Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
Add more filters










Database
Publication year range
1.
Int J Mol Sci ; 18(1)2017 Jan 10.
Article in English | MEDLINE | ID: mdl-28075402

ABSTRACT

All IV iron complexes carry a risk of potentially fatal allergic type hypersensitivity reactions. The mechanism(s) behind these reactions is unknown but the limited data available suggests that classic IgE mediated allergy is exceedingly rare, if ever occurring. Iron-carbohydrate molecules are complex nano-particles and trying to reduce the risk of serious hypersensitivity to antibody binding of an artificial antibody seems meaningless. A recently published analysis of safety data from randomized clinical trials confirms the method reported by Neiser to be useless to predict reaction risk. In conclusion, the study by Neiser et al. is biased, contains no new information, and has no clinical relevance. We are concerned that the association of the authors with a commercial entity has caused a conflict of interest that biases not only the results, but the entire experimental setup against competitors. (Comment on Neiser et al. Int. J. Mol. Sci. 2016, 17, 1185, doi:10.3390/ijms17071185).


Subject(s)
Iron-Dextran Complex/immunology , Iron , Anaphylaxis , Dextrans , Enzyme-Linked Immunosorbent Assay , Humans
3.
Nanomedicine ; 10(1): 119-29, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23891987

ABSTRACT

Artificial antigen presenting cells (aAPC), which deliver stimulatory signals to cytotoxic lymphocytes, are a powerful tool for both adoptive and active immunotherapy. Thus far, aAPC have been synthesized by coupling T cell activating proteins such as CD3 or MHC-peptide to micron-sized beads. Nanoscale platforms have different trafficking and biophysical interaction properties and may allow development of new immunotherapeutic strategies. We therefore manufactured aAPC based on two types of nanoscale particle platforms: biocompatible iron-dextran paramagnetic particles (50-100 nm in diameter) and avidin-coated quantum dot nanocrystals (~30 nm). Nanoscale aAPC induced antigen-specific T cell proliferation from mouse splenocytes and human peripheral blood T cells. When injected in vivo, both iron-dextran particles and quantum dot nanocrystals enhanced tumor rejection in a subcutaneous mouse melanoma model. This is the first description of nanoscale aAPC that induce antigen-specific T cell proliferation in vitro and lead to effective T cell stimulation and inhibition of tumor growth in vivo. FROM THE CLINICAL EDITOR: Artifical antigen presenting cells could revolutionize the field of cancer-directed immunotherapy. This team of investigators have manufactured two types of nanoscale particle platform-based aAPCs and demonstrates that both iron-dextran particles and quantum dot nanocrystals enhance tumor rejection in a melanoma model, providing the first description of nanoscale aAPCs that lead to effective T cell stimulation and inhibition of tumor growth.


Subject(s)
Immunotherapy , Iron-Dextran Complex/therapeutic use , Melanoma/therapy , Nanoparticles/administration & dosage , T-Lymphocytes, Cytotoxic/immunology , Animals , Antigen-Presenting Cells/immunology , Antigens, Neoplasm/immunology , Cell Proliferation/drug effects , Humans , Iron-Dextran Complex/immunology , Melanoma/immunology , Melanoma/pathology , Mice , Nanoparticles/therapeutic use , Quantum Dots/administration & dosage , Quantum Dots/chemistry
4.
Ned Tijdschr Geneeskd ; 156(48): A5264, 2012.
Article in Dutch | MEDLINE | ID: mdl-23191972

ABSTRACT

BACKGROUND: Iron deficiency is a frequent cause of anaemia in pregnancy and often results in fatigue and malaise. To prevent complications during labour, timely iron suppletion is important. CASE DESCRIPTION: A 30-year-old multiparous female presented at the outpatient clinic in her 38th week of this pregnancy because of fatigue and lightheadedness. She had been prescribed oral iron suppletion a month earlier but had not taken the tablets. Because her haemoglobin level had decreased to 6.3 mmol/l, it was decided to start her on intravenous iron dextran treatment. During administration of the test dose, the patient experienced acute dyspnoea and severe abdominal and back pain. Foetal bradycardia was observed and the patient underwent an emergency caesarean section. She delivered a healthy boy whose arterial pH was 7.05 (base excess: -7.6 mmol/l) and venous pH was 7.18 (base excess: -6.8 mmol/l). CONCLUSION: This case demonstrates that dextran anaphylaxis can occur, with potentially lethal consequences, even when no known underlying risk factors are present.


