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Table 10 International research agenda for anaphylaxis 1,2

From: International consensus on (ICON) anaphylaxis

Epidemiology, Patient Risk Factors, Mechanisms, Triggers, and Diagnosis
Epidemiology of anaphylaxis
Prospective studies of:
  - global incidence and prevalence of anaphylaxis in general populations in different countries, in order to obtain reliable population estimates; ideally, concurrent studies will be performed
  - anaphylaxis from all triggers, and from specific triggers including foods, stinging insect and other venoms, drugs, etc.
  - anaphylaxis in different populations: infants, children, teenagers, pregnant women, the elderly, and patients with co-morbidities such as asthma, cardiovascular disease, and mast cell activation disorders
  - the natural history of anaphylaxis based on well-designed longitudinal population-based investigations
Patient risk factors for anaphylaxis
Genotypes, phenotypes and endotypes of patients with anaphylaxis
Development of instruments to quantify patient-specific risk factors, ascertain their relative importance, and predict future anaphylactic episodes
Biologic markers for identification of patients at risk
Prospective studies of the relationship between food-induced anaphylaxis and asthma, in order to ascertain the relationship of anaphylaxis severity and asthma control
Prospective studies of the relationship between food, insect venom, and drug-induced anaphylaxis and cardiovascular disease
Prospective studies of the relationship between anaphylaxis and mast cell activation disorders
Prospective studies of idiopathic anaphylaxis in patients of all ages
Anaphylaxis mechanisms
Further elucidation of mechanisms underlying anaphylaxis, including studies to improve understanding of molecular mechanisms
Studies of IgG-mediated anaphylaxis in humans
Additional studies of agents that can induce anaphylaxis through more than one mechanism, eg. radiocontrast media, biological agents such as infliximab, etc.
Further elucidation of the role of amplifying co-factors in anaphylaxis
Triggers (causes, elicitors, inducers) of anaphylaxis
Prospective studies of trends in triggers, to identify those that are becoming more (or less) common in different patient populations and in different global regions
Additional investigations of food cross-reactivities
Improved methods to detect hidden food allergens
Improved tests to confirm sensitization to anaphylaxis triggers that are uncommon in many countries, but relatively common in others; for example:
  - foods such as buckwheat, silkworm pupa, bird's nest soup, chickpea, flour mites, maize, manioc
  - stings and bites, eg. ants, caterpillars, jellyfish, lizards, scorpions, snakes
Diagnosis of anaphylaxis
Development of operationalized clinical criteria for the diagnosis of anaphylaxis
Validation of these operationalized clinical criteria for use in additional healthcare settings, in community settings, and in different countries
Development and validation of an algorithm for diagnosing anaphylaxis based on clinical criteria
Identification of additional biologic markers for identification of anaphylaxis
Further development of tests for biologic markers that might be useful for confirming the diagnosis of anaphylaxis at the time the patient presents
Development of protocols and algorithms to improve post-mortem identification of anaphylaxis as a cause of death
  1. 1Basic, clinical and applied sciences.
  2. 2This Table extends and amplifies the agendas for anaphylaxis research published independently by WAO and by EAACI.