Epigenetic Alterations in Perioperative Anaphylaxis Among Chinese Patients: A Case-Control Study Protocol

Perioperative anaphylaxis (POA) is a rare but life-threatening complication with significant risks to patient health. Our previous national epidemiologic survey indicates regional differences in the incidence of suspected POA in China, which may be related to environmental and genetic factors. Therefore, this study aims to explore epigenetic alterations in Chinese patients with POA.

This case-control study will involve patients with POA reported on the National Perioperative Anaphylaxis Safety Initiative (NPASI) platform and patients visiting the anesthesia consultation clinic at the China-Japan Friendship Hospital (CJFH). Forty patients and twenty healthy controls will be enrolled in this study, and the POA patients will undergo allergen tests, including skin tests (STs) and/or the basophil activation test (BAT). Demographic information and details of POA events will be collected, and their peripheral blood mononuclear cells (PBMCs) will be isolated for DNA methylation detection. The fragmented DNA, after extraction and quality control, will be subjected to enzymatic conversion followed by whole-genome bisulfite sequencing (WGBS) using high-throughput sequencing. Data filtering and alignment will be performed using the BSMAP tool to map the reads to the reference genome. Differential methylation regions and functional gene pathways will be analyzed between POA patients and controls, aiming to identify epigenetically regulated genes linked to POA. The findings will be validated within the original data set to enhance result robustness.

This study aims to comprehensively investigate the epigenetic alterations associated with POA in Chinese patients. The results are expected to provide fundamental insights into the molecular mechanisms underlying POA, potentially guiding future research and informing preventive strategies in clinical practice.A schematic diagram for the recruitment and epigenetics study of POA patients can be seen in Figure 1.Figure 1Schematic diagram for recruitment and epigenetics study of POA patients.The research was registered on the Chinese Clinical Trial Registry and the registration number is ChiCTR2400089345.