Perioperative anaphylaxis is a severe condition but mortality is rare, mainly due to neuromuscular blocking agents and antibiotics. Pathophysiology of fatal cases is not completely known. Timely administration of adrenaline and fluid therapy are crucial but there is no consensus on the ideal algorithm to manage severe perioperative anaphylaxis.

Vancomycin has been linked with drug reaction with DRESS in HLA-A*32:01 expressing individuals and is associated with activation of drug-specific T lymphocytes. However, the metabolic processes than underpin drug-reactive T-cell activation are undefined. CD4+ and CD8+ vancomycin-specific T-cell clones (TCCs) generated from healthy donors and hypersensitive patients expressing HLA-A*32:01 undergo dose-dependent, drug-specific and HLA restricted glycolytic switching when activated with vancomycin. TCCs displayed ‘energetic’ cross-reactivity with teicoplanin, indicating the master switch for T-cell activation may be located upstream of metabolic signalling.

IgE-mediated sensitisation to egg is common in infants but the underlying mechanisms remain poorly understood. We identified different immunephenotypes between the infants who were IgE-egg sensitised and not-IgE-egg sensitised. Immunological profiles associated with egg sensitisation are detectable at 4–6 months-old and even at birth.

Ara h 2 structure determined in complex with human antibodies. Hypoallergen engineered for reduced IgE binding. Hypoallergen demonstrates reduced anaphylaxis in mice primed with peanut allergic serum.