Liposomal amphotericin B and complement activation-related pseudoallergy (CARPA)

Area of Science:

• Immunology
• Pharmacology
• Clinical Medicine

Background:

• Infusion reactions, including tachycardia, hypertension, and fever, are frequently observed with liposomal amphotericin B administration.
• While animal studies suggest complement activation as the cause, the underlying human pathophysiology remains unevaluated.

Purpose of the Study:

• To investigate the human pathophysiology of infusion reactions associated with liposomal amphotericin B.
• To determine if complement activation is responsible for these reactions in clinical practice.

Main Methods:

• A prospective observational study was conducted.
• Patients experiencing infusion reactions to liposomal amphotericin B were evaluated.

Main Results:

• The study identified complement activation-related pseudoallergy (CARPA) as the cause of infusion reactions.
• This finding confirms the role of complement activation in human patients.

Conclusions:

• Complement activation-related pseudoallergy (CARPA) is the mechanism behind infusion reactions to liposomal amphotericin B in humans.
• This research clarifies the pathophysiology, potentially guiding future management strategies.