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G protein-coupled receptor (GPCR) signaling plays a crucial role in cell functioning. GPCR desensitization is an equally essential process. It allows cells to respond to changing environments and regain sensitivity to new stimuli while preventing unnecessary stimulation when no longer needed. Prolonged exposure to stimuli leads to GPCR desensitization. It involves blocking the receptors from binding and activating additional G proteins. This inhibits activation of downstream effectors, thereby...
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Updated: Dec 16, 2025

An Ex vivo Mast Cell Degranulation Assay using Crude Peritoneal Exudate Cells and Natural Antigen Stimulation
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Expedited Desensitization to Canakinumab.

Neha Sanan1, Jason Schend1, Marija Rowane2

  • 1Department of Pulmonary Critical Care, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

Allergy & Rhinology (Providence, R.I.)
|July 3, 2020
PubMed
Summary
This summary is machine-generated.

Anakinra and canakinumab desensitization protocols are effective for managing hypersensitivity reactions in Familial Mediterranean Fever (FMF) patients. This expedited canakinumab desensitization offers an alternative therapy for those intolerant to other biologic agents.

Keywords:
Familial Mediterranean Feveranakinra (Kineret®)anaphylaxiscanakinumab (ILARIS®)interleukin-1 receptor antagonistintradermal testing

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Area of Science:

  • Immunology
  • Rheumatology
  • Pharmacology

Background:

  • Interleukin-1 (IL-1) antagonists are established treatments for monogenic autoinflammatory diseases like Familial Mediterranean Fever (FMF).
  • Anakinra, an IL-1 receptor antagonist, effectively manages persistent autoinflammation but can cause anaphylaxis.
  • Canakinumab is an anti-IL-1β monoclonal antibody used for autoinflammatory conditions.

Observation:

  • A 51-year-old male with FMF experienced treatment failure with colchicine, NSAIDs, and anakinra.
  • Anakinra desensitization and canakinumab intradermal testing (IDT) induced anaphylactic and allergic symptoms, respectively.
  • The patient presented with gastrointestinal intolerance to colchicine and continued FMF flares.

Findings:

  • An expedited desensitization protocol for canakinumab was successfully implemented.
  • The protocol involved 13 doses with 15-minute intervals, increasing to 150 mg.
  • This novel approach demonstrated efficacy in a patient with hypersensitivity to biologics.

Implications:

  • Hypersensitivity reactions, including anaphylaxis, can occur with biologic agents.
  • Expanding use of biologics may increase the incidence of IgE-mediated hypersensitivities.
  • Expedited desensitization protocols, like the one developed here, are crucial for managing patients intolerant to biologic therapies.