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The following is a summary of “Novel Bradykinin Detection In The Diagnostic Workup Of Patients With Recurrent Angioedema Attacks,” published in the February 2024 issue of Journal of Allergy and Clinical Immunology by Wu et al. 

Recurrent angioedema can result from bradykinin-mediated angioedema (BK-AE) or mast cell activation. Bradykinin measurement helps distinguish pathways for proper treatment. 

Researchers conducted a retrospective study using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to measure bradykinin levels in patients with Hereditary Angioedema (HAE), idiopathic angioedema (IAE) and hereditary angioedema with normal C1-Inhibitor (HAE-nl-C1INH). 

They obtained whole blood samples from patients with HAE, IAE, HAE-nl-C1INH, and RI after consent. They quantified bradykinin and its metabolites using a laboratory-validated LC-MS/MS procedure after cold activation for up to 5 days. 

The results showed LC-MS/MS analysis of 180 samples with mean BK (total) levels: RI 1.44 ng/ml (SEM=0.35, N=54), HAE 240.57 ng/ml (SEM=25.04, N=71), and IAE/HAE-nl-C1INH 41.07 ng/ml (SEM=15.67, N=55). P-values: IAE/HAE-nl-C1INH vs. RI 0.0137, HAE vs. RI <0.0001, and HAE vs. IAE/HAE-nl-C1INH <0.0001. 

Investigators found significant BK levels in patients with IAE and HAE-nl-C1INH, confirming their recurrent angioedema etiology. They confirmed LC-MS/MS as a valuable diagnostic tool for non-histaminergic angioedema. 

Source:jacionline.org/article/S0091-6749(23)01520-8/fulltext