Allergen avoidance: does it work?

The first recorded example of allergen avoidance in the treatment of allerg ic disorders dates from the 16th century. The Italian physician Gerolamo Ca rdano (1501-1576) was invited to Scotland by John Hamilton, Archbishop of S t Andrews land brother of the Regent), to give advice on the treatment of h is asthma. Cardano recommended that the Archbishop should get rid of his fe ather bedding. which was followed by a 'miraculous' remission of otherwise troublesome symptoms. The first controlled attempts to treat asthma by envi ronmental manipulation date to the beginning of 20th century. In 1925, the Leopold brothers treated patients with asthma and other allergic disorders by moving them into a dust free room(1). Storm van Leeuwen created a 'clima te' chamber in The Netherlands in 1927 and demonstrated that asthmatic pati ents improved when moved from their homes into the chamber(2). One year lat er, Dekker observed that measures aimed at reducing the amount of dust in b edrooms had a beneficial effect on asthma symptoms in patients allergic to house dust(3). Van Leeuwen wrote(2): 'In our endeavours to find the cause o f the attack...we utilised the known fact that the environment of the asthm atic patient is, as a rule, of primary importance in determining the intens ity and frequency of his attacks'. Nowadays, more than ever, it is essentia l to address the environmental influences on the increasing prevalence of a sthma and allergic disorders.