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Cited by 11Food Allergy and Anaphylaxis ResearchMast cells and histamineDrug-Induced Adverse Reactions

Beyond IgE–when do IgE-crosslinking and effector cell activation lead to clinical anaphylaxis?

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Poulsen, Lars K., Jensen, Bettina M., Esteban, Vanesa, Garvey, Lene Heise·2017·Frontiers in Immunology
DOI 10.3389/fimmu.2017.00871PMC PMC5554325
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Abstract

Anaphylaxis in humans is inherently difficult to study due to the acuteness of symptoms and the lack of biomarkers serving as risk predictors. Most cases are related to IgE sensitizations to foods, insect venoms, and drugs with mastocytosis patients forming a smaller risk group. However, identifying the relatively small fraction of persons at risk has been exceedingly difficult. In this review, we propose to describe anaphylaxis in a broader context than defined by IgE sensitization alone. Exposure to a trigger, such as an allergen, may lead to anaphylaxis, but in particular, the internal dose sensed by the immune system needs to be established. Moreover, intrinsic patient factors as well as the specific circumstances of the exposure, i.e., the extrinsic factors, need to be thoroughly accounted for. More controversially, other triggers of anaphylaxis, such as increased sensitivity to or reduced catabolism of histamine ("histamine intolerance") or mast cell activation syndrome also named mast cell activation disorder have been suggested, but still with very limited epidemiological evidence that a significant proportion of the observed reactions are caused by these alleged conditions. Thus, when all conditions are considered, it seems as if IgE-mediated reactions are responsible for the vast majority of anaphylactic conditions.

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  • In patients with clonal MC, IgE-dependent and IgE-independent MCA reactions may be severe, often in the form of anaphylaxis, depending on inherent hyperreactivity of MCs and the disease context.

    “In patients with clonal MC, IgE-dependent and IgE-independent MCA reactions may be severe (often in the form of anaphylaxis), depending on both the inherent hyperreactivity of MCs and the disease context”

    From Selecting the Right Criteria and Proper Classification to Diagnose Mast Cell Activation Syndromes: A Critical Review (2021) · cites this paper as [18]

    The Introduction (page unavailable) identifies patients with mastocytosis as at risk of severe reactions, including after mechanical stimuli or insect stings without venom sensitization. The section on endogenous cellular activation (page unavailable) also calls mastocytosis a well-known cause of anaphylaxis. The paper does not specifically establish that both IgE-dependent and IgE-independent reactions in patients with clonal mast cells vary in severity according to inherent mast-cell hyperreactivity and disease context. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Poulsen, L. K., Jensen, B. M., Esteban, V., & Garvey, L. H.
Affiliations
Copenhagen University Hospital (DK)
Corresponding author
Poulsen, Lars K.
ORCID
Venue
Frontiers in Immunology
Publisher
Frontiers Media SA
Published
2017-08-10
Volume
8
Pages
871-871
ISSN
1664-3224 (ISSN-L)
DOI
10.3389/fimmu.2017.00871
PMC
PMC5554325
OpenAlex
W2744675623
Cited by
11
References
1
Citations by year
2022: 2 · 2021: 6 · 2020: 1 · 2019: 1 · 2018: 1
FWCI
0.13
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
  • Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
  • Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
Keywords
anaphylaxis, IgE sensitization, effector cell activation, mastocytosis, food allergy, insect venom allergy, drug hypersensitivity, histamine intolerance, mast cell activation syndrome, anaphylaxis triggers, risk prediction

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