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Cureus Mar 2023Bupropion is an antidepressant utilized widely for the treatment of various mood disorders and smoking cessation due to its favorable side effect profile, cost, and...
Bupropion is an antidepressant utilized widely for the treatment of various mood disorders and smoking cessation due to its favorable side effect profile, cost, and response to therapy. While serious adverse reactions are rare, in the decades since its approval by the FDA, multiple cases of serum sickness-like reactions to bupropion have been reported, amongst other adverse drug reactions (ADRs). This report is of the case of a 25-year-old female who developed a serum sickness-like reaction to bupropion 21 days after initiation of treatment. She did not respond to conservative therapy but did respond promptly to oral corticosteroids and discontinuation of bupropion. This case serves to bolster the existing literature surrounding ADRs to bupropion and other antidepressant medications in the categories of systemic and dermatologic manifestations.
PubMed: 37065375
DOI: 10.7759/cureus.36158 -
International Journal of Molecular... Jan 2023Ozone (O) is an air pollutant that primarily damages the lungs, but growing evidence supports the idea that O also harms the brain; acute exposure to O has been linked...
Ozone (O) is an air pollutant that primarily damages the lungs, but growing evidence supports the idea that O also harms the brain; acute exposure to O has been linked to central nervous system (CNS) symptoms such as depressed mood and sickness behaviors. However, the mechanisms by which O inhalation causes neurobehavioral changes are limited. One hypothesis is that factors in the circulation bridge communication between the lungs and brain following O exposure. In this study, our goals were to characterize neurobehavioral endpoints of O exposure as they relate to markers of systemic and pulmonary inflammation, with a particular focus on serum amyloid A (SAA) and kynurenine as candidate mediators of O behavioral effects. We evaluated O-induced dose-, time- and sex-dependent changes in pulmonary inflammation, circulating SAA and kynurenine and its metabolic enzymes, and sickness and depressive-like behaviors in Balb/c and CD-1 mice. We found that 3 parts per million (ppm) O, but not 2 or 1 ppm O, increased circulating SAA and lung inflammation, which were resolved by 48 h and was worse in females. We also found that indoleamine 2,3-dioxygenase () mRNA expression was increased in the brain and spleen 24 h after 3 ppm O and that kynurenine was increased in blood. Sickness and depressive-like behaviors were observed at all O doses (1-3 ppm), suggesting that behavioral responses to O can occur independently of increased SAA or neutrophils in the lungs. Using SAA knockout mice, we found that SAA did not contribute to O-induced pulmonary damage or inflammation, systemic increases in kynurenine post-O, or depressive-like behavior but did contribute to weight loss. Together, these findings indicate that acute O exposure induces transient symptoms of sickness and depressive-like behaviors that may occur in the presence or absence of overt pulmonary neutrophilia and systemic increases of SAA. SAA does not appear to contribute to pulmonary inflammation induced by O, although it may contribute to other aspects of sickness behavior, as reflected by a modest effect on weight loss.
Topics: Female; Mice; Animals; Ozone; Serum Amyloid A Protein; Kynurenine; Lung; Pneumonia; Phenotype
PubMed: 36675130
DOI: 10.3390/ijms24021612 -
Asian Pacific Journal of Allergy and... Dec 2015Hypersensitivity reactions caused by ant stings are increasingly recognized as an important cause of death by anaphylaxis. Only some species of ants ( e.g. Solenopsis... (Review)
Review
Hypersensitivity reactions caused by ant stings are increasingly recognized as an important cause of death by anaphylaxis. Only some species of ants ( e.g. Solenopsis spp., Myrmecia spp., and Pachycondyla spp.) cause allergic reactions. Ant species are identified by evaluating the morphologic structures of worker ants or by molecular techniques. Ant venom contains substances, including acids and alkaloids, that cause toxic reactions, and those from Solenopsis invicta or the imported fire ant have been widely studied. Piperidine alkaloids and low protein contents can cause local reactions (sterile pustules) and systemic reactions (anaphylaxis). Imported fire ant venoms are cross-reactive; for example, the Sol i 1 allergen from S. invicta has cross-reactivity with yellow jacket phospholipase. The Sol i 3 allergen is a member of the antigen 5 family that has amino acid sequence identity with vespid antigen 5. The clinical presentations of ant hypersensitivity are categorized into immediate and delayed reactions: immediate reactions, such as small local reactions, large local reactions, and systemic reactions, occur within 1-4 hours after the ant stings, whereas delayed reactions, such as serum sickness and vasculitis, usually occur more than 4 hours after the stings. Tools for the diagnosis of ant hypersensitivity are skin testing, serum specific IgE, and sting challenge tests. Management of ant hypersensitivity can be divided into immediate (epinephrine, corticosteroids), symptomatic (antihistamines, bronchodilators), supportive (fluid resuscitation, oxygen therapy), and preventive (re-sting avoidance and immunotherapy) treatments.
