Therapeutic management of hereditary angioedema due to C1 inhibitor deficiency.

Andrea Zanichelli, Marta Mansi, Giulia Periti, Marco Cicardi
Author Information
  1. Andrea Zanichelli: Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Ospedale Luigi Sacco, Milan 20157, Italy. andrea.zanichelli@unimi.it

Abstract

Hereditary angioedema (HAE) due to C1 inhibitor (C1-INH) deficiency is a rare genetic disease characterized by recurrent swellings of the subcutaneous and submucosal tissues that can manifest as cutaneous edema, abdominal pain and laryngeal edema with airway obstruction. These symptoms have a significant impact on patients' quality of life. The reduction in C1-INH function leads to uncontrolled activation of the contact system and generation of bradykinin, the mediator of increased vascular permeability and edema formation. In the past, few treatment options were available; however, several new therapies with proven efficacy have recently become available to treat and prevent HAE attacks, such as plasma-derived and recombinant C1-INHs that replace the deficient protein, bradykinin receptor antagonist (icatibant) that blocks bradykinin activity and kallikrein inhibitor (ecallantide) that prevents bradykinin release. Such therapies can improve disease outcome. This article reviews the therapeutic management of HAE, which involves the treatment of acute attacks and prophylaxis.

MeSH Term

Angioedemas, Hereditary
Bradykinin
Disease Management
Hereditary Angioedema Types I and II
Humans
Peptides
Treatment Outcome

Chemicals

Peptides
ecallantide
icatibant
Bradykinin

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