Classical allergic disorders, such as hay-fever, perennial rhinitis, asthma and urticaria, tend to ‘run in the family’: parents who suffer from them are much more likely than others to produce children with allergies. And if both parents have allergic problems then the children have an even higher chance of being affected. Not that the child and the parent will necessarily suffer from the same disorder. The parent may have severe rhinitis while the child suffers from asthma and eczema – or vice versa. Indeed, the child may begin with eczema in babyhood, lose the symptoms when it is two or three years old, but then develop asthma instead. These facts all suggest an underlying predisposition to allergy that manifests itself in different ways.

Doctors describe this constellation of symptoms as atopy, a word whose derivation and meaning is difficult to pin down. It comes from the Greek and is variously defined as meaning ‘no place’, ‘out of place’ or ‘another place’. It is generally understood to mean that there is a deep-rooted problem which may produce symptoms in various places on the body, not just in one place as with most diseases. Patients with any of these classical allergic symptoms tend to be described as as atopic, especially if other members of their family have allergies. They almost always show a positive reaction to the skin-prick test when tested with a variety of common allergens.

Although atopics have more IgE in their blood than the average person, if the offending allergen can be eliminated – by avoiding a particular food for example – their IgE levels often return to normal. So it seems possible that the root-cause of the problem is a failure to suppress IgE production to particular substances. v-

Clearly the genes responsible for these control mechanisms are not operating normally, but why the controls are so specific for particular substances is not known. It is especially puzzling in individuals who are violently allergic to just one substance. Other, less fortunate, individuals are allergic to a wide range of substances and readily develop new allergic reactions – in such cases it would seem that there is a more generalized fault in the IgE control-mechanism.

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