Topics: Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Cross Reactions; Hypersensitivity; Insect Bites and Stings
PubMed: 26708389
DOI: No ID Found -
Advances in Experimental Medicine and... 2017Historically, serum therapy was previously used to combat infectious pathogens. However, serum sickness and anaphylaxis limited its broad application. The advancement of... (Review)
Review
Historically, serum therapy was previously used to combat infectious pathogens. However, serum sickness and anaphylaxis limited its broad application. The advancement of antibody engineering technologies has made it feasible to generate monoclonal antibodies. There are divergent methods for antibody engineering and optimization. In this chapter, we summarized the latest developments in engineering antibodies for infectious diseases.
Topics: Animals; Anti-Infective Agents; Antibodies; Antibody Specificity; Communicable Diseases; Humans; Protein Engineering
PubMed: 29549641
DOI: 10.1007/978-3-319-72077-7_10 -
CEN Case Reports May 2018Rituximab (RTX) is effective for treating childhood refractory nephrotic syndrome (NS), such as steroid-dependent (SD), frequently relapsing (FR), and steroid-resistant...
Rituximab (RTX) is effective for treating childhood refractory nephrotic syndrome (NS), such as steroid-dependent (SD), frequently relapsing (FR), and steroid-resistant (SR) NS. While RTX has been proven to be effective in treating SDNS, FRNS, and SRNS, it may cause serum sickness, a rare illness characterized by fever, rash, and arthralgia, 10-14 days after primary antigen exposure or within a few days after secondary antigen exposure, by producing human anti-chimeric antibodies (HACAs). A 17-year-old girl with refractory SDNS treated with RTX and oral cyclosporine A was admitted with fever and arthralgia 10 days after the fifth RTX dose was administered. After RTX was started when she was 14-years-old, SDNS remission was then achieved, and prednisolone was discontinued. Although antibiotics and non-steroidal anti-inflammatory agents were administered, fever and arthralgia continued. After various inspections and clinical course, we considered her as RTX-induced serum sickness (RISS). The patient had an elevated HACA level and was diagnosed with RISS. Fever and arthralgia disappeared 5 days after onset. To the best of our knowledge, this is the first reported case of RISS with NS. Fever, rash, and arthralgia after RTX administration can be the initial symptoms.
PubMed: 29305810
DOI: 10.1007/s13730-017-0297-7 -
The Journal of Allergy and Clinical... May 2024
Topics: Humans; Adverse Drug Reaction Reporting Systems; Drug-Related Side Effects and Adverse Reactions; Serum Sickness; United States; United States Food and Drug Administration
PubMed: 38462072
DOI: 10.1016/j.jaip.2024.03.006 -
Allergy, Asthma & Immunology Research Mar 2014Rifampin is commonly used as a first-line anti-tuberculosis drug, but it can induce a serum sickness-like reaction or anaphylaxis. However, it is possible for 1 drug...
Rifampin is commonly used as a first-line anti-tuberculosis drug, but it can induce a serum sickness-like reaction or anaphylaxis. However, it is possible for 1 drug antigen to induce 2 or more simultaneous immunologic reactions. Here, we report a case of a serum-sickness-like reaction and anaphylaxis induced concurrently by rifampin. A 25-year-old male presented with high fever and a maculopapular rash with vesicles on the hands, which developed 2 weeks following regular administration of anti-tuberculosis drugs for tuberculous meningitis, including rifampin. Elevated liver enzymes, peripheral neuropathy, and decreased serum C3 and C4 levels were found. Interestingly, these symptoms were accompanied by severe hypotension. A serum-sickness-like reaction was considered after excluding other potential causes for the fever. A drug provocation test showed that the fever developed after oral administration of rifampin, suggesting that rifampin was the cause of the allergic reaction. However, hypotension, epigastric discomfort, and diarrhea also accompanied these symptoms, indicating that IgE-mediated type I hypersensitivity could be part of the serum sickness-like reaction. An intradermal skin test clearly showed an immediate positive reaction to rifampin. This case was diagnosed as concurrent serum-sickness-like reaction and anaphylaxis induced by rifampin. One drug may therefore induce combined allergic reactions via 2 or more simultaneous hypersensitivity responses.
