Topic Year (reference) Study or Publication Title Author(s) Key Findings and Contributions to Allergy Notable Limitations Study Population Study Type Level of Evidence173
Ancient Maternal Dietary Avoidance 2735-2598 BC174 Interdictions Concerning Foods Chinese emperors Shen Nong and Huang Di Advised pregnant women to avoid shrimp, chicken, meat, and other agents incriminated in skin lesions Ancient Chinese History, lacking detailed methods Ancient Chinese The first known official guideline recommending food avoidance to prevent disease, via Emperor’s decree n/a
Defining a Disease and a Medical Specialty 1906175 Allergy von Pirquet C “For this general concept of a changed reactivity I propose the term Allergy. ‘Allos’ implies deviation from the original state, from the behaviour of the normal individual, as it is used in the words Allorhythmia, Alloptropism.” Opinion n/a Clinical observations n/a
Oral Tolerance Induction 1908176 A case of egg poisoning Schofield AT First modern oral desensitization for food allergy London clinic patient Case Report Level 5
Diagnosing Food Allergy and Inducing Oral Tolerance 1912177 A case of allergy to common foods Schloss OM The early development of food extracts for scratch testing; identification of ovomucoid as the major egg allergen and its use for oral desensitization Single case New York clinic patient Case report Level 5
The Concept of Immunoglobulin E 1921178 The Prausnitz-Kustner Test Prausnitz O & Kustner H Demonstrated passive sensitization of the skin in health subjects by transferring serum from a sensitized individual using the PK test Prausnitz (tolerated fish) & Küstner (allergic to fish) Mechanistic Level 5
Diagnosing Food Allergy 1950179 Allergy for corn and its derivatives: experiments with a masked ingestion test for its diagnosis Loveless MH Amid widely varying reports of the incidence of corn allergy, recognized that positive tests and patient histories often do not match a “blindfold test,” and appealed for standardized FA testing Survey of American Academy of Allergy members, case series from US allergy clinics Case series and cohort Level 4
The Discovery of IgE 1966-8180,181 Immunoglobulin E, a new class of human immunoglobulin K & T Ishizaka; Johansson SGO & Bennich H The search for reagin concludes with the nearly simultaneous identification of IgE, the critical component of an immediate hypersensitivity reaction The IgE receptor, discovered a few years later, confirmed the effector functions of IgE Myeloma cell lines Mechanistic Level 4
Diagnosing Food Allergy
1976182 1988183 Objective clinical and laboratory studies of immediate hypersensitivity reactions to foods in asthmatic children; Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure
May CD, Bock SA, et al.
The gold-standard of diagnosis, the double-blind, placebo-controlled oral food challenge was described and became more accessible to the practicing allergist; defined a SPT <3mm SPT as negative
US asthma center
Cohort
Level 4
Mechanisms of Sensitization 1996184 The dual exposure hypothesis Lack G & Golding J “Avoidance measures would serve only to reduce exposure to peanuts to low levels, and this could paradoxically increase allergic sensitisation to peanuts: low dose exposure to allergens favors production of IgE, and as little as 1 µg of inhaled allergen a year may be sufficient to induce allergic sensitization vias the airways.” Opinion, observed less peanut allergy in some cultures outside Britain that also frequently consumed peanut n/a Level 5
Diagnosing food allergy
1997185 & 2001186
Food-specific IgE values predict OFC outcomes
Sampson HA & Ho DG; Sampson HA
Proposes and validates predictive values or cut-offs, guiding the decision to perform an OFC
Highly atopic population, at high risk for FA
US tertiary care, academic allergy clinic
Cohort
Level 4
At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189 At the time of publication of most of these milestones, the existence of food allergy was questioned by many in the medical community, including most allergists. Despite how remarkable and significant these achievements were for the field of allergy and immunology, it was not until the end of the 20th century that food allergy as a field began to overcome the reputation of being scientifically weak. Over the past three or four decades, due to increasing prevalence, improved epidemiologic studies and increased awareness of food allergy given the risk for severe reactions including fatal anaphylaxis, the study of food allergy is contributing to the understanding of the mechanisms of sensitization and the origins of atopy.187,188 In 1982, Dr. May reflected on the history of food allergy and commented: The probability of encountering these obstacles in the future through repetition of the errors of the past would be lessened by curbing certain tendencies that interfere with learning from the lessons of the past, for example: (1) lack of historical perspective, (2) incompetence in weighing evidence, and (3) the faulty habit of adoption of opinion by feeling rather than reasoning from facts.189