Studies on anaphylactic shock with special reference to the extravasation of plasma protein and its distribution in the body

Abstract

The clinical feature of anaphylactic shock in any species appeared to be superimposed by two types of biological responses, namely, allergic on one hand and shock reaction on the other hand. The major immediate allergic responses are consisted of contraction of smooth muscles, dilatation and increased permeadility of blood vessels. However, patterns of allergic responses are widely different in each species which may characterize the clinical feature of anaphylaxis substantially. For example, acute emphysema with asphyxia due to contraction of smooth muscle of bronchioli is the prominent picture of anaphylactic shock in guinea pigs. Torii et al emphasized that the acute phase of anaphylaxis is very similar to the primary shock in terms of the circulatory dynamics. If animals could survive at this stage through a defence mechanism mainly of sympathicoadrenal system, they may undergo eventually the secondary shock. The delayed phase of anaphylactic shock was reported to be similar to the secondary shock with respect to circulatory dynamics (Torii et al). The extravasation of plasma albumin appeared to characterize the pathophysiological feature of delayed phase of anaphylactic shock. Furthermore, sccording to the author's studies, the extravasation of plasma albumin appeared to be a crucial factor for the prognosis of the further course of the anaphylactic shock. The emergency therapy should be directed not only to overcome the primary shock but to prevent the secondary shock or delayed anaphylaxis at the same time. In this respect both antihistamin and antiinflammatory steroids are very important for the emergency therapy of anaphylaxis.