The late-phase reaction: role of IgE, its receptor and cytokines.

Late phase IgE-mediated reactions (LPR) likely play a major role in the pathogenesis of chronic allergic diseases. Although a number of cellular and humoral alterations in LPR sites have been described recently, the pathogenesis of the LPR is still unclear. LPR follow IgE-mediated but not opiate-induced mast-cell activation suggesting different patterns of mast cell mediator release and/or additional effects of the antigen-IgE interaction. Granulocyte accumulation in developing LPR is accompanied by altered expression of adhesion molecules on local vascular endothelium. Lymphocytes and the cytokines they produce play an important role in developing and perpetuating LPR. These findings point to the likely complex pathogenesis of LPR with implications for the therapy of allergic diseases.