Tip 1 allerjik reaksiyonların klinik görünümleri

Atopik veya anafilaktik tip olarak da adlandırılan Tip I allerjik reaksiyonları; Ig E aracılı acil hipersensitivite reaksiyonlarıdır. Alerjen olarak adlandırılan belirli bir antijene yutma, solunum, enjeksiyon veya doğrudan temas ile tekrar maruz kalınmasıyla tetiklenen reaksiyonlardır. IgE antikorları, histamin granülleri içeren mast hücrelerine ve bazofillere bağlanır. Aynı alerjene daha sonra maruz kalmak, bağlı IgE'nin degranülasyona yol açmasına ve histamin, lökotrien, prostaglandinler gibi mediatörlerin salgılanmasına neden olur. Reaksiyon lokal veya sistemik şekilde görülebilir. Tip I aşırı duyarlılık reaksiyonları sonucu oluşan klinik tablolar; ürtiker, anjiyoödem, anafilaksi,atopik egzema, anafilaksi, besin ve ilaç allerjileri, allerjik astım, allerjik rinit ve allerjik konjonktivit şeklinde gruplandırılır. Bu derlemenin amacı günlük dermatoloji pratiğinde sık ve nadir karşılaşığımız tüm tip 1 allerjik reaksiyonların klinik görünümlerini gözden geçirmek ve bu hastalıkların oluş mekanizmasıyla klinikleri arası bağlantı kurmak hedeflenmiştir.

Anahtar Kelimeler:

Tip 1, allerjik

Clinical manifestations of Type 1 allergic reactions

Abstract Type I allergic reactions, also called atopic or anaphylactic type are IgE-mediated emergency hypersensitivity reactions. These are reactions triggered by re-exposure to a specific antigen called an allergen by ingestion, inhalation, injection or direct contact. IgE antibodies bind to mast cells and basophils containing histamine granules. Subsequent exposure to the same allergen leads to degranulation of the bound IgE and secretion of mediators such as histamine, leukotriene, prostaglandins. The reaction can be seen locally or systemically. Clinical manifestations of type I hypersensitivity reactions; urticaria, angioedema, anaphylaxis, atopic eczema, anaphylaxis, food and drug allergy, allergic asthma, allergic rhinitis and allergic conjunctivitis are grouped. The aim of this review is to review the clinical manifestations of all type 1 allergic reactions that are common and rare in daily dermatology practice, and to establish a connection between these mechanisms and the clinics.

Keywords:

