CHILDHOOD ANAPHYLAXIS: NEW DEVELOPMENTS IN DIAGNOSIS AND TREATMENT

CHILDHOOD_ANAPHYLAXIS_NEW_DEVELOPMENTS _IN_DIAGNOSIS_AND_TREATMENT_kapak

IMMUNOMODULATION AND NOVEL THERAPEUTIC APPROACHES

İlke Baş1 Hülya Ercan Sarıçoban2

1Ege University, Faculty of Medicine, Department of Pediatric Immunology and Allergic Diseases, İzmir, Türkiye
2Yeditepe University, Faculty of Medicine, Department of Pediatric Immunology and Allergic Diseases, İstanbul, Türkiye

Baş E, Ercan Sarıçoban H. Immunomodulation and Novel Therapeutic Approaches. In: Harmancı K, editor. Childhood Anaphylaxis: New Developments in Diagnosis and Treatment. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.297-310.

ABSTRACT

Anaphylaxis is a systemic hypersensitivity reaction with rapid onset that can be life-threatening. Although the primary mechanism is generally considered to be IgE-mediated degranulation of mast cells and basophils, it has been demonstrated that IgG-mediated and mast cell–independent pathways may also contribute to the process. This cascade triggers the release of inflammatory mediators such as histamine, prostaglandins, leukotrienes, and cytokines, resulting in a systemic response that affects multiple organ systems. The most rapid and effective intervention in its management is the administration of epinephrine. Intramuscular epinephrine auto-injectors, developed for this purpose, are life-saving. However, challenges associated with injection usage have brought alternative routes of administration into focus. Intranasal epinephrine formulations, which are not yet available in Turkey, have been approved by the FDA for use in children over 30 kg and adults.

Experimental studies have significantly contributed to a better understanding of the pathophysiology of anaphylaxis. Various immunomodulatory approaches are being investigated with the aim of controlling this life-threatening process and reducing the risk of anaphylaxis. Animal models and in vitro experiments are widely used in the evaluation of anaphylactic reactions. Novel therapeutic strategies are being developed targeting the pathways involved in mast cell and basophil activation, including cytokines, molecules, and receptors, as well as epigenetic mechanisms that regulate the release of mediators such as b-hexosaminidase, serotonin, and histamine. Innovations in immunomodulation and biological therapies hold promise for improving quality of life and reducing the incidence of anaphylaxis in affected patients. Scientific advances in this field lay the groundwork for the development of safer and more effective treatment options in the future. This article aims to summarize the latest scientific developments, provide guidance for clinical practice, and improve the management of anaphylaxis, particularly in pediatric patients.

Keywords: Anaphylaxis; Immunomodulation; Biological agent

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