Yes, the world may be out to get us with allergens around every corner, but we’ve got some tricks up our sleeve to help us cope. Our allergy treatment toolkit includes an impressive suite of tools, and in the second episode of our two-part series on allergies, we focus on three in particular: antihistamine medications, allergy shots, and the epinephrine auto-injector (aka the EpiPen). We take you through how exactly each of these work, trace their development from concept to product, and highlight some of the most promising areas of allergy treatment research today. Have you ever wondered why we have so many different types of antihistamines? Or thought about what the Cold War has to do with the EpiPen? Then this is the episode for you.
| History | Biology |
| Arthur, Greer. “Epinephrine: a short history.” The Lancet Respiratory Medicine 3.5 (2015): 350-351. | Holgate, S.T. and Polosa, R., 2008. Treatment strategies for allergy and asthma. Nature Reviews Immunology, 8(3), pp.218-230. |
| Cataldi, Mauro, et al. “Histamine receptors and antihistamines: from discovery to clinical applications.” History of Allergy 100 (2014): 214-226. | Durham, S.R. and Shamji, M.H., 2023. Allergen immunotherapy: past, present and future. Nature Reviews Immunology, 23(5), pp.317-328. |
| Coady, Peyton, Kenneth L. Dretchen, and Michael Mesa. “Epinephrine Administered in Anaphylaxis: The Evolution of 0.3 mg Dosage.” Therapeutic Advances in Allergy and Rhinology 14 (2023): 27534030231161784. | Parisi, G.F., Leonardi, S., Ciprandi, G., Corsico, A., Licari, A., Del Giudice, M.M., Peroni, D., Salpietro, C. and Marseglia, G.L., 2020. Antihistamines in children and adolescents: A practical update. Allergologia et Immunopathologia, 48(6), pp.753-762. |
| Dale, Henry Hallett, and Patrick Playfair Laidlaw. “The physiological action of β-iminazolylethylamine.” The Journal of physiology 41.5 (1910): 318. | Burks, A.W., Sampson, H.A., Plaut, M., Lack, G. and Akdis, C.A., 2018. Treatment for food allergy. Journal of Allergy and Clinical Immunology, 141(1), pp.1-9. |
| Dunbar. “XLV. Etiology and Specific Therapy of Hay Fever.” Annals of Otology, Rhinology & Laryngology 12.3 (1903): 487-506. | Kemp, S.F., Lockey, R.F., Simons, F.E.R. and World Allergy Organization ad hoc Committee on Epinephrine in Anaphylaxis, 2008. Epinephrine: the drug of choice for anaphylaxis–a statement of the World Allergy Organization. World Allergy Organization Journal, 1, pp.S18-S26. |
| Durham, Stephen R., and Harold Nelson. “Allergen immunotherapy: a centenary celebration.” World Allergy Organization Journal 4 (2011): 104-106. | Simons, F. E. R., & Simons, K. J. 2010. Epinephrine (Adrenaline) in Anaphylaxis. Chemical Immunology and Allergy, 211–222. |
| Durham, Stephen R., and Mohamed H. Shamji. “Allergen immunotherapy: past, present and future.” Nature Reviews Immunology 23.5 (2023): 317-328. | Smith, S.S. and Hilas, O., 2021. Peanut (Arachis hypogaea) allergen powder-dnfp: the first FDA-approved oral immunotherapy for desensitization of peanut allergy in children. The Journal of Pediatric Pharmacology and Therapeutics, 26(7), pp.669-674. |
| Emanuel, M. B. “Histamine and the antiallergic antihistamines: a history of their discoveries.” Clinical & Experimental Allergy 29 (1999): 1-11. | Kim, E.H. and Burks, A.W., 2020. Food allergy immunotherapy: oral immunotherapy and epicutaneous immunotherapy. Allergy, 75(6), pp.1337-1346. |
| Fitzhugh, David J., and Richard F. Lockey. “History of immunotherapy: the first 100 years.” Immunology and Allergy Clinics 31.2 (2011): 149-157. | Tanno, L.K., Worm, M., Ebisawa, M., Ansotegui, I.J., Senna, G., Fineman, S., Geller, M., Gonzalez-Estrada, A., Campbell, D.E., Leung, A. and Muraro, A., 2023. Global disparities in availability of epinephrine auto-injectors. World Allergy Organization Journal, 16(10), p.100821. |
| Freeman, John. “Leonard Noon.” International Archives of Allergy and Immunology 4.4 (1953): 282-284. | Wood, R.A., Togias, A., Sicherer, S.H., Shreffler, W.G., Kim, E.H., Jones, S.M., Leung, D.Y., Vickery, B.P., Bird, J.A., Spergel, J.M. and Iqbal, A., 2024. Omalizumab for the treatment of multiple food allergies. New England Journal of Medicine, 390(10), pp.889-899. |
| Gutermuth, Jan, et al. “111 years of allergen-immunotherapy: a long and successful history of the only available disease-modifier in allergic diseases.” Allergologie select 6 (2022): 248. | FDA. Feb 16, 2024. FDA approves first medication to help reduce allergic reactions to multiple foods after accidental exposure. FDA News Release. https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-help-reduce-allergic-reactions-multiple-foods-after-accidental |
| Igea, J. M. “The history of the idea of allergy.” Allergy 68.8 (2013): 966-973. | Casale, T.B., Oppenheimer, J., Kaliner, M., Lieberman, J.A., Lowenthal, R. and Tanimoto, S., 2024. Adult pharmacokinetics of self-administration of epinephrine nasal spray 2.0 mg versus manual intramuscular epinephrine 0.3 mg by health care provider. The Journal of Allergy and Clinical Immunology: In Practice, 12(2), pp.500-502. |
| Keller, Guillermo A., and Guillermo Di Girolamo. “Antihistamines: past answers and present questions.” Current Drug Safety 5.1 (2010): 58-64. | Ellis, A.K., Casale, T.B., Kaliner, M., Oppenheimer, J., Spergel, J.M., Fleischer, D.M., Bernstein, D., Camargo Jr, C.A., Lowenthal, R. and Tanimoto, S., 2024. Development of neffy, an Epinephrine Nasal Spray, for Severe Allergic Reactions. Pharmaceutics, 16(6), p.811. |
| Nelson, Harold S. “The evolution of allergy immunotherapy.” Annals of Allergy, Asthma & Immunology 126.4 (2021): 357-366. | Westwell‐Roper, C., To, S., Andjelic, G., Lu, C., Lin, B., Soller, L., Chan, E.S. and Stewart, S.E., 2022. Food‐allergy‐specific anxiety and distress in parents of children with food allergy: A systematic review. Pediatric Allergy and Immunology, 33(1), p.e13695. |
| Noon, Leonard. “Prophylactic inoculation against hay fever.” The Lancet 177.4580 (1911): 1572-1573. | Meltzer, E.O., 2001. Quality of life in adults and children with allergic rhinitis. Journal of allergy and clinical immunology, 108(1), pp.S45-S53. |
| Ostrom, Nancy K. “The history and progression of treatments for allergic rhinitis.” Allergy & Asthma Proceedings. Vol. 35. 2014. | |
| Ring, Johannes, and Jan Gutermuth. “100 years of hyposensitization: history of allergen‐specific immunotherapy (ASIT).” Allergy 66.6 (2011): 713-724. | |
| Sampson, Hugh A. “Food allergy: past, present and future.” Allergology International 65.4 (2016): 363-369. | |
| https://news.northeastern.edu/2016/09/14/northeastern-alumnus-the-genius-behind-life-saving-epipen/ | |
| https://www.sciencehistory.org/stories/magazine/a-mighty-pen/ |
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