Worm Margitta, Pazur Kristijan, Morakabati Payam, Redhu Davender
Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Semin Immunopathol. 2025 Aug 13;47(1):34. doi: 10.1007/s00281-025-01056-7.
Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur through both IgE- and non-IgE-mediated pathways. The classic IgE-mediated pathway involves allergen-specific IgE binding to FcεRI on mast cells and basophils, triggering degranulation and the release of inflammatory mediators. Non-IgE-mediated mechanisms, which are commonly associated with drug-induced reactions, at least in mice, involve the activation of the G-protein-coupled receptor (MRGPRX2), triggering mast cell degranulation in an IgE independent manner. Anaphylaxis can also be mediated through IgG immune complex interaction with Fc gamma receptors on various cell types, leading to mediator release. This review will describe current understanding of the pathomechanisms of anaphylaxis. Understanding these diverse pathways is crucial for accurate diagnosis, effective treatment, and prevention of anaphylaxis.
过敏反应是一种严重的、可能危及生命的过敏反应,可通过IgE介导和非IgE介导的途径发生。经典的IgE介导途径涉及变应原特异性IgE与肥大细胞和嗜碱性粒细胞上的FcεRI结合,触发脱颗粒和炎症介质的释放。非IgE介导的机制通常与药物诱导的反应有关,至少在小鼠中是这样,涉及G蛋白偶联受体(MRGPRX2)的激活,以IgE非依赖的方式触发肥大细胞脱颗粒。过敏反应也可通过IgG免疫复合物与各种细胞类型上的Fcγ受体相互作用介导,导致介质释放。本综述将描述目前对过敏反应发病机制的理解。了解这些不同的途径对于准确诊断、有效治疗和预防过敏反应至关重要。