Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Allergy. 2013 Oct;68(10):1338-40. doi: 10.1111/all.12227. Epub 2013 Sep 21.
Anaphylaxis is a severe, potentially life-threatening reaction that can occur in response to common triggers, including food allergens (e.g., peanut), insect stings, and several medications. Activation of mast cells and basophils to release preformed mediators, such as histamine, is thought to be an important process that underlies reactions. Histamine can exert effects through four different receptors, termed H1R-H4R. Despite clinical use of both H1R and H2R blockers in the therapy for acute allergic reactions, there is little mechanistic evidence to support the necessity for blocking H2R, a receptor best characterized for its role in stomach acid production.
Here, we sought to define the necessity for histamine receptors in the pathology of anaphylaxis using H1R and H2R knockout (KO) mice, as well as a H1R/H2R double KO strain.
In response to IgE-mediated systemic anaphylaxis, the symptoms and decreases in core body temperature observed in wild-type mice were reduced but not ablated in either H1R or H2R KO. In contrast, H1R/H2R KO were significantly protected and were indistinguishable from histamine-deficient mice. Intravenous injection of histamine was sufficient to elicit these responses, and similar to IgE-mediated anaphylaxis, loss of both H1R and H2R was necessary for complete protection.
Our data demonstrate definitively that both H1R and H2R participate in the immediate systemic responses during histamine-associated pathophysiology and mechanistically support the utility of H2R-blocking therapeutics in alleviating symptoms of anaphylaxis.
过敏反应是一种严重的、潜在危及生命的反应,可能会对常见的过敏原(例如花生)、昆虫蜇伤和几种药物产生反应。肥大细胞和嗜碱性粒细胞被激活,释放预先形成的介质,如组胺,被认为是反应的一个重要过程。组胺可以通过四个不同的受体(称为 H1R-H4R)发挥作用。尽管 H1R 和 H2R 阻滞剂在急性过敏反应的治疗中得到了临床应用,但几乎没有机制证据支持阻断 H2R 的必要性,H2R 受体是一种以胃酸产生作用而著称的受体。
在这里,我们试图使用 H1R 和 H2R 敲除(KO)小鼠以及 H1R/H2R 双 KO 株来定义组胺受体在过敏反应病理中的必要性。
在 IgE 介导的全身性过敏反应中,与野生型小鼠相比,H1R 或 H2R KO 小鼠观察到的症状和核心体温下降有所减轻,但并未完全消除。相比之下,H1R/H2R KO 小鼠受到显著保护,与缺乏组胺的小鼠无法区分。静脉注射组胺足以引起这些反应,与 IgE 介导的过敏反应类似,完全保护需要同时缺失 H1R 和 H2R。
我们的数据明确表明,H1R 和 H2R 都参与了与组胺相关的病理生理学过程中的即刻全身反应,并且从机制上支持 H2R 阻断治疗在缓解过敏反应症状方面的实用性。