Simionescu Anca Angela, Stanescu Ana Maria Alexandra, Popescu Florin-Dan
Department of Obstetrics and Gynecology Filantropia Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Family Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Life (Basel). 2021 Aug 24;11(9):870. doi: 10.3390/life11090870.
Anaphylaxis is an unpredictable systemic hypersensitivity reaction and constitutes a high risk of maternal and fetal morbidity and mortality when occurring during pregnancy. Currently, the acute management of anaphylaxis is based on clinical parameters. A total serum tryptase is only used to support an accurate diagnosis. There is a need to detect other biomarkers to further assess high-risk patients in obstetrics. Our objective is to present biomarkers in this complex interdisciplinary approach beyond obstetrician and anaesthetic management. Candidate biomarkers derive either from mediators involved in immunopathogenesis or upcoming molecules from systems biology and proteomics. Serum tryptase is determined by singleplex immunoassay method and is important in the evaluation of anaphylactic mast cell degranulation but also in the assessment of other risk factors for anaphylaxis such as systemic mastocytosis. Another category of biomarkers investigates the IgE-mediated sensitization to triggers potentially involved in the etiology of anaphylaxis in pregnant women, using singleplex or multiplex immunoassays. These in vitro tests with natural extracts from foods, venoms, latex or drugs, as well as with molecular allergen components, are useful because in vivo allergy tests cannot be performed on pregnant women in such a major medical emergency due to their additional potential risk of anaphylaxis.
过敏反应是一种不可预测的全身性超敏反应，在孕期发生时会对孕产妇和胎儿的发病及死亡构成高风险。目前，过敏反应的急性处理基于临床参数。血清总类胰蛋白酶仅用于辅助准确诊断。有必要检测其他生物标志物，以进一步评估产科高危患者。我们的目标是通过这种复杂的跨学科方法，呈现除产科医生和麻醉管理之外的生物标志物。候选生物标志物要么源自免疫发病机制中涉及的介质，要么源自系统生物学和蛋白质组学中出现的分子。血清类胰蛋白酶通过单重免疫测定法测定，在评估过敏性肥大细胞脱颗粒方面很重要，在评估过敏反应的其他风险因素（如系统性肥大细胞增多症）方面也很重要。另一类生物标志物使用单重或多重免疫测定法，研究孕妇对可能参与过敏反应病因的触发因素的IgE介导的致敏情况。这些针对食物、毒液、乳胶或药物的天然提取物以及分子变应原成分进行的体外试验很有用，因为在这种重大医疗紧急情况下，由于存在额外的过敏反应潜在风险，无法对孕妇进行体内过敏试验。
