[The problem of food allergies at the present stage].

The increase in the number of patients with allergic diseases, which are caused by food allergy, has become one of the leading problems of the XXI century. Expanding the spectrum of food allergens responsible for the development of food allergies raises the question of increasing knowledge in this area for practitioners. The article presents data on causally significant food allergens and food additives that cause the development of food allergies, as well as information on the main food proteins and their components involved in the formation of cross-reactivity. Modern methods of molecular diagnostics and an algorithm for diagnosing food allergies and food intolerances are presented.

Hymenoptera venoms used to produce allergen extracts.

OBJECTIVE: To review the methods and materials used for collection, purification, commercial production, and clinical application of Hymenoptera venoms. DATA SOURCES: Most of the sources for this review are the experience and expertise of the authors. Published reports and review articles on Hymenoptera venom collection and production were identified through database searches (PubMed). STUDY SELECTIONS: Studies describing the methods for Hymenoptera venom collection and production were selected for review. RESULTS: Meticulous methods for identification and collection of the insects are required. Collection and purification of the venoms from the insects are based on validated methods and result in a commercial extract that is standardized for the major allergenic proteins required for accurate diagnosis and safe and effective treatment of patients allergic to insect sting. The steps required for mixing, purifying, testing, and standardizing the products are described. CONCLUSION: Hymenoptera venom extracts were developed using many new methods for the collection, purification, and commercial production of the unique materials required for this product. Clinical applications for diagnosis and treatment are affected by the integrity and stability of the allergens after processing and purification.

Pollen and pollinosis.

Pollen grains only represent a small fraction of the total amount of the viable biological particles present in the air, but pollen are the most important aeroallergens in the outdoor environment. The analysis of pollen has traditionally been carried out by microscopy, which can be traced back to the 17th century. Modern advances in molecular analysis could improve information for allergy sufferers and health care professionals. Pollen allergy (pollinosis) was first described in the 19th century. The prevalence of respiratory diseases increased dramatically during the latter part of the 20th century and millions of individuals are now affected. A number of scientists devised equipment to examine airborne biological particles during the 19th century, but aerobiological monitoring only became standardized during the 20th century. Airborne pollen are routinely monitored in many parts of the world, such as North America and Europe, and the first limited network has also been created for monitoring airborne allergen concentrations. Monitoring of the environment is often based on a combination of measurements and model results. Source-based models can increase our knowledge of airborne pollen because they can explain situations and processes that are almost impossible to understand using observations alone.

Characterization and standardization of allergen extracts.

This paper summarizes the development of the extraction and characterization of allergens responsible for the induction of immunoglobulin (lg) E-induced allergies from the beginning of the 20th century, including the nomenclature of allergens. The majority of papers characterizing allergens and allergen extracts state that the lack of standardization of allergen extracts is the reason for the paper, and so it has been for more than 100 years. A natural part of that process might be the isolation of an allergen molecule and this starts the speculation of 'what makes that allergen an allergen?' To achieve the perfect standardization is a desirable end that is still awaited. So far none of these problems have been finally solved. I started in allergy shortly after the discovery of IgE in 1967. Since that time the history as I remember it is based on the literature, my interpretation of it, and of course may be a little biased due to personal prejudice! The history of the last 10-15 years has still not matured and it might be a little early to draw conclusions. However, at the end of this chapter I do dare to make a few conclusions after having followed the development in this field for 40 years. As this is history it is not meant to be either comprehensive or technically and scientifically precise in all aspects, but rather draws on some thoughts as to what in my mind have been important developments until now. Specific techniques are only mentioned by name and not intended to be discussed in depth. This activity has, however, pushed me to reflect on my hopes and speculations at the time of my introduction to the field of allergen chemistry. To my surprise I realize that far more than I ever expected at that time has been fulfilled. It has been extremely exciting to be a part of that development.

The history of the idea of allergy.

About 100 years ago, a young paediatrician understood that the function of the immune system should be rationalized not in terms of exemption of disease but in terms of change of reactivity. He coined a new word to represent such an idea: 'allergy': the first contact of the immune system with an antigen changes the reactivity of the individual; on the second and subsequent contacts, this change (or allergy) can induce a spectrum of responses from protective (literally, immune) to hypersensitivity ones. The idea was at first hardly understood by the scientific community because it undermined the essentially protective nature of the immune response as it was defined. Nevertheless, in the next years, the growing clinical evidence led to the acceptance of this new point of view, but not of the new word, at least not unconditionally. The original significance of the neologism 'allergy' became perverted and limited to describe hypersensitivity conditions. Perhaps because of the corruption of the term, today 'allergy' does not have a well-delimited significance among health professionals. Furthermore, the word has long ago escaped from physicians and gone to the streets, where it is popularly used also as synonymous with antipathy and rejection. This vulgarization of the term 'allergy' has significantly increased its imprecision.

Allergic conjunctivitis: the evolution of therapeutic options.

The eye has become the target of intense pharmacologic development because it represents one of the most active sites of allergic inflammation, due to it having no mechanical barrier to prevent the impact of allergens such as pollen on its surface. Over the past 20 years, we have witnessed an astonishing growth in therapeutic advances, ranging essentially from derivatives of simple aspirin to various newly developed biological immunomodulatory agents, using implantable drug delivery devices that exceed the safety and efficacy of those available for other organ systems and resorting to advanced surgical techniques for the correction of sight-threatening, disease-related complications. Overall, with the expanding knowledge base, the intricacy of ocular inflammation appears to be becoming ever more manageable and the clinical allergist/immunologist has an increasing role in the treatment outcomes of patients with anterior inflammatory disorders of the ocular surface primarily allergic conjunctivitis but also including dry eye syndromes.

