TY - JOUR
T1 - Anaphylaxis
T2 - Advances in the Past 10 Years
AU - Weiler, Catherine R.
AU - Schrijvers, Rik
AU - Golden, David B.K.
N1 - Publisher Copyright:
© 2022 American Academy of Allergy, Asthma & Immunology
PY - 2023/1
Y1 - 2023/1
N2 - In the past 10 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 α-tryptasemia, that may impact anaphylactic syndromes. We have learned to recognize new causes (α-gal), new pathways (Mas-related G protein–coupled receptor-X2), 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, using new ways to block the IgE receptor or modulate intracellular signaling pathways.
AB - In the past 10 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 α-tryptasemia, that may impact anaphylactic syndromes. We have learned to recognize new causes (α-gal), new pathways (Mas-related G protein–coupled receptor-X2), 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, using new ways to block the IgE receptor or modulate intracellular signaling pathways.
KW - Anaphylaxis
KW - Hereditary α-tryptasemia
KW - Injectable epinephrine
KW - Risk factors for anaphylaxis
KW - Vaccination-induced anaphylaxis
KW - α-Gal
UR - http://www.scopus.com/inward/record.url?scp=85145451916&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85145451916&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2022.09.019
DO - 10.1016/j.jaip.2022.09.019
M3 - Article
C2 - 36162799
AN - SCOPUS:85145451916
SN - 2213-2198
VL - 11
SP - 51
EP - 62
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 1
ER -