Association between the Renin Angiotensin System and Anaphylaxis

  • K. Hermann
  • J. Ring
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 377)


Patients with hymenoptera venom anaphylaxis before immunotherapy (n=50) showed significantly lower renin, angiotensinogen, angiotensin I and angiotensin II as compared to healthy non-allergic controls (n=25) (p<0.05). A significant inverse correlation between the severity of clinical symptoms and the plasma levels of renin, angiotensinogen, angiotensin I and angiotensin II was found: the lower the levels the more severe the clinical symptoms. Hymenoptera venom allergic patients with repeated anaphylactic reactions during hyposensitization did not tolerate the sting of a living insect (n=6). Sting provocation with a living insect induced clinical symptoms of anaphylaxis in all of the 6 patients. Renin, angiotensinogen, angiotensin I and II remained significantly lower in these patients as compared to healthy non-allergic controls. Likewise, no stimulation of the renin angiotensin system occurred during the anaphylactic reaction. The values of angiotensin II were similar or lower than the values before the anaphylactic reaction. In contrast, patients with successful immunotherapy (n=27) who tolerated the sting of a living insect, renin, angiotensin I and II were significantly higher than in patients without immunotherapy. After immunotherapy, the values for renin, ANG I and ANG II were similar to the values found in healthy non-allergic controls. Patients with a history of hymenoptera venom anaphylaxis (n=22) showed significantly lower ANG II concentrations in their leukocytes as compared to healthy non-allergic controls (n=24). Successful immunotherapy induced a significant 9-fold increase in ANG II as compared to patients without immunotherapy. These findings suggest a possible role of the renin angiotensin system in hymenoptera venom anaphylaxis.


