Kakolyri Maria, Strikou Flora, Kavallari Andriana, Chliva Caterina, Makris Michael, Tiligada Ekaterini
Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Allergy Unit "D. Kalogeromitros," 2nd Department of Dermatology and Venereology, "Attikon" General University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Int Arch Allergy Immunol. 2020;181(1):24-30. doi: 10.1159/000503968. Epub 2019 Nov 21.
Non-steroidal anti-inflammatory drugs (NSAIDs) represent one of the most prevalent causes of drug hypersensitivity reactions (DHRs), yet the underlying processes are far from clear. Despite the established role of histamine in allergic reactions, its precise implication in DHRs is elusive.
This study aimed to explore the connection of basal blood histamine levels to the reported NSAID hypersensitivity.
Sixteen patients reporting hypersensitivity reactions to a single or multiple NSAIDs and/or paracetamol and 18 healthy volunteers serving as the normal control group enrolled in the study. The medical history was recorded and histamine was quantified spectrophotofluorometrically in whole peripheral blood and plasma.
Compared to the normal group, plasma but not whole blood histamine levels were significantly higher in patients (p < 0.001), mainly in the subgroup reporting hypersensitivity to a single agent (p < 0.001). Plasma histamine levels were significantly correlated with the culprit drug selectivity for cyclooxygenase (COX) isozymes (p < 0.001), with higher levels being obtained in patients reporting reactions to COX-1 than to COX-2 selective inhibitors (p < 0.05).
The findings provide first evidence connecting basal blood histamine levels to the reported NSAID-triggered DHRs. Prospective studies are expected to decipher the contribution of histamine-associated parameters to the mechanisms underlying DHRs.
非甾体抗炎药（NSAIDs）是药物超敏反应（DHRs）最常见的原因之一，但其潜在机制仍不清楚。尽管组胺在过敏反应中的作用已得到证实，但其在药物超敏反应中的具体影响仍不明确。
本研究旨在探讨基础血组胺水平与所报告的非甾体抗炎药超敏反应之间的联系。
16例报告对一种或多种非甾体抗炎药和/或对乙酰氨基酚过敏反应的患者以及18名健康志愿者作为正常对照组纳入本研究。记录病史，并采用分光荧光法对全外周血和血浆中的组胺进行定量分析。
与正常组相比，患者血浆组胺水平显著升高，但全血组胺水平无显著变化（p < 0.001），主要是在报告对单一药物过敏的亚组中（p < 0.001）。血浆组胺水平与环氧化酶（COX）同工酶的致病药物选择性显著相关（p < 0.001），对COX-1选择性抑制剂有反应的患者血浆组胺水平高于对COX-2选择性抑制剂有反应的患者（p < 0.05）。
这些发现首次证明基础血组胺水平与所报告的非甾体抗炎药引发的药物超敏反应之间存在联系。预期前瞻性研究将阐明组胺相关参数在药物超敏反应潜在机制中的作用。
