Anaphylactic shock, an exacerbated allergic reaction that can prove fatal, is sometimes caused by the use of drugs during surgery. In most of these extreme reactions, evidence can be provided that patients have anti-drug antibodies of the IgE class. Anti-drug IgE enable activation of mast cells and basophils that release histamine, a potent mediator involved in anaphylaxis. These findings, published on July 10 in the journal S cience Translational Medicine , will help improve diagnosis and treatment for patients with this type of shock.
Anaphylaxis is a hyperacute allergic reaction caused by an inappropriate immune response following the introduction of a usually harmless antigen into the body. When this antigen binds to antibodies already in the body, it triggers the secretion of large quantities of potent vasodilating mediators, sending the patient into a state of shock that may result in multiple organ failure and even death.
Anaphylaxis may be brought about by various substances, including drugs antibiotics or neuromuscular blocking agents , food and insect venom.
In this study, the scientists focused on allergic reactions to neuromuscular blocking agents NMBAs , drugs used during general anesthesia to induce muscle relaxation. The incidence of anaphylactic shock caused by NMBAs is one case in every 10, to 20, surgeries, representing approximately 3 to 5 cases each week in the Greater Paris area.
This unexpected role of IgG antibodies had already been identified in mice in by some of the same authors. This multicenter study known as "NASA", led by Bichat Hospital part of the Paris Public Hospital Network , was launched in by a consortium of scientists, clinical biologists and anesthetists.
