The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Aug 2007
Randomized Controlled Trial Multicenter StudyCritical role of kallikrein in hereditary angioedema pathogenesis: a clinical trial of ecallantide, a novel kallikrein inhibitor.
Hereditary angioedema (HAE) is a rare, autosomal-dominant disorder caused by C1 inhibitor gene mutation. Patients with HAE experience intermittent attacks of edema affecting the oropharynx, abdomen, gastrointestinal tract, and limbs. C1 inhibitor is the primary endogenous inhibitor of the kallikrein-kinin (contact) cascade. Unregulated kallikrein activation generates bradykinin, the likely mediator of the swelling and pain characterizing HAE attacks. Ecallantide, a novel, recombinant protein, potently inhibits kallikrein. This is the first placebo-controlled assessment in human beings of a therapeutic intervention to improve symptoms of HAE attacks under the hypothesis that the contact cascade is the putative pathway responsible for HAE pathology. ⋯ Ecallantide is a promising new therapy for HAE attacks.
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Investigations at the Danish Anesthesia Allergy Centre have included testing for allergy to chlorhexidine since 1999. ⋯ IgE and histamine release can be used to support the diagnosis of allergy to chlorhexidine.
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J. Allergy Clin. Immunol. · Aug 2007
A new mechanism regulating the initiation of allergic airway inflammation.
The earliest immune events induced by allergens are poorly understood, yet are likely essential to understanding how allergic inflammation is established. ⋯ These findings reveal a new paradigm for understanding how allergic inflammation begins and suggest novel possibilities for the prevention and treatment of allergic diseases, such as asthma.