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Allergy. 2015 Oct;70(10):1212-21. doi: 10.1111/all.12677. Epub 2015 Jul 8.

Pathophysiological mechanisms of exercise-induced anaphylaxis: an EAACI position statement.

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Faculty of Health & Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
Department of Public Health and Infectious Diseases, 'Sapienza University', Rome, Italy.
Serviço de Imunoalergologia, Centro Hospitalar São João and Immunology Laboratory, Faculty of Medicine, University of Porto, Porto, Portugal.
Department of Medical Sciences 'M. Aresu', University of Cagliari, Cagliari, Italy.
Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK.
National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation.
Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland.
Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.


This document is the result of a consensus on the mechanisms of exercise-induced anaphylaxis (EIAn), an unpredictable and potentially fatal syndrome. A multidisciplinary panel of experts including exercise physiologists, allergists, lung physicians, paediatricians and a biostatistician reached the given consensus. Exercise-induced anaphylaxis (EIAn) describes a rare and potentially fatal syndrome in which anaphylaxis occurs in conjunction with exercise. The pathophysiological mechanisms underlying EIAn have not yet been elucidated although a number of hypotheses have been proposed. This review evaluates the validity of each of the popular theories in relation to exercise physiology and immunology. On the basis of this evidence, it is concluded that proposed mechanisms lack validity, and it is recommended that a global research network is developed with a common approach to the diagnosis and treatment of EIAn in order to gain sufficient power for scientific evaluation.


allergy; anaphylaxis; exercise; immunology; physiology

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