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Tryptase in acute appendicitis: unveiling allergic connections through compelling evidence

2024-01Journal article Open access
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dc.contributor.authorCarvalho, Nuno
dc.contributor.authorCarolino, Elisabete
dc.contributor.authorFerreira, Margarida
dc.contributor.authorCoelho, Hélder
dc.contributor.authorSantos, Catarina Rolo
dc.contributor.authorBarreira, Ana Lúcia
dc.contributor.authorHenriques, Susana
dc.contributor.authorCardoso, Carlos
dc.contributor.authorMoita, Luís
dc.contributor.authorCosta, Paulo Matos
dc.date.accessioned2024-02-12T11:22:14Z
dc.date.available2024-02-12T11:22:14Z
dc.date.issued2024-01
dc.descriptionThis study is part of a research project which seeks to evaluate the immune–inflammatory response in AA, without specific funding. The cost of mast cell granule protein determination was supported by the Joaquim Chaves Lab.pt_PT
dc.description.abstractThe aetiology of acute appendicitis (AA), the most frequent abdominal surgical emergency, is still unclarified. Recent epidemiologic, clinical, and laboratory data point to an allergic component in the pathophysiology of AA. Mastocytes participate in the Th2 immune response, releasing inflammatory mediators from their granules upon stimulation by IgE-specific antigens. Among the well-known mediators are histamine, serotonin, and tryptase, which are responsible for the clinical manifestations of allergies. We conducted a prospective single-centre study to measure histamine and serotonin (commercial ELISA kit) and tryptase (ImmunoCAP System) concentrations in appendicular lavage fluid (ALF) and serum. Consecutive patients presenting to the emergency department with a clinical diagnosis of AA were enrolled: 22 patients with phlegmonous AA and 24 with gangrenous AA The control group was composed of 14 patients referred for colectomy for colon malignancy. Appendectomy was performed during colectomy. Tryptase levels were strikingly different between histological groups, both in ALF and serum (p < 0.001); ALF levels were higher than serum levels. Tryptase concentrations in ALF were 109 times higher in phlegmonous AA (APA) (796.8 (194.1-980.5) pg/mL) and 114 times higher in gangrenous AA (AGA) (837.4 (272.6-1075.1) pg/mL) than in the control group (7.3 (4.5-10.3) pg/mL. For the diagnosis of AA, the discriminative power of serum tryptase concentration was good (AUC = 0.825), but the discriminative power was weak (AUC = 0.559) for the differential diagnosis between APA and AGA. Mastocytes are involved in AA during clinical presentations of both phlegmonous and gangrenous appendicitis, and no significant differences in concentration were found. No differences were found in serum and ALF concentrations of histamine and serotonin between histological groups. Due to their short half-lives, these might have elapsed by the time the samples were collected. In future research, these determinations should be made immediately after appendectomy. Our findings confirm the hypersensitivity type I reaction as an event occurring in the pathogenesis of AA: tryptase levels in ALF and serum were higher among patients with AA when compared to the control group, which is in line with a Th2 immune response and supports the concept of the presence of an allergic reaction in the pathogenesis of acute appendicitis. Our results, if confirmed, may have clinical implications for the treatment of AA.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCarvalho N, Carolino E, Ferreira M, Coelho H, Santos CR, Barreira AL, et al. Tryptase in acute appendicitis: unveiling allergic connections through compelling evidence. Int J Mol Sci. 2024;25(3):1645.pt_PT
dc.identifier.doi10.3390/ijms25031645pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/17100
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.relation.publisherversionhttps://www.mdpi.com/1422-0067/25/3/1645pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAcute appendicitispt_PT
dc.subjectAllergypt_PT
dc.subjectHistaminept_PT
dc.subjectHypersensitivity type I reactionpt_PT
dc.subjectMastocytespt_PT
dc.subjectPathophysiologypt_PT
dc.subjectSerotoninpt_PT
dc.subjectTryptasept_PT
dc.titleTryptase in acute appendicitis: unveiling allergic connections through compelling evidencept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue3pt_PT
oaire.citation.startPage1645pt_PT
oaire.citation.titleInternational Journal of Molecular Sciencespt_PT
oaire.citation.volume25pt_PT
person.familyNameCarolino
person.givenNameElisabete
person.identifier.ciencia-id1216-EFA3-1E0F
person.identifier.orcid0000-0003-4165-7052
person.identifier.ridF-1012-2015
person.identifier.scopus-author-id25821697000
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication77930d39-ed34-44dc-a4a6-9bf833e5e688
relation.isAuthorOfPublication.latestForDiscovery77930d39-ed34-44dc-a4a6-9bf833e5e688

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