Ed-ucation: Immunology in an Eggshell

What is an Allergic Reaction?

An allergic reaction occurs when the body responds to a foreign object that does not pose a direct threat out of proportion. The trigger could be basically anything! Frequently encountered examples are food, medication, and insect venom. The reaction usually occurs within minutes to an hour and is mediated by antibodies. The human organism produces these antibodies to track down objects from outside.

What is Angioedema?

Angioedema can be hard to distinguish from an allergic reaction. It can either occur through mechanisms similar to allergic reactions or due to deficiencies in body substances that mediate chemical reactions within the body. These are called enzymes.

Why would Anyone care?

Symptom severity in allergic reactions can range from local swelling (e.g., at the location of a bee sting) to generalized hives, difficulty breathing, low blood pressure, and even death. Severe allergic reactions are termed anaphylaxis. Angioedema, in turn, is often characterized by swelling of the face, lips, tongue, and larynx, making airway compromise the most dreaded complication. In these patients, air may be unable to enter the windpipe and lungs anymore. Angioedema can, therefore, also be life-threatening.

Treatment and Prevention

Prevention, i.e., not getting into contact with the trigger, is the most essential cornerstone of the management of both allergic reactions and angioedema. However, this may not always be possible, and emergencies can happen. The good news is that both conditions are treatable when they occur! Patients can receive adrenaline, cortisone, antihistamines, fluids, and other medication.
Awesome fact: Adrenaline may be given by anyone, including laypeople and the patients themselves! It is usually injected into a muscle of the thigh. Sounds complicated, but it’s, in fact, really easy as adrenaline comes in prefilled applicators!

So why is Ed interested in Allergic Reactions and Angioedema?

Some patients suffer from complicated allergic reactions or angioedema. This implies that they either do not respond well to treatment or that their symptoms reoccur after they’ve already felt better. We don’t know yet why this is the case. Ed wants to help us understand the underlying mechanisms in the human body. He strives to identify markers that could help to identify patients at risk for such complicated reactions as early as possible to enable us to have a closer look at them and treat them more efficiently.
In this context, allergic reactions and angioedema seem to cause generalized inflammation responses throughout the entire body. Some of these changes may result in measurable changes of substances that float around in our blood. Ed’s prior research specifically suggests that there may be an association between blood clotting and the severity of the reactions.

Ed’s recent Publications

1. Kienbacher CL, Schörgenhofer C, Ruzicka G, Grafeneder J, Hufnagl C, Jilma B, Schwameis M, Herkner H. The dynamics of thrombolysis over time in acute immunologic reactions. Sci Rep. 2025 Jan 2;15(1):123. doi: 10.1038/s41598-024-84070-3.
2. Kienbacher CL, Schoergenhofer C, Ruzicka G, Grafeneder J, Hufnagl C, Jilma B, Schwameis M, Herkner H. Thromboelastography in acute immunologic reactions: a prospective pilot study. Res Pract Thromb Haemost. 2024 May;8(4):102425. doi: 10.1016/j.rpth.2024.102425.

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