Michael P O'Connell1, Jonathan J Lyons. 1. Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Abstract
PURPOSE OF REVIEW: To discuss the association between the common dominantly inherited genetic trait hereditary alpha-tryptasemia (HαT) and hymenoptera venom-induced anaphylaxis (HVA). RECENT FINDINGS: Elevated BST has been correlated with more severe systemic anaphylaxis in humans in a number of settings - most notably in HVA. Clonal mast cell disease, in particular, systemic mastocytosis, is frequently associated with elevated BST, and is a major risk factor for severe HVA. However, clonal mast cell diseases are believed to be rare, whereas HVA is relatively more common. HαT affects an estimated 3-5% of Western populations and is the common cause for elevated BST in these individuals. An association between HαT and severe HVA, as well as clonal mast cell disease has recently been demonstrated wherein this trait modifies reaction severity in venom allergic individuals. A mechanism underlying this association has been proposed through the identification of naturally occurring heterotetrameric tryptases and characterization of their unique physical attributes. SUMMARY: Here we discuss the long-standing association between elevated BST and HVA severity, how HαT fits into this landscape, and review the clinical and mechanistic evidence that supports HαT as a modifier of HVA.
PURPOSE OF REVIEW: To discuss the association between the common dominantly inherited genetic trait hereditary alpha-tryptasemia (HαT) and hymenoptera venom-induced anaphylaxis (HVA). RECENT FINDINGS: Elevated BST has been correlated with more severe systemic anaphylaxis in humans in a number of settings - most notably in HVA. Clonal mast cell disease, in particular, systemic mastocytosis, is frequently associated with elevated BST, and is a major risk factor for severe HVA. However, clonal mast cell diseases are believed to be rare, whereas HVA is relatively more common. HαT affects an estimated 3-5% of Western populations and is the common cause for elevated BST in these individuals. An association between HαT and severe HVA, as well as clonal mast cell disease has recently been demonstrated wherein this trait modifies reaction severity in venom allergic individuals. A mechanism underlying this association has been proposed through the identification of naturally occurring heterotetrameric tryptases and characterization of their unique physical attributes. SUMMARY: Here we discuss the long-standing association between elevated BST and HVA severity, how HαT fits into this landscape, and review the clinical and mechanistic evidence that supports HαT as a modifier of HVA.
Authors: Cem Akin; Linda M Scott; Can N Kocabas; Nataliya Kushnir-Sukhov; Erica Brittain; Pierre Noel; Dean D Metcalfe Journal: Blood Date: 2007-07-16 Impact factor: 22.113
Authors: Amy P Hsu; Elizabeth P Sampaio; Javed Khan; Katherine R Calvo; Jacob E Lemieux; Smita Y Patel; David M Frucht; Donald C Vinh; Roger D Auth; Alexandra F Freeman; Kenneth N Olivier; Gulbu Uzel; Christa S Zerbe; Christine Spalding; Stefania Pittaluga; Mark Raffeld; Douglas B Kuhns; Li Ding; Michelle L Paulson; Beatriz E Marciano; Juan C Gea-Banacloche; Jordan S Orange; Jennifer Cuellar-Rodriguez; Dennis D Hickstein; Steven M Holland Journal: Blood Date: 2011-06-13 Impact factor: 22.113
Authors: P Vanderslice; S M Ballinger; E K Tam; S M Goldstein; C S Craik; G H Caughey Journal: Proc Natl Acad Sci U S A Date: 1990-05 Impact factor: 11.205
Authors: Steven E Boyden; Avanti Desai; Glenn Cruse; Michael L Young; Hyejeong C Bolan; Linda M Scott; A Robin Eisch; R Daniel Long; Chyi-Chia R Lee; Colleen L Satorius; Andrew J Pakstis; Ana Olivera; James C Mullikin; Eliane Chouery; André Mégarbané; Myrna Medlej-Hashim; Kenneth K Kidd; Daniel L Kastner; Dean D Metcalfe; Hirsh D Komarow Journal: N Engl J Med Date: 2016-02-03 Impact factor: 91.245
Authors: Sarah C Glover; Melody C Carter; Peter Korošec; Patrizia Bonadonna; Lawrence B Schwartz; Joshua D Milner; George H Caughey; Dean D Metcalfe; Jonathan J Lyons Journal: Ann Allergy Asthma Immunol Date: 2021-08-13 Impact factor: 6.248
Authors: Peter Valent; Cem Akin; Boguslaw Nedoszytko; Patrizia Bonadonna; Karin Hartmann; Marek Niedoszytko; Knut Brockow; Frank Siebenhaar; Massimo Triggiani; Michel Arock; Jan Romantowski; Aleksandra Górska; Lawrence B Schwartz; Dean D Metcalfe Journal: Int J Mol Sci Date: 2020-11-27 Impact factor: 5.923