enrolled which included 133 patients with the history of anaphylaxis induced by lbod other than wheat. 186 recurrent urticaria patients, and 94 healthy participants. Clinical comprehensive evaluation by allergists used as the reference gold standard, receiver operator characteristic （ROC） curves were plotted, areas under curve （AUC） tbr specific immunoglobin E （slgE） were compared to evaluate the diagnostic value of lgE specific to wheat, gluten, and 0）-5 gliadin. Patients were followed up by telephone questionnaire 1 year after diagnosis. Results： We reviewed 567 anaphylactic reactions in 283 WDEIA patients. Of these anaphylactic reactions, 415 （73.3%） reactions were potentially life-threatening anaphylaxis. Among the 567 anaphylactic reactions, 75% （425/567） occurred during exercise. The highest AUC （0.910） was observed for sIgE for gluten, followed by omega-5 gliadin （AUC 0.879）. Combined gluten- and co-5 gliadin-specific IgE testing provided sensitivity and specificity of 73.1% and 99.0%, respectively. During the 1-year follow-up period, repeat anaphylaxis was rare when patients observed strict avoidance of wheat products combined with exercise or other triggering agents. Conclusions： In this study, we proposed diagnostic criteria and management of WDEIA patients in China, Our present study suggested that confirmed anaphylactic reactions triggered by wheat with positive slgE to gluten and omega-5-gliadin may provide supportive evidence for clinicians to make WDEIA diagnosis without perforating a food exercise challenge.展开更多
Background Wheat-dependent exercise-induced anaphylaxis （WDEIA） is a complex disease resulting from interaction of environmental and genetic factors. The aim of this study was to investigate the association of three...Background Wheat-dependent exercise-induced anaphylaxis （WDEIA） is a complex disease resulting from interaction of environmental and genetic factors. The aim of this study was to investigate the association of three single nucleotide polymorphisms （SNPs） （IL-4-C590T, IL-4RA A1727G and IL-10-A627C） with WDEIA. Methods SNP genotyping was conducted among the case subset composing 51 patients with WDEIA and four control subsets by sequencing DNA yielded from polymerase chain reaction （PCR）. Statistical analysis of genotype/allele＇s frequencies between cases and controls were carried out through Fisher＇s exact test with the software of SPSS16.0. Results For IL-4-C590T, there were statistically significant differences of genotype frequencies in case-control 1 （P=0.03） and case-control 4 （P=0.001） and statistically significant differences of allele frequencies in three case-control models （case-control 1：OR=4.27 （95% CI=1.40-13.07）, P=0.009; case-control 3：OR=1.99 （95% CI=1.13-3.50）, P=0.02; case-control 4：OR=2.39 （95% CI=1.49-3.84）, P=0.001）. All other association studies showed no statistically significant （P 〉0.05）. Conclusions IL-4-C590T may be related to the susceptibility of WDEIA, and the minor allele C might be a potential risk factor accounting for WDEIA. IL-4RA A1727G and IL-10-A627C might not be involved in the occurrence of WDEIA.展开更多
Anaphylaxis is a complex and dynamic condition,marked by a heterogeneity of triggers,pathophysiological pathways,and clinical presentations.Although IgE-mediated immune responses are the predominant drivers of anaphyl...Anaphylaxis is a complex and dynamic condition,marked by a heterogeneity of triggers,pathophysiological pathways,and clinical presentations.Although IgE-mediated immune responses are the predominant drivers of anaphylaxis,non-IgE-mediated mechanisms,including complement activation,engagement of the contact sys-tem,and IgG-mediated processes,also significantly contribute to its pathogenesis.Furthermore,non-immunemediated pathways,such as MRGPRX2 receptor activation,play a pivotal role in the initiation of anaphylactic reactions.The diagnosis of anaphylaxis predominantly hinges on the recognition of clinical manifestations.Nevertheless,biomarkers like tryptase and CPA3,as well as genetic markers,serve as critical adjuncts in con-firming the diagnosis,evaluating the severity of the reaction,and forecasting the prognosis.The accurate identification and avoidance of allergens are fundamental strategies for preventing recurrent anaphylactic epi-sodes.Provision of epinephrine auto-injectors empower patients with effective tools for self-management.Future research endeavors should concentrate on deepening the understanding of the multifaceted pathophysiology of anaphylaxis,advancing the development of precise diagnostic modalities,and refining therapeutic strategies.Enhancing patient education and management protocols is also essential.These collective efforts are aimed at diminishing the incidence and mortality associated with anaphylaxis,thereby enhancing the quality of life for affected individuals.展开更多
This article summarizes recent advances in the understanding of RNA-binding proteins(RBPs),with a focus on their roles in exercise-induced mRNA regulation and their implications for schizophrenia(SZ).RBPs are critical...This article summarizes recent advances in the understanding of RNA-binding proteins(RBPs),with a focus on their roles in exercise-induced mRNA regulation and their implications for schizophrenia(SZ).RBPs are critical regulators of mRNA stability,splicing,transport,translation,and degradation,directly influencing gene expression through sequence-and structure-specific binding.In the nervous system,RBPs sustain synaptic plasticity,neural development,and neuronal homeostasis.Emerging evidence shows that exercise modulates the expression and activity of RBPs,thereby influencing mRNA translation and neurotransmitter signaling,which may underlie its beneficial effects on brain function.Dysregulation of specific RBPs has been identified in SZ,implicating them in disrupted synaptic transmission,impaired plasticity,and neuroinflammation.RBPs involved in memory and emotional regulation show marked dysfunction in SZ patients.Some RBPs have been proposed as potential biomarkers for early diagnosis and treatment monitoring.Moreover,therapeutic modulation of RBPs,through pharmacological or behavioral interventions such as exercise,may restore neuronal function by targeting post-transcriptional gene regulation.Exercise,as a non-invasive modulator of RBP expression,holds promise as an adjunctive strategy in SZ treatment,particularly in early stages.Further research into RBP-mediated pathways may offer novel insights into SZ pathophysiology and inform the development of targeted interventions.展开更多
