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Platelet-activating factor, histamine, and tryptase levels in human anaphylaxis
Abstract
Background Platelet-activating factor (PAF) is an important mediator and correlates with anaphylaxis severity. How well PAF correlates with severity relative to histamine or tryptase is not known.Objective To analyze the levels of PAF, histamine, and tryptase as a function of severity in patients with acute allergic reactions.Methods PAF, histamine, and tryptase levels were measured in blood samples collected from 23 healthy volunteers and from 41 patients during acute allergic reactions. Reactions were stratified by severity from grade 1 (least severe) to grade 3 (most severe).Results Among the 3 reaction grades, there were significant differences by ANOVA for PAF (P < .0001). The proportion of elevated PAF values increased across severity groups (P = .0009). Increased PAF levels were observed in 20%, 66.7%, and 100% of the patients with grades 1, 2, and 3 allergic reactions, respectively. While the proportion of elevated histamine values increased from 40% to 57% to 70% across grades 1, 2, and 3, respectively, these were not significantly different (P = .40). For tryptase, the proportion of elevated values increased monotonically from 0 in grade 1 to 4.8% in grade 2 to 60% in grade 3 (P = .0002).Conclusions The PAF level was significantly elevated in proportion to the severity of acute allergic reactions. Whereas the PAF level was elevated in all patients with severe anaphylaxis, this was not true for either histamine or tryptase. Neither histamine nor tryptase showed as good correlations with severity scores as did PAF. These data are consistent with a pivotal role for PAF as a mediator of anaphylaxis.
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Metadata
- Authors
- Vadas, P., Perelman, B., & Liss, G.
- Affiliations
- St. Michael's Hospital (CA)
- University of Toronto (CA)
- Corresponding author
- Vadas, Peter
- ORCID
- Vadas, Peter
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 131
- Issue
- 1
- Pages
- 144-149
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2048983224
- Cited by
- 223
- References
- 30
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 16 · 2023: 11 · 2022: 19 · 2021: 19 · 2020: 15 · 2019: 16 · 2018: 17 · 2017: 11 · 2016: 17 · 2015: 26 · 2014: 18 · 2013: 15
- FWCI
- 8.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- platelet-activating factor, histamine, tryptase, anaphylaxis, anaphylaxis severity, acute allergic reactions, severity classification
- MeSH terms
- Adolescent, Adult, Aged, Anaphylaxis, Cross-Sectional Studies, Female, Histamine, Humans, Male, Middle Aged, Platelet Activating Factor, Tryptases, Young Adult
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