Sensitization or Tolerance?
As President of World Allergy Organization-IAACI (WAO), it is my pleasure to be present at the XXII Congress of the European Academy of Allergology and Clinical Immunology and bring you this symposium as part of our series of World Allergy Forums presenting state of the art programs at major allergy conventions around the world.
WAO is the rapidly expanding global umbrella organization representing 59 national and regional allergy and clinical immunology societies. A major role of WAO is the development of educational programs in allergy and clinical immunology for our Member Societies and for outreach presentations to professional medical organizations that have a strong interface with our specialty.
WAO is recognized by World Health Organization (WHO) to be the major global voice of allergy. The importance of allergen exposure and immunological sensitization to the development of asthma has led to a collaboration between WAO and WHO on a WHO Technical Document, Prevention of Allergy and Asthma, which was completed this Fall.
Prevention is, of course, the ideal approach to allergy but progress cannot be made unless we have a clear understanding of the earliest events regarding development of the immune system - what determines whether an allergic phenotype will emerge, be it genetic or maternal or in-utero influences, and how does sensitization occur to begin the "allergic march"? This World Allergy Forum will address fundamental issues dealing with the consequences of allergen stimulation which can lead to sensitization and the allergic consequences of that, or the opposite, and lead to tolerance, which is absence of an immune response. However the population destined to have allergy may not respond in the same way in terms of sensitization vs. tolerance given the same allergenic stimuli.
Although we have come a long way in understanding the nature of the allergic response, the fundamental constitutional differences that lead to allergy vs. non-allergy are still only beginning to be defined, and many of the issues will be elaborated upon at today's meeting.
President, World Allergy Organization
Allergy is a global problem that has been steadily increasing over the last 100 years. National allergy societies have been struggling, pretty much on their own, against this threat to patients and health care. In the late 1990's the Executive Committee of the IAACI decided to support its regional and national allergy society members by taking responsibility globally for information, education and communication in allergy. The name of the society was changed to what you today know as the World Allergy Organization-IAACI (WAO) to better cover the change in aim and responsibility.
Today WAO runs several programmes, ranging from educational outreach programmes like GLORIA to scientific update programmes such as World Allergy Forum, WAF. At this EAACI Congress in Paris the WAF symposium will summarize our current knowledge on the very first stages of an allergic disease. What are the mechanisms of the immunological sensitization, and can we prevent the initial production of allergen specific IgE antibodies? Or promote the development of an immunological tolerance, perhaps without getting any clinically significant IgE-sensitization? "Sensitization or tolerance" is the key dilemma which must be understood and solved to allow primary preventive action, which is the only way to really prevent a further increase in the prevalence of allergic diseases. By good secondary and tertiary prevention we can provide good patient care, but we cannot yet prevent sensitization and disease.
Four excellent, globally representative scientists will discuss aspects of allergen capture and presentation, T-cell regulatory functions and dampening of the inflammatory cascade. The final presentation highlights the much discussed immunological concept of high dose tolerance as an alternative to allergen avoidance, and the practical dilemma this poses; should we have more pets or no pets? I am sure you will enjoy this outstanding programme.
Past President, World Allergy Organization