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Molecular biology and genetics of allergy and asthma
  1. G G Andersona,
  2. J F J Morrisonb
  1. aAsthma Genetics Group, University of Oxford, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK, bMolecular Medicine Unit, University of Leeds, St James’s University Hospital, Leeds, UK
  1. Dr G G Anderson, Asthma Genetics Group, University of Oxford, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK.

https://doi.org/10.1136/adc.78.5.488

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    In the past few years considerable progress has been made in understanding the pathogenesis of allergy at the cellular and subcellular level. In particular, advances in cell biology and DNA technology have shed light on the cell interactions that are pivotal in orchestrating the inflammation underlying allergy. Although much has now been established in the cellular mechanism of allergic inflammation, the fundamental question of why some people suffer from the disease and others do not has only begun to be answered by molecular genetics, which has implicated the inheritance of several genes that predispose to the development of allergy.

    Definitions

    Allergy comprises a group of syndromes that includes asthma, atopic dermatitis, and hay fever, and tends to occur in familial clusters. These diseases have classically been described as caused by an allergic response characterised by immediate hypersensitivity reactions (that is, weal and flare to intradermal allergens), increased serum IgE, and increased bronchial reactivity to specific or non-specific inhaled allergens. In contrast, a significant proportion of patients with asthma and urticaria are seen without an atopic background. This is limited to the molecular biology of atopic asthma as an example to illustrate the advances in the basic science of allergy.

    Syndrome of asthma

    Asthma is a syndrome characterised by diffuse narrowing of the bronchi that is relieved either spontaneously or after appropriate treatment with bronchodilators or anti-inflammatory drugs. Asthma is a spectrum of diseases ranging from paroxysms of cough, wheeze, and dyspnoea occurring periodically over time with complete or near complete symptom free periods, to persistent chronic asthma with frequent symptoms and the need for continuing treatment to maintain control of symptoms, and asthma that is resistant to steroids and is characterised by an incomplete reversibility of airflow obstruction despite treatment with bronchodilators and corticosteroids in high doses.

    Prevalence

    Asthma affects about 10% of children and …

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