New Nomenclature and Clinical Aspects of Allergic Diseases

  • S.G.O. Johansson
Part of the Allergy Frontiers book series (ALLERGY, volume 2)

The discovery of IgE and its role in allergic inflammation opened new doors to the understanding of allergy. However, it also became obvious that the current terminology for allergic disorders was most confusing. It had developed during the 100 years since the first case of allergy was reported but its development was influenced by the different clinical specialities involved and their traditions. The European Association of Allergology and Clinical Immunology, EAACI, and the World Allergy Organization, WAO, nominated multi-national and multi-speciality committees for nomenclature revision and since some 5 years we now trying to implement the new terminology.

Hypersensitivity describes objectively reproducible symptoms or signs initiated by exposure to a defined stimulus at a dose tolerated by normal persons. If the reactions are mediated by an immunological mechanism it should be called allergy. Allergic asthma and allergic rhino-conjunctivitis are mostly mediated by IgE antibodies and this is often the case also for atopic eczema and allergic anaphylaxis. Atopic individuals have a genetic constitution promoting IgE-sensitization. Other allergies, e.g. allergic contact dermatitis is lymphocyte mediated and IgG antibodies to e.g. dextran can build immune complexes that activates complement.

Allergy is an increasing, global problem. We must use one and the same nomenclature in order to be able to collaborate on scientific understanding, improved diagnosis and treatment and optimal patient care.


