Article
Emergency Medicine
Joseph Stoldt, Courtney Cox, Erin Matusz
Summary: Tranexamic acid is a potentially safe and effective treatment option for angiotensin converting enzyme inhibitor-induced angioedema, according to this case report. Previous small case reports have demonstrated the efficacy of tranexamic acid in treating this condition, and this report provides further evidence of its effectiveness.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Medicine, General & Internal
Sengul Aksakal
Summary: This study contributes to the causes and treatment approaches of isolated angioedema by investigating the causes of 80 cases, including some rare or unknown causes in the literature.
POSTGRADUATE MEDICAL JOURNAL
(2023)
Review
Biochemistry & Molecular Biology
Sylwia Smolinska, Dario Antolin-Amerigo, Florin-Dan Popescu
Summary: Bradykinin metabolism and its receptors are crucial in drug-induced angioedema without urticaria due to increased vascular permeability. Many cardiovascular and diabetic drugs can cause BK-mediated AE. Inhibition of angiotensin-converting enzyme and neprilysin impair BK catabolism. Dipeptidyl peptidase-IV inhibitors reduce the breakdown of BK and substance P. Additionally, angiotensin receptor blockers, thrombolytic agents, and statins may also induce BK-mediated AE. Understanding the pathophysiological mechanisms is essential for preventing and treating drug-induced AE.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Biochemistry & Molecular Biology
Wojciech Dyga, Aleksander Obtulowicz, Tomasz Mikolajczyk, Anna Bogdali, Pawel Dubiela, Krystyna Obtulowicz
Summary: This study aimed to investigate the role of bradykinin receptor 1 in the pathogenesis of hereditary angioedema (HAE). Comparing with healthy subjects, significant differences were found in the subpopulation of lymphocytes and monocytes in patients with HAE, and the expression levels of both BR1 and BR2 increased significantly during HAE attacks. Additionally, HAE patients showed elevated levels of TNF-alpha and IL-1 in plasma.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Allergy
Gesa Bindke, Manuela Gehring, Dorothea Wieczorek, Alexander Kapp, Timo Buhl, Bettina Wedi
Summary: This study compared HAE, ACE-AE, and CSU-AE for the first time, identifying Tie-2 as a promising biomarker candidate for HAE. FAP-alpha and tPA may serve as markers for AE in general, while sE-selectin and Ang-2 were increased in BK-AE only. The study adds information to the role of endothelial dysfunction and serine proteases in different AE subtypes.
Article
Emergency Medicine
Kellie Wang, Haden Geiger, Andre McMahon
Summary: Tranexamic acid (TXA), an antifibrinolytic agent, may be a beneficial treatment modality in the management of ACE inhibitor-induced angioedema (ACEI-AE) based on a case report, but further investigation is warranted to confirm its efficacy.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Medicine, General & Internal
Emel Aygoeren-Puersuen, Andrea Zanichelli, Danny M. Cohn, Mauro Cancian, Roman Hakl, Tamar Kinaciyan, Markus Magerl, Inmaculada Martinez-Saguer, Marcin Stobiecki, Henriette Farkas, Sorena Kiani-Alikhan, Vesna Grivcheva-Panovska, Jonathan A. Bernstein, H. Henry Li, Hilary J. Longhurst, Paul K. Audhya, Michael Smith, Christopher M. Yea, Andreas Maetzel, Daniel K. Lee, Edward P. Feener, Richard Gower, William R. Lumry, Aleena Banerji, Marc A. Riedl, Marcus Maurer
Summary: This study evaluated a novel oral plasma kallikrein inhibitor, sebetralstat, for on-demand treatment of hereditary angioedema attacks. The results showed that sebetralstat rapidly suppressed plasma kallikrein activity, leading to longer time to use of conventional treatment and faster symptom relief compared to placebo. The study provided important evidence for future clinical trials.
