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HAE Pathophysiology and Underlying Mechanisms
- Source :
- Clinical Reviews in Allergy & Immunology. 51:216-229
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Remarkable progress in understanding the pathophysiology and underlying mechanisms of hereditary angioedema has led to the development of effective treatment for this disorder. Progress in three separate areas has catalyzed our understanding of hereditary angioedema. The first is the recognition that HAE type I and type II result from a deficiency in the plasma level of functional C1 inhibitor. This observation has led to a detailed understanding of the SERPING1 mutations responsible for this deficiency as well as the molecular regulation of C1 inhibitor expression and function. The second is that the fundamental cause of swelling is enhanced contact system activation leading to increased generation of bradykinin. Substantial progress has been made in defining the parameters regulating bradykinin generation and catabolism as well as the receptors that transduce the biologic effects of kinins. The third is the understanding that tissue swelling in hereditary angioedema primarily involves the function of endothelial cell adherens junctions. This knowledge is driving increased attention to the role of endothelial biology in determining disease activity in hereditary angioedema. While there has been considerable progress made, large gaps still remain in our knowledge. Important areas that remain poorly understood include the factors that lead to very low plasma functional C1 inhibitor levels, the triggers of contact system activation in hereditary angioedema, and the role of the bradykinin B1 receptor. The phenotypic variability of hereditary angioedema has been extensively documented but never understood. The mechanisms discussed in this chapter likely contribute to this variability. Future progress in understanding these mechanisms should provide new means to improve the diagnosis and treatment of hereditary angioedema.
- Subjects :
- 0301 basic medicine
Bradykinin
Bioinformatics
Severity of Illness Index
C1-inhibitor
Capillary Permeability
Adherens junction
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Humans
Immunology and Allergy
Medicine
Receptor
biology
business.industry
Receptors, Bradykinin
Angioedemas, Hereditary
Endothelial Cells
General Medicine
Plasma levels
medicine.disease
Phenotype
Pathophysiology
030104 developmental biology
Gene Expression Regulation
chemistry
Hereditary angioedema
Immunology
Androgens
Disease Progression
biology.protein
Cytokines
business
Complement C1 Inhibitor Protein
Signal Transduction
030215 immunology
Subjects
Details
- ISSN :
- 15590267 and 10800549
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Clinical Reviews in Allergy & Immunology
- Accession number :
- edsair.doi.dedup.....9823ec6d90a4e0eab6da22a89311519b
- Full Text :
- https://doi.org/10.1007/s12016-016-8561-8