Dataset Information

Cardiovascular changes during peanut-induced allergic reactions in human subjects.

ABSTRACT:

Background

Food allergy is the most common cause of anaphylaxis. Changes in posture during acute reactions can trigger fatal outcomes, but the impact of allergic reactions on the cardiovascular system in nonfatal reactions remains poorly understood.

Objective

Our aim was to systematically evaluate changes in cardiovascular function during acute allergic reactions to peanut.

Methods

Participants underwent double-blind placebo-controlled food challenge to peanut as part of a clinical trial. Changes in hemodynamic parameters (heart rate, stroke volume, blood pressure, and peripheral blood flow) and electrocardiogram findings during food challenges were assessed using noninvasive continuous monitoring.

Results

A total of 57 adults (median age 24 years [interquartile range = 20-29]), 53% of whom were female, participated; 22 (39%) had anaphylaxis. Acute reactions were associated with significant changes in stroke volume (mean decrease of 4.2% [95% CI = 0.8-7.6; P = .03]), heart rate (mean increase 11.6% [95% CI = 8.4-14.8; P < .0001]), and peripheral blood flow (mean increase 19.7% [95% CI = 10.8-28.6; P < .0001]), irrespective of reaction severity. These changes were reproduced at a subsequent repeat peanut challenge in 26 participants, and could be reversed with administration of intravenous fluids which resulted in faster resolution of abdominal symptoms.

Conclusions

In this first detailed human study of cardiovascular changes during food-induced allergic reactions, we found evidence for significant fluid redistribution, independent of reaction severity. This provides a sound rationale for optimizing venous return during significant allergic reactions to food. Finally, these data provide a new paradigm for understanding severity in anaphylaxis, in which poor outcomes may occur as a result of a failure in compensatory mechanisms.

SUBMITTER: Ruiz-Garcia M

PROVIDER: S-EPMC7858218 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Cardiovascular changes during peanut-induced allergic reactions in human subjects.

Ruiz-Garcia Monica M Bartra Joan J Alvarez Olaya O Lakhani Ashna A Patel Shalinee S Tang Alistair A Sim Marcus M Shamji Mohamed H MH Skypala Isabel I Mills E N Clare ENC Lyon Alexander R AR Hayward Carl C Durham Stephen R SR Turner Paul J PJ Boyle Robert J RJ

The Journal of allergy and clinical immunology 20200721 2

<h4>Background</h4>Food allergy is the most common cause of anaphylaxis. Changes in posture during acute reactions can trigger fatal outcomes, but the impact of allergic reactions on the cardiovascular system in nonfatal reactions remains poorly understood.<h4>Objective</h4>Our aim was to systematically evaluate changes in cardiovascular function during acute allergic reactions to peanut.<h4>Methods</h4>Participants underwent double-blind placebo-controlled food challenge to peanut as part of a ...[more]

PMID: 32707226

Similar Datasets

Project description:BackgroundThe management of peanut allergy relies on allergen avoidance and epinephrine autoinjector for rescue treatment in patients at risk of anaphylaxis. Biomarkers of severity and threshold of allergic reactions to peanut could significantly improve the care for patients with peanut allergy.ObjectiveWe sought to assess the utility of the basophil activation test (BAT) to predict the severity and threshold of reactivity to peanut during oral food challenges (OFCs).MethodsThe severity of the allergic reaction and the threshold dose during OFCs to peanut were determined. Skin prick tests, measurements of specific IgE to peanut and its components, and BATs to peanut were performed on the day of the challenge.ResultsOf the 124 children submitted to OFCs to peanut, 52 (median age, 5 years) reacted with clinical symptoms that ranged from mild oral symptoms to anaphylaxis. Severe reactions occurred in 41% of cases, and 57% reacted to 0.1 g or less of peanut protein. The ratio of the percentage of CD63(+) basophils after stimulation with peanut and after stimulation with anti-IgE (CD63 peanut/anti-IgE) was independently associated with severity (P = .001), whereas the basophil allergen threshold sensitivity CD-sens (1/EC?? × 100, where EC?? is half maximal effective concentration) value was independently associated with the threshold (P = .020) of allergic reactions to peanut during OFCs. Patients with CD63 peanut/anti-IgE levels of 1.3 or greater had an increased risk of severe reactions (relative risk, 3.4; 95% CI, 1.8-6.2). Patients with a CD-sens value of 84 or greater had an increased risk of reacting to 0.1 g or less of peanut protein (relative risk, 1.9; 95% CI, 1.3-2.8).ConclusionsBasophil reactivity is associated with severity and basophil sensitivity is associated with the threshold of allergic reactions to peanut. CD63 peanut/anti-IgE and CD-sens values can be used to estimate the severity and threshold of allergic reactions during OFCs.

Dataset Information

Cardiovascular changes during peanut-induced allergic reactions in human subjects.

Background

Objective

Methods

Results

Conclusions

Publications

Cardiovascular changes during peanut-induced allergic reactions in human subjects.

Similar Datasets

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