1913 Nobel Prize in Physiology or Medicine
Reason for Award
for elucidating the mechanisms and dangers of anaphylaxis (acute hypersensitivity reactions)
Laureates
France
Explanation
Our bodies have a defense system called immunity that pushes out germs and viruses. Sometimes, however, the immune system reacts far too strongly and becomes dangerous. Richet discovered that when he injected dogs with a protein twice, the second shot caused a severe shock. He named this frightening reaction “anaphylaxis,” showing that people and animals can suffer serious allergy-like attacks. Thanks to his findings, doctors began to think about treatments and safety steps to protect us.
Related Keywords
anaphylaxis
A systemic immediate hypersensitivity reaction that appears within minutes to hours after re-exposure to a specific antigen. Rapid progression of hypotension, airway edema, urticaria, and gastrointestinal symptoms may lead to death without prompt treatment. Although typically IgE-dependent, non-IgE mechanisms involving complement or direct mast-cell activation also exist. Intramuscular adrenaline is the first-line therapy, accompanied by airway management and fluid resuscitation. Major triggers include foods, drugs, and Hymenoptera venom; recent reports implicate immunotherapies and biologics as well.
IgE antibody
A class of immunoglobulin that binds with high affinity to FcεRI receptors on mast cells and basophils. Antigen-induced cross-linking triggers intracellular signaling and release of histamine and cytokines. Although serum levels are low compared with other classes, IgE correlates with allergy severity. Identified in 1966 by the Ishizakas, it marked a turning point in understanding anaphylaxis. Anti-IgE therapy (omalizumab) is now used for asthma and urticaria.
histamine
A biogenic amine derived from histidine and stored in high concentrations within mast-cell and basophil granules. Via the H1 receptor it induces vasodilation, increased vascular permeability, and smooth-muscle contraction, driving key anaphylactic symptoms. First pharmacologically characterized by Dale in 1927, it led to the creation of antihistamines. Four histamine receptors are now known, mediating gastric acid secretion and CNS functions as well. Clinically, histamine metabolites together with serum tryptase help confirm anaphylaxis.
immediate hypersensitivity
Corresponds to Type I in the Gell & Coombs classification, occurring within minutes after antigen binding. Mediator release from mast cells and Th2 cytokines are central, encompassing anaphylaxis, urticaria, and allergic rhinitis. Sensitization involves IL-4/IL-13-dependent class switching to IgE. During elicitation, histamine, leukotrienes, and prostaglandin D2 drive immediate symptoms, while eosinophil infiltration produces late-phase effects. Recent work highlights the interplay of genetic factors (e.g., FLG mutations, HLA alleles) and environmental changes (reduced microbiome diversity).
mast cell
A bone-marrow-derived immune cell resident in tissues that contains numerous granules. Degranulation is triggered by IgE cross-linking, complement fragments, or mechanical stimuli, releasing histamine and tryptase. Expresses CD117 (c-kit), and its function is modulated by tyrosine-kinase inhibitors like imatinib. Unlike short-lived basophils, mast cells are long-lived and participate in tissue repair, but their hyperactivation is lethal in anaphylaxis. In systemic mastocytosis, clonal expansion markedly raises anaphylactic risk.
allergic shock
An older term for anaphylaxis, describing a shock condition in which rapid vasodilation and plasma leakage deplete circulating volume. A “high-risk” variant lacks preceding skin signs, delaying diagnosis. WHO guidelines focus on a systolic blood pressure below 90 mmHg or age-specific thresholds. Adrenaline administration takes priority; in patients on β-blockers, higher doses or adjunctive vasopressin may be required. Fluid-refractory cases call for continuous IV adrenaline or additional noradrenaline.
desensitization
A procedure in which minute antigen doses are gradually increased to transiently reduce mast-cell reactivity. Used for life-saving administration of penicillin or certain chemotherapeutic drugs in allergic patients. Proposed mechanisms include FcεRI internalization and down-regulation of signaling molecules. It represents an intentional manipulation opposite to Richet’s observation that even tiny antigen amounts can provoke shock. Ongoing exposure is required to maintain tolerance; discontinuation re-establishes sensitization.