Assem E S
Agents Actions. 1984 Apr;14(3-4):435-40. doi: 10.1007/BF01973845.
Histamine release from the basophil leucocytes of patients with apparently non-immune, anaphylactiod reactions to neuromuscular blockers ( NMB ) has been studied in vitro. Substantial release was obtained in the majority of patients with clinical reactions, with little or no release in normal subjects. The chemical specificity and selectivity varied in individual patients: each individual reacting to one agent or a particular combination of NMB drugs. The test was of considerable diagnostic and predictive value. We studied some of the characteristics of the histamine release process and the effect of certain modulators. The findings strongly suggest a non-cytotoxic secretory process requiring the presence of two quaternary ammonium groups as suggested by the rarity of release with tubocurarine; inhibition of succinyldicholine (suxamethonium)-induced histamine release by serum cholinesterase treatment, acetylcholine and tubocurarine; and the bell-shaped dose-response curve, particularly with suxamethonium. Histamine release by all NMB was completely inhibited in calcium-free medium, and markedly potentiated by deuterium oxide, a microtubule stabilizer. Both tachyphylaxis (by prior exposure to the specific agent in absence of calcium), and cross-tachyphylaxis with anti-IgE were elicited.
对非免疫性类过敏反应的神经肌肉阻滞剂（NMB）患者嗜碱性白细胞组胺释放进行了体外研究。大多数有临床反应的患者获得了大量释放，而正常受试者几乎没有或没有释放。化学特异性和选择性在个体患者中有所不同：每个个体对一种药物或特定组合的NMB药物有反应。该试验具有相当大的诊断和预测价值。我们研究了组胺释放过程的一些特征以及某些调节剂的作用。研究结果强烈提示一种非细胞毒性分泌过程，该过程需要两个季铵基团的存在，这一点从筒箭毒碱释放罕见可以看出；血清胆碱酯酶处理、乙酰胆碱和筒箭毒碱对琥珀酰胆碱（司可林）诱导的组胺释放有抑制作用；以及钟形剂量反应曲线，尤其是司可林。在无钙培养基中，所有NMB诱导的组胺释放均被完全抑制，而微管稳定剂氧化氘则显著增强了组胺释放。通过预先在无钙情况下接触特定药物引发了快速耐受性，并且与抗IgE产生了交叉快速耐受性。
