Nonallergic angioedema: role of bradykinin

  title={Nonallergic angioedema: role of bradykinin},
  author={Murat Baş and V Adams and Tatsiana Suvorava and Tim Niehues and Thomas K. Hoffmann and Georg Kojda},
Angioedema is an underestimated clinical problem. Many cases are nonallergic reactions, e.g. bradykinin‐induced angioedema caused by genetic defects and angiotensin‐converting enzyme (ACE) inhibitors. This difference is crucial for successful therapy, in particular when complete emergency care is not available. Five important forms of nonallergic angioedema can be distinguished: hereditary (HAE), acquired (AAE), renin‐angiotensin‐aldosterone system (RAAS)‐blocker‐induced (RAE), pseudoallergic… 

Bradykinin-mediated angioedema.

Some new drugs have been introduced in the treatment of bradykinin B2-receptor antagonist, icatibant, and kallikrein inhibitor, ecallantide, which allow to improve treatment outcomes.

Current pharmacotherapy of bradykinin-mediated angioedema

  • H. Farkas
  • Medicine
    Expert opinion on pharmacotherapy
  • 2013
The range of targeted therapeutic options has increased in recent years and includes measures to handle emergencies, prevent edematous episodes and manage additional types of bradykinin-mediated angioedema.

Efficacy of tranexamic acid in sporadic idiopathic bradykinin angioedema

Three causes should be considered as follows: angiotensin convertase enzyme (ACE) inhibitors because ACE is a kininase and AO occur up to 1%; a type III hereditary AO in which gain-of-function mutations of the coagulation factor XII can be involved; and idiopathic bradykinin AO that can be either familial or sporadic.

ACE inhibitor-induced angioedema.

[Bradykinin-induced angioedema: Definition, pathogenesis, clinical presentation, diagnosis and therapy].

Bradykinin-induced angioedema are acquired forms induced by drugs or antibody formation, e.g., during the course of oncologic disease, and represent effective therapeutic options--both for acute and prophylactic treatment.

Angioedema induced by angiotensin-converting enzyme inhibitors

The present review will focus on current and relevant aspects of ACEI-induced angioedema, including the pathological mechanism, epidemiology and risk factors, differential diagnosis, patient management and treatment.

Angioedema Due to ACE Inhibitors

The epidemiology, pathophysiology, genetics, clinical symptoms, diagnosis, and treatment of ACEI-AAE are reviewed.

Pharmacologic management of angioedema induced by angiotensin-converting enzyme inhibitors.

  • M. ScaleseTravis S Reinaker
  • Medicine, Biology
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2016
FFP, C1 inhibitor, and icatibant appear to be safe and effective therapeutic options for the management of ACEI-induced angioedema, whereas it appears ecallantide should be avoided.

Angioedema Due to Bradykinin Dysregulation.

  • M. CicardiB. Zuraw
  • Medicine
    The journal of allergy and clinical immunology. In practice
  • 2018

Angioedema induced by cardiovascular drugs: new players join old friends

There is no clinical evidence suggesting that inhibition of B2 might relieve the symptoms and/or prevent invasive treatment including coniotomy or tracheotomy in angioedema caused by DPP IV or neprilysin inhibitors.



Bradykinin and the pathophysiology of angioedema.

Drug-Induced Angioedema without Urticaria

Angioedema without urticaria is a clinical syndrome characterised by self-limiting local swellings involving the deeper cutaneous and mucosa tissue layers that can occur in patients with other conditions and as an adverse drug reaction.

Evaluation and management of angioedema of the head and neck

  • M. Baş
  • Medicine
    Current opinion in otolaryngology & head and neck surgery
  • 2006
Current data suggest that the nonapetide bradykinin plays a crucial role in the pathogenesis of most forms of nonallergic angioedema, while histamine acts as the main biogenic mediator in allergic angIOedema.

ACE Inhibitor-Induced Angioedema

It is suggested that immunological processes and several mediator systems (bradykinin, histamine, substance P and prostaglandins) are involved in the pathogenesis of angioedema, and a relationship between ACE inhibitor-induced angIOedema and increased levels of (tissue) bradykinsin is suggested.

Investigation of angioedema associated with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.

  • B. MaldeJ. RegaladoP. Greenberger
  • Medicine
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 2007

ACE Inhibitor‐Related Angioedema: Can Angiotensin‐Receptor Blockers Be Safely Used?

If angiotensin receptor blocker therapy is being considered in a patient with prior ACE inhibitor‐related angioedema there should be some justification for the use, which might include the presence of heart failure or proteinuric nephropathic states among other considerations.

Increased sensitivity to bradykinin among African Americans.

Angioedema Associated With Angiotensin II Receptor Antagonists: Challenging Our Knowledge of Angioedema and Its Etiology

A new class of antihypertensives developed in part to eliminate cough and angioedema associated with ACE inhibitors act by selectively binding to angiotensin II receptor sites, thereby eliminating the hypertensive effects of angiotENSin without affecting local and systemic bradykinin levels.