Angioedema Research Center, Barzilai University Medical Center, Ashkelon, Israel.
Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
J Allergy Clin Immunol. 2024 Aug;154(2):398-411.e1. doi: 10.1016/j.jaci.2024.03.024. Epub 2024 Apr 25.
Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, may occur only once or be recurrent, may exhibit wheals or not, and may be due to mast cell mediators, bradykinin, or other mechanisms. Several different taxonomic systems are currently used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize AE treatment.
We developed a consensus on the definition, acronyms, nomenclature, and classification of AE (DANCE).
The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific and medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022).
The DANCE initiative resulted in an international consensus on the definition, classification, and terminology of AE. The new consensus classification features 5 types and endotypes of AE and a harmonized vocabulary of abbreviations/acronyms.
The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic assessment and treatment of AE. DANCE does not replace current clinical guidelines, and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by physicians using sound clinical judgment. We anticipate that this new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.
血管性水肿（AE）表现为皮下和/或黏膜下组织间歇性、局限性、自限性肿胀。AE 具有异质性，可以是遗传性的，也可以是获得性的，可能只发生一次，也可能反复发作，可能出现风团，也可能不出现，可能是由于肥大细胞介质、缓激肽或其他机制引起的。目前有几种不同的分类系统，这使得比较研究结果、开展多中心合作以及协调 AE 治疗变得困难。
我们就 AE 的定义、缩写、命名和分类达成了共识（DANCE）。
该倡议涉及来自 35 个国家的 91 名专家，并得到 53 个科学和医学协会以及患者组织的认可。通过在线讨论和使用 Delphi 过程进行投票，在 16 个月的时间内（2021 年 6 月至 2022 年 11 月）达成了共识。
DANCE 倡议就 AE 的定义、分类和术语达成了国际共识。新的共识分类具有 5 种 AE 类型和表型，以及一个协调一致的缩写/首字母缩略词词汇。
DANCE 分类补充了当前关于 AE 诊断评估和治疗的临床指南和专家共识建议。DANCE 并不取代当前的临床指南，也不应被误解为以影响医生根据临床判断开出的药物报销的方式影响其应用。我们预计，这种新的 AE 分类法和命名法将协调和促进 AE 研究和临床研究，从而改善患者的护理。