Plasma Renin Activity Anaphylactic Reaction Renin Angiotensin System Positive Skin Prick Test Hymenoptera Venom 
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  1. 1.
    Deszö B, Jacobsen J, Paulsen K, Evidence for the presence of angiotensins in normal, unstimulated alveolar macrophages and monocytes. J Hypertens 1989; 7: 5–11.CrossRefGoogle Scholar
  2. 2.
    Fisher MM and Baldo BA. Acute anaphylactic reactions. Med J Australia 1988; 149: 34–38.PubMedGoogle Scholar
  3. 3.
    Goetzl EJ, Klickstein LB, Watt KWK, Wintroub BU, The preferential human mononuclear leukocyte chemotactic activity of the substituent tetrapeptides of angiotensin II. Biochem Biophys Res Commun 1980; 97: 1097–1102.PubMedCrossRefGoogle Scholar
  4. 4.
    Hermann K, Ganten D, linger Th, Bayer C and Lang RE. Measurement and characterization of angiotensin peptides in plasma. Clin Chem 1988;34(6): 1046–1051.PubMedGoogle Scholar
  5. 5.
    Hermann K, Raizada MK, Sumners C and Phillips MI, Immunocytochemical and biochemical characterization of angiotensin I and II in cultured neuronal and glial cells from rat brain. Neuroendocrinol 1988; 47: 125–132.CrossRefGoogle Scholar
  6. 6.
    Hermann K and Ring J. Hymenoptera venom anaphylaxis: may decreased levels of angiotensin peptides play a role? Clin Exp Allergy 1990;20:569–570.PubMedCrossRefGoogle Scholar
  7. 7.
    Hermann K, Phillips MI and Ring J, High-performance liquid chromatography for the separation of angiotensin and its metabolites in human plasma and sweat. J Chromat Sci 1990; 28: 524–528.CrossRefGoogle Scholar
  8. 8.
    Hermann K and Ring J, The renin angiotensin system and hymenoptera venom anaphylaxis. Clin Exp Allergy 1993; 23: 762–769.PubMedCrossRefGoogle Scholar
  9. 9.
    Hermann K, Ring J. Human leukocytes contain angiotensin I, angiotensin II and angiotensin metabolites. Int Arch Allergy Immunol 1994; 103: 152–159.PubMedCrossRefGoogle Scholar
  10. 10.
    Johnson HM and Torres BA. Immunoregulatory properties of neuroendocrine peptide hormones. In Ishizaka K, Kallos P, Lachman PJ and Waksman BH, eds, Neuroimmunoendocrinology, Karger, Basel 1988, pp 37–60.CrossRefGoogle Scholar
  11. 11.
    Lang RE, Heil JWE, Ganten D, Hermann K, Unger Th and Rascher W, Oxytocin unlike vasopressin is a stress hormone in the rat. Neuroendocrinol 1983; 37: 314–316.CrossRefGoogle Scholar
  12. 12.
    Michailov ML, Schad H, Dahlheim H, Jacob ICM and Brechtelsbauer H, Renin-angiotensin system responses of acute graded hemorrhage in dogs. Circ Shock 1987; 21: 217–224.PubMedGoogle Scholar
  13. 13.
    Müller U, Johannsson SGO, Streit C, Hymenoptera sting hypersensitivity: IgE, IgG and haemagglutinating antibodies to bee venom constituents in relation to exposure and clinical reactions to bee stings. Clin Allergy 1978; 8: 267–272.PubMedCrossRefGoogle Scholar
  14. 14.
    Nussey SS, Page SR, Ang VTY and Jemkins JS, The response of plasma oxytocin to surgical stress. Clin Endocrinol 1988; 28: 277–282.CrossRefGoogle Scholar
  15. 15.
    Proppe DW. Control of plasma renin activity in heat-stressed baboons on varied salt intake. J Appl Physiol 1987;62(4):1531–1537.PubMedGoogle Scholar
  16. 16.
    Przybilla B. In vitro histamine release (HR) as additional method for diagnosis of insect venom allergy. J Allergy Clin Immunol 1986;77:143.Google Scholar
  17. 17.
    Przybilla B, Ring J, Griesshammer B. Diagnostische Befunde bei Hymenopteren-Giftallergie. Allergologie 1989;12(5):192–202.Google Scholar
  18. 18.
    Przybilla B and Ring J. Hymenoptera venom allergy. In: Ring J, Przybilla B, eds. New Trends in Allergy III, Berlin, Heidelberg, New York, London, Paris, Tokyo, Hong Kong, Barcelona, Budapest: Springer Verlag, 1991, pp 335–349.CrossRefGoogle Scholar
  19. 19.
    Reisman RE, Wypych J, Arbesman CE, Stinging insect allergy: Detection and clinical significance of venom IgE antibodies. J Allergy Clin Immunol 1975; 56: 443–449.PubMedCrossRefGoogle Scholar
  20. 20.
    Reisman RE, Lazell M, Doerr J, Insect venom allergy: a prospective case showing lack of correlation between immunologic reactivity and clinical sensitivity. J Allergy Clin Immunol 1981; 68: 406–408.PubMedCrossRefGoogle Scholar
  21. 21.
    Ring J, Messmer K, Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 1977; 26: 466–469.CrossRefGoogle Scholar
  22. 22.
    Simon MR, Engel DE, Weinstock JV, Roi LD. The effect of angiotensin II on human mononuclear cell reactivity: Suppression of PHA-P-induced thymidine incorporation. Immunol Invest 1985; 14: 389–400.PubMedCrossRefGoogle Scholar
  23. 23.
    Stare, Th and Stalcup SA, Time course of changes of plasma renin activity and catecholamines during hemorrhage in conscious sheep. Circ Shock 1987; 21: 129–140.Google Scholar
  24. 24.
    Weinstock JV, Blum AM, Isolated liver granulomas of murine Schistosoma mansoni contain components of the angiotensin system. J Immunol 1983; 131: 2529–2532.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • K. Hermann
    • 1
  • J. Ring
    • 1
  1. 1.Department of DermatologyUniversity Hospital Eppendorf, University of HamburgHamburgGermany

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