In the past 10 years, anaphylaxis has grown into its own special area of study within Allergy-Immunology, both at the bench and at the bedside. This review focuses on some of the most clinically relevant advances over the past decade. These include simplified and more inclusive diagnostic criteria for adults and children, uniform definition of biphasic anaphylaxis, and improved systems for objective severity grading. Studies reported in the past decade have led to improved understanding of normal and abnormal regulation of mast cell function, translating into better diagnostic and therapeutic approaches to patients with anaphylaxis. Research has provided improved recognition and treatment of mast cell disorders and has identified a new condition, hereditary α-tryptasemia, that may impact anaphylactic syndromes. We have learned to recognize new causes (α-gal), new pathways (Mas-related G protein–coupled receptor-X2), and many risk factors for severe anaphylaxis. The stability of epinephrine in autoinjectors was reported to be very good for several years after the labeled expiry date, and it can tolerate freezing and thawing. Repeated and prolonged exposure to excessive heat leads to degradation of epinephrine activity. New treatments to prevent severe anaphylaxis have been described, using new ways to block the IgE receptor or modulate intracellular signaling pathways.

在过去的 10 年里，过敏反应已经发展成为过敏免疫学中自己的特殊研究领域，无论是在实验室还是在床边。本综述侧重于过去十年中一些与临床最相关的进展。其中包括针对成人和儿童的简化且更具包容性的诊断标准、双相过敏反应的统一定义以及改进的客观严重程度分级系统。过去十年报道的研究提高了对肥大细胞功能正常和异常调节的理解，转化为对过敏反应患者更好的诊断和治疗方法。研究改进了对肥大细胞疾病的认识和治疗，并确定了一种新病症，即遗传性 α-类胰蛋白酶血症，它可能会影响过敏性综合征。我们已经学会识别新原因 (α-gal)、新途径（Mas 相关 G 蛋白偶联受体-X2）和许多严重过敏反应的危险因素。据报道，自动注射器中肾上腺素的稳定性在标明有效期后的几年内都非常好，并且可以耐受冷冻和解冻。反复和长时间暴露在过热环境中会导致肾上腺素活性下降。已经描述了防止严重过敏反应的新疗法，使用新方法来阻断 IgE 受体或调节细胞内信号通路。反复和长时间暴露在过热环境中会导致肾上腺素活性下降。已经描述了防止严重过敏反应的新疗法，使用新方法来阻断 IgE 受体或调节细胞内信号通路。反复和长时间暴露在过热环境中会导致肾上腺素活性下降。已经描述了防止严重过敏反应的新疗法，使用新方法来阻断 IgE 受体或调节细胞内信号通路。