Happy 25th birthday, Bet v 1!

As the deputy editor of WAOJ I am concentrating on basic science, but with continuous focus on the clinical relevance of submitted studies for our allergic and atopic patients. The questions that follow me are 1.) “What makes an allergen an allergen?” and 2.) “Why do humans and other mammalians form IgE?”. Within the period which I personally can oversee in the allergy field, i.e. roughly 25 years, tremendous efforts and luckily also progress have been made in understanding allergy mechanisms, from the Th1-Th2 [1] paradigm to Tregs [2], from immunoblot [3] and molecular cloning of allergens [4-6] to cloning of IgE receptors [7,8], the cognition of their function in antigen presentation [9,10] and transgenic models imitating human disease [11]. This time span covered the transition from allergen extracts to molecular allergology. The latter is perhaps the most significant change that we experienced, which so far at least resulted in the improved diagnosis of allergies [12]. We may today decide between molecules causing less or more severe symptoms and between allergens that are associated with the different clinical pictures. This means true help for optimal patient care. For instance, Fel d 1 from cat and Can f 1 from dog are significantly associated with asthma and may be regarded as biomarkers for it [13]. Not only molecules, but also carbohydrate decorations like alpha-Gal may cause severe symptoms – and be associated not only with pet and insect sensitization, but also with severe food allergy, or –amazingly, with hypersensitivity reactions to biological agents when expressed in insect vectors [14]. From the first analyses of allergen extract we have started to experience that not all, but a limited number of compounds act as allergens, i.e. form and bind IgE [15]. Why is that so? At least for some molecules research has so far brought out the interesting information that sensitization may have to do with the function of the molecules.