History Of Food Allergy

In this chapter we will first consider whether there is real evidence on the basis of literature for early descriptions in antiquity of pathogenic reactions after food intake that could be comparable to allergy, for instance in the scriptures of Hippocrates or Lucretius. On this topic we are skeptical, which is in agreement with the medical historian Hans Schadewaldt. We also assert that it is unlikely that King Richard III was the first food-allergic individual in medical literature. Most probably it was not a well-planned poisoning ('allergy') with strawberries, but rather a birth defect (' ... his harm was ever such since his birth') that allowed the Lord Protector to bring Mylord of Ely to the scaffold in the Tower, as we can read in The History of King Richard III by Thomas More (14781535; published by his son-in-law, Rastell, in 1557). In 1912, the American pediatrician Oscar Menderson Schloss (1882-1952) was probably the first to describe scratch tests in the diagnosis of food allergy. Milestones in the practical diagnosis of food allergy are further discussed, including scratch tests, intradermal tests, modified prick tests and prick-to-prick tests. False-negative results can be attributed to the phenomenon of a 'cat-amnestic reaction' according to Max Werner (1911-1987), or to the fermentative degradation of food products. Prior to the discovery of immunoglobulin E, which marked a turning point in allergy diagnosis, and the introduction of the radioallergosorbent test in 1967, several more or less reliable techniques were used in the diagnosis of food allergy, such as pulse rate increase after food intake according to Coca, the leukopenic index, drop in basophils or drastic platelet decrease. The 'leukocytotoxic test' (Bryan's test), today called the 'ALCAT' test, shows no scientific evidence. The double-blind placebo-controlled food challenge test remains the gold standard in the diagnosis of food allergy. For the future, component-resolved diagnostics with the use of recombinant molecular allergens or chip arrays, such as the ISAC technique, hold a lot of promise. With regard to the clinical situation, a subjective selection is given, touching on the pollen-associated food allergies ('birch-mugwort-celery-spice syndrome'), as well as the new phenomenon of lethal food allergies that have appeared since the 1980s. Finally, rare ways of elicitation of a 'derivative allergy', first described by Erich Fuchs (1921-2008), for example by kissing, as well as 'oral allergy syndrome' and oral hyposensitization are considered. (C) 2014 S. Karger AG, Basel