scholarly journals COVID-19 Vaccine Anaphylaxis: Current Evidence and Future Approaches

2021 ◽  
Vol 2 ◽  
Author(s):  
Wannada Laisuan
Keyword(s):  
Skin Testing ◽  
Safety Information ◽  
Basophil Activation Test ◽  
Current Evidence ◽  
Severe Allergic Reaction ◽  
Allergic Reactions ◽  
Post Vaccination ◽  
Pathway Activation ◽  
Ige Mediated ◽  
G Protein Coupled

Vaccine anaphylaxis is rare; however, severe allergic reactions after administration of a coronavirus disease 2019 (COVID-19) vaccines have been reported. Excipients in the vaccine may play a role in severe allergic reactions post-vaccination. Various mechanisms, including IgE-mediated pathways, direct mass cell stimulation via the Mas-related G protein-coupled receptor-X2, and complement pathway activation, have been proposed to cause the anaphylaxis. Skin testing, using the basophil activation test, has been used to clarify the mechanism of the anaphylaxis and provide safety information for the next injection. Here, we review the current evidence and suggested approaches for patients who experienced an immediate severe allergic reaction to the first dose of a COVID-19 vaccine.

scholarly journals Unlocking the Non-IgE-Mediated Pseudo-Allergic Reaction Puzzle with Mas-Related G-Protein Coupled Receptor Member X2 (MRGPRX2)

Cells ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1033
Author(s):  
Mukesh Kumar ◽  
Karthi Duraisamy ◽  
Billy Kwok Chong CHOW
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
Allergic Reaction ◽  
G Protein ◽  
Cell Activation ◽  
Mast Cell Activation ◽  
Allergic Reactions ◽  
Ige Mediated ◽  
G Protein Coupled

Mas-related G-protein coupled receptor member X2 (MRGPRX2) is a class A GPCR expressed on mast cells. Mast cells are granulated tissue-resident cells known for host cell response, allergic response, and vascular homeostasis. Immunoglobulin E receptor (FcεRI)-mediated mast cell activation is a well-studied and recognized mechanism of allergy and hypersensitivity reactions. However, non-IgE-mediated mast cell activation is less explored and is not well recognized. After decades of uncertainty, MRGPRX2 was discovered as the receptor responsible for non-IgE-mediated mast cells activation. The puzzle of non-IgE-mediated pseudo-allergic reaction is unlocked by MRGPRX2, evidenced by a plethora of reported endogenous and exogenous MRGPRX2 agonists. MRGPRX2 is exclusively expressed on mast cells and exhibits varying affinity for many molecules such as antimicrobial host defense peptides, neuropeptides, and even US Food and Drug Administration-approved drugs. The discovery of MRGPRX2 has changed our understanding of mast cell biology and filled the missing link of the underlying mechanism of drug-induced MC degranulation and pseudo-allergic reactions. These non-canonical characteristics render MRGPRX2 an intriguing player in allergic diseases. In the present article, we reviewed the emerging role of MRGPRX2 as a non-IgE-mediated mechanism of mast cell activation in pseudo-allergic reactions. We have presented an overview of mast cells, their receptors, structural insight into MRGPRX2, MRGPRX2 agonists and antagonists, the crucial role of MRGPRX2 in pseudo-allergic reactions, current challenges, and the future research direction.

scholarly journals 162. Assessment of Beta-lactam Allergies as Rationale for Receipt of Vancomycin for Surgical Prophylaxis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S90-S90
Author(s):  
Kendall J Tucker ◽  
YoungYoon Ham ◽  
Haley K Holmer ◽  
Caitlin M McCracken ◽  
Ellie Sukerman ◽  
...  
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Skin Testing ◽  
Cross Reactivity ◽  
Penicillin Allergy ◽  
Beta Lactam ◽  
First Line ◽  
Surgical Prophylaxis ◽  
Inappropriate Use ◽  
Oral Amoxicillin ◽  
Ige Mediated

Abstract Background Beta-lactam (BL) antibiotics are first-line agents for most patients receiving antimicrobial prophylaxis in surgical procedures. Despite evidence showing low cross-reactivity between classes of BLs, patients with allergies commonly receive vancomycin as an alternative to avoid allergic reaction. The objective of this study was to identify potentially inappropriate use of vancomycin surgical prophylaxis among patients with reported BL allergies. Methods Adult patients (≥18 years) receiving vancomycin for surgical prophylaxis with a reported penicillin and/or cephalosporin allergy at our institution between August 2017 to July 2018 were retrospectively evaluated for potential eligibility for penicillin allergy testing and/or receipt of standard prophylaxis. Surgery type and allergy history were extracted from the electronic medical record. Per our institution’s penicillin-testing protocol, patients with IgE-mediated reactions < 10 years ago were eligible for penicillin skin testing (PST), mild reactions or IgE-mediated reaction > 10 years ago were eligible for direct oral amoxicillin challenge, and severe non-IgE mediated allergies were ineligible for penicillin allergy evaluation or BL prophylaxis. Results Among 830 patients who received vancomycin for surgical prophylaxis, 196 reported BL allergy and were included in the analysis (155 with penicillin allergy alone; 21 with cephalosporin allergy; 20 with both cephalosporin and penicillin allergy). Approximately 40% of surgeries were orthopedic. Six patients were ineligible for BL prophylaxis. Per institutional protocol, 73 of 155 patients (48%) may have qualified for PST; 81 of 155 (52%) patients may have received a direct oral amoxicillin challenge. Only 3 of 22 patients with history of methicillin-resistant Staphylococcus aureus appropriately received additional prophylaxis with vancomycin and a BL. Conclusion Patients with BL allergies often qualify for receipt of a first-line BL antibiotic. An opportunity exists for improved BL allergy assessment as an antimicrobial stewardship intervention. Future studies should evaluate outcomes associated with BL allergy evaluation and delabeling in patients receiving surgical prophylaxis. Disclosures All Authors: No reported disclosures

scholarly journals Iodine allergy: Common misperceptions

2021 ◽  
Author(s):  
Nicole R Wulf ◽  
John Schmitz ◽  
Amy Choi
Keyword(s):  
Literature Review ◽  
Adverse Reactions ◽  
Povidone Iodine ◽  
Cross Reactivity ◽  
Current Evidence ◽  
Allergic Reactions ◽  
Iodinated Contrast Media ◽  
Inclusion Criteria ◽  
Iodinated Contrast ◽  
Final Article

