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 |