Abstract
Allergy Classic anaphylaxis is thought to depend on immunoglobulin E (IgE) engagement of Fc receptors on granulocytes, but allergen-specific IgE is not always present. To resolve this conundrum, Jonsson et al. studied samples from people who experienced anaphylaxis after anesthesia. Drug-specific IgG complexes could trigger neutrophils ex vivo, and anaphylactic subjects had increased neutrophil extracellular traps. Not all of the subjects had detectable antidrug IgE. Thus, alternative pathways may be at play, and knowledge of these pathways could aid the development of tests to reduce risks in anesthesia. Sci. Transl. Med. 11 , eaat1479 (2019).
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