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- Kounis_syndrome abstract "Kounis syndrome is a group of symptoms that manifests as unstable vasospastic or nonvasospastic angina and even as acute myocardial infarction and is triggered by the release of inflammatory mediators following an allergic insult [1]. The name was given by a group of scientists from USA [2] and Greece [3] because Professor Nicholas G Kounis, cardiologist from Greece, was the first to discover that the same inflammatory mediators, released during acute allergic episodes, are also increased in blood or urine of patients suffering from acute coronary syndromes and that a common pathophysiologic pathway exists between hypersensitivity and acute coronary episodes. Taking previously underrated, scattered and rarely diagnosed, clinical phenomena and presenting their pathophysiology, this scientist described in 1991, for the first time, the syndrome of "allergic angina" [4]. Allergic angina could progress to acute myocardial infarction which was named ‘‘allergic myocardial infarction’’ [5–7]. In 1995, Kovanen et al. examined specimens of coronary arteries from 20 patients who had died of acute myocardial infarction and found that the degree of mast cell degranulation was much higher (200 to 1 ratio) at the sites of plaque erosion or rupture than in adjacent areas or in the more distant unaffected areas [8]. He concluded that collagen-degrading proteases, from mast cells, could induce plaque erosion and/or rupture. Following this clinical description, Constantinides [9], in 1995, raised the possibility that ‘‘even ordinary allergic reactions could promote plaque disruption’’. This was based on Constantinides’s observation that circulating mast cell precursors could penetrate the open junctions between endothelial cells that line human atheromatous plaques in contrast to closed junctions over the normal arterial intima [10]. Braunwald [11], in 1998, categorized allergic angina in a subgroup of dynamic coronary occlusion lesions by quoting that ‘‘allergic reactions with mediators such as histamine or leukotrienes acting on coronary vascular smooth muscle’’ can induce vasospastic angina. Today, allergic angina and allergic myocardial infarction constitute dangerous and life-threatening ubiquitous diseases that affect patients of any age, involve numerous and continuously increasing causes with broadening clinical manifestations, and cover a widespectrum of mast cell–activation disorders that are referred to as Kounis syndrome. Furthermore, Kounis syndrome has familiarized physicians with these scattered, underrated and until now rarely diagnosed clinical phenomena and has enabled them to correctly diagnose and apply appropriate life saving therapeutic measures [12-17]. Kounis syndrome is defined as "the concurrence of acute coronary syndromes with conditions associated with mast cell activation, involving interrelated and interacting inflammatory cells, and including allergic or hypersensitivity and anaphylactic or anaphylactoid insults." "It is caused by inflammatory mediators such as histamine, neutral proteases, arachidonic acid products, platelet activating factor and a variety of cytokines and chemokines released during the activation process [18,19].Inflammatory mediators including histamine, neutral proteases, arachidonic acid products, platelet activating factor and a variety of cytokines and chemokines are increased in blood or urine in both allergic episodes and acute coronary syndromes. The release of mediators during allergic insults has been incriminated as a cause of coronary artery spasm and/or atheromatous plaque erosion or rupture. A common pathway between allergic and non-allergic coronary syndromes seems to exist. Today, there is evidence that mast cells not only enter the culprit region before plaque erosion or rupture but they release their contents before an actual coronary episode. Kounis syndrome, as consequence, of the above pathophysiologic association is regarded as nature’s own experiment and magnificent natural paradigm showing novel way in an effort to prevent acute coronary syndromes.It has been shown that the same mediators, released during acute allergic episodes, are increased in blood or urine of patients suffering from acute coronary syndromes of nonallergic etiology [18,19]. Consequently, the same substances from the same cells are present in both acute allergic episodes and acute coronary syndromes.Does, therefore, Kounis syndrome represent a magnificent natural paradigm and nature’s own experiment in a final trigger pathway implicated in cases of coronary artery spasm and plaque rupture? Drugs and natural molecules which stabilize mast cell membrane and monoclonal antibodies that protect mast cell surface could emerge as novel therapeutic modalities capable of preventing acute coronary and cerebrovascular events [20].".
- Kounis_syndrome wikiPageID "41392304".
- Kounis_syndrome wikiPageLength "10572".
- Kounis_syndrome wikiPageOutDegree "17".
- Kounis_syndrome wikiPageRevisionID "651907397".
- Kounis_syndrome wikiPageWikiLink Allergy.
- Kounis_syndrome wikiPageWikiLink Angina.
- Kounis_syndrome wikiPageWikiLink Angina_pectoris.
- Kounis_syndrome wikiPageWikiLink Antihistamine.
- Kounis_syndrome wikiPageWikiLink Atheroma.
- Kounis_syndrome wikiPageWikiLink Category:Heart_diseases.
- Kounis_syndrome wikiPageWikiLink Chemokine.
- Kounis_syndrome wikiPageWikiLink Coronary_thrombosis.
- Kounis_syndrome wikiPageWikiLink Corticosteroid.
- Kounis_syndrome wikiPageWikiLink Cytokine.
- Kounis_syndrome wikiPageWikiLink Eosinophil.
- Kounis_syndrome wikiPageWikiLink Eosinophil_granulocyte.
- Kounis_syndrome wikiPageWikiLink Histamine.
- Kounis_syndrome wikiPageWikiLink Histamine_antagonist.
- Kounis_syndrome wikiPageWikiLink Inflammation.
- Kounis_syndrome wikiPageWikiLink Inflammatory_mediators.
- Kounis_syndrome wikiPageWikiLink Mast_cell.
- Kounis_syndrome wikiPageWikiLink Myocardial_infarction.
- Kounis_syndrome wikiPageWikiLink Prinzmetals_angina.
- Kounis_syndrome wikiPageWikiLink Vasodilation.
- Kounis_syndrome wikiPageWikiLink Vasodilator.
- Kounis_syndrome wikiPageWikiLinkText "Kounis syndrome".
- Kounis_syndrome hasPhotoCollection Kounis_syndrome.
- Kounis_syndrome wikiPageUsesTemplate Template:Citation_style.
- Kounis_syndrome wikiPageUsesTemplate Template:Technical.
- Kounis_syndrome subject Category:Heart_diseases.
- Kounis_syndrome hypernym Group.
- Kounis_syndrome type Article.
- Kounis_syndrome type Band.
- Kounis_syndrome type Article.
- Kounis_syndrome comment "Kounis syndrome is a group of symptoms that manifests as unstable vasospastic or nonvasospastic angina and even as acute myocardial infarction and is triggered by the release of inflammatory mediators following an allergic insult [1].".
- Kounis_syndrome label "Kounis syndrome".
- Kounis_syndrome sameAs m.09gd2y0.
- Kounis_syndrome sameAs Q6434647.
- Kounis_syndrome sameAs Q6434647.
- Kounis_syndrome wasDerivedFrom Kounis_syndrome?oldid=651907397.
- Kounis_syndrome isPrimaryTopicOf Kounis_syndrome.