The renin angiotensin system and hymenoptera venom anaphylaxis

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Abstract
Components of the renin angiotensin system, namely renin, angiotensinogen, angiotensin I and II and aldosterone were measured in plasma of patients with hymenoptera venom anaphylaxis (n= 50) and healthy non‐allergic controls (n= 25). Patients with a history of anaphylactic reactions to hymenoptera venom who did not undergo immunotherapy showed significantly reduced renin, angiotensinogen, angiotensin I and angiotensin II in plasma as compared with controls (PPr=‐0.567, Pr= ‐0.656, PP < 0.0001) was found: the lower the levels the more severe the clinical symptoms. No correlation was found for aldosterone. Hymenoptera venom allergic patients with repeated anaphylactic reactions during hyposensitization did not tolerate the sting of a living insect (n= 6). In these patients, renin, angiotensinogen, angiotensin I and II remained significantly lower than in healthy non‐allergic controls. Patients with successful immunotherapy (n= 27) who tolerated the sting of a living insect had renin, angiotensin I and II significantly higher than patients without immunotherapy. These findings suggest a possible role of the renin angiotensin system in hymenoptera venom anaphylaxis.