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Histamine has two basic centres, namely the aliphatic amino group and whichever nitrogen atom of the imidazole ring does not already have a proton. Under physiological conditions, the aliphatic amino group (having a pK a around 9.4) will be protonated, whereas the second nitrogen of the imidazole ring (pK a ≈ 5.8) will not be protonated. [11]
Anaphylactic shock is caused by a severe anaphylactic reaction to an allergen, antigen, drug, or foreign protein causing the release of histamine which causes widespread vasodilation, leading to hypotension and increased capillary permeability. Signs of anaphylaxis Signs typically occur after exposure to an allergen and may include:
Vasodilation is also a major component of anaphylaxis. [12] Inflammation causes not only vasodilation but also causes increased vascular permeability, allowing neutrophils, complement proteins, and antibodies to reach the site of infection or damage. [7]
Histamine intolerance is a presumed set of adverse reactions (such as flush, itching, rhinitis, etc.) to ingested histamine in food. The mainstream theory accepts that there may exist adverse reactions to ingested histamine, but does not recognize histamine intolerance as a separate medical condition that can be diagnosed. [1]
The extent of vasoconstriction may be slight or severe depending on the substance or circumstance. Many vasoconstrictors also cause pupil dilation. Medications that cause vasoconstriction include: antihistamines, decongestants, and stimulants. Severe vasoconstriction may result in symptoms of intermittent claudication. [1]
Once released, the histamine can react with local or widespread tissues through histamine receptors. [citation needed] Histamine, acting on H 1-receptors, produces pruritus, vasodilation, hypotension, flushing, headache, bradycardia, bronchoconstriction, increase in vascular permeability and potentiation of pain. [2]
Antihistamines can alleviate some of the milder symptoms of an allergic reaction, but do not treat all symptoms of anaphylaxis. [88] Antihistamines block the action of histamine, which causes blood vessels to dilate and become leaky to plasma proteins. Histamine also causes itchiness by acting on sensory nerve terminals.
Degranulation in mast cells is part of an inflammatory response, and substances such as histamine are released. Granules from mast cells mediate processes such as "vasodilation, vascular homeostasis, innate and adaptive immune responses, angiogenesis, and venom detoxification."