Background:The pathogenesis of allergic asthma is classically understood to involve allergens crosslinking Immunoglobulin E(IgE)bound to mast cells,leading to the release of histamine and other inflammatory mediators....Background:The pathogenesis of allergic asthma is classically understood to involve allergens crosslinking Immunoglobulin E(IgE)bound to mast cells,leading to the release of histamine and other inflammatory mediators.Objective:This study aims to explore whether different allergens have distinct IgE-dependent mechanisms in mouse models of both asthma and anaphylaxis.Methods:Wild type(WT)and IgE knockout(IgE KO)mice were used to generate asthma mouse models.Lung inflammation was assessed by histological analysis and inflammatory cells in Bronchial Alveolar Lavage Fluids(BALF).Passive Cutaneous Anaphylaxis(PCA)was conducted to quantify IgE,and Toluidine Blue staining was used to visualize mast cell recruitment.Results:All allergen-treated mice exhibited significant airway inflammation.Compared to WT mice,HDM-treated IgE KO mice showed an attenuated inflammatory profile,particularly with reduced eosinophils.These mice had lower serum levels of HDM-specific IgE and IgG1 as well as reduced levels of Th2 cytokines interleukin 4(IL-4)and IL-5 in BALF.CRE-treated IgE KO mice also displayed a reduced inflammation,with significant differences only in eosinophils.Interestingly,no significant differences in airway inflammation were observed between OVA-treated IgE KO mice and WT mice.Furthermore,both HDM and CRE-induced PCA model showed significantly less Evan’s blue dye leakage and mast cell recruitment in the ears of IgE KO mice compared to WT mice,with no differences for OVA-induced PCA and mast cell recruitment.Conclusion:The results highlight the variability in IgE pathway dependence among different allergens,emphasizing the need for further research to delineate the underlying mechanisms.展开更多
Objective To observe modulatory effects of electroacupuncture （EA） on hypothalamus-pituitary adrenal （HPA） axis, thymus-exponent （TE）, γ-IFN and interleukin-2 （IL-2） in rats with exercise-induced immunosuppre...Objective To observe modulatory effects of electroacupuncture （EA） on hypothalamus-pituitary adrenal （HPA） axis, thymus-exponent （TE）, γ-IFN and interleukin-2 （IL-2） in rats with exercise-induced immunosuppression. Methods Forty-three SD rats were randomly, by using digits, divided into three groups： group A, B and C. Group A （n=10） was taken as a control group. Rats in group B （n=17） accepted intense swimming exercise for 150 min each time, 6 times each week for 8 weeks. Rats in group C （n=16） accepted EA intervention following each swimming since the second week of swimming exercise with the same duration and times as those in group B. The indices reflecting functional states of the HPA axis such as hypothalamic corticotropin releasing hormone （CRH）, plasma adrenocorticotropic hormone （ACTH）, corticosterone （CORT） etc. and changes in TE, serum γ-IFN, and IL-2 were determined. Results （1） Compared with group A, the values of ACTH and CORT in group B significantly increased （P〈0.01, P〈0.05）, but no significant differences were found in group C （both P〉0.05） though they were somewhat elevated. Compared with group A, CRH values increased by 85.14% in group B and decreased by 64.09% in group C, respectively, but both differences were without statistical significance （both P〉0.05）. Serum IL-2, γ-IFN and TE values in group B were significantly lower than those in group A（P〈0.05, P〈0.01 ）, among which γ-IFN decreased by 32.19%. The values of IL-2, γ-IFN and TE in group C tended to reduce but without significance, compared with group A. （2） Compared with group B, ACTH value in group C was very significantly lowered than that in group B （P〈0.01）, and CRH value was lower while CORT value was higher than those in group B but without significance （both P〉0.05）. The values of TE and γ-IFN in group C were significantly higher than those in group B （P〈0.01, P〈0.05）. Conclusion （1） Long-term of intense exercise induces accentuation of functions of the HPA axis and sustained high level of CORT, resulting in neuroendocrine disturbance and inhibition of immune functions. （2） EA provides favorable modulation on long-term of intense exercise-induced lowering of immune function and on the HPA axis.展开更多
The occurrence of exercise-induced fatigue can be delayed and exercise endurance can be strengthened by removing lactic acid, decreasing serum creatine kinase, elevating hemoglobin, maintaining blood glucose, eliminat...The occurrence of exercise-induced fatigue can be delayed and exercise endurance can be strengthened by removing lactic acid, decreasing serum creatine kinase, elevating hemoglobin, maintaining blood glucose, eliminating free radical, regulating amino acid metabolism and retaining heart rate with transcutaneous electrical acupoint stimulation （TEAS）. Problems in the above researching field are generalized in this paper. For instance, the point selection is relatively simple; the selection of wave band, frequency and duration during the application of TEAS apparatus are not unified; and observation indices mainly remained in the aspect of biochemistry. It also prospects the future directions of TEAS relieving exercise-induced fatigue including selecting acupuncture point by differentiation of symptoms and signs, setting uniform standards for TEAS, and studying the mechanisms of TEAS relieving exercise-induced fatigue by testing gonadal axis, adrenal axis, gene and protein .展开更多
Chinese bayberry Myrica rubra is a very popular fruit in southeastern China.In spite of its wide consumption,no allergies to this fruit have been reported previously.Here we report on a 40-year-old woman suffering fro...Chinese bayberry Myrica rubra is a very popular fruit in southeastern China.In spite of its wide consumption,no allergies to this fruit have been reported previously.Here we report on a 40-year-old woman suffering from anaphylaxis to Chinese bayberry fruit.Prick-prick skin tests revealed strong reactions to fresh Chinese bayberry fruits as well as to peach,and weaker reactions to some other fruits including apple,melon,and banana.ImmunoCAP analysis revealed identical titers of specific IgE(4.3 kU A /L) to peach extract and its lipid transfer protein(LTP,rPru p 3),which was confirmed by detection of a 9 kD band following immunoblotting.Immunoblot analysis with Chinese bayberry extract gave bands of 22,45,and 90 kD,but no 9 kD band was recognized.There was also no evidence of LTP recognition for loquat(36 kD) or melon(24 kD).This first report of a severe allergic reaction to Chinese bayberry fruit in a patient with LTP-mediated peach allergy indicates that other as yet unidentified non-pollen related fruit allergens are involved in this new severe fruit allergy.展开更多
