Immediate or Type 1 patterns of allergy can largely be attributed to IgE and a sub-population of immune cells, the mast cells and basophils. These cells degranulate if sufficient antigen reacts with IgE antibodies which act as receptors on the cell's surface. An inherited tendency to make excessive amounts of IgE antibody is one characteristic of atopic individuals.

The most explosive, immediate, and obvious allergic reactions begin with allergens attaching to basophil and mast cells triggering their degranulation.  Allergens meet reactive cells just under the surface of the skin, respiratory, gastrointestinal and genitourinary tracts. Mast cells release three sets of mediators with dramatic, immediate, local and systemic effects.

The immediate hypersensitivity model of food allergy is attractive to physicians and researchers, because it is obvious and relatively simple, but it selects only a subgroups with food allergy. While type 1 reactions are important patterns of immune activity, some physicians have claimed it is the only valid form of allergic reaction. Their opinion is not acceptable.

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