Labella Marina, Garcia-Neuer Marlene, Castells Mariana
Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Allergy, Virgen del Rocío University Hospital, Sevilla, Spain.
Curr Opin Allergy Clin Immunol. 2018 Jun;18(3):190-197. doi: 10.1097/ACI.0000000000000435.
Recognize the presentation of anaphylaxis for prompt management and treatment and to provide tools for the diagnosis of the underlying cause(s) and set up a long-term treatment to prevent recurrence of anaphylaxis.
The recent description of phenotypes provides new insight and understanding into the mechanisms and causes of anaphylaxis through a better understanding of endotypes and biomarkers for broad clinical use.
Anaphylaxis is the most severe hypersensitivity reaction and can lead to death. Epinephrine is the first-line treatment of anaphylaxis and it is life-saving. Patients with first-line therapy-induced anaphylaxis are candidates for desensitization to increase their quality of life and life expectancy. Desensitization is a breakthrough novel treatment for patients with anaphylaxis in need of first-line therapy, including chemotherapy, mAbs, aspirin and others. Ultrarush with venom immunotherapy should be considered in patients who present with life-threatening anaphylaxis after Hymenoptera sting with evidence of IgE-mediated mechanisms. Food desensitization is currently being expanded to provide increased safety to adults and children with food-induced anaphylaxis.
认识过敏反应的表现以便及时进行管理和治疗，并提供诊断潜在病因的工具，建立长期治疗方案以预防过敏反应复发。
对表型的最新描述通过更好地理解广泛临床应用的内型和生物标志物，为过敏反应的机制和病因提供了新的见解和认识。
过敏反应是最严重的超敏反应，可导致死亡。肾上腺素是过敏反应的一线治疗药物，可挽救生命。一线治疗引发过敏反应的患者是脱敏治疗的候选对象，以提高其生活质量和预期寿命。脱敏是一种突破性的新型治疗方法，适用于需要一线治疗的过敏反应患者，包括化疗、单克隆抗体、阿司匹林等。对于膜翅目昆虫叮咬后出现危及生命的过敏反应且有IgE介导机制证据的患者，应考虑采用毒液免疫疗法进行超快速脱敏。食物脱敏目前正在扩大应用范围，以提高食物诱导性过敏反应的成人和儿童的安全性。
