Histamine release

Morphine has certain undesirable side effects. Among these are respiratory depression, nausea, and vomiting, depression of the cough reflex, cardiovascular depression and hypotension, smooth muscle contraction (constipation), and histamine release (93). Morphine s onset of action, duration, and low therapeutic indices have prompted a search for a more effective opiate iv anesthetic. Extreme simplification of the complex morphine molecule has resulted in anilido —piperidines, the fentanyl class of extremely potent opiate iv anesthetics (118,119). 

An allergen is usually an inert substance (e.g. pollen, house dust mite faeces) that in some individuals can trigger the generation of an (inappropriate) antigenic response. Mediated by TH2 lymphocytes, it causes B-Lymphocytes to produce lgE. Subsequent exposure of a sensitized individual to the allergen is therefore able to cross-link IgE antibodies on the surface of mast cells and trigger an immune response and histamine release. 

The surrounding redness caused by the vasodilatation of local blood vessels in the skin (hyperaemia). Histamine released at the site of contact acts on sensory nerve endings in the skin. Impluses travel along the axon to other peripheral branches of the same neuron to cause release of vasodilataory peptide neurotransmitters from nerve endings serving a wider area of skin than the initial contact point. Impluses reaching the CNS are interpreted as itch and pain. 

Dermatologic-histamine release, pruritus, flushing, and red eyes... 

Figure 3.1 A schematic representation of the control mechanism that stimulates gastric acid secretion, and the intervention points used to treat ulcers. The parietal cells and gastric cells form part of the epithelial cell lining of the stomach. Histamine release is usually triggered as part ofthe enteric nervous system response to distension of the stomach when food is eaten.

TBT and TFT are membrane-active molecules, and their mechanism of action appears to be strongly dependent on organotin(IV) lipophilicity. They function as ionophores and produce hemolysis, release Ca(II) from sarcoplasmic reticulum, alter phosphatodylseiine-induced histamine release, alter mitochondrial membrane permeability and perturb membrane enzymes. Organotin(IV) compounds have been shown to affect cell signaling they activate protein kinase and increase free arachidonic acid through the activation of phospholipase... 

The direct histamine release evoked by several substances (e.g. codeine, dextran in certain rat strains or gelatine blood substitutes) led to the development of the concept of pseudo-allergic reactions by Paul Kallos [10]. 

Shim JY, Kim BS, Cho SH, Min KU, Hong SJ Allergen-specific conventional immunotherapy decreases immunoglobulin E-mediated basophil histamine releasability. Clin Exp Allergy 2003 33 52-57. 

Conroy MC, Adkinson NF Jr, Lichtenstein LM SO Measurement of IgE on human basophils relation to serum IgE and anti-IgE-induced histamine release. J Immunol 1977 118 1317-1321. 

Hide M, Francis DM, Grattan CEH, Hakimi J, Kochan JP, Greaves MW Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med 1993 328 1599. Sd... 

If patients have experienced anaphylaxis, the identification of any possible elicitor is important to help avoid further episodes. With skin tests and specific IgE antibodies combined with history, a relevant allergy may be detected. Cellular tests monitoring basophil histamine release or basophil activation may be helpful in some patients who resist diagnosis by standard means [26,31]. 

Maly FE, Marti-Wyss S, Blumer S, Cuhat-Stark I, Wiithrich B Mononuclear blood cell sulfidoleukot-riene generation in the presence of interleukin-3 and whole blood histamine release in honey bee and yellow jacket venom allergy. J Investig Allergol Clin Immunol 1997 7 217-224. 49... 

Immediate hypersensitivity reactions to RCM are associated with histamine release from basophils and mast cells [27], and extensive mast cell activation in vivo associated with clinical symptoms has been demonstrated by Earoche et al. [31]. Patients with hypersensitivity reactions after contrast medium exposure had increased plasma levels of both histamine and tryptase, and levels correlated with severity. Also other investigators have reported high levels of tryptase in connection with severe or fatal reactions [21, 33]. 

Ring J, Endrich B, Intaglietta M Histamine release, complement consumption, and microvascular changes after radiographic contrast media infusion in rabbits. J 43 Lab Clin Med 1978 92 584-594. 

The rate of non-lgE-mediated immediate hypersensitivity reactions usually varies between 20 and 50% [1-7, 9], They are assumed to result from direct non-specific mast cell and basophil activation, which causes direct histamine release [19], Histamine release is predominantly found with the use of the benzylisoquinoUnes d-tubocurarine, atracurium and mivacurium, and the aminosteroid rapacuronium. Severe bronchospasm related to rapacuronium administration has been reported in children and adults. It might be related to the higher affinity of rapacuronium for M2 versus M3 muscarinic receptors [20]. Rapacuronium has been withdrawn from the market in the USA. 

Antibiotics. Antibiotics are commonly administered peroperatively. At the present time, allergy to (3-lactams represents 12-15% of the peroperative reactions observed in France [9]. Vancomycin, which is increasingly used for prophylaxis, has been incriminated in some cases. The red man syndrome is due to non-specific histamine release induced by a rapid intravenous administration [21]. 

Opioids. Reactions to morphine, codeine phosphate, meperidine, fentanyl and its derivatives are uncommon. Because of their direct histamine-releasing properties, especially regarding morphine and codeine, distinction between anaphylaxis and non-immune-mediated histamine release is not always easy. Only 12 cases were recorded in the last 2 years epidemiologic survey in France, 9 of them being related to morphine administration [9]. 

Renz C, Lynch J, Thurn J, Moss J Histamine release... 

Mata E, Gueant JL. Moneret-Vautrin DA, Bermejo N, Gerard P, Nicolas JP. Laxenaire MC Chnical evaluation of in vitro leukocyte histamine release in allergy to muscle relaxant drugs. Allergy 1992 47 471. 

Contrary to other elicitors of non-immune anaphylactic reactions (radiocontrast media, neuromuscular blocking agents, non-steroidal anti-inflammatory drugs (NSAIDs)) where there are at least hypothetical concepts regarding the pathomecha-nism of these reactions via increased mediator release (e.g. histamine release, shift in arachidonic acid metabolism from prostaglandins towards leukotrienes, etc.) [26], there is almost no literature regarding the pathomechanism of these reactions after LA application. 

Lorenz W Duda D, Dick W Sitter H, Doenicke A, Black A, Weber D, Menke H, Stinner B, Junginger T, Rothmund M, Ohmann CH, Healy MJ Incidence and clinical importance of perioperative histamine release randomised study of volume loading and antihistamines after induction of anaesthesia. Lancet 1994 343 933-940. 

Attaching some short peptidic sequences to adamantane makes it possible to design novel antagonists. The bradykinin antagonist, which is used as an anticancer agent, is an example. The adamantane-based peptidic bradykinin analog was utilized in strucmre-activity relationship (SAR) studies on the bradykinin receptors and showed a potent activity in inhibition of bradykinin-induced cytokine release and stimulation of histamine release [142]. 

Histamine release in the hypothalamus is higher during the active waking than the quiescent phase of behaviour, whether this is associated with darkness (in rats) or light (rhesus monkey). The firing rate of histamine neurons is also higher during arousal... 

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