Subject(s)
Anaphylaxis/chemically induced , Anemia, Iron-Deficiency/complications , Hematinics/immunology , Iron-Dextran Complex/immunology , Pregnancy Complications/drug therapy , Adult , Anemia, Iron-Deficiency/drug therapy , Dietary Supplements , Female , Hematinics/administration & dosage , Humans , Iron, Dietary/administration & dosage , Iron-Dextran Complex/administration & dosage , Patient Compliance , Pregnancy , Pregnancy Complications/immunology
5.
Clin Exp Immunol ; 166(1): 80-6, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21910724

ABSTRACT

The prevalence of allergic diseases has increased dramatically during the last four decades and is paralleled by a striking increase in iron intake by infants in affluent societies. Several studies have suggested a link between increased iron intake and the marked increase in prevalence of allergic diseases. We hypothesized that the increased iron intake by infants offers an explanation for the increased prevalence of allergic disease in industrialized societies during the past four decades. A well-established mouse model of ovalbumin (OVA)-driven allergic asthma was used to test the effects of differences in iron intake and systemic iron levels on the manifestations of allergic asthma. Surprisingly, iron supplementation resulted in a significant decrease in airway eosinophilia, while systemic iron injections lead to a significant suppression of both allergen-induced airway eosinophilia and hyperreactivity compared to placebo. In contrast, mice fed on an iron-deprived diet did not show any difference in developing experimentally induced allergic asthma when compared to those fed on an iron-sufficient control diet. In contrast to our hypothesis, airway manifestations of allergic asthma are suppressed by both increased levels of iron intake and systemic iron administrations in the mouse model.


Subject(s)
Asthma , Cytokines/biosynthesis , Immunoglobulin E/blood , Iron-Dextran Complex/pharmacology , Iron , Methacholine Chloride/adverse effects , Allergens/adverse effects , Allergens/immunology , Animals , Asthma/blood , Asthma/chemically induced , Asthma/immunology , Biomarkers/blood , Bronchial Hyperreactivity/blood , Bronchial Hyperreactivity/chemically induced , Bronchial Hyperreactivity/immunology , Bronchoalveolar Lavage Fluid/immunology , Cytokines/immunology , Disease Models, Animal , Enzyme-Linked Immunosorbent Assay , Eosinophilia/blood , Eosinophilia/chemically induced , Eosinophilia/immunology , Humans , Immunoglobulin E/immunology , Infant , Injections, Intraperitoneal , Iron/immunology , Iron/metabolism , Iron/pharmacology , Iron-Dextran Complex/immunology , Lung/drug effects , Lung/immunology , Lung/pathology , Male , Methacholine Chloride/immunology , Mice , Mice, Inbred BALB C , Ovalbumin/adverse effects , Ovalbumin/immunology , Phenanthrolines/analysis , Plethysmography
6.
Kidney Int ; 63(1): 217-24, 2003 Jan.
Article in English | MEDLINE | ID: mdl-12472786

