Anaphylaxis is an immediate-type allergic reaction involving the whole organism. It is the most life-threatening allergic condition. Although there are few exact epidemiological data regarding prevalence, estimates regarding insect sting anaphylaxis range from 1-3% in the general population, but much higher values have been reported by some authors for food and drug-induced anaphylaxis. Anaphylaxis is the main acute killer of allergic individuals. Although anaphylaxis was discovered at the beginning of the 20th century, there are still many unresolved issues. These include non-IgE-mediated anaphylactoid reactions, non-immunologically mediated anaphylactoid (pseudo-allergic) reactions, pathophysiological events at the microcirculatory level, appropriate therapy for the acute reaction, strategies for prevention, public education about the problem and new approaches to prevention and therapy at the IgE level. All these subjects are discussed in this book. Since anaphylaxis occurs acutely and is unforeseen, it is very difficult to organize controlled studies regarding therapy and prevention.
The spectrum of symptomatology covers many clinical areas (skin, respiratory, cardiovascular and gastrointestinal system), therefore inter-disciplinary approaches are necessary for progress in the field. There is widespread uncertainty among physicians about therapy, especially concerning self-administered treatment. In this important book, an multidisciplinary group of experts explore the pathophysiology of different types of anaphylactic and anaphylactoid reactions. Evidence is presented on the epidemiology of these conditions while problems relating to diagnosis, therapy and prevention are examined in detail. This thorough and up-to-date coverage of the subject will be of great interest to all clinical immunologists, researchers and physicians who deal with this life-threatening condition. Related Novartis Foundation symposia: 252 Generation and effector functions of regulatory lymphocytes Chair: Jean-Francois Bach Immunoinformatics: bioinformatic strategies for better understanding of immune function Chair: Hans-Georg Rammensee Cancer and inflammation Chair: Siamon Gordon
Chair's introduction (Galli). History and classification of anaphylaxis (Ring et al). Rethinking TH2 antibody responses and allergic sensitization (Stern et al). General discusssion I. The high affinity receptor for IgE, FceRI (Metzger). Effector cells of anaphylaxis: mast cells and basophils (Schwartz). Cytokine enhancement of anaphylaxis (Strait et al). General discussion II. Patterns of anaphylaxis: acute and later phase features of allergic reactions (Golden). Fatal anaphylaxis in the UK, 1992-2001 (Pumphrey). The human heart as a shock organ in anaphylaxis (Marone et al). General discussion III. Food-induced anaphylaxis (Sampson). Anaphylaxis to insect venom (Mosbech). Anaphylaxis to anaesthetic drugs (Fisher). General discussion IV. The radiocontrast molecule in anaphylaxis. A surprising antigen (Lasser). General discussion V. Epinephrine (adrenaline) in the first-aid, out-of-hospital treatment of anaphylaxis (Simons). New approaches for the treatment of anaphylaxis (Leung et al). Patient's perspective and publc policy regarding anaphylaxis (Munoz-Furlong). Final discussion. Index of contributors. Subject index.