By Dr. Larry Chiaramonte
One of the reasons I have practiced allergy medicine with such enthusiasm over the years is that the immune system, specifically as it pertains to allergies, is inherently dramatic. In our book, you will see that we resort continually to non-medical metaphors to explain the workings of the biology of allergy, and they are vivid. Police actions. Military maneuvers, both strategic and tactical. All the stuff of a good action movie. Even the two critical antibodies are part of the story. IgG is the Good antibody; IgE is the Evil one.
We explain in the book that IgE didn’t start out bad. It was there to fight parasites that are common in less hygienic societies. It is still utilized by the body for this purpose in parts of the world without good sanitation. In allergic people, however, as we explain in the book, it’s as if these antibodies had been entombed for hundreds of years, and when they come out, they’re intent on destroying something like, well, The Mummy, only the targets are proteins in otherwise harmless things like ragweed or peanuts.
IgE(vil) is the class of antibody responsible for allergic symptoms, and IgG(ood) blocks the reaction of IgE [allergic antibody] with the allergen. The objective to is to have more good stuff than bad stuff.
For me, an additional fascination is how this battle between good and evil has played out over the course of human history, and as an occasional feature of this blog, I will be sharing some of this drama with you.
For example, allergies were the mysterious reason King Menses of Egypt was killed by the sting of a wasp at some between 3640 and 3300BC. Allergy to horses caused Britannicus, the son of the Roman Emperor Claudius, to withdraw in disgrace from battle.
In 1906 a pediatrician Clemens von Pirquet, borrowed the word allergy from the Greek word meaning “altered state”. (By the way, the sci-fi thriller “Altered States” has nothing to do with allergies.) The events in an allergic reaction include the body’s recognition of a foreign material, production of specific chemical response and a greater reaction to the foreign material on a second exposure. Most of the time this doesn’t affect the individual, but with allergies a parasite-fighting system goes rogue.
In the late 1800s, Dr. Charles Blackley’s children came in from playing in the English countryside with some stalks of grass. The pollen from these stalks caused him to have an allergic attack. In addition a few grains on a starch caused swelling. Dr Blackley knew he had a clue to his springtime “hay fever” and “hay asthma.” He collected pollen, then systematically applied it to his skin, conjunctiva, nose, and airways. He surmised that something in his own physiology and not in that of non-allergic people caused his symptoms, and the positive skin test was born. Now we know that IgE was the culprit.
In 1911, English Doctors Noon and Freeman both had spring pollen allergies. They injected themselves with grass pollen extracts. They thought the pollen contained a poison like snake venom, and they could build resistance though the antibodies created by the injections. They missed the fact that while the pollen did not contain a poison, it does contain antigens that naturally cause allergic IgE antibodies in some people. They were on the road to discovery of the two types of antibodies, IgG and IgE.
Coming soon: Good vs. Evil: part deux