Pathomechanism: Genetic and Immunological Factors

Abstract

Evaluation of much of the early literature on heredity in atopy proves difficult mainly because of the terminology in use at that time. It was imprecise and included atopic manifestations other than the principal ones. A hereditary predisposition to atopy, as postulated by Coca and Cooke (1923), including the transferability of specific antibodies, was subsequently confirmed by several authors. These included Edgren (1943), who demonstrated an increased frequency of respiratory atopic manifestations in patients who had previously suffered from AD. Clinicians investigating atopic subjects found hereditary background of atopy, including asthma, rhinitis, and AD, in 62%–68% in their cases (Rost and Marchionini 1932; Korting 1958; Baer 1955), and, despite possible sources of error, the Scandinavian series of Hellerström and Lidman (1956) and of the author (Rajka 1960) both gave the incidence as 68%. Reports on “allergic” children gave an even higher incidence (Freeman and Johnson 1964; Kaufman and Frick 1976). These and similar findings support the conclusion that the coexistence of AD and atopic respiratory disease is genetically determined (Schwartz 1952; Schnyder 1960; Rajka 1960).