ArticleCells2021
MRGPRX2 Activation by Rocuronium: Insights from Studies with Human Skin Mast Cells and Missense Variants.
Article in Cells, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 42 citations in OpenAlex.
- Article
- Structural determinants of ligand response specificity in the mast cell activating GPCR, MRGPRX2.The Journal of biological chemistry · 2026Article
- Drug-induced anaphylaxis: Molecular pathophysiology, diagnosis, and management.Asia Pacific allergy · 2026Article
- In silico assessment of neuromuscular blocking agents and fluoroquinolones as ligands of the Mas-related G protein-coupled receptor X2.Pharmacological reports : PR · 2026Article
- Mutations ofThe journal of allergy and clinical immunology. Global · 2025Review
- The prevalence of genetic variants of the Mas-related G-protein-coupled receptor X2 in patients does not explain perioperative hypersensitivity reactions to neuromuscular blocking agents.Frontiers in pharmacology · 2025Article
- Non-IgE-Mediated Immediate Drug-Induced Hypersensitivity Reactions.The journal of allergy and clinical immunology. In practice · 2024Article
- Clinical variables and genetic variants associated with perioperative anaphylaxis in Chinese Han population: A pilot study.The World Allergy Organization journal · 2024Article
- The development of murine bone marrow-derived mast cells expressing functional human MRGPRX2 forFrontiers in immunology · 2024Article
- Recent insights into the mechanisms of anaphylaxis.Current opinion in immunology · 2023Review
- 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
- GRK2 differentially regulates FcεRI and MRGPRB2-mediated responses in mast cells.Frontiers in immunology · 2023Article
- Mas-Related G Protein-Coupled Receptor-X2 and Its Role in Non-immunoglobulin E-Mediated Drug Hypersensitivity.Immunology and allergy clinics of North America · 2022Review
- Inhibition of MRGPRX2 but not FcεRI or MrgprB2-mediated mast cell degranulation by a small molecule inverse receptor agonist.Frontiers in immunology · 2022Article
- 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
- MRGPRX2 and Adverse Drug Reactions.Frontiers in immunology · 2021Review
- Novel Insights on MRGPRX2-Mediated Hypersensitivity to Neuromuscular Blocking Agents And Fluoroquinolones.Frontiers in immunology · 2021Article
- Murepavadin, a Small Molecule Host Defense Peptide Mimetic, Activates Mast CellsFrontiers in immunology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Perioperative hypersensitivity (POH) to the neuromuscular blocking drug (NMBD) rocuronium was previously thought to be IgE and mast cell (MC)-mediated. However, the recent seminal observation that rocuronium induces degranulation in murine peritoneal MCs (PMCs) via Mas-related G protein-coupled receptor B2 (MrgprB2) led to the idea that POH to this drug involves the activation of MRGPRX2 (human ortholog of MrgprB2). Furthermore, based on the demonstration that a patient with POH to rocuronium displayed three missense mutations (M196I, L226P and L237P) in MRGPRX2's transmembrane domains, it was proposed that this hypersensitivity reaction resulted from aberrant activation of this receptor. We found that rocuronium at 20 µg/mL caused degranulation in mouse PMCs via MrgprB2 but required at least 500 µg/mL to induce degranulation in human MCs via MRGPRX2. Furthermore, RBL-2H3 cells transiently expressing M196I, L226P and L237P variants did not display enhanced degranulation in response to rocuronium when compared to the wild-type receptor. These findings provide the first demonstration that rocuronium induces degranulation in human MCs via MRGPRX2. Furthermore, the important differences between MrgprB2 and MRGPRX2 and the inability of rocuronium to induce enhanced response in cells expressing MRGPRX2 variants suggest that the mechanism of its POH is more complex than previously thought.
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Registered trials
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.