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Anesthesiology Sep 2023
Topics: Humans; Anaphylaxis; Drug Hypersensitivity; Perioperative Period
PubMed: 37247347
DOI: 10.1097/ALN.0000000000004597 -
Anesthesiology Sep 2023
Topics: Humans; Anaphylaxis; Drug Hypersensitivity; Perioperative Period
PubMed: 37247351
DOI: 10.1097/ALN.0000000000004594 -
Anesthesiology Sep 2023
Topics: Humans; Anaphylaxis; Drug Hypersensitivity; Perioperative Period
PubMed: 37247349
DOI: 10.1097/ALN.0000000000004596 -
Anesthesiology Sep 2023
Topics: Humans; Anaphylaxis; Drug Hypersensitivity; Perioperative Period
PubMed: 37247348
DOI: 10.1097/ALN.0000000000004595 -
Annals of Allergy, Asthma & Immunology... Aug 2023
Topics: Humans; Anaphylaxis; Epinephrine
PubMed: 37536870
DOI: 10.1016/j.anai.2023.05.024 -
International Journal of Molecular... May 2021Anaphylaxis is a severe allergic reaction, rapid in onset, and can lead to fatal consequences if not promptly treated. The incidence of anaphylaxis has risen at an... (Review)
Review
Anaphylaxis is a severe allergic reaction, rapid in onset, and can lead to fatal consequences if not promptly treated. The incidence of anaphylaxis has risen at an alarming rate in past decades and continues to rise. Therefore, there is a general interest in understanding the molecular mechanism that leads to an exacerbated response. The main effector cells are mast cells, commonly triggered by stimuli that involve the IgE-dependent or IgE-independent pathway. These signaling pathways converge in the release of proinflammatory mediators, such as histamine, tryptases, prostaglandins, etc., in minutes. The action and cell targets of these proinflammatory mediators are linked to the pathophysiologic consequences observed in this severe allergic reaction. While many molecules are involved in cellular regulation, the expression and regulation of transcription factors involved in the synthesis of proinflammatory mediators and secretory granule homeostasis are of special interest, due to their ability to control gene expression and change phenotype, and they may be key in the severity of the entire reaction. In this review, we will describe our current understanding of the pathophysiology of human anaphylaxis, focusing on the transcription factors' contributions to this systemic hypersensitivity reaction. Host mutation in transcription factor expression, or deregulation of their activity in an anaphylaxis context, will be updated. So far, the risk of anaphylaxis is unpredictable thus, increasing our knowledge of the molecular mechanism that leads and regulates mast cell activity will enable us to improve our understanding of how anaphylaxis can be prevented or treated.
Topics: Anaphylaxis; Animals; Humans; Inflammation Mediators; Models, Biological; Mutation; Transcription Factors
PubMed: 34066544
DOI: 10.3390/ijms22094935 -
Journal of Investigational Allergology... 2015Knowledge of the epidemiology of anaphylaxis has improved during the last 10 years thanks to the increased number of publications with improved methodological... (Review)
Review
Knowledge of the epidemiology of anaphylaxis has improved during the last 10 years thanks to the increased number of publications with improved methodological robustness. Consequently, we better understand the distribution and frequency of anaphylaxis and the characteristics of fatal anaphylaxis. We now know that anaphylaxis is more frequent than previously thought (up to 50-103 cases per 100 000 person-years), although the distribution differs with the age group (up to 3 times in patients aged 0-4 years), cause (food-induced anaphylaxis is more frequent in young people, drug-induced and Hymenoptera anaphylaxis in older patients), and geographical area (more prevalent in areas with less sunlight). A controversial and unresolved issue is whether this high incidence of anaphylaxis is a real increase or merely the result of better identification of anaphylaxis by the attending physician. Recurrence of anaphylaxis has been recorded in one-third of cases, although it is the least studied area of the epidemiology of anaphylaxis. Fatal anaphylaxis, on the other hand, has been widely studied. We know that death from anaphylaxis is a rare and extraordinary event (0.12 to 1.06 deaths per million person-years) and more likely in older individuals in the case of drug and Hymenoptera anaphylaxis. Studies conducted during the last 10 years are highly powered since they include large numbers of patients (national records of hospitalized patients) over long time periods (10-20 years) or have been conducted with representative samples of the general population.