Atopic Eczema Allergic Rhinitis Allergic Disease Contact Dermatitis Allergic Contact Dermatitis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Johansson SGO, O'B Hourihane J, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, Kowalski ML, Mygind N, Ring J, van Cauwenberge P, van Hage-Hamsten M, Wüthrich B. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy 2001; 56:813–824.PubMedCrossRefGoogle Scholar
  2. 2.
    Johansson SGO, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TAE, Ring J, Thien F, Van Cauwenberge P, Williams HC. Revised nomenclature for allergy for global use: Report of the Nomenclaure Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immun 2004; 113:832–836.PubMedCrossRefGoogle Scholar
  3. 3.
    Mygind N, Dahl R, Pedersen S, Thestrup-Pedersen K. Essential Allergy. 2nd ed. Blackwell Science, Oxford, 1996.Google Scholar
  4. 4.
    Gell PGH, Coombs RRA. Clinical Aspects of Immunology, 2nd. ed. Blackwell, Oxford/ Edinburgh, 1968, pp 575–596.Google Scholar
  5. 5.
    Coca AF, Cooke RA. On the classification of the phenomena of hypersensitiveness. J Immunol 1923; 8:163–182.Google Scholar
  6. 6.
    Prauznitz C, Küstner H. Studien über die Überempfindlichkeit. Zbl Bakt Parasits Infect I Abt Orig 1921; 86:160–169.Google Scholar
  7. 7.
    Coca AF, Grove EF. Studies in hypersensitiveness. XIII. A study of the atopic reagins. J Immunol 1925; 10:445–464.Google Scholar
  8. 8.
    Pepys J (Editorial). “Atopy”: a study in definition. Allergy 1994; 49:397–399.PubMedCrossRefGoogle Scholar
  9. 9.
    Williams HC (ed.). What Is Atopic Dermatitis and how Should It Be Defined in Epidemiological Studies? Cambridge University Press, Cambridge, 2000.Google Scholar
  10. 10.
    Coca AF. Familial Non-Reaginic Food Allergy. Thomas, Springfield, IL, 1953.Google Scholar
  11. 11.
    Rajka G. Atopic Dermatitis. W.B. Saunders, London, 1975.Google Scholar
  12. 12.
    Bennich HH, Ishizaka K, Johansson SGO, Rowe DS, Stanworth DR, Terry WD. Immunoglobulin E, a new class of human immunoglobulin. Bull. Org. mond. Santé, Bull World Health Organ 1968; 38:151–152.Google Scholar
  13. 13.
    Ishizaka K, Ishizaka T, Hornbrook MM. Physicochemical properties of reaginic antibody. V. Correlation of reaginic activity with ? E-globulin antibody. J Immunol 1966; 97:840.PubMedGoogle Scholar
  14. 14.
    Stanworth DR, Humphrey JH, Bennich H, Johansson SGO. Specific inhibition of the Prausnitz-Küstner reaction by an atypical human myeloma protein. Lancet 1967; ii:330–332.CrossRefGoogle Scholar
  15. 15.
    Pepys J. Atopy. In: Gill, PGH, Coombs, RRA, Lachmann, PJ (eds.). Clinical Aspects of Immunology. 3rd ed. Blackwell Scientific, Oxford, 1975, pp 877–902.Google Scholar
  16. 16.
    Gots RE, Hamosh TD, Flamm WG, Carr CJ. Multiple chemical sensitivities: a symposium on the State of the Science. Regul Toxicol Pharm 1993; 18:61–78.CrossRefGoogle Scholar
  17. 17.
    Lubbe J, Wüthrich B. Amalgamallergie und Amalgamkontroverse. Schweiz Med Wochenschr 1996; 126:661–665.PubMedGoogle Scholar
  18. 18.
    Lidén S. Sensitivity to electricity – a newcomer among environmental epidemics. Allergy 1996; 51:519–544.PubMedGoogle Scholar
  19. 19.
    Szceklik A. Mechanisms of aspirin-induced asthma. Allergy 1997; 52:619–619.Google Scholar
  20. 20.
    Patterson R, Greenberger PA, Halwig JM, Liotta JL, Roberts M. ABPA natural history and classification of early disease by serologic and roentgenographic studies. Arch Intern Med 1986; 146:916–921.PubMedCrossRefGoogle Scholar
  21. 21.
    Hedin H, Richter W, Ring J. Dextran-induced anaphylactoid reactions in man. Role of dextran reactive antibodies. Int Arch Aller Appl Immun 1976; 52:145–159.Google Scholar
  22. 22.
    Von Pirquet C. Allergie. Münchener med. Wochenschrift 1906; 30:1457.Google Scholar
  23. 23.
    Salvaggio JE, Buechner HA, Seabury H. Bagassosis I. Precipitins against extracts of crude bagasse in the serum of patients with bagassosis. Ann Intern Med 1966; 64:748–754.Google Scholar
  24. 24.
    Marsh DG. Allergens. In: Sela M (ed.). The Antigens. Academic, New York, 1975, pp 271–359.Google Scholar
  25. 25.
    Bousquet J, Lockey RF, Malling H-J (eds.). WHO Position Paper Allergen Immunotherapy: Therapeutic Vaccines for Allergic Diseases. Allergy 1998; 44, Supplement 53:1–42.Google Scholar
  26. 26.
    Fick RB, Jardieu PM. IgE and anti-IgE Therapy in Asthma and Allergic Disease. Marcel Dekker, New York, 2002.Google Scholar
  27. 27.
    Aas K. The Biochemical and Immunological Basis of Bronchial Asthma. Charles C Thomas, Springfield, IL, 1972.Google Scholar
  28. 28.
    Haahtela T, Heiskala M, Suoniemi I. Allergic disorders and immediate skin test reactivity in Finnish adolescents. Allergy 1980; 35:433–441.PubMedCrossRefGoogle Scholar
  29. 29.