BACKGROUND:While epinephrine is the recommended first-line therapy for the reversal of anaphylaxis symptoms,inappropriate use persists because of misunderstandings about proper dosing and administration or misconcepti...BACKGROUND:While epinephrine is the recommended first-line therapy for the reversal of anaphylaxis symptoms,inappropriate use persists because of misunderstandings about proper dosing and administration or misconceptions about its safety.The objective of this review was to evaluate the safety of epinephrine for patients with anaphylaxis,including other emergent conditions,treated in emergency care settings.METHODS:A MEDLINE search using PubMed was conducted to identify articles that discuss the dosing,administration,and safety of epinephrine in the emergency setting for anaphylaxis and other conditions.RESULTS:Epinephrine is safe for anaphylaxis when given at the correct dose by intramuscular injection.The majority of dosing errors and cardiovascular adverse reactions occur when epinephrine is given intravenously or incorrectly dosed.CONCLUSION:Epinephrine by intramuscular injection is a safe therapy for anaphylaxis but training may still be necessary in emergency care settings to minimize drug dosing and administration errors and to allay concerns about its safety.展开更多
Peginterferon is a key drug used to treat chronic viral hepatitis that is known for causing various side effects.Side effects occurring immediately after administration include headache, nausea, and influenza-like sym...Peginterferon is a key drug used to treat chronic viral hepatitis that is known for causing various side effects.Side effects occurring immediately after administration include headache, nausea, and influenza-like symptoms, such as fever and joint pain.However, reports of anaphylactic shock are extremely rare.Here we report a patient with protracted anaphylaxis who suffered shock symptoms after peginterferon α-2a administration for chronic hepatitis C.Although the patient improved temporarily with shock treatment, symptoms of anaphylaxis recurred.As peginterferon is often administered on an outpatient basis, it is important to recognize life-threatening side effects that may develop in a protracted manner.展开更多
OBJECTIVE:To study the anaphylaxis of Qingkailing injection(QI) and its components.METHODS:Experimental anaphylactoid and allergic reactions were used.Changes in the behaviors of Beagles and serum levels of histamine,...OBJECTIVE:To study the anaphylaxis of Qingkailing injection(QI) and its components.METHODS:Experimental anaphylactoid and allergic reactions were used.Changes in the behaviors of Beagles and serum levels of histamine,immunoglobulin(Ig)E,IgG,IgM,eosinophil cationic protein(ECP),and interleukin(IL)-4,as well as blood pressure,after injecting QI and its components on the forelimb veins of Beagles were observed.RESULTS:According to comprehensive determination of abnormal behavior scores and changes in serum levels of histamine,IgE,IgG,IgM,ECP,and IL-4,as well as in blood pressure,radix isatidis and hyodeoxycholic acid caused anaphylactoid reactions,and honeysuckle,radix isatidis,hydrolysate,cholic acid and Gardenia jasminoides caused allergic reactions.The anaphylaxis of QI involved anaphylactoid and allergic reactions.CONCLUSION:QI and its components need to be refined further to improve the safety,efficacy,and quality of its use in clinical settings.展开更多
The sting of Giant Asian honeybee(Apis dorsata) or Bambara in Sinhala and Kanmge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions,which could be fatal in sensit...The sting of Giant Asian honeybee(Apis dorsata) or Bambara in Sinhala and Kanmge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions,which could be fatal in sensitized individuals.We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients’skin.展开更多
BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting.Current guidelines recommend:1) quick diagnosis using standard criteri...BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting.Current guidelines recommend:1) quick diagnosis using standard criteria;2) first-line treatment with epinephrine;and 3) discharge with a prescription for an epinephrine auto-injector,written instructions regarding long-term management,and a referral(preferably,allergy) for follow-up.However,studies suggest low concordance with guideline recommendations by emergency medicine(EM) providers.The study aimed to evaluate how emergency departments(EDs) in the United States(US) manage anaphylaxis in relation to guideline recommendations.METHODS:This was an online anonymous survey of a random sample of EM health providers in US EDs.RESULTS:Data analysis included 207 EM providers.For respondent EDs,approximately 9%reported using agreed-upon clinical criteria to diagnose anaphylaxis;42%reported administering epinephrine in the ED for most anaphylaxis episodes;and <50%provided patients with a prescription for an epinephrine auto-injector and/or an allergist referral on discharge.Most provided some written materials,and follow-up with a primary care clinician was recommended.CONCLUSIONS:This is the first cross-sectional survey to provide "real-world" data showing that practice in US EDs is discordant with current guideline recommendations for the diagnosis,treatment,and follow-up of patients with anaphylaxis.The primary gaps are low(or no) utilization of standard criteria for defining anaphylaxis and inconsistent use of epinephrine.Prospective research is recommended.展开更多
Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain- containing 5 （FNDC5） protein. Once released to circulation upon exercise or cold exposure, irisin stimulates brow...Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain- containing 5 （FNDC5） protein. Once released to circulation upon exercise or cold exposure, irisin stimulates browning of white adipose tissue （WAT） and uncoupling protein I （UCP1） expression, leading to an increase in total body energy expenditure by augmented UCPl-mediated thermogenesis. It is currently unknown whether irisin is secreted by bone upon exercise or whether it regulates bone metabolism in vivo. In this study, we found that 2 weeks of voluntary wheel-running exercise induced high levels of FNDC5 messenger RNA as well as FNDC5/irisin protein expression in murine bone tissues. Increased immunoreactivity due to exercise-induced FNDC5/irisin expression was detected in different regions of exercised femoral bones, including growth plate, trabecular bone, cortical bone, articular cartilage, and bone-tendon interface. Exercise also increased expression of osteogenic markers in bone and that of UCP1 in WAT, and led to bodyweight loss. Irisin intraperitoneal （IP） administration resulted in increased trabecular and cortical bone thickness and osteoblasts numbers, and concurrently induced UCP1 expression in subcutaneous WAT. Lentiviral FNDC5 IP administration increased cortical bone thickness. In vitro studies in bone cells revealed irisin increases osteoblastogenesis and mineralization, and inhibits receptor activator of nuclear factor-kB ligand （RANKL）- induced osteoclastogenesis. Taken together, our findings show that voluntary exercise increases irisin production in bone, and that an increase in circulating irisin levels enhances osteogenesis in mice.展开更多
