Anaesthesia-related allergy: from new insights in pathomechanisms to reliable diagnostic instruments.

Allergy during anaesthesia is an important health problem with a significant mortality and morbidity. Unfortunately, correct diagnosis is not always straightforward and too frequently overlooked. Thereby placing the patients at unnecessary risk for future life-threatening reactions. Uncertainties associated with skin testing with some of these drugs, and the general unavailability of drug-specific immunoglobulin E tests contribute to the frequent failure to adequately investigate and establish underlying mechanisms of reactions by distinguishing IgE-dependent from IgE-independent true anaphylactic reactions in these patients. In this project we would like to further explore the underlying pathomechanisms of immediate type hypersensitivity reactions that occur during general anaesthesia. For this purpose, we will take opportunity of having developed and validated up-to-date flow cytometric techniques like basophil activation tests and a cellular histamine content assay (HistaFlow®: patented by our laboratory) and recently having developed tools to culture mast cells out of circulating CD34+ progenitor cells. This will enable a combined analysis of surface markers and histamine release after IgE-dependent and IgE-dependent basophil and mast cell activation. Moreover, by having set in place a reference centre with high throughput of patients, it is anticipated that these experiments not only might culminate in the development of novel diagnostics tests to document drug hypersensitivity reactions, but also might help to define save anaesthetic alternatives.

Keywords:MAST CELLS, BASOPHILS, ALLERGY, ANESTHETIC AGENT

Disciplines:Immunology, Laboratory medicine, Palliative care and end-of-life care, Regenerative medicine, Other basic sciences, Other clinical sciences, Other health sciences, Nursing, Other paramedical sciences, Other translational sciences, Other medical and health sciences