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Das menschliche Herz als Schockorgan in der Anaphylaxie

  • Übersicht_Allergo J Int; 23: 60
  • Published:
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Zusammenfassung

Anaphylaxie ist eine potenziell letale allergische Reaktion vom Soforttyp. Mastzellen und basophile Granulozyten sind durch die Freisetzung vasoaktiver Mediatoren und Zytokine die wichtigsten primären Effektorzellen der Anaphylaxie. Im menschlichen Herzen wurden Mastzellen zwischen Herzmuskelzellen, im perivaskulären Bereich, in der Adventitia und in der arteriellen Intima nachgewiesen. Aus dem menschlichen Herzgewebe isolierte Mastzellen („human heart mast cells“ [HHMC]) von Patienten, die ein Spenderherz erhalten, exprimieren hochaffine Immunglobulin-E(IgE)-Rezeptoren (FcεRI), C3a, C5a und Kit-Rezeptoren. Anti-IgE, Anti-FcεRI und Immunglobulin-Superantigene stimulieren HHMC in vitro zur Sekretion zuvor gebildeter Mediatoren (Histamin, Tryptase, Chymase und Renin) sowie zur De-novo-Synthese von Cysteinylleukotrien C4 (LTC4) und Prostaglandin D2 (PGD2). Während der Anaphylaxie kommt es zur Komplementaktivierung und Bildung von Anaphylatoxin. C5a und C3a bewirken in vitro die Freisetzung von Histamin und Tryptase aus HHMC. Therapeutische Wirkstoffe (Allgemeinanästhetika, Protamin u. a.) und Diagnostika (Röntgenkontrastmittel u. a.), die eine anaphylaktische Reaktion auslösen können, aktivieren HHMC in vitro. Bekommen Patienten im Rahmen einer Katheterdiagnostik in geringen Konzentrationen Histamin und Cysteinylleukotriene verabreicht, führt dies zu erheblichen systemischen und koronaren hämodynamischen Effekten. Diese Befunde weisen darauf hin, dass HHMC und ihre Mediatoren eine Rolle in schweren anaphylaktischen Reaktionen spielen.

Zitierweise: Marone G, Genovese A, Varricchi G, Granata F. Human heart as a shock organ in anaphylaxis. Allergo J Int 2014; 23: 60–6 DOI 10.1007/s40629-014-0007-3

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Abbreviations

C3aR:

C3a-Rezeptor

C5aR:

C5a-Rezeptor

CBF:

Koronarer Blutfluss

CVR:

Koronarer Gefäßwiderstand

CysLT2:

Cysteinylleukotrien-Rezeptor 2

CysLT1:

Cysteinylleukotrien-Rezeptor 1

DCM:

Dilatative Kardiomyopathie

ECP:

„Eosinophil cationic protein“

FcεRI:

Hochaffine Immunglobulin-E-Rezeptoren

HHMC:

Aus menschlichem Herzgewebe isolierte Mastzellen

ICM:

Ischämische Kardiomyopathie

IgE:

Immunglobulin E

LTC4 :

Cysteinylleukotrien C4

LTD4 :

Cysteinylleukotrien D4

LV:

Linksventrikulär

MBP:

„Major basic protein“

PAF:

Plättchenaktivierender Faktor

PGD2 :

Prostaglandin D2

SCF:

Stammzellfaktor

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Authors and Affiliations

  1. Abteilung für Translationale Medizin, Universität Neapel Federico II, Neapel, Italien

    Gianni Marone, Arturo Genovese, Gilda Varricchi & Francescopaolo Granata

  2. Zentrum für Immunologische Grundlagenforschung und klinische Forschung (CISI), Universität Neapel Federico II, Neapel, Italien

    Gianni Marone & Arturo Genovese

  3. Abteilung für Translationale Medizin, Universität Neapel Federico II, Via S. Pansini 5, 80131, Neapel, Italien

    Gianni Marone

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  1. Gianni Marone
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  2. Arturo Genovese
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  4. Francescopaolo Granata
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Correspondence to Gianni Marone.

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Erklärung zu Interessenkonflikten

Der Autor erklärt, dass bei der Erstellung des Beitrags kein Interessenkonflikt vorlag.

Danksagungen

Diesen Beitrag widmen wir Prof. Johannes Ring zur Würdigung seiner Pionierleistungen auf dem Gebiet der Anaphylaxieforschung. Diese Arbeit wurde durch Forschungsförderung vom Ministero dell’Istruzione, Università e Ricerca (MIUR; G. Marone und A. Genovese), vom Istituto Superiore di Sanità AIDS Project „Role of basophils in HIV-1 infection“ (G. Marone), vom Regione Campania „CISI-Lab Project“ und vom CRÈME Project (G. Marone) unterstützt. G. Marone ist der Träger des Paul-Ehrlich-Preises 2011.

Zitierweise

Marone G, Genovese A, Varricchi G, Granata F. Human heart as a shock organ in anaphylaxis. Allergo J Int 2014; 23: 60–6 DOI 10.1007/s40629-014-0007-3

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Marone, G., Genovese, A., Varricchi, G. et al. Das menschliche Herz als Schockorgan in der Anaphylaxie. Allergo J 23, 24–30 (2014). https://doi.org/10.1007/s15007-014-0517-9

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  • DOI: https://doi.org/10.1007/s15007-014-0517-9

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