AIM: To investigate the expression of mast cell tryptase and carboxypeptidase A in drug-related fatal anaphylaxis.METHODS: The expression of mast cell tryptase and carboxypeptidase A in 15 autopsy cases of drugrelated...AIM: To investigate the expression of mast cell tryptase and carboxypeptidase A in drug-related fatal anaphylaxis.METHODS: The expression of mast cell tryptase and carboxypeptidase A in 15 autopsy cases of drugrelated fatal anaphylaxis and 20 normal autopsy cases were detected. First, the expression of mast cell tryptase was determined in stomach, jejunum, lung, heart, and larynx by immunofluorescence. Different tissues were removed and fixed in paraformaldehyde solution, then paraffin sections were prepared for immunofluorescence. Using specific mast cell tryptase and carboxypeptidase A antibodies, the expression of tryptase and carboxypeptidase A in gastroenterology tract and other tissues were observed using fluorescent microscopy. The postmortem serum and pericardial fluid were collected from drug-related fatal anaphylaxis and normal autopsy cases. The level of mast cell tryptase and carboxypeptidase A in postmortem serum and pericardial fluid were measured using fluor enzyme linked immunosorbent assay(FEIA) and enzyme linked immunosorbent assay(ELISA) assay. The expression of mast cell tryptase and carboxypeptidase A was analyzed in drug-related fatal anaphylaxis cases and compared to normal autopsy cases.RESULTS: The expression of carboxypeptidase A was less in the gastroenterology tract and other tissues from anaphylaxis-related death cadavers than normal controls. Immunofluorescence revealed that tryptase expression was significantly increased in multiple organs, especially the gastrointestinal tract, from anaphylaxis-related death cadavers compared to normal autopsy cases(46.67 ± 11.11 vs 4.88 ± 1.56 in stomach, 48.89 ± 11.02 vs 5.21 ± 1.34 in jejunum, 33.72 ± 5.76 vs 1.30 ± 1.02 in lung, 40.08 ± 7.56 vs 1.67 ± 1.03 in larynx, 7.11 ± 5.67 vs 1.10 ± 0.77 in heart, P < 0.05). Tryptase levels, as measured with FEIA, were significantly increased in both sera(43.50 ± 0.48 μg/L vs 5.40 ± 0.36 μg/L, P < 0.05) and pericardial fluid(28.64 ± 0.32 μg/L vs 4.60 ± 0.48 μg/L, P < 0.05) from the anaphylaxis group in comparison with the control group. As measured by ELISA, the concentration of carboxypeptidase A was also increased more than 2-fold in the anaphylaxis group compared to control(8.99 ± 3.91 ng/m L vs 3.25 ± 2.30 ng/m L in serum, 4.34 ± 2.41 ng/m L vs 1.43 ± 0.58 ng/m L in pericardial fluid, P < 0.05).CONCLUSION: Detection of both mast cell tryptase and carboxypeptidase A could improve the forensic identification of drug-related fatal anaphylaxis.展开更多
Background:Platelet rich plasma(PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury.However,the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not...Background:Platelet rich plasma(PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury.However,the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not been fully elucidated in exercise-induced muscle damage.The purpose of this investigation the effects of intramuscular delivery of PRP on hematologic and biochemical responses and recovery strategy muscle damage induced by high intensity muscle exercise(exercise-induced muscle damage,EIMD).Methods:Moderately active male volunteers participated in this study and were assigned to a control group(control,n = 6) and PRP administration group(PRP,n = 6).The subjects performed exercise with a load of 80% one repetition maximum(1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm was reached.The arms were treated with saline or autologous PRP post-24 h EIMD.Venous blood samples were obtained in the morning to establish a baseline value and 1–4 days post-exercise and were analyzed for serum ferritin,iron,iron binding capacity(IBC),creatinine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),and alanine aminotransferase(ALT).Results:The baseline levels of plasma iron,ferritin,IBC,CK,LDH,AST,and ALT were similar in both the control and PRP groups.However,24-h following exercise a significant increase in these parameters was observed in both groups between 1 and 4 days during the recovery period.Interestingly,PRP administration decreased plasma iron levels compared to the control on the second day post-exercise.Plasma IBC increased in PRP group from Days 2 to 4 post-exercise compared to the control group whilst PRP administration had no effect on plasma ferritin,CK,AST,ALT,or LDH.Conclusion:Acute exhaustive exercise increased muscle damage markers,including plasma iron,IBC,and ferritin levels,indicating muscle damage induced by exercise.PRP administration improves inflammation by reversing the increase in the iron levels post-exercise without displaying any myotoxicity and may have a role to play in the recovery of exercise-induced muscle damage.展开更多
Objective Patients undergoing cardiac surgery are exposed to a large range of drugs and foreign substances,which might result in anaphylaxis.Severe anaphylaxis in cardiac surgical patients could be life-threatening.Th...Objective Patients undergoing cardiac surgery are exposed to a large range of drugs and foreign substances,which might result in anaphylaxis.Severe anaphylaxis in cardiac surgical patients could be life-threatening.Therefore,timely diagnosis and proactive treatment are crucial.Definition of anaphylaxis,epidemiology of anaphylaxis and common allergens,specific anaphylaxis,diagnosis and management of peri-operative anaphylaxis in cardiac surgery patients were discussed in this review.展开更多
文摘Food-dependent,exercise-induced anaphylaxis(FDEIA)is a potentially life-threatening disorder that often occurs with exercise,and patients typically have eaten a specific food within hours before disease onset.This disease is exceedingly rare,with a prevalence of 0.02%.No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly.Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years.As the anaphylactic symptoms had not been controlled after traditional treatments,the patient was given subcutaneous injection of dupilumab seven times within 33 weeks.During dupilumab treatments,the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis.Thus,dupilumab may improve the allergic reactions in FDEIA patients.
