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Título : Characterization of anaphylaxis reveals different metabolic changes depending on severity and triggers.
Autor : Perales Chorda, Carolina.
Obeso Montero, David.
Barber Hernández, Domingo.
Villaseñor Solis, Alma Cristina.
Barbas Arribas, María del Coral.
Materias: Alergia a los alimentos.H-NMRDrug anaphylaxisFood anaphylaxisGrading anaphylaxisIgE-mediated anaphylaxisUntargeted metabolomicsUPLC-MS
Fecha de publicación : 8-sep-2021
Resumen : Background: Despite the increasing incidence of anaphylaxis, its underlying molecular mechanisms and biomarkers for appropriate diagnosis remain undetermined. The rapid onset and potentially fatal outcome in the absence of managed treatment prevent its study. Up today, there are still no known biomarkers that allow an unequivocal diagnosis. Therefore, the aim of this study was to explore metabolic changes in patients suffering anaphylactic reactions depending on the trigger (food and/or drug) and severity (moderate and severe) in a real-life set-up. Methods: Eighteen episodes of anaphylaxis, one per patient, were analysed. Sera were collected during the acute phase (T1), the recovery phase (T2) and around 2–3 months after the anaphylactic reaction (T0: basal state). Reactions were classified following an exhaustive allergological evaluation for severity and trigger. Sera samples were analysed using untargeted metabolomics combining liquid chromatography coupled to mass spectrometry (LC-MS) and proton nuclear magnetic resonance spectroscopy (1 H-NMR). Results: ‘Food T1 vs T2’ and ‘moderate T1 vs T2’ anaphylaxis comparisons showed clear metabolic patterns during the onset of an anaphylactic reaction, which differed from those induced by drugs, food + drug or severe anaphylaxis. Moreover, the model of food anaphylaxis was able to distinguish the well-characterized IgE (antibiotics) from non-IgE-mediated anaphylaxis (nonsteroidal anti-inflammatory drugs), suggesting a differential metabolic pathway associated with the mechanism of action. Metabolic differences between ‘moderate vs severe’ at the acute phase T1 and at basal state T0 were studied. Among the altered metabolites, glucose, lipids, cortisol, betaine and oleamide were observed altered. Conclusions: The results of this exploratory study provide the first evidence that different anaphylactic triggers or severity induce differential metabolic changes along time or at specific time-point, respectively. Besides, the basal status T0 might identify high-risk patients, thus opening new ways to understand, diagnose and treat anaphylaxis.
Descripción : Artículo en colaboración con: David Obeso, Laura Twomey, Ayelén Rojas-Benedicto, Leonor Puchades-Carrasco, Marta Roca, Antonio Pineda-Lucena, José Julio Laguna, Coral Barbas, Vanesa Esteban, Jaume Martí-Garrido, Ethel Ibañez-Echevarria, Ramón López-Salgueiro, Domingo Barber, Alma Villaseñor, Dolores Hernández Fernández de Rojas
En: Clinical & Experimental Allergy. e-ISSN 1365-2222 2021, 26 Jul : 1-15
URI : http://hdl.handle.net/10637/12974
Derechos: http://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
Otros identificadores : 000000723333
Aparece en las colecciones: Facultad de Farmacia

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