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IgE and non-IgE-mediated pathways in anaphylaxis
Margitta Worm1, Kristijan Pazur2, Payam Morakabati2
1Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. margitta.worm@charite.de.
Seminars in Immunopathology
|August 13, 2025
Summary
Anaphylaxis, a severe allergic reaction, involves IgE-mediated and non-IgE-mediated pathways. Understanding these diverse mechanisms is key for diagnosis, treatment, and prevention of anaphylaxis.
Area of Science:
- Immunology
- Allergy Research
- Pathophysiology
Background:
- Anaphylaxis is a severe, life-threatening allergic reaction.
- It can be triggered by both immunoglobulin E (IgE)-mediated and non-IgE-mediated pathways.
- Current understanding of these diverse mechanisms is critical for clinical management.
Purpose of the Study:
- To review the current understanding of anaphylaxis pathomechanisms.
- To elucidate the roles of IgE-dependent and IgE-independent pathways.
- To highlight the importance of diverse pathway knowledge for clinical practice.
Main Methods:
- Literature review of anaphylaxis pathomechanisms.
- Detailed description of IgE-mediated pathways involving FcεRI.
- Explanation of non-IgE-mediated pathways, including MRGPRX2 activation and IgG immune complexes.
Main Results:
- The classic IgE pathway involves mast cell and basophil degranulation.
- Non-IgE pathways include MRGPRX2 activation (drug-induced reactions) and IgG immune complexes.
- These diverse mechanisms contribute to anaphylaxis onset and severity.
Conclusions:
- Diverse pathways contribute to anaphylaxis, necessitating a comprehensive understanding.
- Accurate diagnosis and effective treatment strategies depend on recognizing these varied mechanisms.
- Further research into non-IgE-mediated anaphylaxis is crucial for improved patient outcomes.
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