The pathophysiology of anaphylaxis

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:140

Article

Reber, Laurent L.^1,2,3,5  Hernandez, Joseph D.⁴  Galli, Stephen J.^3,5,6 

[1] Inst Pasteur, Dept Immunol, Unit Antibodies Therapy & Pathol, Paris, France

[2] Inst Natl Sante & Rech Med, Paris, France

[3] Stanford Univ, Sch Med, Dept Pathol, Stanford, CA 94305 USA

[4] Stanford Univ, Sch Med, Dept Pediat, Div Allergy Immunol & Rheumatol, Stanford, CA 94305 USA

[5] Stanford Univ, Sch Med, Dept Microbiol & Immunol, Stanford, CA 94305 USA

[6] Stanford Univ, Sch Med, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA

关键词: Anaphylaxis;    basophils;    cysteinyl leukotrienes;    epinephrine;    food allergy;    histamine;    IgE;    mast cells;    platelet-activating factor;    urticaria;   

DOI  :  10.1016/j.jaci.2017.06.003

来源: Elsevier

【 摘 要 】

Anaphylaxis is a severe systemic hypersensitivity reaction that is rapid in onset; characterized by life-threatening airway, breathing, and/or circulatory problems; and usually associated with skin and mucosal changes. Because it can be triggered in some persons by minute amounts of antigen (eg, certain foods or single insect stings), anaphylaxis can be considered the most aberrant example of an imbalance between the cost and benefit of an immune response. This review will describe current understanding of the immunopathogenesis and pathophysiology of anaphylaxis, focusing on the roles of IgE and IgG antibodies, immune effector cells, and mediators thought to contribute to examples of the disorder. Evidence from studies of anaphylaxis in human subjects will be discussed, as well as insights gained from analyses of animal models, including mice genetically deficient in the antibodies, antibody receptors, effector cells, or mediators implicated in anaphylaxis and mice that have been 'humanized'' for some of these elements. We also review possible host factors that might influence the occurrence or severity of anaphylaxis. Finally, we will speculate about anaphylaxis from an evolutionary perspective and argue that, in the context of severe envenomation by arthropods or reptiles, anaphylaxis might even provide a survival advantage.

【 授权许可】

Free