Edited by: Thomas Bieber
Anaphylaxis: opportunities of stratified medicine for diagnosis and risk assessment
Article first published online: 22 NOV 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 68, Issue 12, pages 1499–1508, December 2013
How to Cite
Anaphylaxis: opportunities of stratified medicine for diagnosis and risk assessment. Allergy 2013; 68: 1499–1508., .
- Issue published online: 5 DEC 2013
- Article first published online: 22 NOV 2013
- Manuscript Accepted: 11 OCT 2013
- augmentation factor;
- component-resolved diagnostics;
- personalized medicine
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.