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Phenotypes, endotypes and biomarkers in anaphylaxis

current insights

Sala-Cunill, Annaa,b,c; Guilarte, Mara,b,c; Cardona, Victoriaa,b,c

Current Opinion in Allergy and Clinical Immunology: October 2018 - Volume 18 - Issue 5 - p 370–376
doi: 10.1097/ACI.0000000000000472
ANAPHYLAXIS AND INSECT ALLERGY: Edited by Gianenrico Senna and Mariana Castells

Purpose of review The aim of the review is to describe the different clinical pictures of anaphylaxis (phenotypes), in relation to the underlying mechanisms and potential biomarkers, to describe anaphylaxis endotypes. This may aid in achieving a better understanding, management and outcomes of such severe reactions.

Recent findings Different anaphylaxis phenotypes have been outlined, ranging from the classical type-I-like to those suggestive of cytokine-storm-like or complement-mediated reactions. Underlying mechanisms differ and biomarkers of cells and systems involved are being identified (tryptase, IL-6, bradykinin etc.)

Summary Identifying specific phenotypes/endotypes will allow the application of precision medicine in patients with anaphylaxis, providing insights to the most appropriate approach in each case.

aAllergy Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron

bAllergy Research Unit, Vall d’Hebron Research Institute (VHIR), Barcelona

cARADyAL Research Network, Madrid, Spain

Correspondence to Mar Guilarte, Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Ps. Vall d’Hebron 119-129, 08035 Barcelona, Spain. Tel: +34 932746169; e-mail: mguilarte@vhebron.net

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