Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, University of Western Australia, Perth, Western Australia, Australia.
Curr Allergy Asthma Rep. 2012 Feb;12(1):33-41. doi: 10.1007/s11882-011-0231-6.
A range of mediators are generated during anaphylaxis, with redundancy of effects, multiple overlapping pathways, and involvement of several cell types. Key steps in the reaction occur at the site of initial contact, and mediators may not be detectable systemically. Furthermore, the potencies of various mediators vary enormously, and clinical effects may occur below our level of detection. We also do not know what converts (amplifies) a local reaction into systemic anaphylaxis. Murine models have identified several novel mediators that may propagate and/or regulate this process and also indicate that circulating neutrophils may play an important role in reaction amplification. Differential expression of various genes within specific intracellular signalling pathways of mediator release may further explain the varying severities of anaphylactic reactions. As our knowledge of the mechanisms of activation, key mediators, and the regulation of mediator release improves, new treatments for prevention and acute management may emerge.
在过敏反应过程中会产生一系列介质，这些介质具有冗余的作用、多个重叠的途径和涉及多种细胞类型。反应的关键步骤发生在初始接触部位，介质可能不会在系统中被检测到。此外，各种介质的效力差异极大，临床效应可能低于我们的检测水平。我们也不知道是什么将（放大）局部反应转化为全身性过敏反应。鼠模型已经鉴定出几种可能传播和/或调节这一过程的新型介质，并且还表明循环中性粒细胞可能在反应放大中发挥重要作用。介质释放的特定细胞内信号转导途径中各种基因的差异表达可能进一步解释过敏反应的不同严重程度。随着我们对激活机制、关键介质和介质释放调控的认识的提高，预防和急性管理的新治疗方法可能会出现。
