The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis published in early 2011 provide a global perspective on patient risk factors, triggers, clinical diagnosis, treatment, and prevention of anaphylaxis. In this 2012 Update, subsequently published, clinically relevant research in these areas is reviewed.
Patient risk factors and co-factors that amplify anaphylaxis have been documented in prospective studies. The global perspective on the triggers of anaphylaxis has expanded. The clinical criteria for the diagnosis of anaphylaxis that are promulgated in the Guidelines have been validated. Some aspects of anaphylaxis treatment have been prospectively studied. Novel investigations of self-injectable epinephrine for treatment of anaphylaxis recurrences in the community have been performed. Progress has been made with regard to measurement of specific IgE to allergen components (component-resolved testing) that might help to distinguish clinical risk of future anaphylactic episodes to an allergen from asymptomatic sensitization to the allergen. New strategies for immune modulation to prevent food-induced anaphylaxis and new insights into subcutaneous immunotherapy to prevent venom-induced anaphylaxis have been described.
Research highlighted in this Update strengthens the evidence-based recommendations for assessment, management, and prevention of anaphylaxis made in the WAO Anaphylaxis Guidelines.
aDepartment of Pediatrics & Child Health and Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, Canada
bCátedra NeumonologĂa, Alergia e InmunologĂa, Facultad de Ciencias MĂ©dicas, Universidad Nacional de Rosario, Rosario, Argentina
cDepartment of Allergy, Immunology and Respiratory Diseases, University Hospital, Ancona, Italy
dSection of Allergy, Asthma and Immunology, Department of Pediatrics and Medicine, University of Chicago, Chicago, Illinois, USA
eDepartment of Allergy, National Hospital Organization, Sagamihara National Hospital, Clinical Research Center for Allergy & Rheumatology, Kanagawa, Japan
fPediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
gUniversity of South Florida Morsani College of Medicine, Tampa, Florida, USA
hDepartment of Dermatology and Allergy, Tech. Universitat Muenchen, Munich, Germany
iCentro Medico Docente La Trinidad, Caracas, Clinica El Avila, Caracas, Venezuela
jThe Allergy Unit, Verona General Hospital, Verona, Italy
kCenter for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
lDepartment of Rheumatology, Allergy & Immunology, Tan Tock Seng Hospital, Singapore
mAllergie-Centrum-Charité, Klinik fur Dermatologie und Allergologie, Charité, Universitatsmedizin, Berlin, Germany
Correspondence to Professor F. Estelle R. Simons, Room FE125, 820 Sherbrook Street, Winnipeg, Manitoba, Canada, R3A 1R9. Tel: +1 204 787 2537; fax: +1 204 787 5040; e-mail: lmcniven@hsc.mb.ca
