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Allergen avoidance: does it work?
1Lung Function Unit, North West Lung Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.
Insights
Allergen avoidance, a treatment for allergic disorders, has a long history. Environmental manipulation significantly improves asthma and allergy symptoms.
Area of Science:
- Environmental Medicine
- Allergology
- History of Medicine
Background:
- Allergen avoidance has been recognized as a therapeutic strategy for allergic disorders since the 16th century.
- Early documented cases highlight physician Gerolamo Cardano's successful recommendation of feather bedding removal for asthma treatment.
Purpose of the Study:
- To trace the historical evolution of allergen avoidance and environmental manipulation in managing allergic diseases.
- To underscore the contemporary significance of environmental factors in the rising prevalence of asthma and allergies.
Main Methods:
- Historical review of documented cases and controlled studies on allergen avoidance.
- Analysis of early 20th-century environmental interventions for asthma, including dust-free rooms and climate chambers.
Main Results:
- Gerolamo Cardano reported a 'miraculous' remission of asthma symptoms in the 16th century following feather bedding removal.
- Controlled studies in the early 20th century demonstrated asthma symptom improvement through environmental changes like dust reduction and climate-controlled chambers.
Conclusions:
- Environmental manipulation has been a cornerstone in managing allergic disorders for centuries.
- The historical success of allergen avoidance reinforces its critical role in addressing the current increase in asthma and allergic conditions.
Abstract:
The first recorded example of allergen avoidance in the treatment of allergic disorders dates from the 16th century. The Italian physician Gerolamo Cardano (1501-1576) was invited to Scotland by John Hamilton, Archbishop of St Andrews (and brother of the Regent), to give advice on the treatment of his asthma. Cardano recommended that the Archbishop should get rid of his feather bedding, which was followed by a 'miraculous' remission of otherwise troublesome symptoms. The first controlled attempts to treat asthma by environmental manipulation date to the beginning of 20th century. In 1925, the Leopold brothers treated patients with asthma and other allergic disorders by moving them into a dust free room. Storm van Leeuwen created a 'climate' chamber in The Netherlands in 1927 and demonstrated that asthmatic patients improved when moved from their homes into the chamber. One year later, Dekker observed that measures aimed at reducing the amount of dust in bedrooms had a beneficial effect on asthma symptoms in patients allergic to house dust. Van Leeuwen wrote: 'In our endeavours to find the cause of the attack ... we utilised the known fact that the environment of the asthmatic patient is, as a rule, of primary importance in determining the intensity and frequency of his attacks'. Nowadays, more than ever, it is essential to address the environmental influences on the increasing prevalence of asthma and allergic disorders.