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The current evidence regarding iodine-containing compounds and iodine allergy cross-reactivity is reviewed. Summary Iodine is an essential human nutrient found in the thyroid gland. It is used in the synthesis of the thyroid hormones thyroxine and triiodothyroxine. Patients who report having adverse reactions to iodine-containing substances are often labelled as having an “iodine allergy,” which can result in delays in care or patients being denied essential ICM or other iodine-containing drugs. A literature review was conducted to evaluate the evidence regarding iodine allergy and iodine-containing drugs. Of 435 articles considered potentially appropriate for full review (plus 12 additional articles included on the basis of references from the eligible articles), 113 could not be obtained. After exclusion of 353 articles that did not meet all inclusion criteria, the remaining 81 articles were included in the review. The results of the literature review indicated that iodine has not been shown to be the allergen responsible for allergic reactions to iodinated contrast media, amiodarone, povidone-iodine, and other iodine-containing compounds. Conclusion There is a lack of evidence to support cross-reactivity between iodine-containing compounds in so called iodine-allergic individuals.

IgE-Mediated Allergic Reactions after the First Administration of Glatiramer Acetate in Patients with Multiple Sclerosis

2014 ◽  
Vol 165 (4) ◽  
pp. 244-246 ◽  
Author(s):  
Mercè Corominas ◽  
Idoia Postigo ◽  
Victoria Cardona ◽  
Ramon Lleonart ◽  
Lucía Romero-Pinel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Allergic Reactions ◽  
Ige Mediated

scholarly journals The Role of Carrageenan in Inflammatory Bowel Diseases and Allergic Reactions: Where Do We Stand?

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3402
Author(s):  
Barbara Borsani ◽  
Raffaella De Santis ◽  
Veronica Perico ◽  
Francesca Penagini ◽  
Erica Pendezza ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Experimental Models ◽  
Gelling Agent ◽  
Current Evidence ◽  
Allergic Reactions ◽  
Processed Foods ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Carrageenan (CGN) is a high molecular weight polysaccharide extracted from red seaweeds, composed of D-galactose residues linked in β-1,4 and α-1,3 galactose-galactose bond, widely used as a food additive in processed foods for its properties as a thickener, gelling agent, emulsifier, and stabilizer. In recent years, with the spread of the Western diet (WD), its consumption has increased. Nonetheless, there is a debate on its safety. CGN is extensively used as an inflammatory and adjuvant agent in vitro and in animal experimental models for the investigation of immune processes or to assess the activity of anti-inflammatory drugs. CGN can activate the innate immune pathways of inflammation, alter the gut microbiota composition and the thickness of the mucus barrier. Clinical evidence suggests that CGN is involved in the pathogenesis and clinical management of inflammatory bowel diseases (IBD), indeed food-exclusion diets can be an effective therapy for disease remission. Moreover, specific IgE to the oligosaccharide α-Gal has been associated with allergic reactions commonly referred to as the “α-Gal syndrome”. This review aims to discuss the role of carrageenan in inflammatory bowel diseases and allergic reactions following the current evidence. Furthermore, as no definitive data are available on the safety and the effects of CGN, we suggest gaps to be filled and advise to limit the human exposure to CGN by reducing the consumption of ultra-processed foods.

Scar Formation and Tuberculin Conversion Following BCG

2021 ◽  
Vol 15 (11) ◽  
pp. 3056-3057
Author(s):  
Muhammad Sarfraz ◽  
Zahid Jamil ◽  
Muhammad Naim Ashraf ◽  
Saima Arshad ◽  
Zirwa Sarfraz ◽  
...  
Keyword(s):  
Skin Testing ◽  
Case Series ◽  
Operational Definition ◽  
Scar Formation ◽  
Bcg Vaccine ◽  
Base Line ◽  
Positive Skin ◽  
Post Vaccination ◽  
Vaccination Programs ◽  
Bcg Vaccination

Objective: To determine frequency of scar formation and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age presenting at outpatient department of Fauji Foundation Hospital Lahore. Study Design: Descriptive case series. Place and Duration of Study: Outdoor Department of Pediatrics, Fauji Foundation Hospital, Lahore from 1st July 2020 to 30th December 2020. Methodology: Ninety seven children were included. Base line demographic information of patients (age, gender, weight on weight machine) was recorded. 0.5 ml BCG was administered in right arm. Tuberculin skin test was assessed as per operational definition. After 48 to 72 hours, scar formation was assessed after 1 month. Data regarding scar formation and positive tuberculin conversion test was recorded. Results: The mean age was 3.20±1.46 years, 39 (40.21%) were male whereas 58 (59.79%) were females. The scar formation following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age was 59 (60.82%) and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years was recorded in 47 (48.45%). Conclusion: Most babies have developed a post-vaccination scar. The combination of the BCG scar and the positive skin testing tuberculin was very important. The development of BCG scars had no effect on age or sex. Greater trials are advised in order to detect the true extent of the problem and to evaluate regularly the BCG vaccination programs. Keywords: Infants, Tuberculosis, BCG vaccination, Scar formation, Positive tuberculin conversion test

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