ABSTRACT

BACKGROUND: Iron dextran administration is associated with a high incidence of adverse reactions including anaphylaxis and death. Although dextran, rather than iron, is believed to be the cause of these reactions, it is not known whether iron dextran-sensitive patients can be safely administered another form of parenteral iron, sodium ferric gluconate in sucrose (SFGC). METHODS: In a 69 center, prospective, double-blind, controlled trial of safety and tolerability of SFGC, the rate of reactions to SFGC and placebo in 144 iron dextran-sensitive patients was compared with 2194 patients who were previously tolerant to iron dextran preparations. Serum tryptase levels, a marker of mast cell degranulation, also were measured. RESULTS: Among 143 iron dextran-sensitive patients exposed to SFGC, three (2.1%) were intolerant. All three had suspected allergic events to SFGC, including one patient with a serious reaction (0.7%). One dextran-sensitive patient (0.7%) had a suspected allergic reaction after placebo. In contrast, among 2194 iron dextran-tolerant patients, reactions to SFGC were significantly less common, with SFGC intolerance seen in seven patients (0.3%; P = 0.020), including five (0.2%) who had suspected allergic events (P = 0.010), but none who had serious events (0.0%; P = 0.061). Two iron dextran-tolerant patients (0.09%) had allergic-like reactions following placebo injections. Two of the three suspected allergic events in the iron dextran-sensitive group were confirmed as mast cell dependent by a 100% increase in serum tryptase, while there were no confirmed allergic events in the iron dextran-tolerant group. Long-term exposure to SFGC in iron dextran-sensitive patients resulted in intolerance in only one additional patient and no serious adverse events. CONCLUSIONS: Patients with a history of iron dextran sensitivity had approximately sevenfold higher rates of reaction to both placebo and SFGC compared to iron dextran tolerant patients. However, logistic regression analysis, performed to account for the higher reaction rate to placebo, suggests that this increased reactivity was not drug-specific nor immunologically mediated, but represented host idiosyncrasy. These results support the conclusions that reactions to SFGC can be attributed to pseudoallergy, and that SFGC is not a true allergen.


Subject(s)
Ferric Compounds/adverse effects , Iron-Dextran Complex/adverse effects , Kidney Failure, Chronic/drug therapy , Renal Dialysis , Drug Hypersensitivity/immunology , Female , Ferric Compounds/administration & dosage , Ferric Compounds/immunology , Humans , Iron-Dextran Complex/administration & dosage , Iron-Dextran Complex/immunology , Kidney Failure, Chronic/immunology , Male , Mast Cells/immunology , Middle Aged , Prospective Studies , Serine Endopeptidases/blood , Sucrose , Tryptases
8.
Ann Allergy ; 72(3): 224-8, 1994 Mar.
Article in English | MEDLINE | ID: mdl-7510461

ABSTRACT

Systemic reactions resembling anaphylaxis have occurred after intravenous (IV) iron-dextran administration, a treatment modality that has acquired increased acceptance following the use of erythropoietin for the anemia of patients with chronic renal diseases. Three such patients sustained anaphylactoid reactions immediately after receiving IV test doses of iron-dextran which were their only known exposures. In an effort to determine the mechanism of their reactions, we applied tests for (1) basophil degranulation by iron-dextran, basophil histamine release; (2) a type I anaphylactic reaction, specific IgE antibodies; and (3) an immune complex activation, specific IgG antibodies against iron-dextran. Six other patients with renal diseases served as controls, three of whom had tolerated IV iron-dextran, and three without known exposure. One patient only had any test abnormalities. Her initial positive basophil histamine release and specific IgG antibodies reversed and declined respectively at a 4-month follow-up study. She had developed anaphylaxis, and her studies had been performed at a time after anaphylaxis earlier than the other two. The mechanisms of iron-dextran anaphylaxis may be multiple and not be detectable several months after the incident. Prospective studies will probably be required for a predictive test to be developed.


Subject(s)
Anaphylaxis/chemically induced , Iron-Dextran Complex/immunology , Renal Dialysis , Adult , Aged , Antibodies, Anti-Idiotypic/analysis , Antibody Specificity , Basophils/metabolism , Dose-Response Relationship, Immunologic , Female , Histamine Release/drug effects , Humans , Male , Middle Aged
9.
Acta Haematol ; 59(2): 99-103, 1978.
Article in English | MEDLINE | ID: mdl-415480

ABSTRACT

A patient with regional enteritis had received iron dextran for treatment of iron deficiency. Subsequently he developed a large (3.1 g/100 ml) IgG-K serum spike which had precipitin activity against dextran sulfate but not a variety of other antigens. There has been no evidence of multiple myeloma and the spike gradually disappeared spontaneously over the course of 2 years. We speculate that the monoclonal protein may have developed as a response to the iron dextran injections under the immunologic stress of a chronic inflammatory disease.


Subject(s)
Crohn Disease/immunology , Hypergammaglobulinemia/chemically induced , Immunoglobulin G , Iron-Dextran Complex/immunology , Adult , Humans , Male
SELECTION OF CITATIONS
SEARCH DETAIL
...