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Upon allergen re\u2010exposure, allergic patients exhibit a sequence of symptoms that vary in terms of affected organ systems, severity, time of onset and allergen reactivity thresholds. This review focuses on the sequence of immediate immunological and clinical events that occur during allergen exposure in individuals with FA. It highlights both clinical and immunological baseline risk factors and discusses recent advances in understanding the acute allergic response. We explore the implications of immune mechanistic knowledge for predicting clinical reactivity and therapy of FA. 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