PubMed: 24587958
DOI: 10.4168/aair.2014.6.2.183 -
BioFactors (Oxford, England) Nov 2022Platelet-activating factor (PAF, 1-alkyl-2-acetyl-sn-glycero-3-phosphorylcholine) was discovered when the mechanisms involved in the deposition of immune complex in... (Review)
Review
Platelet-activating factor (PAF, 1-alkyl-2-acetyl-sn-glycero-3-phosphorylcholine) was discovered when the mechanisms involved in the deposition of immune complex in tissues were being scrutinized in the experimental model of rabbit serum sickness. The initial adscription of PAF to IgE-dependent anaphylaxis was soon extended after disclosing its release from phagocytes stimulated by calcium mobilizing agents, formylated peptides, and phagocytosable particles. This explains why ongoing research in the field turned to the analysis of immune cell types and stimuli involved in PAF production with the purpose of establishing its role in pathology. This was spurred by the identification of the chemical structure of PAF and the enzymic mechanisms involved in its biosynthesis and degradation, which showed commonalities with those involved in eicosanoid production and the Lands' cycle of phospholipid fatty acid remodeling. The reassignment of PAF function in immunopathology is explained by the finding that the most robust mechanisms leading to PAF production are associated with opsonic and non-opsonic phagocytosis, depending on the cell type. While polymorphonuclear leukocytes exhibit opsonic phagocytosis, monocyte-derived dendritic cells show a marked preference for non-opsonic phagocytosis associated with C-type lectin receptors. This is particularly relevant to the defense against fungal invasion and explains why PAF exerts an autocrine feed-forwarding mechanism required for the selective expression of some cytokines.
Topics: Animals; Rabbits; Platelet Activating Factor; Cytokines; Monocytes; Hypersensitivity, Immediate
PubMed: 36176024
DOI: 10.1002/biof.1888 -
Mediators of Inflammation 2016High-altitude deacclimatization syndrome (HADAS) is emerging as a severe public health issue that threatens the quality of life of individuals who return to lower...
High-altitude deacclimatization syndrome (HADAS) is emerging as a severe public health issue that threatens the quality of life of individuals who return to lower altitude from high altitude. In this study, we measured serum levels of SOD, MDA, IL-17A, IL-10, TNF-α, and HADAS score in HADAS subjects at baseline and 50th and 100th days and to evaluate the relationship between interleukins, including IL-17A, and HADAS. Our data showed that and the serum IL-17A levels and HADAS score decreased over time in the HADAS group, and serum IL-17A levels were significantly higher in the HADAS group at baseline and 50th day compared with controls (p < 0.05). Furthermore, baseline serum levels of MDA and TNF-α were significantly higher, while SOD and IL-10 levels were lower in HADAS subjects compared with controls (p < 0.05). It is interesting that serum levels of IL-17A were clearly interrelated with HADAS incidence and severity (p < 0.05). ROC curve analysis showed that combined serum IL-17A and IL-10 levels were a better predictor of HADAS incidence than serum levels of IL-17A or IL-10 alone. These data suggest that serum levels of IL-17A are a novel predictive index of HADAS.
Topics: Acclimatization; Adolescent; Adult; Altitude; Altitude Sickness; Humans; Interleukin-10; Interleukin-17; Male; Tumor Necrosis Factor-alpha; Young Adult
PubMed: 27190491
DOI: 10.1155/2016/1732352 -
Frontiers in Allergy 2023Several monoclonal antibodies have been approved by the Food and Drug Administration (FDA) to treat allergic disorders, including omalizumab, dupilumab, mepolizumab,... (Review)
Review
Several monoclonal antibodies have been approved by the Food and Drug Administration (FDA) to treat allergic disorders, including omalizumab, dupilumab, mepolizumab, reslizumab, benralizumab, tralokinumab and tezepelumab, and their indications continue to expand. Although the risks associated with these agents are overall low, hypersensitivity reactions have been described and are reported more frequently with increased use. We provide a comprehensive review of clinical features, diagnosis and management of hypersensitivity reactions attributed to these agents. We aim to provide useful information for the clinician managing hypersensitivity reactions to these monoclonal antibodies, as well as highlight the need for future research to address specific gaps in knowledge.
PubMed: 37637139
DOI: 10.3389/falgy.2023.1219735