Allergy, 4th Edition: Expert Consult Online and Print

403 Pages·2011·31.31 MB·English

by  Stephen T. Holgate MD DSc FRCP FRCPE MRC

A L L E R G Y
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4
th

EDITION
A L L E R G Y
Stephen T Holgate David H Broide
CBE BSc MB BS MB ChB
MD DSc CSci FRCP FRCP(Edin) FRCPath Professor of Medicine
FSB FIBMS FMedSci University of California, San Diego
La Jolla, CA, USA
MRC Clinical Professor of
Immunopharmacology
School of Medicine
Fernando D Martinez
MD
Infection, Inflammation and Immunity Division
University of Southampton Regents’ Professor
Southampton General Hospital Director, BIO5 Institute
Southampton, UK Director, Arizona Respiratory Center
Swift-McNear Professor of Pediatrics
The University of Arizona
Martin K Church MPharm PhD DSc Tucson, AZ, USA
FAAAAI
Professor of Immunopharmacology
Department of Dermatology and Allergy
Allergy Centre Charitè
Charitè Universitätsmedizin
Berlin, Germany
Emeritus Professor of Immunopharmacology
University of Southampton
Southampton, UK
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2012
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First edition 1993
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Notices
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British Library Cataloguing in Publication Data
Allergy. – 4th ed.
1. Allergy.
I. Holgate, S. T.
616.9′7–dc22
ISBN-13: 9780723436584
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preface
In 1992, we published the first edition of an entirely new text on allergic diseases
and their mechanisms based on specifically designed, clear and informative dia-
grams. This allowed us to produce a text that found a unique niche between the
more heavily referenced books and the more superficial guides. In this edition,
the reader was introduced to the individual cells and mediators that participate
in the allergic response and this information was then built on to describe the
histopathological features, diagnoses and treatment of allergic responses occurring
in all major organs.
When preparing the second edition, we took note of the feedback of many
clinicians who asked us if we could put primary emphasis on the clinical mani-
festations of allergy and augment this with a solid scientific background. We kept
this format for the third edition. This format has appeared to be very successful
with our readers, so much so that it was awarded ‘Book of the Year’ prize by the
British Medical Association.
Now, 19 years after the original Allergy we are at the fourth edition with two
new editors. Dr Lawrence Lichtenstein has retired and we welcome Dr David
Broide and Dr Fernando Martinez to the editorial team. We have also updated
the format slightly by emphasising the clinical aspects while reducing the cellular
science to a single chapter introducing mechanisms of allergic disease. Further-
more, two new chapters have been added, one on eosinophilia, including eosi-
nophilic oesophagitis and the other on systemic mastocytosis.
One thing that has not changed is our policy of inviting international authorities,
often two or more authors from different countries, to work together to produce
their sections. Although this approach is not without its logistical problems, we
believe it has produced a more authoritative text and we thank all the authors
for their forbearance. Indeed, we owe a great debt of gratitude to the many
experts who have contributed such informative chapters.
As readers, we hope that you will appreciate the fourth edition of Allergy and
that you find its content enjoyable and educative to read. As we requested in the
first three editions, please give us your feedback on the book so that we can refine
it even further in the future.
