Basal Tryptase High Levels Associated with a History of Arterial Hypertension and Hypercholesterolemia Represent Risk Factors for Severe Anaphylaxis in Hymenoptera Venom-Allergic Subjects over 50 Years Old
Basal Tryptase High Levels Associated with a History of Arterial Hypertension and Hypercholesterolemia Represent Risk Factors for Severe Anaphylaxis in Hymenoptera Venom-Allergic Subjects over 50 Years Old
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与动脉高血压和高胆固醇血症史相关的基础类胰蛋白酶水平高是 50 岁以上膜翅目毒液过敏受试者发生严重过敏反应的危险因素
DOI：
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发表时间：
2020
影响因子：
2.8
通讯作者：
L. Farioli
中科院分区：
文献类型：
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作者：
E. Pastorello;L. Borgonovo;D. Preziosi;J. Schroeder;V. Pravettoni;M. G. Aversano;S. Pastori;M. Bilò;M. Piantanida;L. Losappio;M. Nichelatti;C. Rossi;L. Farioli
简介：对Hyattera毒液（HV）过敏可能导致危及生命的过敏反应。一些影响症状严重程度的因素仍然不确定。本研究的目的是通过比较既往发生过局部大反应（LLR）和全身反应（SR）的患者之间的临床和免疫化学生物标志物，确定与HV过敏人群中最严重反应相关的临床方面。研究方法：我们选择了有HV过敏史的成年患者，诊断试验阳性，并且与一种单一的Hyplitera物种相关。比较了既往LLR和SR患者的年龄、性别、特应性、血清基础类胰蛋白酶（sBT）值、总IgE、毒液特异性IgE、高血压、心血管疾病和高胆固醇血症病史。结果：纳入460例成人患者（381例SR，79例LLR）。年龄（p = 0.0097）、男性（p < 0.0001）、动脉高血压（p = 0.046）、高胆固醇血症（p = 0.009）和较高sBT水平（p = 0.0004）作为独立变量与重度反应显著相关。此外，考虑到之前的变量作为风险因素，随着积极变量数量的增加，Mueller III + IV的几率显着且逐步增加。经任何阳性变量校正后，sBT ≥6.4 ng/mL的患者发生Mueller IV级反应的风险增加（p < 0.0001）。结论：根据我们的结果，年龄较大、男性、动脉高血压、高胆固醇血症和sBT水平升高≥6.4 ng/mL是成人HV重度速发型过敏反应的风险因素。特应性和过敏性哮喘不会增加HV诱导SR的风险。
Introduction: Allergy to Hymenoptera venom (HV) may lead to life-threatening anaphylaxis. Some of the factors influencing the symptom’s severity are still undetermined. The aim of this study was to identify the clinical aspects associated with the most severe reactions in a population with HV allergy, by comparing clinical and immunochemical biomarkers between patients with previous local large reactions (LLRs) and systemic reactions (SRs). Methods: We selected adult patients with a history of HV allergy, with positive diagnostic tests and a correlation with one single Hymenoptera species. Age, gender, atopy, serum basal tryptase (sBT) value, total IgE, venom-specific IgE, history of hypertension, cardiovascular diseases, and hypercholesterolemia were compared between patients with previous LLRs and SRs. Results: 460 adult patients (381 SRs, 79 LLRs) were included. Age (p = 0.0097), male gender (p < 0.0001), arterial hypertension (p = 0.046), hypercholesterolemia (p = 0.009), and higher sBT levels (p = 0.0004) were significantly associated with severe reactions as independent variables. Moreover, considering the previous variables as risk factors, there was a significant and progressive increase in the odds of being Mueller III + IV as the number of positive variables increased. Patients with sBT ≥6.4 ng/mL adjusted for any of the positive variables had increased the risk of Mueller grade IV reaction (p < 0.0001). Conclusion: According to our results, older age, male gender, arterial hypertension, hypercholesterolemia, and increased levels of sBT ≥6.4 ng/mL are risk factors for severe anaphylaxis to HV in adults. Atopy and allergic asthma do not increase the risk of HV-induced SRs.
儿童昆虫过敏的流行病学研究。
DOI：
10.1016/s0022-3476(82)80750-6
发表时间：
1982
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Schuberth,KC;Lichtenstein,LM;Kagey-Sobotka,A;Szklo,M;Kwiterovich,KA;Valentine,MD
通讯作者：
Valentine,MD