Angioedema without urticaria: novel findings which must be measured in clinical setting.

Abstract

PURPOSE OF REVIEW:

Angioedema without urticaria is composed of an increasing subtype's variety and presents a challenging diagnosis. This review summarizes the subtypes recently described and subsequent new findings helpful within their classification.

RECENT FINDINGS:

New methods to measure cleaved high molecular weight kininogen and activated plasma kallikrein have emerged as potential biochemical tests to identify bradykinin-mediated angioedema. Three new subtypes of hereditary angioedema (HAE) with normal C1 inhibitor were described in the past two years: HAE due to mutation in plasminogen gene, in kininogen gene, and in angiopoietin-1 gene; implicating the fibrinolytic and contact systems, and the regulation of vasculature, respectively. The understanding of some mechanisms in angioedema has been improved, compatible to the dominant-negative for some C1 inhibitor variants; furthermore, the increased activation of truncated F12 mutants by plasma kallikrein; and the diminished binding of angiopoietin-1 to its receptor.

SUMMARY:

The validation of biomarkers for the contact system activation could be beneficial in differentiating bradykinin - from histaminergic-mediated angioedema. Currently, the available laboratorial tests are still somewhat restricted to the evaluation of the complement activation and the mediators of nonhistaminergic and nonbradykinin-mediated angioedema remain to be identified.

• Authors: Camila Lopes Veronez, Anete Sevciovic Grumach
• Journal: Current opinion in allergy and clinical immunology (Curr Opin Allergy Clin Immunol) Vol. 20 Issue 3 Pg. 253-260 (06 2020) ISSN: 1473-6322 [Electronic] United States
• PMID: 32073435 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• ANGPT1 protein, human
• Angiopoietin-1
• Biomarkers
• KNG1 protein, human
• Kininogens
• Plasminogen

Topics

• Angioedemas, Hereditary (diagnosis, genetics, immunology)
• Angiopoietin-1 (genetics)
• Biomarkers
• Complement Activation (genetics)
• Diagnosis, Differential
• Humans
• Kininogens (genetics)
• Mutation
• Plasminogen (genetics)