Microdialysis in the evaluation of the allergic reaction
MICALL
Anaphylaxis is a rapidly progressing and potentially life threatening reaction most commonly elicited by
foods, insect stings and drugs. The mechanisms and pathways of anaphylaxis largely remain obscure. It is
believed to be mediated by activation of mast cells in the gastrointestinal mucosa or skin, resulting in
sensory nerve activation and increased local allergen absorption and subsequently in the degranulation of
systemic mast cells. Diagnosis relies on the patients’ history, skin prick test and specific IgE, and in unclear
cases supplemented with a challenge with the suspected allergen. In cases of suspected allergy to insulin or
penicillin there is often a mismatch between the patient’s history and results from skin tests, specific IgE
and outcome of challenge. It is doubtfull whether skin test is useful in the diagnosis in these cases, and that
false positive outcome will prevent the patient from receiving important treatment. The significance of
positive skin tests and IgE will be investigated by applying microdialysis technique to the skin making it
possible to measure different extracellular mediators. Skin tests with the culprit drug will be performed,
and attempt to both enhance and inhibit the reactions will be done.
The projects will be:
1. Release of histamine and other mediators upon ICT with penicillin, insulin and grass in allergic patients.
2. Release of histamine and other mediators upon ICT with penicillin and grass on skin pretreated with
autologous serum.
3. Influence of local neural blockage on immediate and delayed skin reactions.
It is expected that this project will provide us with a better understanding of allergy to penicillin and insulin
and improve the assessment of the patients.
The study will be performed at the Department of Dermatology and Allergy Center, Odense University
Hospital.
Ph.D-student
Line Kring Tannert, MD
Department of Dermatology and Allergy Center, Odense University Hospital
Main supervisor
Carsten Bindslev-Jensen, Professor, Head of Department, MD, Ph.D., MDSci
Project supervisors
Charlotte Gotthard Mørtz, Associate professor, MD, Ph.D.
Per Stahl Skov, Professor, MD, MDSci