STH, MKC, DHB, FDM 2012
vii
list of contributors
Mitsuru Adachi MD PhD David H Broide MB ChB Adnan Custovic DM MD PhD FRCP
Professor of Medicine Professor of Medicine Professor of Allergy
Division of Allergology and Respiratory University of California, San Diego Head, Respiratory Research Group
Medicine La Jolla, CA University of Manchester
School of Medicine USA Education and Research Centre
Showa University University Hospital of South Manchester
William W Busse MD
Tokyo, Japan Manchester, UK
Professor of Medicine
Sarah Austin MS Allergy, Pulmonary and Critical Care Charles W DeBrosse MD MS
Scientific Operations Manager Medicine Allergy and Immunology Fellow
Laboratory of Allergic Diseases Department of Medicine Cincinnati Children’s Hospital Medical
National Institute of Allergy and Infectious University of Wisconsin School of Center
Diseases Medicine and Public Health Cincinnati, OH
National Institutes of Health Madison, WI USA
Bethesda, MD USA
Pascal Demoly MD PhD
USA
Virginia L Calder PhD Professor and Head
Leonard Bielory MD Senior Lecturer in Immunology Allergy Department
Director Department of Genetics Maladies Respiratoires – Hôpital Arnaud
STARx Allergy and Asthma Research UCL Institute of Ophthalmology de Villeneuve
Center London, UK University Hospital of Montpellier
Springfield, NJ Montpellier, France
Thomas B Casale MD
Rutgers University
Professor of Medicine Stephen R Durham MA MD FRCP
Center for Environmental Prediction
Chief, Division of Allergy/Immunology Professor of Allergy and Respiratory
New Brunswick, NJ
Creighton University Medicine
Professor
Omaha, NE Head, Allergy and Clinical Immunology
Medicine, Pediatrics, Ophthalmology and
USA National Heart and Lung Institute
Visual Sciences
Imperial College and Royal Brompton
New Jersey Medical School Martin K Church MPharm PhD DSc
Hospital
Newark, NJ
FAAAAI London, UK
USA
Professor of Immunopharmacology
Stephan C Bischoff MD Department of Dermatology and Allergy Mark S Dykewicz MD
Professor of Medicine Allergy Centre Charitè Professor of Internal Medicine
Department of Clinical Nutrition and Charitè Universitätsmedizin Director, Allergy and Immunology
Prevention Berlin, Germany Section on Pulmonary, Critical Care,
University of Hohenheim Emeritus Professor of Allergy and Immunologic Diseases
Stuttgart, Germany Immunopharmacology Allergy and Immunology Fellowship
University of Southampton Program Director
Attilio L Boner MD Southampton, UK Wake Forest University School of Medicine
Professor of Pediatrics Center for Human Genomics and
Pediatric Department Jonathan Corren MD Personalized Medicine Research
University of Verona Associate Clinical Professor of Medicine Winston-Salem, NC
Verona, Italy Division of Pulmonary and Critical Care USA
Medicine
Larry Borish MD Section of Clinical Immunology and Allergy Pamela W Ewan CBE FRCP FRCPath
Professor of Medicine University of California Consultant Allergist and Associate Lecturer
Asthma and Allergic Disease Center Los Angeles, CA Head, Allergy Department
University of Virginia USA Cambridge University Hospitals
Charlottesville, VA National Health Service Foundation Trust
USA Peter S Creticos MD Cambridge, UK
Associate Professor of Medicine
Piera Boschetto MD PhD Medical Director Clive EH Grattan MA MD FRCP
Associate Professor of Occupational Asthma and Allergic Diseases Consultant Dermatologist
Medicine Division of Allergy and Clinical Immunology Dermatology Centre
Department of Clinical and Experimental Johns Hopkins University Norfolk and Norwich University Hospital
Medicine Baltimore, MD Norwich, UK
University of Ferrara USA
Ferrara, Italy
viii
list of contributors
Rebecca S Gruchalla MD PhD Martha Ludwig PhD David B Peden MD MS
Professor of Internal Medicine and Associate Professor Professor of Pediatrics, Medicine and
Pediatrics School of Biomedical, Biomolecular and Microbiology/Immunology
Section Chief, Division of Allergy and Chemical Sciences Chief, Division of Pediatric Allergy,
Immunology The University of Western Australia Immunology, Rheumatology and Infectious