文摘Wheat dependent exercise-induced anaphylaxis（WDEIA） is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life（QOL） is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form（FAQLQ-AF） and Food Allergy Independent Measure（FAIM） after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion（26/28）. Symptoms of anaphylaxis included cutaneous（26/28）, respiratory（11/28）, gastro-intestinal（5/28） and cardiovascular manifestations（27/28）. Skin prick tests were positive to salt soluble（89.3%） and salt insoluble wheat allergen extracts（100%）. Positive rate to wheat, gluten and omega-5 gliadin specific Ig E was 64.3%, 92.9% and 92.9% respectively. Specific Ig E to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA（sensitivity： 89.3%; and specificity： 88.9%）. The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin Ig E had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific Ig E to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.
文摘BACKGROUND The practice of Indian Ayurvedic medicine is spreading in Western countries and Shilajit is one of the most used drugs, for its antioxidant activities and immunomodulatory effects. Albeit Shilajit has showed a high degree of safety, it can act as cofactor of anaphylaxis, especially in condition at high risk, such as mast cell activation syndrome(MCAS). We reported this case to sensitize practitioners to investigate to the use of complementary and alternative medicine,in case of exercise-induced anaphylaxis(EIAn).CASE SUMMARY A 43-year-old woman, working as a dance teacher, developed urticaria after ingestion of rice, tuna and Shilajit, which did not respond to intramuscular corticosteroids. Subsequently, she developed dyspnoea and hypotension with loss of consciousness that arose 1 h after sexual activity. The patient did not refer personal history of atopy. Specific IgE for main food allergens resulted negative,with total IgE levels of 14 IU/L. Oral provocation test with Shilajit was not perfomed because the patient refused, but we performed prick-by-prick and patch test that resulted negative. Serum tryptase at the time of anaphylaxis was 20.6 μg/L that fell down to of 10.6 μg/L after therapy, but has remained at the high value after two days and during the follow-up. We performed an analysis of the c-KIT gene in peripheral blood, which was negative. We felt the diagnosis consistent with EIAn in a patient with a possible MCAS.CONCLUSION In Western countries the use of drugs from Ayurvedic medicine is more common than in the past. These substances can be cofactors of anaphylaxis in patients with risk factors.
基金This study was supported by grants from the CAMS Innovation Fund for Medical Sciences （No. 2016-12M-1-003） and the Natural Science Foundation of China （No. 81273277）.
文摘Background： Wheat-dependent, exercise-induced anaphylaxis （WDEIA） is an allergic reaction induced by intense exercise combined with wheat ingestion. The gold standard for diagnosis of WDEIA is a food exercise challenge： however, this test is unacceptable for Chinese WDEIA patients and unable to be approved by the Ethics Committee of Chinese hospitals due to substantial risk. There are no diagnostic criteria tbr Chinese WDEIA patients. The aim of present study was to propose new practical diagnosis criteria t＇or Chinese WDE1A patients. Methods： We prospectively included 283 clinically diagnosed WDEIA patients from January 1,2010 to June 30, 2014, and in tile meanwhile, three groups were enrolled which included 133 patients with the history of anaphylaxis induced by lbod other than wheat. 186 recurrent urticaria patients, and 94 healthy participants. Clinical comprehensive evaluation by allergists used as the reference gold standard, receiver operator characteristic （ROC） curves were plotted, areas under curve （AUC） tbr specific immunoglobin E （slgE） were compared to evaluate the diagnostic value of lgE specific to wheat, gluten, and 0）-5 gliadin. Patients were followed up by telephone questionnaire 1 year after diagnosis. Results： We reviewed 567 anaphylactic reactions in 283 WDEIA patients. Of these anaphylactic reactions, 415 （73.3%） reactions were potentially life-threatening anaphylaxis. Among the 567 anaphylactic reactions, 75% （425/567） occurred during exercise. The highest AUC （0.910） was observed for sIgE for gluten, followed by omega-5 gliadin （AUC 0.879）. Combined gluten- and co-5 gliadin-specific IgE testing provided sensitivity and specificity of 73.1% and 99.0%, respectively. During the 1-year follow-up period, repeat anaphylaxis was rare when patients observed strict avoidance of wheat products combined with exercise or other triggering agents. Conclusions： In this study, we proposed diagnostic criteria and management of WDEIA patients in China, Our present study suggested that confirmed anaphylactic reactions triggered by wheat with positive slgE to gluten and omega-5-gliadin may provide supportive evidence for clinicians to make WDEIA diagnosis without perforating a food exercise challenge.
文摘Background Wheat-dependent exercise-induced anaphylaxis （WDEIA） is a complex disease resulting from interaction of environmental and genetic factors. The aim of this study was to investigate the association of three single nucleotide polymorphisms （SNPs） （IL-4-C590T, IL-4RA A1727G and IL-10-A627C） with WDEIA. Methods SNP genotyping was conducted among the case subset composing 51 patients with WDEIA and four control subsets by sequencing DNA yielded from polymerase chain reaction （PCR）. Statistical analysis of genotype/allele＇s frequencies between cases and controls were carried out through Fisher＇s exact test with the software of SPSS16.0. Results For IL-4-C590T, there were statistically significant differences of genotype frequencies in case-control 1 （P=0.03） and case-control 4 （P=0.001） and statistically significant differences of allele frequencies in three case-control models （case-control 1：OR=4.27 （95% CI=1.40-13.07）, P=0.009; case-control 3：OR=1.99 （95% CI=1.13-3.50）, P=0.02; case-control 4：OR=2.39 （95% CI=1.49-3.84）, P=0.001）. All other association studies showed no statistically significant （P 〉0.05）. Conclusions IL-4-C590T may be related to the susceptibility of WDEIA, and the minor allele C might be a potential risk factor accounting for WDEIA. IL-4RA A1727G and IL-10-A627C might not be involved in the occurrence of WDEIA.
文摘Anaphylaxis is a complex and dynamic condition,marked by a heterogeneity of triggers,pathophysiological pathways,and clinical presentations.Although IgE-mediated immune responses are the predominant drivers of anaphylaxis,non-IgE-mediated mechanisms,including complement activation,engagement of the contact sys-tem,and IgG-mediated processes,also significantly contribute to its pathogenesis.Furthermore,non-immunemediated pathways,such as MRGPRX2 receptor activation,play a pivotal role in the initiation of anaphylactic reactions.The diagnosis of anaphylaxis predominantly hinges on the recognition of clinical manifestations.Nevertheless,biomarkers like tryptase and CPA3,as well as genetic markers,serve as critical adjuncts in con-firming the diagnosis,evaluating the severity of the reaction,and forecasting the prognosis.The accurate identification and avoidance of allergens are fundamental strategies for preventing recurrent anaphylactic epi-sodes.Provision of epinephrine auto-injectors empower patients with effective tools for self-management.Future research endeavors should concentrate on deepening the understanding of the multifaceted pathophysiology of anaphylaxis,advancing the development of precise diagnostic modalities,and refining therapeutic strategies.Enhancing patient education and management protocols is also essential.These collective efforts are aimed at diminishing the incidence and mortality associated with anaphylaxis,thereby enhancing the quality of life for affected individuals.
