Peter Korošec (Avtor), Gunter Sturm (Avtor), Jonathan J. Lyons (Avtor), Tinkara Pirc Marolt (Avtor), Manca Svetina (Avtor), Mitja Košnik (Avtor), Mihaela Zidarn (Avtor), Mark Kačar (Avtor), Nina Frelih (Avtor), Nika Lalek (Avtor), Ajda Demšar (Avtor), Samo Zver (Avtor), Matevž Škerget (Avtor), Ewa Czarnobilska (Avtor), Wojciech Dyga (Avtor), Sanja Popović-Grle (Avtor), Miroslav Samaržija (Avtor), Lisa Arzt-Gradwohl (Avtor), Urban Čerpes (Avtor), Grzegorz Porebski (Avtor), Branko Pevec (Avtor), Eva Schadelbauer (Avtor), Peter Kopač (Avtor), Julij Gyula Šelb (Avtor), Matija Rijavec (Avtor)

Povzetek

Background In patients who require venom immunotherapy (VIT), there is a need to identify underlying mast cell (MC) disorders since these may affect the risk and severity of future sting reactions and the long-term effectiveness of VIT. Methods 1319 individuals with Hymenoptera venom allergy (HVA) who needed VIT from referral centers in Slovenia, Austria, Croatia, and Poland underwent examination for KIT p.D816V in peripheral blood leukocytes (PBL) using a highly sensitive PCR test and tryptase genotyping by digital droplet PCR. We also included 183 control individuals with large local reactions (LLRs) to Hymenoptera stings and with asymptomatic sensitization to Hymenoptera venoms. Results 285 of 1319 individuals recommended for VIT (21.6%) were positive for KIT p.D816V in PBL, preferably those who present with severe reaction (33.9% [n = 207 of 610] with Ring-Messmer grade 3–4 vs. 11% [n = 78 of 709] with Grade 1–2; p < .0001), whereas only 1.3% (n = 2 of 152) of controls with LLR and none with asymptomatic sensitization (n = 31) had KIT p.D816V. KIT p.D816V allelic burden was higher in those with severe reaction (median 0.018% [n = 207] in Grade 3–4 vs. 0.001% [n = 78] in Grade 1–2; p < .0001), and the majority had normal baseline serum tryptase levels (69% [n = 196 of 285]). All KIT p.D816V-positive individuals (n = 41) who underwent bone marrow (BM) biopsy were found to have underlying clonal diseases, principally BM mastocytosis. HαT was also associated with severe HVA and symptoms (p < .01), and remarkably, 31.0% (n = 31 of 100) were found to have concomitant KIT p.D816V. Concomitant HαT and KIT p.D816V showed an additive effect, and having both was associated with the highest risk for severe HVA, even higher than having either HαT or KIT p.D816V alone (OR = 3.8; p < .01). Conclusions By employing prospective universal tryptase genotyping and examination for KIT p.D816V in PBL in large HVA populations, we have demonstrated a high burden of clonal MC disorders and HαT in patients who require VIT.

Ključne besede

anaphylaxis;hereditary α-tryptasemia;hypersensitivity;immunotherapy;mast cell;mastocytosis;venom;

Podatki

Jezik: Angleški jezik
Leto izida:
Tipologija: 1.01 - Izvirni znanstveni članek
Organizacija: UL FFA - Fakulteta za farmacijo
Založnik: Wiley-Blackwell
UDK: 616-097
COBISS: 190093315 Povezava se bo odprla v novem oknu
ISSN: 1398-9995
Št. ogledov: 629
Št. prenosov: 352
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Slovenski jezik
Sekundarne ključne besede: anafilaksija;dedna α-triptazemija;preobčutljivost;imunoterapija;mastociti;mastocitoza;strupi kožekrilcev;
Vrsta dela (COBISS): Članek v reviji
Komentar vira: Opis z dne 25. 3. 2024; Nasl. z nasl. zaslona;
Strani: str. 2458-2469
Letnik: ǂVol. ǂ79
Zvezek: ǂiss ǂ9
Čas izdaje: Sep. 2024
DOI: 10.1111/all.16084
ID: 24930183