| Title: | Hereditary α-tryptasemia is associated with anaphylaxis to antibiotics and monoclonal antibodies |
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| Authors: | ID Korošec, Peter, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Lyons, Jonathan J. (Author)
ID Svetina, Manca, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Koudová, Monika (Author)
ID Bittóová, Martina (Author)
ID Zidarn, Mihaela, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Sedláčková, Lenka (Author)
ID Rijavec, Matija, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Kopač, Peter, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author) |
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| Files: |  URL - Source URL, visit https://www.sciencedirect.com/science/article/pii/S2213219825003691
 PDF - Presentation file, download (733,20 KB)
MD5: CD374FFE205E3F910EF21E81088A3AE6
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
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| Abstract: | 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 . |
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| Keywords: | immunology, drug allergy, anaphylaxis, antibiotics, monoclonal antibodies, α-tryptase, hereditary α-tryptasemia |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Submitted for review: | 02.10.2024 |
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| Article acceptance date: | 07.04.2025 |
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| Publication date: | 17.04.2025 |
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| Publisher: | Elsevier, 2013- |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 1449-1456.e4 |
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| Numbering: | Vol. 13, iss. 6 |
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| Source: | The journal of allergy and clinical immunology. In practice |
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| PID: | 20.500.12556/DiRROS-22721  |
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| UDC: | 616-097 |
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| ISSN on article: | 2213-2201 |
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| DOI: | 10.1016/j.jaip.2025.04.013 |
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| COBISS.SI-ID: | 233461507 |
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| Copyright: | © 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/). |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 22. 4. 2025;
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| Publication date in DiRROS: | 18.06.2025 |
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| Views: | 467 |
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| Downloads: | 253 |
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