文摘This article summarizes recent advances in the understanding of RNA-binding proteins(RBPs),with a focus on their roles in exercise-induced mRNA regulation and their implications for schizophrenia(SZ).RBPs are critical regulators of mRNA stability,splicing,transport,translation,and degradation,directly influencing gene expression through sequence-and structure-specific binding.In the nervous system,RBPs sustain synaptic plasticity,neural development,and neuronal homeostasis.Emerging evidence shows that exercise modulates the expression and activity of RBPs,thereby influencing mRNA translation and neurotransmitter signaling,which may underlie its beneficial effects on brain function.Dysregulation of specific RBPs has been identified in SZ,implicating them in disrupted synaptic transmission,impaired plasticity,and neuroinflammation.RBPs involved in memory and emotional regulation show marked dysfunction in SZ patients.Some RBPs have been proposed as potential biomarkers for early diagnosis and treatment monitoring.Moreover,therapeutic modulation of RBPs,through pharmacological or behavioral interventions such as exercise,may restore neuronal function by targeting post-transcriptional gene regulation.Exercise,as a non-invasive modulator of RBP expression,holds promise as an adjunctive strategy in SZ treatment,particularly in early stages.Further research into RBP-mediated pathways may offer novel insights into SZ pathophysiology and inform the development of targeted interventions.
文摘Background:The pathogenesis of allergic asthma is classically understood to involve allergens crosslinking Immunoglobulin E(IgE)bound to mast cells,leading to the release of histamine and other inflammatory mediators.Objective:This study aims to explore whether different allergens have distinct IgE-dependent mechanisms in mouse models of both asthma and anaphylaxis.Methods:Wild type(WT)and IgE knockout(IgE KO)mice were used to generate asthma mouse models.Lung inflammation was assessed by histological analysis and inflammatory cells in Bronchial Alveolar Lavage Fluids(BALF).Passive Cutaneous Anaphylaxis(PCA)was conducted to quantify IgE,and Toluidine Blue staining was used to visualize mast cell recruitment.Results:All allergen-treated mice exhibited significant airway inflammation.Compared to WT mice,HDM-treated IgE KO mice showed an attenuated inflammatory profile,particularly with reduced eosinophils.These mice had lower serum levels of HDM-specific IgE and IgG1 as well as reduced levels of Th2 cytokines interleukin 4(IL-4)and IL-5 in BALF.CRE-treated IgE KO mice also displayed a reduced inflammation,with significant differences only in eosinophils.Interestingly,no significant differences in airway inflammation were observed between OVA-treated IgE KO mice and WT mice.Furthermore,both HDM and CRE-induced PCA model showed significantly less Evan’s blue dye leakage and mast cell recruitment in the ears of IgE KO mice compared to WT mice,with no differences for OVA-induced PCA and mast cell recruitment.Conclusion:The results highlight the variability in IgE pathway dependence among different allergens,emphasizing the need for further research to delineate the underlying mechanisms.
基金Supported by Guangdong Natural Science Foundation Project: 050042740
文摘Objective To observe modulatory effects of electroacupuncture （EA） on hypothalamus-pituitary adrenal （HPA） axis, thymus-exponent （TE）, γ-IFN and interleukin-2 （IL-2） in rats with exercise-induced immunosuppression. Methods Forty-three SD rats were randomly, by using digits, divided into three groups： group A, B and C. Group A （n=10） was taken as a control group. Rats in group B （n=17） accepted intense swimming exercise for 150 min each time, 6 times each week for 8 weeks. Rats in group C （n=16） accepted EA intervention following each swimming since the second week of swimming exercise with the same duration and times as those in group B. The indices reflecting functional states of the HPA axis such as hypothalamic corticotropin releasing hormone （CRH）, plasma adrenocorticotropic hormone （ACTH）, corticosterone （CORT） etc. and changes in TE, serum γ-IFN, and IL-2 were determined. Results （1） Compared with group A, the values of ACTH and CORT in group B significantly increased （P〈0.01, P〈0.05）, but no significant differences were found in group C （both P〉0.05） though they were somewhat elevated. Compared with group A, CRH values increased by 85.14% in group B and decreased by 64.09% in group C, respectively, but both differences were without statistical significance （both P〉0.05）. Serum IL-2, γ-IFN and TE values in group B were significantly lower than those in group A（P〈0.05, P〈0.01 ）, among which γ-IFN decreased by 32.19%. The values of IL-2, γ-IFN and TE in group C tended to reduce but without significance, compared with group A. （2） Compared with group B, ACTH value in group C was very significantly lowered than that in group B （P〈0.01）, and CRH value was lower while CORT value was higher than those in group B but without significance （both P〉0.05）. The values of TE and γ-IFN in group C were significantly higher than those in group B （P〈0.01, P〈0.05）. Conclusion （1） Long-term of intense exercise induces accentuation of functions of the HPA axis and sustained high level of CORT, resulting in neuroendocrine disturbance and inhibition of immune functions. （2） EA provides favorable modulation on long-term of intense exercise-induced lowering of immune function and on the HPA axis.
基金Supported by Shanghai Sports Technology Soaring Program: 09 Tf015
文摘The occurrence of exercise-induced fatigue can be delayed and exercise endurance can be strengthened by removing lactic acid, decreasing serum creatine kinase, elevating hemoglobin, maintaining blood glucose, eliminating free radical, regulating amino acid metabolism and retaining heart rate with transcutaneous electrical acupoint stimulation （TEAS）. Problems in the above researching field are generalized in this paper. For instance, the point selection is relatively simple; the selection of wave band, frequency and duration during the application of TEAS apparatus are not unified; and observation indices mainly remained in the aspect of biochemistry. It also prospects the future directions of TEAS relieving exercise-induced fatigue including selecting acupuncture point by differentiation of symptoms and signs, setting uniform standards for TEAS, and studying the mechanisms of TEAS relieving exercise-induced fatigue by testing gonadal axis, adrenal axis, gene and protein .
