Classification and management of hypersensitivity reactions
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20222971Keywords:
Hypersensitive, Reaction, Allergen, ImmunoglobulinAbstract
An inappropriate or excessive immune response to an antigen that has unfavourable effects is referred as a hypersensitivity reaction. People who have experienced at least one prior exposure to the antigen are more likely to have the symptoms. Nearly 60 years ago, Gell and Coombs first classified hypersensitivity reactions into four broad categories. Many forms of hypersensitivity reactions frequently occur at the same time, especially in allergic disorders. The purpose of this research is to review the available information about the classification and management of hypersensitivity reactions. Allergen-specific immunoglobulin E, which is associated with the high-affinity receptors of basophils and mast cells mediates type 1 hypersensitivity reactions. These receptors are cross-linked by allergens, which release mediators that elicit urticaria, angioedema, and anaphylaxis. Immunoglobulin G and immunoglobulin M attach to self-antigens on cell surfaces in type II reactions, which can lead to phagocytosis, and cytotoxicity that is complement-directed and antibody-dependent all of which can lead to tissue damage. Immune complexes of immunoglobulin G and immunoglobulin M with antigens, which deposit in tissues and directly harm organs, mediate type III reactions. T cells mediate type IV reactions which are delayed responses. In every case of allergic hypersensitivity, the trigger must be stopped right away. Antihistamines, glucocorticoids, and epinephrine are used to treat acute responses Some potential management techniques include drug allergy testing, graded challenges, desensitization, and/or choosing an alternative, non-cross-reactive substance. Further clinical research is however needed for the elaborated study of hypersensitive reactions and development of preventive strategies.
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References
Warrington R, Watson W, Kim HL, Antonetti FR. An introduction to immunology and immunopathology. Allergy Asthma, Clin Immunol. 2011;7(1):S1.
Dispenza MC. Classification of hypersensitivity reactions. Allergy Asthma Proceedings. 2019;40(6):470-3.
Murphy KM WC. Janeway’s immunobiology. 9th ed. New York: Garland Science, Taylor and Francis. 2017.
Schnyder B, Brockow K. Pathogenesis of drug allergy--current concepts and recent insights. Clin Exp Allergy. 2015;45(9):1376-83.
Posadas SJ, Pichler WJ. Delayed drug hypersensitivity reactions-new concepts. Clin Experimental Aller. 2007;37(7):989-9.
Tedner SG, Asarnoj A, Thulin H, Westman M, Konradsen JR, Nilsson C. Food allergy and hypersensitivity reactions in children and adults-A review. J Internal Med. 2022;291(3):283-302.
Justiz Vaillant AA VR, Zito PM. Immediate Hypersensitivity Reactions. StatPearls Treasure Island (FL): StatPearls Publishing. 2022.
Böhm R, Proksch E, Schwarz T, Cascorbi I. Drug Hypersensitivity. Deutsches Arzteblatt Int. 2018;115(29-30):501-12.
Bongrand P. Immunological bases and classification of allergy. Arch Pediatr. 1999;6(1):20s-28s.
Sheldon J, Wheeler RD, Riches PG. CHAPTER 30 - Immunology for clinical biochemists. In: Marshall WJ, Lapsley M, Day AP, Ayling RM, eds. Clinical Biochemistry: Metabolic and Clinical Aspects (Third Edition). Churchill Livingstone. 2014;560-603.
Lieberman P, Nicklas RA, Randolph C. Anaphylaxis--a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341-84.
Holsapple MP, Kaminski NE. Immune System. In: Wexler P, ed. Encyclopedia of Toxicology (Second Edition). New York: Elsevier. 2005;573-96.
Salmon JE. 46 - Mechanisms of Immune-Mediated Tissue Injury. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine (Twenty Fourth Edition). Philadelphia: W.B. Saunders. 2012;226-30.
King TC. 2 - Inflammation, Inflammatory Mediators, and Immune-Mediated Disease. In: King TC, ed. Elsevier's Integrated Pathology. Philadelphia: Mosby. 2007;21-57.
Fierer J, Looney D, Pechère J-C. 2 - Nature and Pathogenicity of Micro-organisms. In: Cohen J, Powderly WG, Opal SM, eds. Infectious Diseases (Fourth Edition). Elsevier. 2017;4-25.e21.
Dykewicz MS, Lam JK. Drug Hypersensitivity Reactions. Med Clin N Am. 2020;104(1):109-28.
Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug hypersensitivity reactions. J Allergy Clin Immunol. 2011;127(3):S67-73.
Tham EH, Cheng YK, Tay MH, Alcasabas AP, Shek LP. Evaluation and management of hypersensitivity reactions to chemotherapy agents. Postgraduate Med J. 2015;91(1073):145-50.
Lee C, Gianos M, Klaustermeyer WB. Diagnosis and management of hypersensitivity reactions related to common cancer chemotherapy agents. Ann Allergy Asthma Immunol. 2009;102(3):179-87.
Picard M, Galvão VR. Current Knowledge and Management of Hypersensitivity Reactions to Monoclonal Antibodies. J Allergy Clin Immunol Practice. 2017;5(3):600-9.
Castells M. Rapid desensitization of hypersensitivity reactions to chemotherapy agents. Curr Drug Safety. 2006;1(3):243-51.
Tham EH, Cheng YK, Tay MH, Alcasabas AP, Shek LPC. Evaluation and management of hypersensitivity reactions to chemotherapy agents. Postgraduate Med J. 2015;91(1073):145-50.