UT Southwestern Medical Center Perth, WA, Australia Diseases
Dallas, TX Director, Center for Environmental
Piero Maestrelli MD
USA Medicine, Asthma and Lung Biology
Professor of Occupational Medicine
Deputy Director for Child Health,
Melanie Hingorani MA MBBS Department of Environmental Medicine
NC Translational & Clinical Sciences
FRCOphth MD and Public Health Institute (CTSA) School of Medicine
Consultant Ophthalmologist University of Padova The University of North Carolina at Chapel
Ophthalmology Department Padova, Italy Hill
Hinchingbrooke Hospital Hans-Jorgen Malling MD DMSci Chapel Hill, NC
Huntingdon, Cambridgeshire USA
Associate Professor
Richard Desmond Children’s Eye Centre
Moorfields Eye Hospital Allergy Clinic R Stokes Peebles MD
Gentofte University Hospital
London, UK Professor of Medicine
Copenhagen, Denmark
Division of Allergy, Pulmonary, and Critical
Stephen T Holgate CBE BSc MB BS Fernando D Martinez MD Care Medicine
MD DSc CSci FRCP FRCP(Edin) Vanderbilt University School of Medicine
Regents’ Professor
FRCPath FSB FIBMS FMedSci Nashville, TN
Director, BIO5 Institute
MRC Clinical Professor of USA
Director, Arizona Respiratory Center
Immunopharmacology
Swift-McNear Professor of Pediatrics Thomas AE Platts-Mills MD PhD FRS
School of Medicine
The University of Arizona
Infection, Inflammation and Immunity Department of Medicine
Tucson, AZ
Division Division of Allergy and Immunology
USA
University of Southampton University of Virginia
Southampton General Hospital Marcus Maurer MD Charlottesville, VA
Southampton, UK Professor of Dermatology and Allergy USA
John W Holloway PhD Director of Research Susan Prescott BMedSci(Hons)
Department of Dermatology and Allergy
Professor of Allergy and Respiratory MBBS PhD FRACP
Allergie-Centrum-Charité/ECARF
Genetics, Human Development & Health Winthrop Professor
Charité – Universitätsmedizin Berlin
Faculty of Medicine School of Paediatrics and Child Health
Berlin, Germany
University of Southampton University of Western Australia
Southampton, UK Dean D Metcalfe MD Paediatric Allergist and Immunologist
Chief, Laboratory of Allergic Diseases Princess Margaret Hospital for Children
Patrick G Holt DSc FRCPath FAA National Institute of Allergy and Infectious Perth, WA, Australia
Head, Division of Cell Biology
Diseases
Telethon Institute for Child Health Marc E Rothenberg MD PhD
National Institutes of Health
Research and Centre for Child Health Professor of Pediatrics
Bethesda, MD
Research Director, Division of Allergy and
USA
University of Western Australia Immunology
Perth, WA, Australia Dean J Naisbitt PhD Director, Cincinnati Center for Eosinophilic
Senior Lecturer Disorders
Alexander Kapp MD PhD MRC Centre for Drug Safety Science Cincinnati Children’s Hospital Medical
Professor of Dermatology and Allergy Department of Pharmacology Center
Chairman and Director University of Liverpool University of Cincinnati College of
Department of Dermatology and Allergy Liverpool, UK Medicine
Hannover Medical School Cincinnati, OH
Hannover, Germany Hans Oettgen MD PhD USA
Associate Chief
Phil Lieberman MD Division of Immunology Hugh A Sampson MD
Clinical Professor of Medicine and Children’s Hospital Dean for Translational Biomedical
Pediatrics Associate Professor of Pediatrics Sciences
University of Tennessee College of Harvard Medical School Kurt Hirschhorn Professor of Pediatrics
Medicine Boston, MA Department of Pediatrics and Immunology
Memphis, TN USA The Mount Sinai School of Medicine
USA The Jaffe Food Allergy Institute
B Kevin Park PhD New York, NY
Susan Lightman PhD FRCP
Professor, Translational Medicine USA
FRCOphth FMedSci
MRC Centre for Drug Safety Science
Professor of Clinical Ophthalmology Department of Pharmacology
UCL/Institute of Ophthalmology University of Liverpool
Moorfields Eye Hospital Liverpool, UK
London, UK
ix
list of contributors
Glenis K Scadding MA MD FRCP Philip J Thompson MBBS FRACP Erika von Mutius MD MSc
Hon. Consultant Allergist and Rhinologist MRACMA FCCP Professor of Pediatrics
Royal National Throat, Nose and Ear Director, Lung Institute of Western Dr. von Haunersche Children’s Hospital
