Application of Precision Medicine to the Treatment of Anaphylaxis

Marina Labella; Marlene Garcia-Neuer; Mariana Castells


Curr Opin Allergy Clin Immunol. 2018;18(3):190-197. 

In This Article


Anaphylaxis is the most severe HSR and can lead to death. Classification based on phenotypes, endotypes and biomarkers allows for a better understanding of anaphylaxis presentation, mechanisms and mediators. Epinephrine is the first-line life-saving treatment for anaphylaxis and should not be delayed. Patients with first-line therapy-induced anaphylaxis are candidates for RDD increasing their quality of life and life expectancy. Postanaphylaxis assessment is mandatory for patients to learn to identify triggers, early symptoms and the indications and timing of epinephrine autoinjector use. It is important to recognize the psychological impact that anaphylaxis can trigger with long-lasting sequelae. Desensitization is a breakthrough novel treatment for patients with anaphylaxis in need of first-line therapy, including chemotherapy, mAbs, aspirin and others. Ultrarush with venom immunotherapy should be considered in patients who present with life-threatening anaphylaxis after Hymenoptera sting with evidence of IgE-mediated mechanism. Food desensitization is currently being expanded to provide increased safety for adults and children with food-induced anaphylaxis.