Contemporary concepts of anaphylaxis pathogenesis
https://doi.org/10.23946/2500-0764-2026-11-2-28-37
Abstract
Anaphylaxis is an acute life-threatening condition characterized by rapid onset of systemic disturbances and a high risk of adverse outcomes. Classically, the pathogenesis of anaphylaxis has been attributed to IgE-mediated activation of mast cells and basophils with subsequent release of inflammatory mediators leading to vasodilation, increased vascular permeability, and bronchospasm. However, in recent years, a new understanding of the multifactorial nature of this syndrome has emerged, incorporating systemic, cellular, and molecular mechanisms that extend beyond the traditional allergological paradigm. The aim of this article is to provide a comprehensive review of contemporary concepts of anaphylaxis pathogenesis with an emphasis on the integration of immune, vascular, neurogenic, and metabolic mechanisms. The paper analyzes key pathophysiological pathways, including IgE- and non-IgE-mediated mast cell activation, complementand contact-dependent cascades, neuroimmune interactions, endothelial dysfunction, as well as the role of mitochondrial dysregulation and oxidative stress. Particular attention is given to the phenotypic heterogeneity of anaphylaxis and its association with the development of arterial hypotension, vascular leakage, and shock. The presented data substantiate the need to revise classical views on the pathogenesis of anaphylaxis and provide a foundation for further fundamental research and the development of targeted diagnostic and therapeutic approaches
About the Author
Yu. V. Bykov
Stavropol State Medical University
Russian Federation
Russian Federation
Dr. Yuri V. Bykov, Cand. Sci. (Medicine), Associate Professor of the Department of Anesthesiology and Intensive Care Medicine with a course of additional professional education
Mira St., 310, Stavropol, 355020
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For citations:
Bykov Yu.V. Contemporary concepts of anaphylaxis pathogenesis. Fundamental and Clinical Medicine. 2026;11(2):28-37. (In Russ.) https://doi.org/10.23946/2500-0764-2026-11-2-28-37
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