The prominence of catecholamines and their congeners in allergic diseases rests chiefly on their use in asthma and acute hypersensitivity reactions, such as anaphylaxis. They act in these indications by activating both α- and β-adrenoceptors. Adrenaline, the prototype, was discovered in the adrenals in 1893/1894. In 1939, dopa decarboxylase was the first enzyme in the biosynthesis of catecholamines to be described. Later other catecholamines like noradrenaline and dopamine were characterized. The identification of the active chemicals went along with studies regarding catecholamine receptors. It took until 1948 before the existence of at least two different receptors for the different effects was accepted. Meanwhile, genes from all mammalian catecholamine receptors have been cloned.
This review of the major milestones in the history of ocular allergy and immunology shows how significantly this subdiscipline has contributed to the tremendous progress in the understanding of mechanisms of allergic and immunologic diseases, as well as in their better management. It also indicates unmet needs and priority areas for future research.
Over the last 2,000 years a variety of terms have been used for the description of phenomena possibly related to allergy. Many have been forgotten, while some of them have remained. In Greco-Roman literature the term 'idiosyncrasy' was used to describe an individual characterization of a health condition, possibly comparable to 'constitution'. The same term was also used to describe individual reaction patterns, and the term 'antipathy' was used in a similar sense. 'Hypersensitivity' originated from the German word 'Überempfindlichkeit' and was first used in a medical sense by Emil von Behring when he described untoward reactions to his antitoxin containing serum therapy. 'Anaphylaxis' was coined by Richet and Portier to describe the new phenomenon of a life-threatening general pathogenic reaction after repeated injection of antigen. In 1906, Clemens von Pirquet introduced the term 'allergy' in order to bring more clarity to the confusing debate regarding protective and harmful immunity. In order to characterize the familial occurrence of hypersensitivity reactions such as asthma, hay fever and others, the American allergists A.F. Coca and R.A. Cooke introduced the term 'atopy'. Contrary to anaphylaxis, which was experimentally induced, this type of 'hypersensitiveness' occurred spontaneously. The nature of the pathogenic factor was called the 'atopic reagin' and was found to be transferable with serum by Prausnitz and Küstner. After the detection of immunoglobulin (Ig) E as the carrier of this type of hypersensitivity, the term 'atopy' gained a new sense, since IgE is a characteristic - yet not exclusive - parameter of the so-called atopic diseases. Clinically similar diseases such as asthma, rhinoconjunctivitis or eczema can be found in the absence of IgE, and are then called 'intrinsic' variants of the same disease.
It may be a coincidence, but it is a fact that the first clear characterization of hay fever began in England where modern industrialization started in Europe. Only at the end of the 20th century were associations of the increasing prevalence of allergy with outdoor air pollution discussed. The seminal study came from Japan from the group of T. Miyamoto linking the increase in Japanese cedar pollinosis to an increased prevalence of Diesel cars and probably exposure to Diesel exhaust in epidemiological, animal experimental and in vitro studies. In Germany first epidemiological studies were done in North Rhine-Westphalia and Bavaria in 1987 and 1988 showing a striking prevalence of allergic disease of up to 10-20% in preschool children. After German reunification the most surprising observation was a lower prevalence of hay fever in East German children compared to the West, although there was a much higher air pollution with SO2 and large particulate matter. Modern smog as found over West German cities most likely originating from traffic exhaust and consisting of fine and ultrafine particles was shown to be associated with higher incidence rates of allergy and allergic sensitization. In the 10 years after reunification there was a steep increase of allergy prevalence in East German children reaching almost the same level as in West Germany. Obviously, a multitude of lifestyle factors - beyond air pollution - may be involved in the explanation of this phenomenon. Surprisingly the skin manifestation of atopy, namely atopic eczema, was more frequent in East German children compared to the West, thus differing from airway allergy. Meanwhile in vitro studies and animal experiments have shown that a variety of air pollutants mostly from environmental tobacco smoke (indoors) and from traffic exhaust (outdoors) can stimulate immune cells inducing a Th2-dominated response besides their irritative effects. While 50 years ago in allergy textbooks a clear distinction was made between 'toxic' or 'allergic', the newly developed concept of allergotoxicology has stimulated research tremendously, meaning 'the investigation of effects of toxic substances upon the induction, elicitation and maintenance of allergic reactions'.
Pollen grains only represent a small fraction of the total amount of the viable biological particles present in the air, but pollen are the most important aeroallergens in the outdoor environment. The analysis of pollen has traditionally been carried out by microscopy, which can be traced back to the 17th century. Modern advances in molecular analysis could improve information for allergy sufferers and health care professionals. Pollen allergy (pollinosis) was first described in the 19th century. The prevalence of respiratory diseases increased dramatically during the latter part of the 20th century and millions of individuals are now affected. A number of scientists devised equipment to examine airborne biological particles during the 19th century, but aerobiological monitoring only became standardized during the 20th century. Airborne pollen are routinely monitored in many parts of the world, such as North America and Europe, and the first limited network has also been created for monitoring airborne allergen concentrations. Monitoring of the environment is often based on a combination of measurements and model results. Source-based models can increase our knowledge of airborne pollen because they can explain situations and processes that are almost impossible to understand using observations alone.