Serum MRGPRX2 as a Long-term Biomarker for Iodinated Contrast Media-Induced Anaphylaxis

Area of Science:

• Immunology
• Allergy and Clinical Immunology
• Pharmacology

Background:

• Anaphylaxis diagnosis relies on clinical history; tryptase utility is limited.
• Mas-related G protein-coupled receptor-X2 (MRGPRX2) is expressed in mast cells and mediates degranulation.
• Investigating novel biomarkers for immediate hypersensitivity reactions (IHRs) is crucial.

Purpose of the Study:

• To evaluate Mas-related G protein-coupled receptor-X2 (MRGPRX2) as a diagnostic biomarker for iodinated contrast media (ICM)-induced immediate hypersensitivity reactions (IHRs).
• To assess the correlation between serum MRGPRX2 levels and the occurrence of anaphylaxis following ICM administration.

Main Methods:

• A cohort of 173 patients with documented ICM-induced IHRs within 4 months were enrolled.
• Serum MRGPRX2 concentrations were measured using an enzyme-linked immunosorbent assay (ELISA).
• Patients were categorized into anaphylaxis (33) and non-anaphylaxis (140) groups; time intervals (0-2 months and 2-4 months) were analyzed.

Main Results:

• Serum MRGPRX2 levels were significantly higher in the anaphylaxis group compared to the non-anaphylaxis group (29.9 ± 24.1 vs. 20.7±17.5, P = 0.044).
• MRGPRX2 demonstrated moderate predictive ability for anaphylaxis (AUC = 0.61, P = 0.058).
• In the 2-4 month interval group (T2), anaphylaxis patients showed higher MRGPRX2 levels (36.5±19.2 vs. 20.5±19.0, P = 0.035).

Conclusions:

• Serum MRGPRX2 is a potential long-term biomarker for predicting anaphylaxis, particularly following iodinated contrast media administration.
• The study suggests MRGPRX2 may be useful for diagnosing anaphylaxis beyond the acute phase.
• Further research in larger, diverse populations is warranted to confirm MRGPRX2's role in various drug-induced IHRs.