Nonallergic angioedema: role of bradykinin

@article{Ba2007NonallergicAR,
  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},
  journal={Allergy},
  year={2007},
  volume={62}
}
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… 

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References

SHOWING 1-10 OF 204 REFERENCES

Bradykinin and the pathophysiology of angioedema.

Drug-Induced Angioedema without Urticaria

TLDR
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
TLDR
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

TLDR
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?

TLDR
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

TLDR
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.
...