ReviewInternational journal of molecular sciences2017
Reclassifying Anaphylaxis to Neuromuscular Blocking Agents Based on the Presumed Patho-Mechanism: IgE-Mediated, Pharmacological Adverse Reaction or "Innate Hypersensitivity"?
Review in International journal of molecular sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
32 citing papers in PubMed, 88 citations in OpenAlex.
- Safety outcomes of half-dose fluorescein and indocyanine green angiography: a clinical assessment of adverse events.Japanese journal of ophthalmology · 2026Article
- Drug-induced anaphylaxis: Molecular pathophysiology, diagnosis, and management.Asia Pacific allergy · 2026Article
- The Role of Mast Cells in Healing Purulent Wounds Using a Drug from the Polyhexamethylene Guanidine Group with the Antiseptic Polyhexanide: An Ultrastructural Study.International journal of molecular sciences · 2025Article
- General anesthesia allergy causes and mechanisms.Asia Pacific allergy · 2025Review
- Perioperative anaphylaxis in children and first successful cisatracurium desensitization.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Article
- Drug-Induced Anaphylaxis in Children.Biomedicines · 2024Review
- Drug-induced hypersensitivity reactions in a Lebanese outpatient population: A decade-long retrospective analysis (2012-2021).The journal of allergy and clinical immunology. Global · 2024Article
- Immunological Mechanisms in Cutaneous Adverse Drug Reactions.Biomolecules & therapeutics · 2024Review
- A quarter of a century fundamental and translational research in perioperative hypersensitivity and anaphylaxis at the Antwerp university hospital, a Belgian Centre of Excellence of the World Allergy Organization.The World Allergy Organization journal · 2023Article
- Patient Characteristics Associated With Reactions to Mrgprx2-Activating Drugs in an Electronic Health Record-Linked Biobank.The journal of allergy and clinical immunology. In practice · 2023Observational
- Article
- New Mechanistic Advances in FcεRI-Mast Cell-Mediated Allergic Signaling.Clinical reviews in allergy & immunology · 2022Review
- Pathophysiological, Cellular, and Molecular Events of the Vascular System in Anaphylaxis.Frontiers in immunology · 2022Review
- Quaternary ammonium compounds in hypersensitivity reactions.Frontiers in toxicology · 2022Review
- What do we know about perioperative hypersensitivity reactions and what can we do to improve perioperative safety?Annals of medicine · 2021Article
- Allergic reactions against Covıd-19 vaccinesTurkish journal of medical sciences · 2021Review
- Revisiting the role of MRGPRX2 on hypersensitivity reactions to neuromuscular blocking drugs.Current opinion in immunology · 2021Review
- Multifaceted MRGPRX2: New insight into the role of mast cells in health and disease.The Journal of allergy and clinical immunology · 2021Review
- Review
- Concurrent positive skin tests to prophylactic antibiotics and rocuronium in two patients with life-threatening anaphylaxis after induction of anesthesia.JA clinical reports · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Approximately 60% of perioperative anaphylactic reactions are thought to be immunoglobulin IgE mediated, whereas 40% are thought to be non-IgE mediated hypersensitivity reactions (both considered non-dose-related type B adverse drug reactions). In both cases, symptoms are elicited by mast cell degranulation. Also, pharmacological reactions to drugs (type A, dose-related) may sometimes mimic symptoms triggered by mast cell degranulation. In case of hypotension, bronchospasm, or urticarial rash due to mast cell degranulation, identification of the responsible mechanism is complicated. However, determination of the type of the underlying adverse drug reaction is of paramount interest for the decision of whether the culprit drug may be re-administered. Neuromuscular blocking agents (NMBA) are among the most frequent cause of perioperative anaphylaxis. Recently, it has been shown that NMBA may activate mast cells independently from IgE antibodies via the human Mas-related G-protein-coupled receptor member X2 (MRGPRX2). In light of this new insight into the patho-mechanism of pseudo-allergic adverse drug reactions, in which as drug-receptor interaction results in anaphylaxis like symptoms, we critically reviewed the literature on NMBA-induced perioperative anaphylaxis. We challenge the dogma that NMBA mainly cause IgE-mediated anaphylaxis via an IgE-mediated mechanism, which is based on studies that consider positive skin test to be specific for IgE-mediated hypersensitivity. Finally, we discuss the question whether MRGPRX2 mediated pseudo-allergic reactions should be re-classified as type A adverse reactions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.