Mechanisms of the Immediate Allergic Reaction and Some Therapeutic Implications

Allergic disease in children is still thought of by many pediatricians solely from a clinical standpoint. Therapy under such circumstances remains empiric. Present knowledge of the mechanisms of the immediate allergic reaction is admittedly imperfect. Sufficient has been learned, however, to give what seems to be a rational explanation of the reaction and so to give a logical basis for certain forms of treatment.

Diagrammatic presentation usually makes a chain of events more easily understood. The schematic representation to be given here is a compilation of several which have been published previously together with some information not previously diagrammed.^1-3 It is in accord with and extends the concept of Boyd.^4a One should not view this diagram, however, as the complete and final explanation of the immediate allergic mechanism but rather, as MacKay⁵ pointed out a few years ago, as a template which we construct and then hold