Reports of allergy have been found from as long ago as over 3000 years B.C., with the first reported case noted for King Menses of Egypt, who was killed by the sting of a wasp. Sir Thomas More provided an authoritative account of allergy when King Richard III used his allergy to strawberries to good effect in arranging the judicial murder of Lord William Hastings. The King surreptitiously ate some strawberries just prior to giving an audience to Hastings and promptly developed acute urticaria. He then accused Hastings of putting a curse on him, an action that demanded the head of Hastings on a plate.1
Historically, all forms of hypersensitivity were classified as allergies, and all were thought to be caused by an improper activation of the antibody class called Immunoglobulin E (IgE) - Teruka and Kimishige Ishizaka were among the first to isolate and describe IgE in the 1960s. There are five types of hypersensitivity with common allergy giving rise to immediate reactivity called Type 1 or atopic. Type 2 is classified as antibody dependent and comprises certain autoimmune diseases. Type 3 hypersensitivity is characterized as a delayed response caused by deposition of immune complexes. These reactions are slow to develop and are related to systemic autoimmune diseases such as rheumatoid arthritis, lupus erythematosus and immune complex glomerulonephritis, as well as some symptoms of malaria and serum sickness. Contact dermatitis (poison ivy), atopic dermatitis (eczema) and celiac disease are examples of Type 4, or cell-mediated, hypersensitivity. Type 5 or stimulatory hypersensitivity is a subclass of Type 2 in which the antibody targets are membrane bound receptors. Binding of the antibody to the receptors either mimics the binding of the natural substance, or inhibits the binding of the natural substances.
Later, it became clear that several different disease mechanisms were implicated, with the common link between these varying hypersensitivities being a disordered activation of the immune system in one way or another. A new scheme for classification was established by P. Gell and R. Coombs in the early 1960s to reflect the different immunological responses observed for immediate versus delayed hypersensitive responses.2 The word "allergy" was then restricted to type I hypersensitivities (anaphylactic hypersensitivities), which are caused by the classical IgE mechanism.
Major Breakthroughs in Allergy Characterization and Research
1819 - Dr. John Bostock first accurately described hay fever as a disease that affected the upper respiratory tract.
1869 - To investigate his own hay fever, Charles Blakely performed the first skin test by applying pollen through a small break in his skin. Today's skin testing methods vary in the way in which the allergen extract is introduced into the skin; however, the principle remains the same.
1902 - Charles Richet and Paul Portier invented the word 'anaphylaxis' when in the course of other immunization research they discovered this life threatening response to medications and protein substances.
1906 - Austrian Pediatrician Clemens von Pirquet first used the word 'allergy' to describe the strange, non-disease related symptoms that some diphtheria patients developed when treated with a horse serum antitoxin.
1911-1914 - The work of Leonard Noon and John Freeman helped established the basis for immunotherapy or allergy shots.
1937 - Daniel Bovet synthesized the first antihistamine drug. He and his colleagues found antihistamines, in blocking the effects of the chemical histamine, also protected against some of the symptoms of anaphylaxis.
1948 - Philip Hench and Edward Kendall discovered and introduced corticosteroids into clinical medicine. These drugs were found to be effective in the treatment of asthma and both immediate and delayed allergic reactions.
1953 - Researches James F. Riley and Geoffrey B. West discovered the mast cell granule to be the major source of histamine in the body. In this fundamental contribution to the understanding of inflammatory and allergic reactions, Riley and West depended on a valued partner and experimental subject named Judy. This ten-year-old cocker spaniel earned a place in canine history thanks to her mast cell tumor, which had the highest histamine content ever recorded.
1967 - Kimishige and Teruko Ishizaka further explained the allergy process by discovering the role of IgE class antibodies as the principal mediator in the allergic reaction.
1980's - In the early 1980s Professor Bengt I Sameulsson received the Nobel Prize in Medicine/Physiology for identifying leukotrienes as the elusive 'slowing reacting substance of anaphylaxis' which had been implicated in allergic inflammation many years earlier.
1. Auckland Allergy Clinic. (2001) The History of Allergy. http://www.allergyclinic.co.nz/guides/39.html
2. Gell, P. (1968). Clinical Aspects of Immunology. Oxford: Blackwell Scientific. ISBN 0632018003.