Hospital Australia Inc Ludwig Maximilian University
London, UK Winthrop Professor of Respiratory Munich, Germany
Medicine
Peter D Sly MBBS MD DSc FRACP John O Warner MD FRCP FRCPCH
Director, Centre for Asthma, Allergy and
Senior Clinical Research Fellow FMedSci
Respiratory Research
Queensland Children’s Medical Research Professor of Paediatrics and
University of Western Australia
Institute Head of Department
Clinical Professor
University of Queensland Imperial College
Curtin University
Brisbane, Australia Honorary Consultant Paediatrician
Consultant Respiratory Physician
Imperial College Healthcare NHS Trust
Geoffrey A Stewart PhD Sir Charles Gairdner Hospital
London, UK
Winthrop Professor Western Australia
School of Biomedical, Biomolecular and Perth, WA, Australia Thomas Werfel MD
Chemical Sciences Peter Valent MD Professor of Medicine
The University of Western Australia Department of Dermatology and
Associate Professor of Internal Medicine
Perth, WA, Australia Allergology
Division of Hematology and
Hannover Medical School
Hemostaseology
Hannover, Germany
Department of Internal Medicine I and
Ludwig Boltzmann Cluster Oncology Bruce L Zuraw MD
Medical University of Vienna
Professor of Medicine
Vienna, Austria
University of California, San Diego and
San Diego VA Healthcare System
La Jolla, CA
USA
x
1
Introduction to
mechanisms of allergic
disease
Hans Oettgen and David H Broide
DEFINITION
An improved understanding of
Introduction to the immune response
the mechanisms mediating
allergic inflammation provides The immune system has evolved to play a pivotal role in host defence against
a rationale for the infection as without a functioning immune system individuals would be
development of targeted predisposed to develop a variety of infections from viruses, bacteria,
therapies to prevent and treat fungi, protozoa, and multicellular parasites. The key components of a well-
allergic disorders. functioning immune system include the ability to generate both innate and
adaptive immune responses (Fig. 1.1). The innate immune system comprises
cellular elements that are both resident in tissues (i.e. epithelium, macro-
phages, mast cells) for a rapid response and circulating leukocytes that are
recruited from the blood stream (neutrophils, eosinophils, basophils, mono-
nuclear cells, natural killer (NK) cells, and NK T cells). In addition to the
cellular response the innate immune system has humoral elements (comple-
ment, antimicrobial peptides, mannose-binding lectin), which provides a
mechanism for an immediate response to infection that is not antigen specific
and does not have immunological memory. In contrast, the adaptive immune
response generated by its component T and B cells is slower to respond to
infections (taking days) but has the advantage of exhibiting antigen specificity
and immunological memory. A malfunctioning immune system may lead not
only to immunodeficiency with recurrent infections, but also to autoimmu-
nity and allergic diseases. In this chapter, we focus on the cellular and
molecular mechanisms through which an aberrant immune response to low
levels of otherwise innocuous and ubiquitous environmental exposures such
as airborne grass pollens or ingested foods may trigger a range of allergic
responses from chronic symptoms affecting quality of life to acute severe
allergic reactions that are life threatening.
Overview of the allergic immune response
Allergic diseases such as allergic rhinitis, asthma, and food allergy are char-
acterized by the ability to make an IgE antibody response to an environmental
allergen. There is both a strong genetic (see Ch. 2) as well as environmental
contribution to the development of allergic disease (see Chs 3 and 4). Immu-
noglobulin E (IgE)-mediated allergic responses most frequently occur on
mucosal (nose, conjunctiva, airway, gastrointestinal tract) or skin surfaces as
these anatomical sites contain high levels of mast cells to which IgE is affixed.
© 2012 Elsevier Ltd
DOI: 10.1016/B978-0-7234-3658-4.00005-6 11