[Allergen specific immunotherapy celebrated 100 years in 2011!]. / Allergo-immunologie. 1. L'immunothérapie spécifique d'allergène a fêté ses 100 ans en 2011!

Allergen specific immunotherapy begun 100 years ago, when Leonard Noon published his works. Important progress have been made ever since and numerous studies published. The indications enlarged with the time and thus, more allergen based treatments became available. The purpose of this article is to give a quick review of specific immunotherapy history on occasion of its centenary, and summarize the most important clinical developments reached in 2011 in this field.

Hundred years of allergen immunotherapy.

Allergic rhinitis was almost unknown until the early 19th century, but within 100 years it was described as a modern epidemic. Pollen was identified as the likely cause of hayfever and although the nature and mechanisms of the sensitivity remained obscure, it was speculated that hayfever might be caused by a toxin in pollen. Vaccination schedules were developed to treat this, but later it became clear that an antibody was responsible. The first clinical trials of specific immunotherapy (SIT) were published in 1911 and 1914 and were followed by several similar papers from the United States. The use of skin prick tests and new allergen extraction techniques accelerated the development of SIT, which became a widespread practice, especially in the United States. Formal controlled clinical trials were reported in 1953 (United Kingdom) and in 1965 (United States). Since then, many controlled clinical trials have confirmed the efficacy of SIT, and although some concerns have arisen around safety, SIT remains a valid option for treating allergic disease. Recent developments include the introduction of sublingual immunotherapy, and clinical trials of recombinant and peptide vaccines. Future developments should increase efficacy and safety, but the biggest challenge to the wider use of SIT is probably economic, as patients and healthcare providers become increasingly critical of all forms of allergy treatments.

The History of IgE: From discovery to 2010.

The discovery of IgE and the role of IgE-mediated inflammation gave clinical allergy a scientific backbone, and as a result, the reputation of the specialty allergy has increased considerably over the years. Allergy diagnosis was improved by assays for in vitro determination of the presence and concentration of IgE antibodies, and clinical knowledge also broadened, allowing better service for the increasing number of allergic individuals. Access to immune assays for allergens finally allowed characterization and standardization of allergen preparations used for diagnosis and allergen-specific immunotherapy. Improved basic molecular technologies have further increased our knowledge about the complex component composition of an allergen extract, introduced IgE-specific immunotherapy, and allowed the allergist to better handle even severe allergic reactions such as anaphylaxis.

Lanolin allergy: history, epidemiology, responsible allergens, and management.

Allergy to lanolin has been recognized by dermatologists for decades. This review summarizes the history, epidemiology, and allergenicity of lanolin and its derivatives. "The lanolin paradox" and the safety of pharmaceutical-grade lanolin products are also discussed.

Prevalence of Artemisia species pollinosis in western Poland: impact of climate change on aerobiological trends, 1995-2004.

BACKGROUND: Artemisia species pollen represents a major cause of allergy in Central Europe. Variations in the pollen season, the influence of climate variables and the prevalence of pollinosis to it were analyzed in Poznan, in western Poland between 1995 and 2004. METHODS: A Hirst volumetric spore trap was used for atmospheric sampling. Pollination date trend analysis and Spearman correlation tests were performed. Skin prick tests (SPT) and allergen specific immunoglobulin (lg)E antibody measurements were performed in 676 and 524 patients, respectively. RESULTS: The Artemisia species pollen season grew longer due to a clear advance in the starting day and only a slightly earlier end point; the peak day also came slightly earlier. Rainfall in the first fortnight of July highly influenced pollen season severity. Temperature was directly correlated with daily Artemisia species pollen levels; relative humidity was inversely correlated. Twelve percent of patients had a positive SPT reaction to Artemisia species. Their symptoms were rhinitis and conjunctivitis (15%), atopic dermatitis (15%), chronic urticaria (14.3%), bronchial asthma (2.4%), and facial and disseminated dermatitis (1.3%). Elevated specific IgE concentrations were detected in the sera of 10.1% of patients. CONCLUSIONS: Artemisia species pollen is an important cause of pollinosis in western Poland. Pollen season intensity is highly influenced by rainfall in the previous weeks. Trends towards earlier season starts and longer duration, possibly caused by climate change, may have an impact on the allergic population.

[100 years of allergy: Clemens von Pirquet - his idea of allergy and its immanent concept of disease]. / 100 Jahre Allergie: Clemens von Pirquet - sein Allergiebegriff und das ihm zugrunde liegende Krankheitsverständnis.

Coming from his clinical research in the field of infectiology and immunology the Viennese pediatrician Clemens von Pirquet (1874-1929) introduced the term "allergy" in 1906. With it he wanted to describe in general a change in reactivity of the organism, namely in time, quality and quantity. In contrast to the widely accepted use of the word "allergy" today, where it is restricted to specific immunologic hypersensitivity reactions against harmless foreign antigens, allergy in Pirquets sense comprised as general term likewise increases and decreases of the reactivity and so both "hyper-" and "hyposensitivity reactions". In the context with the expansion of allergy to the human predisposition Pirquet emphasized, that the change of reactivity does not only depend on exogenous substances (so called allergens), but also on endogenous factors of the organism itself. - The orientation towards the organism and his reactivity is the central idea, which can be found in the complete works of Pirquet from 1903 to 1929 and which is presented in this publication for the first time. It is the true essence of his theory of allergy.

100 years of 'Allergy': can von Pirquet's word be rescued?

Summary It is 100 years since Clemens von Pirquet wrote his classic paper introducing the term 'allergy'. Although the word is no longer used in the way he intended, his concept of 'changed reactivity' laid the foundation for the modern science of immunology.