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Anaphylaxis: Opportunities of stratified medicine for diagnosis and risk assessment

机译：过敏反应：用于诊断和风险评估的分层药物的机会

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摘要

The risk to develop anaphylaxis depends on the sensitization pattern, the proportion of the involved immunoglobulin classes, the avidity and affinity of immunoglobulins to bind an allergen, characteristics of the allergen, the route of allergen application, and, last but not least, the presence of cofactors of anaphylaxis. To be able to calculate the risk to develop anaphylaxis and to anticipate the severity of the reactions under certain conditions, it is necessary to understand how all these factors interact with each other. Important progress for risk assessment in anaphylaxis is based on component-resolved stratified diagnostics, which allow to (i) determine a patient′s sensitization pattern on a molecular basis, (ii) correlate clinical responses to defined sensitization patterns, and (iii) better identify cross-reactive allergens. Together with the increasing knowledge regarding the role and mode of action of cofactors of anaphylaxis, these data pave the way to unscramble the complex interactions determining the clinical relevance of sensitizations, the risk of anaphylaxis, and the severity of reactions. As a consequence, this understanding allows to better determine the individual risk in response to an identified allergen and results in more specific advices and education for our patients to prevent further life-threatening anaphylactic reactions.
机译：发生过敏反应的风险取决于敏化模式，涉及的免疫球蛋白类别的比例，免疫球蛋白与过敏原结合的亲和力和亲和力，过敏原的特性，过敏原的应用途径以及最后但并非最不重要的过敏的辅助因子。为了能够计算出发生过敏反应的风险并预测某些条件下反应的严重性，有必要了解所有这些因素如何相互作用。过敏性风险评估的重要进展基于组件分解的分层诊断，该诊断可（i）在分子基础上确定患者的敏化模式，（ii）将临床反应与已定义的敏化模式相关联，并且（iii）识别交叉反应的过敏原。连同对过敏反应辅助因子的作用和作用方式的认识不断增加，这些数据为解读复杂的相互作用铺平了道路，这些相互作用决定了致敏作用的临床相关性，过敏反应的风险和反应的严重性。因此，这种理解可以更好地确定对已识别的过敏原的个体风险，并为我们的患者提供更具体的建议和教育，以防止进一步威胁生命的过敏反应。

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