Type 1, allergic,

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1. Son JH, Park SY, Cho YS, Chung BY, Kim HO, Park CW. Immediate Hypersensitivity Reactions Induced by Triamcinolone in a Patient with Atopic Dermatitis. J. Korean Med. Sci. 2018;33(12):e87
2. Justiz Vaillant AA, Zito PM.Immediate Hypersensitivity Reactions. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.2019 Feb 19.
3. Simon D.Recent Advances in Clinical Allergy and Immunology. Int Arch Allergy Immunol 2018;177:324–333.
4. Fernandez J, Doña I.Diagnosing and managing patients with drug hypersensitivity. Expert Rev Clin Immunol. 2018 Jan;14(1):29-41.
5. Böhm R1, Proksch E, Schwarz T, Cascorbi I.Drug Hypersensitivity.Dtsch Arztebl Int. 2018 Jul 23;115(29-30):501-512. doi: 10.3238/arztebl.2018.0501.
6. Warrington R, Silviu-Dan F, Wong T.Drug allergy.Allergy Asthma Clin Immunol. 2018 Sep 12;14(Suppl 2):60.
7. Nasr IH, Wahshi HA.Food Intolerance versus Food Allergy.J Integr Food Sci Nutr 2017:1:1-3.
8. Kim EH, Burks W.Immunological basis of food allergy (IgE-mediated, non-IgE-mediated, and tolerance).Chem Immunol Allergy. 2015;101:8-17. doi: 10.1159/000371646.
9. Stukus DR, Mikhail I.Pearls and Pitfalls in Diagnosing IgE-Mediated Food Allergy.Curr Allergy Asthma Rep. 2016 May;16(5):34. doi: 10.1007/s11882-016-0611-z.
10. Sampson HA, Aceves S, Bock SA, et al. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol 2014; 134:1016.
11. Foong RX, Giovannini M, du Toit G. Food-dependent exercise-induced anaphylaxis.Curr Opin Allergy Clin Immunol. 2019 Jun;19(3):224-228.
12. Jawairia M1, Shahzad G, Mustacchia P. Eosinophilic gastrointestinal diseases: review and update.ISRN Gastroenterol. 2012;2012:463689.
13. Antia C, Baquerizo K, Korman A, Bernstein JA, Alikhan A.Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up.J Am Acad Dermatol. 2018;79(4):599-614.
14. Radonjic-Hoesli S1, Hofmeier KS2, Micaletto S3, Schmid-Grendelmeier P3, Bircher A2, Simon D4.Urticaria and Angioedema: an Update on Classification and Pathogenesis.Clin Rev Allergy Immunol. 2018;54(1):88-101.
15. Kanani A, Betschel SD, Warrington R.Urticaria and angioedema.Allergy Asthma Clin Immunol.2018 Sep 12;14(Suppl 2):59.
16. Aalto-Korte K1.When should the diagnosis 'contact urticaria' be used ?Contact Dermatitis. 2017 Nov;77(5):323-324. doi: 10.1111/cod.12884. Epub 2017 Sep 21.
17. Ana Rita Rodrigues Barata1 and Luis Conde-Salazar. Protein contact dermatitis - Case report.An Bras Dermatol 2013 Jul-Aug; 88(4): 611–613.
18. Price A, Ramachandran S, Smith GP, Stevenson ML, Pomeranz MK, Cohen DE.Oral allergy syndrome (pollen-food allergy syndrome).Dermatitis. 2015;26(2):78-88.
19. Busse PJ1, Smith T.Histaminergic Angioedema. Immunol Allergy Clin North Am 2017;37(3):467-481.
20. Fischer D1, Vander Leek TK2, Ellis AK3, Kim H. Anaphylaxis.Allergy Asthma Clin Immunol. 2018 Sep 12;14(Suppl 2):54.
21. Golden DB, Demain J, Freeman T, Graft D, et al.Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol. 2017 Jan;118(1):28-54.
22. Hill DA, Spergel JM. The atopic march: Critical evidence and clinical relevance. Ann Allergy Asthma Immunol 2018; 120:131.
23. Kusari A, Han AM, Schairer D, Eichenfield LF.Atopic Dermatitis: New Developments.Dermatol Clin. 2019 Jan;37(1):11-20.
24. Mastrorilli C, Caffarelli C, Hoffmann-Sommergruber K.Food allergy and atopic dermatitis: Prediction, progression, and prevention. Pediatr Allergy Immunol. 2017 Dec;28(8):831-840.
25. Roerdink EM, Flokstra-de Blok BM, Blok JL, et al. Association of food allergy and atopic dermatitis exacerbations. Ann Allergy Asthma Immunol 2016; 116:334.
26. Ćosićkić A, Skokić F, Selimović A, et al. Development of Respiratory Allergies, Asthma and Allergic Rhinits in Children with Atopic Dermatitis.Acta Clin Croat. 2017 Jun;56(2):308-317.
27. Small P, Keith PK, Kim H.Allergic rhinitis. Allergy Asthma Clin Immunol. 2018 Sep 12;14(Suppl 2):51. doi: 10.1186/s13223-018-0280-7.
28. Sacchetti M, Abicca I, Bruscolini A, Cavaliere C, Nebbioso M, Lambiase A.Allergic conjunctivitis: current concepts on pathogenesis and management. J Biol Regul Homeost Agents 2018;32(1 Suppl. 1):49-60.
29. Schatz M1, Rosenwasser L2.The allergic asthma phenotype.J Allergy Clin Immunol Pract 2014 Nov-Dec;2(6):645-8; quiz 649.