Article
Allergy
Iris Leibovich-Nassi, Avner Reshef
Summary: A prodrome is a set of signs and symptoms indicating the onset of a disease, frequently reported by patients with hereditary angioedema (HAE) to predict attacks. However, there is still debate over the definition and investigation of prodromes, leading to uncertainty about their contribution to diagnosis and treatment of disorders.
CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Jonas Ghouse, Gustav Ahlberg, Laura Andreasen, Karina Banasi, Soren Brunak, Michael Schwinn, Ina Holst Larsen, Oscar Petersen, Erik Sorensen, Henrik Ullum, Eva Rye Rasmussen, Niclas Eriksson, Paer Hallberg, Mia Wadelius, Henning Bundgaard, Morten S. Olesen
Summary: A genetic locus at chromosome 14q32.2 was found to be associated with ACE inhibitor-related angioedema in individuals of European descent. Carriers of the risk allele had significantly lower blood pressure, suggesting a potential mechanism linking genetic variants near the bradykinin receptor B2 gene with angioedema risk.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Editorial Material
Medicine, General & Internal
Raffi Tachdjian, Douglas T. Johnston
Summary: Acute angioedema is a serious condition that requires prompt intervention, as patients may be at risk of airway obstruction at any time. The disease is caused by three mediators, each requiring different management strategies based on individual circumstances.
POSTGRADUATE MEDICINE
(2021)
Article
Medicine, General & Internal
Katarzyna Piotrowicz-Wojcik, Malgorzata Bulanda, Aldona Juchacz, Joanna Jamroz-Brzeska, Jacek Gocki, Krzysztof Kuziemski, Robert Pawlowicz, Grzegorz Porebski
Summary: This study investigated the clinical characteristics and treatment practices of 138 adult HAE patients in Poland, finding that plasma-derived C1-INH, icatibant, and recombinant C1-INH were the main treatments used for attacks. Symptomatic women had a higher frequency of attacks and were more likely to treat themselves compared to men, while older patients experienced longer delays in diagnosis and self-administered rescue medication less frequently.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Allergy
T. Caballero
Summary: This review explores the current therapy for hereditary angioedema due to C1-esterase inhibitor deficiency (C1-INH-HAE) and provides a brief overview of drugs under development. Pharmacological treatment is based on three pillars: treatment of acute attacks, short-term prophylaxis, and long-term prophylaxis. New drugs targeting the kallikrein-kinin system are being investigated for long-term prophylaxis in C1-INH-HAE patients.
JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY
(2021)
Article
Immunology
Olav Rogde Gramstad, Camilla Schjalm, Tom Eirik Mollnes, Erik Waage Nielsen
Summary: C1 inhibitor (C1Inh) deficiency is associated with an increased thromboinflammatory load, which may explain the impact on thrombosis and inflammation seen in hereditary angioedema (HAE). The study measured various cytokines, complement activation markers, and haemostatic markers in HAE patients and healthy controls.
CLINICAL AND EXPERIMENTAL IMMUNOLOGY
(2023)
Article
Biology
Lucia Liotti, Luca Pecoraro, Carla Mastrorilli, Riccardo Castagnoli, Francesca Saretta, Francesca Mori, Stefania Arasi, Simona Barni, Mattia Giovannini, Lucia Caminiti, Michele Miraglia Del Giudice, Elio Novembre
Summary: Angioedema (AE) is a vascular reaction that affects subcutaneous and submucosal tissues and is often accompanied by wheals. AE without wheals (AEwW) is rare, and distinguishing between mast cell-mediated and bradykinin-mediated or leukotriene-mediated AE is crucial for accurate diagnosis and treatment. AEwW can be hereditary or acquired, and different clinical features and responses to antihistamines can help determine the cause.
Review
Medicine, General & Internal
Xiuyan Qi, Huiqian Lin
Summary: This study investigates factors related to and treatment of orolingual angioedema (OA) after thrombolysis with alteplase. The most common factor for increased risk of OA after recombinant tissue plasminogen activator was concomitant use of angiotensin-converting enzyme inhibitors (ACEI). It is recommended to inquire about allergies and current ACEI use before intravenous thrombolytic therapy.
