Recognize the signs of anaphylaxis (type I hypersensitivity) and know how to treat it aggressively
Yolanda Lewis-Ragland MD
What to Do – Interpret the Data, Make a Decision, Take Action
Anaphylaxis is an acute, multisystem, and severe allergic reaction, known also as type I hypersensitivity reaction. The term comes from the Greek words ana (again) and phylaxis (protection). Anaphylaxis occurs when a person is exposed to a trigger substance, called an allergen, to which they are sensitized. Re-exposure to the trigger substance intensifies what is normally a protective immune response and it become detrimental.
Classification
Gell and Coombs classified hypersensitivity reactions into four types:
Type I reactions (i.e., immediate hypersensitivity reactions) involve immunoglobulin (Ig) E-mediated release of histamine and other mediators from mast cells and basophils.
Type II reactions (i.e., cytotoxic hypersensitivity reactions) involve IgG or IgM antibodies bound to cell surface antigens, with subsequent complement fixation.
Type III reactions (i.e., immune-complex reactions) involve circulating antigen-antibody immune complexes that deposit in postcapillary venules, with subsequent complement fixation.
Type IV reactions (i.e., delayed hypersensitivity reactions, cell-mediated immunity) are mediated by T cells rather than by antibodies.
Type I Hypersensitivity
Type I hypersensitivity reactions are extremely important to recognize and treat because their reactions are immediate; abrupt in onset, usually occurring within 15 to 30 minutes from the time of exposure; and potentially life threatening. This “immediate” reaction assists with the identification of the triggering antigen. Anaphylaxis is related to the action of IgE and other anaphylatoxins, which act to release histamine and other mediators from mast cells during degranulation. Histamine has a number of effects, including the vasodilation of arterioles and constriction of bronchioles in the lungs.