By Johannes Ring
Anaphylaxis is the main dramatic and possibly life-threatening manifestation of an immediate-type hypersensitive reaction response. even if identified for over a hundred years, it nonetheless poses many unresolved questions, and its functional administration and acute remedy are usually extra empiric in nature than evidence-based. during this e-book, a multidisciplinary team of specialists assessment the cutting-edge within the pathophysiology, epidemiology, analysis and scientific symptomatology of anaphylaxis. Its etiology in regards to various elicitors equivalent to insect venoms, radiocontrast media, analgesics, normal and native anesthetics is tested intimately. eventually, remedy modalities for anaphylaxis are mentioned either for acute reactions and as normal administration strategies for sufferers in danger. delivering thorough and updated insurance of this often underestimated challenge, this ebook is of curiosity not just to allergologists and immunologists, but additionally to all physicians and affected sufferers.
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Additional resources for Anaphylaxis (Chemical Immunology and Allergy, Vol. 95)
J Allergy Clin Immunol 2001;108:861–866. 3 Kane KE, Cone DC: Anaphylaxis in the prehospital setting. J Emerg Med 2004;27:371–377. Epidemiology of Anaphylaxis 4 Smit DV, Cameron PA, Rainer TH: Anaphylaxis presentation in a emergency department in Hong Kong: incidence and predictors of biphasic reactions. J Emerg Med 2005;28:381–388. 5 Kiratiseavee S, Ranesg S: Evaluation of pediatric patients admitted with adverse food reactions to an inner-city pediatric ED. J Allergy Clin Immunol 2007;119:S114.
Among adults, food allergy is the third most frequent cause of anaphylaxis (fig. 2). In addition, food allergens may account as a cofactor in the context of anaphylaxis. In exercised-induced anaphylaxis, food allergens are the most frequent elicitators. Among many possible food allergens which may account for exercise-induced anaphylaxis, it has been shown recently that the allergenic component ω–5 gliadin from wheat is a frequent cause . As this 14 Worm sensitization can now be measured by determination of specific IgE, the diagnostic workup for this clinical entity has been significantly improved .
In the presence of IL-4 also differentiation of naive T cells into Th2 takes place (fig. 1). When IgE bound to FcεRI (high-affinity receptor for IgE) on mast cells and basophils crosslinks with the specific allergen, release of vasoactive amines (such as histamine), lipid mediators (such as prostaglandin D, platelet-activating factor, leukotriene C4 (LTC4), LTD4 and LTE4), chemokines (CXC-chemokine ligand 8 (CXCL8), CXCL10, CC-chemokine ligand 2 (CCL2), CCL4 and CCL5) and other cytokines (such as IL-4, IL-5 and IL-13) occur, which are responsible for the signs and symptoms of immediate phase of the allergic reactions .