基金Project (Nos. 30971970 and 30600266) supported by the National Natural Science Foundation of China
文摘Chinese bayberry Myrica rubra is a very popular fruit in southeastern China.In spite of its wide consumption,no allergies to this fruit have been reported previously.Here we report on a 40-year-old woman suffering from anaphylaxis to Chinese bayberry fruit.Prick-prick skin tests revealed strong reactions to fresh Chinese bayberry fruits as well as to peach,and weaker reactions to some other fruits including apple,melon,and banana.ImmunoCAP analysis revealed identical titers of specific IgE(4.3 kU A /L) to peach extract and its lipid transfer protein(LTP,rPru p 3),which was confirmed by detection of a 9 kD band following immunoblotting.Immunoblot analysis with Chinese bayberry extract gave bands of 22,45,and 90 kD,but no 9 kD band was recognized.There was also no evidence of LTP recognition for loquat(36 kD) or melon(24 kD).This first report of a severe allergic reaction to Chinese bayberry fruit in a patient with LTP-mediated peach allergy indicates that other as yet unidentified non-pollen related fruit allergens are involved in this new severe fruit allergy.
文摘BACKGROUND:While epinephrine is the recommended first-line therapy for the reversal of anaphylaxis symptoms,inappropriate use persists because of misunderstandings about proper dosing and administration or misconceptions about its safety.The objective of this review was to evaluate the safety of epinephrine for patients with anaphylaxis,including other emergent conditions,treated in emergency care settings.METHODS:A MEDLINE search using PubMed was conducted to identify articles that discuss the dosing,administration,and safety of epinephrine in the emergency setting for anaphylaxis and other conditions.RESULTS:Epinephrine is safe for anaphylaxis when given at the correct dose by intramuscular injection.The majority of dosing errors and cardiovascular adverse reactions occur when epinephrine is given intravenously or incorrectly dosed.CONCLUSION:Epinephrine by intramuscular injection is a safe therapy for anaphylaxis but training may still be necessary in emergency care settings to minimize drug dosing and administration errors and to allay concerns about its safety.
文摘Peginterferon is a key drug used to treat chronic viral hepatitis that is known for causing various side effects.Side effects occurring immediately after administration include headache, nausea, and influenza-like symptoms, such as fever and joint pain.However, reports of anaphylactic shock are extremely rare.Here we report a patient with protracted anaphylaxis who suffered shock symptoms after peginterferon α-2a administration for chronic hepatitis C.Although the patient improved temporarily with shock treatment, symptoms of anaphylaxis recurred.As peginterferon is often administered on an outpatient basis, it is important to recognize life-threatening side effects that may develop in a protracted manner.
基金Supported by National Science and Technology Major Projects(No.2010ZX09502-002)
文摘OBJECTIVE:To study the anaphylaxis of Qingkailing injection(QI) and its components.METHODS:Experimental anaphylactoid and allergic reactions were used.Changes in the behaviors of Beagles and serum levels of histamine,immunoglobulin(Ig)E,IgG,IgM,eosinophil cationic protein(ECP),and interleukin(IL)-4,as well as blood pressure,after injecting QI and its components on the forelimb veins of Beagles were observed.RESULTS:According to comprehensive determination of abnormal behavior scores and changes in serum levels of histamine,IgE,IgG,IgM,ECP,and IL-4,as well as in blood pressure,radix isatidis and hyodeoxycholic acid caused anaphylactoid reactions,and honeysuckle,radix isatidis,hydrolysate,cholic acid and Gardenia jasminoides caused allergic reactions.The anaphylaxis of QI involved anaphylactoid and allergic reactions.CONCLUSION:QI and its components need to be refined further to improve the safety,efficacy,and quality of its use in clinical settings.
文摘The sting of Giant Asian honeybee(Apis dorsata) or Bambara in Sinhala and Kanmge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions,which could be fatal in sensitized individuals.We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients’skin.
基金supported in part by an unrestricted educational grant from Mylan Specialty Pharmaceuticals(Basking Ridge,NJ)
文摘BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting.Current guidelines recommend:1) quick diagnosis using standard criteria;2) first-line treatment with epinephrine;and 3) discharge with a prescription for an epinephrine auto-injector,written instructions regarding long-term management,and a referral(preferably,allergy) for follow-up.However,studies suggest low concordance with guideline recommendations by emergency medicine(EM) providers.The study aimed to evaluate how emergency departments(EDs) in the United States(US) manage anaphylaxis in relation to guideline recommendations.METHODS:This was an online anonymous survey of a random sample of EM health providers in US EDs.RESULTS:Data analysis included 207 EM providers.For respondent EDs,approximately 9%reported using agreed-upon clinical criteria to diagnose anaphylaxis;42%reported administering epinephrine in the ED for most anaphylaxis episodes;and <50%provided patients with a prescription for an epinephrine auto-injector and/or an allergist referral on discharge.Most provided some written materials,and follow-up with a primary care clinician was recommended.CONCLUSIONS:This is the first cross-sectional survey to provide "real-world" data showing that practice in US EDs is discordant with current guideline recommendations for the diagnosis,treatment,and follow-up of patients with anaphylaxis.The primary gaps are low(or no) utilization of standard criteria for defining anaphylaxis and inconsistent use of epinephrine.Prospective research is recommended.
