20.500.12556/DiRROS-22721 Hereditary α-tryptasemia is associated with anaphylaxis to antibiotics and monoclonal antibodies Background Hereditary α-tryptasemia, a genetic trait caused by increased α-tryptase copy number, is associated with idiopathic and venom anaphylaxis. Objective We aimed to determine the impact of tryptase genotypes on drug-induced anaphylaxis. Methods A prospective discovery cohort of 99 patients from a referral center in Slovenia with acute anaphylaxis to drugs underwent tryptase genotyping by droplet digital PCR. For validation, we included a cohort of 26 patients from the Czech Republic. Associated inciting agents and the severity of the reactions were subsequently examined. Results Hereditary α-tryptasemia was associated with drug-induced anaphylaxis with a prevalence of 13% (n = 13 of 99) in the discovery cohort and 15% in the validation cohort (n = 4 of 26). Hereditary α-tryptasemia was identified in every individual with elevated basal serum tryptase levels (11.6-21.9 ng/mL; n = 14) within both cohorts of patients. Hereditary α-tryptasemia was more prevalent in individuals with antibiotic- or mAb-induced anaphylaxis in both the discovery and validation cohorts (n = 13 of 51; 26%) compared to those with anaphylaxis resulting from neuromuscular blocking agents, nonsteroidal anti-inflammatory drugs, contrast, chlorhexidine, or other drugs (n = 5 of 74; 7%; P = .02; odds ratio = 4.1; 95% CI, 1.3-11.1). Overall, we found fewer individuals with no ⍺-tryptase than in the general population, and there was a trend for subjects with more ⍺-tryptase copies to have more severe reactions. Thus, among subjects with three ⍺-tryptase copies, the prevalence of severe anaphylaxis was 73%, compared with 59% with one to two ⍺-tryptase copies and 58% for subjects without ⍺-tryptase. Conclusions Risk for anaphylaxis to antibiotics and biologics is associated with inherited differences in α-tryptase–encoding copies at Tryptase α/β1 . immunology drug allergy anaphylaxis antibiotics monoclonal antibodies α-tryptase hereditary α-tryptasemia imunologija alergije antibiotiki dednost monoklonska protitelesa true false true Elsevier, 2013- The journal of allergy and clinical immunology. In practice Angleški jezik Slovenski jezik © 2025 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Neznano 2025-06-18 14:01:59 2025-06-18 14:01:59 2025-10-24 03:52:03 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 22. 4. 2025; str. 1449-1456.e4 iss. 6 Vol. 13 Jun. 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2024-10-02 2025-04-07 2025-04-17 616-097 2213-2201 10.1016/j.jaip.2025.04.013 233461507 https://www.sciencedirect.com/science/article/pii/S2213219825003691 1 48b8d2a9-4c2b-11f0-bf0a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=32961 RAZ_Korosec_Peter_2025.pdf RAZ_Korosec_Peter_2025.pdf 1 CD374FFE205E3F910EF21E81088A3AE6 643dd429a48873b388f0c09f30973a1b516d608f9a914f0aaf3880469e715271 304bcf23-4c2c-11f0-bf0a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=32964 Univerzitetna klinika za pljučne bolezni in alergijo Golnik 0 0 0