过敏反应是急性的,可能致命的,需要及时诊断和管理的全身性超敏反应。预测谁可能面临严重的风险仍然具有挑战性,危及生命的过敏反应.过敏反应可由一系列过敏原引起,比如某些食物,药物,乳胶,昆虫叮咬,等。增加临床症状严重程度和增加不良预后风险的辅助因素包括运动,压力,传染病,潜在的肥大细胞病,活动性过敏性疾病如哮喘,高龄,摄入某些药物,既往过敏反应史,和延迟或错过了肾上腺素的管理。根据欧洲过敏反应登记处,食物是过敏反应的主要引发剂,尤其是鸡蛋,牛奶,和坚果,在儿童和青少年。对昆虫毒液的反应也在成年后被注意到。早期识别体征和症状以及及时治疗对于避免严重甚至致命后果的过敏反应管理至关重要。对于个人和临床医生来说,确定过敏反应的原因至关重要。过敏反应的生物标志物,比如组胺,胰蛋白酶,血小板活化因子(PAF),糜蛋白酶,羧肽酶A3,二肽基肽酶I(DPPI),Basogranulin,CCL-2,hsa-miR-451a,可能有助于诊断和管理。这篇综述文章的目的是全面概述当前的证据和专家意见,这些证据和意见涉及个体易发生过敏反应的危险因素。此外,它提供了对潜在生物标志物和遗传标志物的见解,以进行准确的诊断和管理。这篇综述强调了专家指导在提高患者预后和实现过敏性发作自我管理方面的重要性。
Anaphylaxis is an acute, potentially fatal, systemic hypersensitivity reaction that warrants prompt diagnosis and management. It continues to be challenging to anticipate who may be at risk of a severe, life-threatening allergic reaction.
Anaphylaxis can be caused by a range of allergens, such as certain foods, medications, latex, insect stings, etc. Cofactors that augment the severity of clinical symptoms and increase the risk of poor outcomes include exercise, stress, infectious diseases, underlying mast cell disease, active allergic disease such as asthma, advanced age, intake of certain medications, history of previous anaphylaxis, and delayed or missed administration of adrenaline. According to the European
Anaphylaxis Registry, food is the major elicitor of
anaphylaxis, especially eggs, cow milk, and nuts, in children and adolescents. Reaction to insect venom has also been noted in young adulthood. Early recognition of signs and symptoms and prompt treatment are crucial in
anaphylaxis management to avoid serious and even fatal outcomes. It is crucial for both individuals and clinicians to identify the cause of
anaphylaxis. Biomarkers of anaphylaxis, such as histamine, tryptase, platelet activation factor (PAF), chymase, carboxypeptidase A3, dipeptidyl peptidase I (DPPI), basogranulin, CCL-2, hsa-miR-451a, may be useful in diagnosis and management. The purpose of this review article is to present a comprehensive overview of current evidence and expert opinions regarding the risk factors that predispose individuals to anaphylaxis. Additionally, it provides insights into potential biomarkers and genetic markers for accurate diagnosis and management. This review underscores the significance of expert guidance in enhancing patient outcomes and enabling self-management of anaphylactic episodes.