Anaphylaxis in the 21st century: phenotypes, endotypes, and biomarkers

• Published in: Journal of asthma and allergy Vol. 11; pp. 121 - 142
• Main Authors: Jimenez-Rodriguez, Teodorikez, Garcia-Neuer, Marlene, Alenazy, Leila A, Castells, Mariana
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Adrenergic agonists; Allergy; Anaphylaxis; Antigens; Aspirin; Asthma; Autoimmune progesterone dermatitis; B cells; Biological markers; Biomarkers; Blood platelets; Blood pressure; Cytokines; Dermatitis; Diagnosis; Diagnostic errors; Epinephrine; Food allergies; Genetic aspects; Health aspects; Health care industry; Health care reform; Hives (Disease); Hypersensitivity; Hypersensitivity reactions; Icatibant; Immunoglobulins; Immunology; Medical diagnosis; Medicine; Morbidity; Pathogenesis; Phenotypes; Precision medicine; Progesterone; Quality of life; Respiratory diseases; Review; Sex hormones; Task forces; Tryptase; Tumor necrosis factor-TNF; Urticaria; Spain; precision medicine; anaphylaxis; epinephrine; autoimmune progesterone dermatitis; tryptase; hypersensitivity reactions
• ISSN: 1178-6965; 1178-6965
• DOI: 10.2147/JAA.S159411

Anaphylaxis is the most serious of all allergic reactions and can be fatal. The diagnosis is frequently delayed, and misdiagnosis often occurs with asthma or urticaria. Biomarkers such as tryptase are not routinely checked, and appropriate treatment with epinephrine is not administered in a majority of cases, increasing the risk of poor outcomes. The objective of this review is to provide a better understanding of the pathophysiology of anaphylaxis with a description of phenotypes, endotypes, and biomarkers available in both the clinical and research settings. Expanding knowledge with regard to the presentation, causes, and triggers for anaphylaxis among health care providers will improve its diagnosis and management, increase patient safety, and decrease morbidity and mortality.