Drug induced Kounis syndrome: does oxidative stress play a role?

Luisa Ricciardi,Valeria Tigano,Eleonora Di Salvo,Sebastiano Gangemi,Mariateresa Cristani,Fabiana Furci,Paola Lucia Minciullo,Marco Casciaro

doi:10.1186/s12948-018-0099-2

Abstract

BackgroundKounis syndrome (KS) has been described as the coincidental occurrence of acute coronary syndromes during an allergic reaction with cardiac anaphylaxis. It is caused by inflammatory mediators released after exposure to drugs, food, environmental and other triggers. Oxidative stress occurring in various inflammatory disorders causes molecular damage with the production of advanced oxidation products (AOPPs) and advanced glycation end products (AGEs).Case presentationMarkers of oxidative stress were evaluated in a patient who had experienced KS after antibiotic administration in order to investigate the possible role of these molecules in KS. No data, up to now, are available on biomarkers of oxidative stress in patients with drug-induced KS.ConclusionsAOPPs, but not AGEs, were significantly increased in the KS affected patient compared to controls as already reported in mastocytosis affected patients.

Highlights

Kounis syndrome (KS) has been described as the coincidental occurrence of acute coronary syndromes during an allergic reaction with cardiac anaphylaxis
advanced oxidation protein products (AOPPs), but not advanced glycation end products (AGEs), were significantly increased in the KS affected patient compared to controls as already reported in mastocytosis affected patients
The mechanism of KS consists in the release of inflammatory cytokines through mast cell activation, causing cardiac anaphylaxis with coronary artery vasospasms and/or atheromatous plaque erosion or rupture

Summary

Introduction

Kounis syndrome (KS) has been described as the coincidental occurrence of acute coronary syndromes during an allergic reaction with cardiac anaphylaxis. It is caused by inflammatory mediators released after exposure to drugs, food, environmental and other triggers. Case presentation: Markers of oxidative stress were evaluated in a patient who had experienced KS after antibiotic administration in order to investigate the possible role of these molecules in KS. We report on a case of KS, occurred after antibiotic administration, that we investigated for serum levels of oxidative stress markers such as advanced oxidation protein products (AOPPs) and advanced glycation end products (AGEs) in order to evaluate the possible role of these molecules in KS.

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