Anaphylaxis: Advances in the past 10 years

Elsevier

Available online 24 September 2022

The Journal of Allergy and Clinical Immunology: In PracticeAbstract

In the past ten years, anaphylaxis has grown into its own special area of study within Allergy-Immunology, both at the bench and at the bedside. This review focuses on some of the most clinically relevant advances over the past decade. These include simplified and more inclusive diagnostic criteria for adults and children, uniform definition of biphasic anaphylaxis, and improved systems for objective severity grading. Studies reported in the past decade have led to improved understanding of normal and abnormal regulation of mast cell function, translating into better diagnostic and therapeutic approaches to patients with anaphylaxis. Research has provided improved recognition and treatment of mast cell disorders, and has identified a new condition, hereditary alpha tryptasemia, that may impact anaphylactic syndromes. We have learned to recognize new causes (alpha-gal), new pathways (MRGPRX2), and many risk factors for severe anaphylaxis. The stability of epinephrine in autoinjectors was reported to be very good for several years after the labeled expiry date, and it can tolerate freezing and thawing. Repeated and prolonged exposure to excessive heat leads to degradation of epinephrine activity. New treatments to prevent severe anaphylaxis have been described, utilizing new ways to block the IgE receptor or modulate intracellular signaling pathways.

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© 2022 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology

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