基金supported by a R01DE21464 through the National Institutes of Healthan Innovation in Oral Care Award through International Association for Dental Research and Glaxo Smith Kline Consumer Healthcare+2 种基金an Award through International Team of Implantology to JCby GZUCM Science Fund for Creative Research Groups(2016KYTD10)GZUCM Torch Program(A1-AFD015142Z08)to JZ
文摘Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain- containing 5 （FNDC5） protein. Once released to circulation upon exercise or cold exposure, irisin stimulates browning of white adipose tissue （WAT） and uncoupling protein I （UCP1） expression, leading to an increase in total body energy expenditure by augmented UCPl-mediated thermogenesis. It is currently unknown whether irisin is secreted by bone upon exercise or whether it regulates bone metabolism in vivo. In this study, we found that 2 weeks of voluntary wheel-running exercise induced high levels of FNDC5 messenger RNA as well as FNDC5/irisin protein expression in murine bone tissues. Increased immunoreactivity due to exercise-induced FNDC5/irisin expression was detected in different regions of exercised femoral bones, including growth plate, trabecular bone, cortical bone, articular cartilage, and bone-tendon interface. Exercise also increased expression of osteogenic markers in bone and that of UCP1 in WAT, and led to bodyweight loss. Irisin intraperitoneal （IP） administration resulted in increased trabecular and cortical bone thickness and osteoblasts numbers, and concurrently induced UCP1 expression in subcutaneous WAT. Lentiviral FNDC5 IP administration increased cortical bone thickness. In vitro studies in bone cells revealed irisin increases osteoblastogenesis and mineralization, and inhibits receptor activator of nuclear factor-kB ligand （RANKL）- induced osteoclastogenesis. Taken together, our findings show that voluntary exercise increases irisin production in bone, and that an increase in circulating irisin levels enhances osteogenesis in mice.
基金Supported by the National Natural Science Foundation of ChinaNo.81172905+1 种基金Shanxi Province Science Foundation for YouthsNo.2012021032-2
文摘AIM: To investigate the expression of mast cell tryptase and carboxypeptidase A in drug-related fatal anaphylaxis.METHODS: The expression of mast cell tryptase and carboxypeptidase A in 15 autopsy cases of drugrelated fatal anaphylaxis and 20 normal autopsy cases were detected. First, the expression of mast cell tryptase was determined in stomach, jejunum, lung, heart, and larynx by immunofluorescence. Different tissues were removed and fixed in paraformaldehyde solution, then paraffin sections were prepared for immunofluorescence. Using specific mast cell tryptase and carboxypeptidase A antibodies, the expression of tryptase and carboxypeptidase A in gastroenterology tract and other tissues were observed using fluorescent microscopy. The postmortem serum and pericardial fluid were collected from drug-related fatal anaphylaxis and normal autopsy cases. The level of mast cell tryptase and carboxypeptidase A in postmortem serum and pericardial fluid were measured using fluor enzyme linked immunosorbent assay(FEIA) and enzyme linked immunosorbent assay(ELISA) assay. The expression of mast cell tryptase and carboxypeptidase A was analyzed in drug-related fatal anaphylaxis cases and compared to normal autopsy cases.RESULTS: The expression of carboxypeptidase A was less in the gastroenterology tract and other tissues from anaphylaxis-related death cadavers than normal controls. Immunofluorescence revealed that tryptase expression was significantly increased in multiple organs, especially the gastrointestinal tract, from anaphylaxis-related death cadavers compared to normal autopsy cases(46.67 ± 11.11 vs 4.88 ± 1.56 in stomach, 48.89 ± 11.02 vs 5.21 ± 1.34 in jejunum, 33.72 ± 5.76 vs 1.30 ± 1.02 in lung, 40.08 ± 7.56 vs 1.67 ± 1.03 in larynx, 7.11 ± 5.67 vs 1.10 ± 0.77 in heart, P < 0.05). Tryptase levels, as measured with FEIA, were significantly increased in both sera(43.50 ± 0.48 μg/L vs 5.40 ± 0.36 μg/L, P < 0.05) and pericardial fluid(28.64 ± 0.32 μg/L vs 4.60 ± 0.48 μg/L, P < 0.05) from the anaphylaxis group in comparison with the control group. As measured by ELISA, the concentration of carboxypeptidase A was also increased more than 2-fold in the anaphylaxis group compared to control(8.99 ± 3.91 ng/m L vs 3.25 ± 2.30 ng/m L in serum, 4.34 ± 2.41 ng/m L vs 1.43 ± 0.58 ng/m L in pericardial fluid, P < 0.05).CONCLUSION: Detection of both mast cell tryptase and carboxypeptidase A could improve the forensic identification of drug-related fatal anaphylaxis.
文摘Background:Platelet rich plasma(PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury.However,the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not been fully elucidated in exercise-induced muscle damage.The purpose of this investigation the effects of intramuscular delivery of PRP on hematologic and biochemical responses and recovery strategy muscle damage induced by high intensity muscle exercise(exercise-induced muscle damage,EIMD).Methods:Moderately active male volunteers participated in this study and were assigned to a control group(control,n = 6) and PRP administration group(PRP,n = 6).The subjects performed exercise with a load of 80% one repetition maximum(1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm was reached.The arms were treated with saline or autologous PRP post-24 h EIMD.Venous blood samples were obtained in the morning to establish a baseline value and 1–4 days post-exercise and were analyzed for serum ferritin,iron,iron binding capacity(IBC),creatinine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),and alanine aminotransferase(ALT).Results:The baseline levels of plasma iron,ferritin,IBC,CK,LDH,AST,and ALT were similar in both the control and PRP groups.However,24-h following exercise a significant increase in these parameters was observed in both groups between 1 and 4 days during the recovery period.Interestingly,PRP administration decreased plasma iron levels compared to the control on the second day post-exercise.Plasma IBC increased in PRP group from Days 2 to 4 post-exercise compared to the control group whilst PRP administration had no effect on plasma ferritin,CK,AST,ALT,or LDH.Conclusion:Acute exhaustive exercise increased muscle damage markers,including plasma iron,IBC,and ferritin levels,indicating muscle damage induced by exercise.PRP administration improves inflammation by reversing the increase in the iron levels post-exercise without displaying any myotoxicity and may have a role to play in the recovery of exercise-induced muscle damage.
文摘Objective Patients undergoing cardiac surgery are exposed to a large range of drugs and foreign substances,which might result in anaphylaxis.Severe anaphylaxis in cardiac surgical patients could be life-threatening.Therefore,timely diagnosis and proactive treatment are crucial.Definition of anaphylaxis,epidemiology of anaphylaxis and common allergens,specific anaphylaxis,diagnosis and management of peri-operative anaphylaxis in cardiac surgery patients were discussed in this review.
