Immune-mediated hypersensitivity

NMBAs Immune-Mediated Hypersensitivity Reactions Are Predominant... 

Most anaphylactoid reactions are due to a direct or chemical release of histamine, and other mediators, from mast cells and basophils. Immune-mediated hypersensitivity reactions have been classified as types I-IV. Type I, involving IgE or IgG antibodies, is the main mechanism involved in most anaphylactic or immediate hypersensitivity reactions to anaesthetic drugs. Type II, also known as antibody-dependent hypersensitivity or cytotoxic reactions are, for example, responsible for ABO-incompatible blood transfusion reactions. Type III, immune complex reactions, include classic serum sickness. Type IV, cellular responses mediated by sensitised lymphocytes, may account for as much as 80% of allergic reactions to local anaesthetic. 

Hypersensitivity reactions due to drug treatments are a major cause for concern as these reactions are common and can be life-threatening. To date, with the noticeable exception of contact sensitivity, available animal models or assays are not reliable to predict the potential for a drug candidate to induce hypersensitivity reactions in human beings (Choquet-Kastyle vski and Descotes, 1998 Bala et al, 2005). In addition to the fact that immune-mediated hypersensitivity reactions have long and erroneously been considered not to be reproducible in animals, major hurdles are the current lack of understanding... 

---