ABSTRACT

Complement (C) activation can lead to a syndrome called C activation-related pseudoallergy (CARPA). Among the hemodynamic symptoms, the rise of pulmonary arterial pressure (PAP) is the most prominent and reproducible measure of CARPA in the porcine model, which is invariably present with all reactogenic nanomedicines (RNM). The rise of PAP to i.v. bolus injection of certain RNMs is remarkably constant and reproducible if the dose and administration schedule is the same in all animals. Depending on the features of RNMs, their administration speed and the use of anti-allergic premedication, the prevalence of CARPA in man can reach 30–40% with mostly transient and mild symptoms. The constant and, at the same time highly variable symptoms of CARPA in pigs reflect the simplicity and at the same time the complexity of a “stress reaction in blood”, a novel immune phenomenon brought to light by the introduction of nanotechnology in pharmacotherapy.