Association of protamine IgE and IgG antibodies with life-threatening reactions to intravenous protamine

Article Abstract:

The action of heparin, an anticoagulant, can be reversed by protamine. Protamine, a class of proteins derived from fish sperm, diminishes or reverses the anticoagulant effect of heparin. Life threatening reactions to protamine administered intravenously have been reported with increasing frequency as a consequence of the increased use of protamines in surgery and in cardiac studies. Reviews of former cases have shown that such reactions are much more common when patients received daily injections of protamine-insulin preparations. This study investigated whether or not the formation of antibodies against insulin-protamine injections are the cause of the observed difficulty with protamine injection. [Antibodies are specific molecules formed by the body to react against foreign proteins (antigens). Antibodies are the specific mediator of the immune reaction.] This study analyzed 27 patients (both diabetic and non-diabetic) who had acute reactions to intravenous protamine injections, and a control group of 43 diabetic patients who tolerated protamine without reaction. In diabetic patients who had previously received protamine-insulin injections, the presence of serum antibodies against protamine was a significant risk factor for acute reactions to protamine injection. The authors conclude that protamine-insulin dependent diabetics experience an increased risk of serious reactions when intravenous protamine is given. The underlying mechanism is the presence of antibody mediated interactions. In nondiabetic subjects, the presence of similar antibodies was also associated with increased risk.

Health aspects, Analysis, Causes of, Immunoglobulin G, Anaphylaxis, Heparin, Immunoglobulin E

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A controlled trial of immunotherapy for asthma in allergic children

Article Abstract:

Allergy shots may not benefit allergic children with moderate to severe year-round asthma. Researchers randomly assigned 121 allergic children with moderate to severe year-round asthma to a course of injections of allergen extracts or placebo. They tracked medication use, symptoms, and peak flow rates over a two-year period. Medication scores declined overall and about 30% of the group experienced partial or complete remission of asthma. However, there were no differences between treated and control groups, and no differences in symptoms, peak flow rates, or medical visits. These results may only apply to children receiving optimal medical treatment.

Drug therapy, Asthma in children, Childhood asthma

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Immunotherapy for allergic rhinitis

Article Abstract:

Immunotherapy for hay-fever was introduced in 1911, when people were given allergy shots consisting of grass-pollen extract. This treatment became less common when anti-histamine drugs were introduced in the 1940s. However, grass-pollen immunotherapy has few side effects and is specific for hay-fever. Patients often continue to benefit long after the treatment stops. A 1999 study confirmed this fact, noting that patients treated with three years of grass-pollen immunotherapy went an additional three years without symptoms when the treatment was stopped. However, patients must still attempt to minimize exposure to allergic substances.

Care and treatment, Editorial, Hay-fever, Hay fever

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