Seminars in Immunopathology

, Volume 34, Issue 5, pp 643–653

Food-induced anaphylaxis: mast cells as modulators of anaphylactic severity

  • Simon P. Hogan
  • Yui Hsi Wang
  • Richard Strait
  • Fred D. Finkelman
Review

DOI: 10.1007/s00281-012-0320-1

Cite this article as:
Hogan, S.P., Wang, Y.H., Strait, R. et al. Semin Immunopathol (2012) 34: 643. doi:10.1007/s00281-012-0320-1

Abstract

A food-induced anaphylactic reaction can occur within seconds to a few hours following exposure to the causal food allergen and often affects multiple organ systems including gastrointestinal, cutaneous, respiratory, and cardiovascular. A conundrum in the allergy field is that consumption of the same allergen can cause reactions of vastly different severity in separate individuals; one patient may experience a mild non-life-threatening reaction characterized by pruritis of lips or urticaria whereas another may experience a life-threatening reaction that involves respiratory and cardiovascular compromise leading to loss of consciousness and sometimes death. While there are tests available to determine the predictive risk value of a positive food challenge test or clinical reactivity, there is currently no reliable method to distinguish between individuals who are at risk of mild non-life-threatening versus life-threatening reaction. Recent research has significantly advanced our understanding of the involvement of immune pathways in the effector phase of food-induced anaphylaxis; a void remains regarding our understanding of the contribution of these pathways to severity of disease. In this review, we discuss mild non-life-threatening versus life-threatening food-induced anaphylaxis and factors (co-morbidities and immune activation) that predispose individuals to more severe disease. Furthermore, we summarize recent advancements in our understanding of the involvement of underlying immune pathways in systemic and food-induced anaphylaxis in mouse systems and discuss how these pathways may contribute to more severe disease phenotype.

Keywords

Mast cellsAnaphylaxisSystemicIntestinalMouse

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Simon P. Hogan
    • 1
    • 6
  • Yui Hsi Wang
    • 1
  • Richard Strait
    • 2
  • Fred D. Finkelman
    • 3
    • 4
    • 5
  1. 1.Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati College of MedicineCincinnatiUSA
  2. 2.Division of Emergency Medicine, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati College of MedicineCincinnatiUSA
  3. 3.Department of MedicineCincinnati Veterans Affairs Medical CenterCincinnatiUSA
  4. 4.Division of Allergy, Immunology and Rheumatology, Department of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA
  5. 5.Division of Molecular and Cellular Immunology, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati College of MedicineCincinnatiUSA
  6. 6.Division of Allergy and ImmunologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA