期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 140, 期 2, 页码 335-348出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2017.06.003
关键词
Anaphylaxis; basophils; cysteinyl leukotrienes; epinephrine; food allergy; histamine; IgE; mast cells; platelet-activating factor; urticaria
资金
- European Commission (Marie Sklodowska-Curie Individual Fellowship) [H2020-MSCA-IF-2014 656086]
- Institut National de la Sante et de la Recherche Medicale (INSERM)
- National Institutes of Health [U19 AI104209, NS 080062, R01 AR067145]
- Department of Pathology, Stanford University School of Medicine
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.
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