Lippi Giuseppe, Favaloro Emmanuel J
Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Department of Haematology, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), Pathology West, NSW Health Pathology, Westmead, Australia.
Semin Thromb Hemost. 2016 Feb;42(1):63-8. doi: 10.1055/s-0035-1568876. Epub 2015 Dec 30.
Allergic diseases are very frequent conditions worldwide. The pathogenesis of allergic reactions and venous thromboembolism (VTE) shares several risk factors and predisposing conditions. In particular, the concentration of immunoglobulin E (IgE) is considerably increased in patients with allergic diseases, and this immunoglobulin exert many prothrombotic and antifibrinolytic activities, especially through interaction with mast cells. Therefore, this narrative review is aimed to provide an overview of the current scientific evidence supporting a potential relationship between allergy and the risk of VTE. Although no prospective studies have been published so far, the evidence provided by six large cross-sectional studies and several case reports support the existence of an unquestionable epidemiological association between different allergic diseases (especially atopy, asthma, and celiac disease) and venous thrombosis. Two additional investigations reported that the concentration of IgE might predict the onset of severe complications of pulmonary embolism such as pulmonary infarction and pleural fluid accumulation. Therefore, the existence of a convincing epidemiologic link between allergy and VTE paves the way to future investigations aimed to establish whether the prevention or treatment of allergic diseases might be regarded as an effective measure to lower the risk of VTE.
过敏性疾病在全球范围内都非常常见。过敏反应和静脉血栓栓塞（VTE）的发病机制有若干共同的风险因素和诱发条件。特别是，过敏性疾病患者体内免疫球蛋白E（IgE）的浓度会显著升高，这种免疫球蛋白具有多种促血栓形成和抗纤维蛋白溶解活性，尤其是通过与肥大细胞相互作用来实现。因此，本叙述性综述旨在概述当前支持过敏与VTE风险之间潜在关系的科学证据。尽管目前尚未发表前瞻性研究，但六项大型横断面研究和若干病例报告提供的证据支持不同过敏性疾病（尤其是特应性、哮喘和乳糜泻）与静脉血栓形成之间存在明确的流行病学关联。另外两项研究报告称，IgE浓度可能预测肺栓塞严重并发症的发生，如肺梗死和胸腔积液。因此，过敏与VTE之间令人信服的流行病学联系为未来的研究铺平了道路，这些研究旨在确定过敏性疾病的预防或治疗是否可被视为降低VTE风险的有效措施。
