What is
the mechanism of anaphylaxis? What is the difference between anaphylactic and
anaphylactoid reactions?
Anaphylaxis is an IgE-mediated allergic
reaction. Antigens crosslinking two molecules of IgE bound on a mast cell or a
basophil trigger degranulation of the cell with release of fac-tors such as
histamine, platelet-activating factor (PAF), eosinophil and neutrophil
chemotactic factors, vasodilating prostaglandins and leukotrienes, adenosine,
and serotonin. These factors in turn activate the complement and coagula-tion
cascades. They also have direct effects, the most relevant being systemic
arteriolar vasodilation, with an acute increase in vascular permeability and
bronchoconstriction.
Anaphylactoid reactions are clinically
indistinguishable from anaphylaxis. However, the mechanism of action differs in
that IgE is not involved. Anaphylactoid reactions are a result of direct
degranulation of mast cells and basophils with release of the same mediators as
in anaphylactic reactions.
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