[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.

[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.

A history of latex allergy.

Archaeologists have found that latex items were used as early as 1600 BC, but it took until approximately 1900 AD before surgical gloves were commonly used. Descriptions of apparent allergic reactions to natural rubber appeared in the medical literature in 1927, and irritant and delayed-contact reactions were reported in 1933. Although irritant and delayed-contact reactions to rubber products were increasingly recognized, immediate-type allergic reactions were not reported again until 1979. However, after 1980, increasing numbers of contact urticarial reactions to latex were reported, and investigations suggested that many of these reactions were IgE-mediated. In 1984, the first anaphylactic reactions caused by latex surgical gloves were reported, followed in 1991 by the first report of a fatal anaphylactic reaction to latex. Increasing recognition of latex allergy led to divergent paths of investigation. Critical early questions were whether the observed reactions were truly IgE-mediated, and if they were IgE-mediated, what was the source of the allergen? If the allergen was present in latex products, where did it come from? Was it present in raw latex or was it added during processing? As knowledge about the allergens improved, efforts were made to develop and test materials for skin testing and for allergen-specific IgE assays. Now more than 10 unique proteins are recognized as major latex allergens. Although much has been learned about latex allergy, important unanswered questions remain, including the sources of latex exposure that led to sensitization, why latex allergy increased dramatically during the 1980s, and the prevalence of latex allergy in diverse populations. This review concentrates on the history of latex use in medicine and the dramatic emergence of immediate-type latex allergy.

Immediate hypersensitivity. A brief, personal history.

The discovery of anaphylaxis by Portier and Richet that reinjection of a substance caused disease instead of immunity was sensational as it was against the prevailing DOGMA. Passive transmission of hypersensitivity with human antibody by Prausnitz (the P-K reaction, 1921) was an important step in the study of human hypersensitivity. Anaphylaxis was shown to be the consequence of liberation of vasoactive substances (histamine and SRS-A) from mast cells when the allergen crosslinks two IgE molecules fixed to mast cell Ig receptors (Ovary, 1961). The use of smooth muscle contraction (Dale, 1913) and vascular permeability increase (PCA, Ovary, 1948) became important for experimental studies. The clonal selection of antibody formation (Burnet, 1929) opened a new era in immunological concepts. The demonstration of the Fc receptor on mast cells (Ovary, 1961) called attention to the importance of cellular receptors. The carrier effect (Ovary & Benacerraf, 1963) was explained by recognition by T cell receptors of a processed carrier fragment complexed to Ia molecules (Unanue, Grey, 1981). Human IgE responsible for allergies was discovered in 1965 by K. & T. Ishizaka. Tonegawa in 1973 destroyed the "one gene-one protein" DOGMA, showing that the immunoglobulin, germline gene is discontinuous: i.e., composed of exons (which will form the Ig molecule) separated by introns. The CD4 cells were subdivided into Th1 and Th2 cells (Mosmann & Coffman, late 1980's). The Th2 secretes IL-4 necessary for IgE production (Paul, Vitetta, & others, early 1980's). B cells multiply before antibody production or become memory B cells, but what causes a B cell to become a memory cell is not known. The B cell does not change specificity but can switch the isotype using "switch recombinase" and the s segment of the Ig molecules (Honjo, early 1980's). IgE production was shown to be suppressed by lymphokines, such as IFN-gamma and IL-2. A great progress in understanding the mechanism of allergic reaction has been the result of intense investigations by many scientists. A more complete understanding, better prophylaxis and an improved treatment are the goals of the near future.