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An increasing number of individuals suffer from acute anaphylaxis, particularly food-associated reactions. The symptoms of anaphylaxis are triggered soon after allergens (such as peanut antigens, insect venom, or certain medications) enter the circulation of sensitized subjects who have elevated levels of antigen-specific immunoglobulin E (IgE) antibodies in their circulation. Mast cells (MCs) are the primary effectors of anaphylaxis and become activated when allergens make contact with IgE antibodies bound to the surfaces of MCs. Upon activation, MCs rapidly release prestored inflammatory mediators. When this occurs simultaneously throughout the body, anaphylaxis and shock result. As MCs are typically found in the perivascular abluminal surface of relatively impregnable blood vessels, how these cells perceive and interact with blood-borne allergens is unclear.

Extravascular …