    Haahtela T, Klaukka T, Koskela K, Erhola M, Laitinen LA. Working Group of the Asthma Programme in Finland 1994–2004. Asthma programme in Finland: a community problem needs community solutions. Thorax 2001; 56:806–814PubMedCrossRefGoogle Scholar
  30. 30.
    Bousquet J, Van Cauwenberge P. Allergic rhinitis and its impact on asthma. J Allergy Clin Immun 2001; 108:147–334.CrossRefGoogle Scholar
  31. 31.
    Bielory L. Allergic and immunologic disorders of the eye. Part 2: ocular allergy. J Allergy Clin Immun 2000; 106:1019–1032.PubMedCrossRefGoogle Scholar
  32. 32.
    Montan PG, Scheynius A, Van der Ploeg I. Similar T helper Th2-like cytokine mRNA expression in vernal keratoconjunctivitis regardless of atopic constitution. Allergy 2002; 57:436–441.PubMedCrossRefGoogle Scholar
  33. 33.
    Johansson SGO, Bieber T. New diagnostic classification of allergic skin disorders. Curr Opin Allergy Clin Immunol 2002; 2:403–406.PubMedCrossRefGoogle Scholar
  34. 34.
    Wise F, Sulzberger MB. Footnote on problem of eczema, neurodermatitis and lichenification. In: Wise F, Sulzberger MB (eds.). The 1933 Year Book of Dermatology and Syphilogy. The Year Book Publishers, Chicago, IL, 1993, pp 38–39.Google Scholar
  35. 35.
    Williams HC. Defining cases. In Williams HC, Strachan DP (eds.). The Challenge of Dermato-Epidemiology. CRC Press, Boca Raton, FL, 1997, pp 13–23.Google Scholar
  36. 36.
    Wüthrich B. Zur Immunpathologie der Neurodermitis constitutionalis. Eine klinisch-immunologische Studie mit besonderer Berücksichtigung der Immunglobuline E und der spezifischen Reagine im zeitlichen Verlauf. Hans Huber, Bern/Stuttgart/Wien, 1975, pp 92–124.Google Scholar
  37. 37.
    Darsow U, Ring J. Atopic eczema, allergy and the atopy patch test. Allergy Clin Immunol Int 2002; 14:170–173.CrossRefGoogle Scholar
  38. 38.
    Schäfer T, Krämer U, Vieluf D, Abeck H, Behrendt H, Ring J. The excess of atopic eczema in East Germany is related to the intrinsic type. Brit J Dermatol 2000; 143:992–998.CrossRefGoogle Scholar
  39. 39.
    Cabon N, Ducombs G, Mortureux P, Perromat M, Taieb A. Contact allergy to aeroallergens in children with atopic dermatitis: comparison with allergic contact dermatitis. Contact Dermatitis 1996; 35:27–32.PubMedCrossRefGoogle Scholar
  40. 40.
    Böhme M, Svensson A, Kull I, Nordvall SL, Wahlgren C-F. Clinical features of atopic dermatitis at two years of age: a prospective, population-based case-control study. Acta Derm Venerol 2001; 81:93–97.Google Scholar
  41. 41.
    Schmid (-Grendelmeier) P, Simon D, Simon HU, Adkis CA, Wüthrich B. Epidemiology, clinical features and immunology of the “intrinsic” (non-IgE-mediated) type of atopic dermatitis (constitutional dermatitis). Allergy 2001; 56:841–849.CrossRefGoogle Scholar
  42. 42.
    Novembre E, Cianferoni A, Lombardi E, Bernardini R, Pucci N, Vierucci A. Natural history of “intrinsic” atopic dermatitis. Allergy 2001; 56:452–453.PubMedCrossRefGoogle Scholar
  43. 43.
    Wüthrich B, Schmid-Grendelmeier. Natural history of AEDS. Allergy 2002; 57:267–268.PubMedCrossRefGoogle Scholar
  44. 44.
    Hjort N, Roed-Petersen J. Occupational protein contact dermatitis in food handlers. Contact Dermatitis 1976; 2:28–42.CrossRefGoogle Scholar
  45. 45.
    Poley GE, Slater JE. Latex allergy. J Allergy Clin Immun 2000; 105:1054–1062.PubMedCrossRefGoogle Scholar
  46. 46.
    Turjanmaa K, Alenius H, Mäkinen-Kiljunen S, Reunala T, Palosuo T. Natural rubber latex allergy. Allergy 1996; 51:593–602.PubMedGoogle Scholar
  47. 47.
    Greaves M. Chronic urticaria. J Allergy Clin Immun 2000; 105:664–672.PubMedCrossRefGoogle Scholar
  48. 48.
    Bruijnzeel-Koomen C, Ortolani C, Aas K, Bindslev-Jensen C, Björkstén B, Moneret-Vautrin D, Wüthrich B. Position Paper. Adverse reactions to food. Allergy 1995; 50:623–635.PubMedCrossRefGoogle Scholar
  49. 49.
    Ortolani C, Bruijnzeel-Koomen C, Bengtsson U, Bindslev-Jensen C, Björkstén B, Host A, Ispano M, Jarisch R, Madsen C, Nekam K, Paganelli R, Poulsen LK, Wüthrich B. Position Paper. Controversial aspects of adverse reactions to food. Allergy 1999; 54:27–45.PubMedCrossRefGoogle Scholar
  50. 50.
    Pichler WJ, Schnyder B, Zanni MP, Hari Y, von Greyerz S. Role of T cells in drug allergies. Allergy 1998; 53:225–232.PubMedCrossRefGoogle Scholar
  51. 51.
    Birnbaum J, Vervloet D, Charpin D. Atopy and systemic reactions to hymenoptera stings. Allergy Proc 1994; 15:49–52.PubMedCrossRefGoogle Scholar
  52. 52.
    Ring J, Behrendt H. Anaphylaxis and anaphylactoid reactions. Classification and pathophysiology. Clin Rev Allergy Immunol 1999; 17:387–399.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • S.G.O. Johansson
    • 1
    • 2
  1. 1.Department of Medicine, Clinical Immunology and Allergy UnitKarolinska University HospitalStockholmSweden
  2. 2.Department of Clinical Immunology and Transfusion MedicineKarolinska University HospitalStockholmSweden

Personalised recommendations