Topics: Age Distribution; Age Factors; Allergy and Immunology; Anaphylaxis; Cause of Death; Female; Humans; Incidence; Male; Prevalence; Prognosis; Recurrence; Risk Assessment; Risk Factors; Sex Distribution; Sex Factors; Time Factors
PubMed: 26182682
DOI: No ID Found -
Allergology International : Official... Apr 2017Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers... (Review)
Review
Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence. Infantile atopic dermatitis associated with food allergy type is especially important as the onset of most food allergies occurs during infancy. We have discussed the neonatal and infantile gastrointestinal allergy and special forms of immediate type food allergy types separately. Diagnostic procedures are highlighted, such as probability curves and component-resolved diagnosis, including the recent advancement utilizing antigen-specific IgE. The oral food challenge using a stepwise approach is recommended to avoid complete elimination of causative foods. Although oral immunotherapy (OIT) has not been approved as a routine treatment by nationwide insurance, we included a chapter for OIT, focusing on efficacy and problems. Prevention of food allergy is currently the focus of interest, and many changes were made based on recent evidence. Finally, the contraindication between adrenaline and antipsychotic drugs in Japan was discussed among related medical societies, and we reached an agreement that the use of adrenaline can be allowed based on the physician's discretion. In conclusion, this guideline encourages physicians to follow the principle to let patients consume causative foods in any way and as early as possible.
Topics: Allergens; Anaphylaxis; Animals; Combined Modality Therapy; Diagnosis, Differential; Disease Management; Food; Food Hypersensitivity; Humans; Incidence; Japan; Phenotype; Population Surveillance; Practice Guidelines as Topic; Risk Factors; Treatment Outcome
PubMed: 28285847
DOI: 10.1016/j.alit.2017.02.001 -
Anales Del Sistema Sanitario de Navarra 2003Anaphylaxis is a potentially mortal, underdiagnosed clinical picture. The most frequent triggering agents are drugs and foodstuffs. The first therapeutic option,... (Review)
Review
Anaphylaxis is a potentially mortal, underdiagnosed clinical picture. The most frequent triggering agents are drugs and foodstuffs. The first therapeutic option, adrenaline, although clearly indicated, is not carried out with the desired frequency due basically to the high number of cases of anaphylaxis that are not diagnosed as such. In patients with a first episode of anaphylaxis, posterior aetiological diagnosis is crucial to avoid the appearance of new episodes. The only case of anaphylaxis in which immunotherapy with the allergen must be evaluated, is that in which the causal agent is the poison of hymenopters.
Topics: Anaphylaxis; Humans; Risk Factors
PubMed: 13679969
DOI: No ID Found -
Journal of Clinical Anesthesia Jun 2024We conducted this meta-analysis to summarize the available evidence and evaluate the relationship between a history of allergies/allergic diseases and perioperative... (Meta-Analysis)
Meta-Analysis Review
STUDY OBJECTIVE
We conducted this meta-analysis to summarize the available evidence and evaluate the relationship between a history of allergies/allergic diseases and perioperative anaphylaxis to offer preventive decision support.
DESIGN
Systematic review and meta-analysis of observational studies.
SETTING
We searched the MEDLINE (OVID), EMBASE, and the Cochrane Central Register of Controlled Trials databases for observational studies. Two investigators independently performed the search, screened the articles, and collected the study details.
MEASUREMENTS
Several databases were systematically searched to evaluate the relationship between a history of allergies/allergic diseases and perioperative anaphylaxis using subgroup analysis, sensitivity analysis and meta-regression.
MAIN RESULTS
A total of 19 studies involving 672 anaphylaxis episodes, 5608 immune-mediated reactions, and 1126 severe episodes met the eligibility criteria and were included in this meta-analysis. Drug allergies, food allergies, a history of allergies, and atopy increased the incidence of perioperative anaphylaxis (Drug allergies, odds ratio [OR] 3.54, 95% confidence interval [CI] 1.07-11.69; Food allergies, OR 2.29, 95% CI 1.23-4.26; A history of allergies, OR 4.86, 95% CI 3.65-6.49; Atopy, OR 3.58, 95% CI 1.47-8.71), but not the presence of immune-mediated reactions and the severity of perioperative anaphylaxis.
CONCLUSIONS
Patients with previous drug allergies, food allergies, a history of allergies, or atopy are more likely to develop anaphylaxis during the perioperative period. Additional studies should be carried out to determine whether a history of allergies/allergic diseases is a major factor for perioperative anaphylaxis when confounders are controlled.
Topics: Humans; Anaphylaxis; Food Hypersensitivity; Drug Hypersensitivity; Incidence; Perioperative Period
PubMed: 38387242
DOI: 10.1016/j.jclinane.2024.111408