{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:19:55Z","timestamp":1791537595044,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In some cases, anaphylactic shock (AS) is still lethal, despite rapid use of epinephrine. High doses of epinephrine are associated with severe complications. Platelet\u2010activating factor (PAF) is secreted in massive amounts during AS, and a high plasma level is correlated with increased AS severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effect of ABT\u2010491, a PAF\u2010receptor antagonist and possible adjunct treatment, alone or in combination with epinephrine during AS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AS was induced by intravenous injection of 1\u00a0mg ovalbumin into ovalbumin\u2010sensitized rats. Rats were then randomly assigned to 5 groups (n\u00a0=\u00a010 per group): SHAM (vehicle only), SHOCK (no treatment), ABT (ABT\u2010491 1\u00a0mg\/kg), EPI (epinephrine 5\u00a0\u00b5g as a bolus then 10\u00a0\u00b5g\u00a0kg<jats:sup>\u22121<\/jats:sup>\u00a0min<jats:sup>\u22121<\/jats:sup> by continuous infusion, followed by a reducing protocol) and EPI\u2010ABT (both treatments).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ovalbumin injection resulted in a severe decrease in mean arterial pressure, left ventricular inotropy (max d<jats:italic>P<\/jats:italic>\/d<jats:italic>t<\/jats:italic>) and left ventricular shortening fraction (LVSF). All rats from the ABT group survived until the end of the experiment. ABT\u2010491 prevented the LVSF decrease observed in the SHOCK group (at T15: ABT 50%\u00a0\u00b1\u00a011% vs SHOCK 36%\u00a0\u00b1\u00a09%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01), significantly reduced the dose of epinephrine needed to treat anaphylactic shock (EPI\u2010ABT 314\u00a0\u00b1\u00a067\u00a0\u00b5g\/kg vs EPI 475\u00a0\u00b1\u00a069\u00a0\u00b5g\/kg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and reduced the time to restore basal MAP (ABT 23\u00a0\u00b1\u00a07\u00a0minutes vs EPI\u2010ABT 13\u00a0\u00b1\u00a05\u00a0minutes, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Clinical Relevance<\/jats:title><jats:p>AS was characterized by early cardiac dysfunction in our model. Treatment with ABT\u2010491 allowed survival until the end of the experiment and reduced cardiac dysfunction. Use of the PAF\u2010R antagonist had a synergistic effect with epinephrine and allowed a significant reduction in epinephrine consumption. Use of PAF\u2010R antagonists during AS could reduce epinephrine\u2010related complications and improve the treatment of epinephrine refractory cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.13540","type":"journal-article","created":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T11:50:16Z","timestamp":1574423416000},"page":"383-390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Treatment with a platelet\u2010activating factor receptor antagonist improves hemodynamics and reduces epinephrine requirements, in a lethal rodent model of anaphylactic shock"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7274-6018","authenticated-orcid":false,"given":"Charles","family":"Tacquard","sequence":"first","affiliation":[{"name":"Department of anesthesia and intensive care H\u00f4pitaux Universitaires de Strasbourg Nouvel H\u00f4pital Civil Strasbourg France"},{"name":"Groupe 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