Pioneers of Allergy: Personal Reflections Bergmann K-C, Ring J (eds): History of Allergy. Chem Immunol Allergy. Basel, Karger, 2014, vol 100, pp 350–352 DOI: 10.1159/000360097

Alfred William Frankland London, UK

Place(s) of university education Oxford Who were your most important teachers in allergology? Dr. John Freeman, Prof. Tom Platts-Mills Please list your 5 most important publications Frankland AW, Augustin R: Prophylaxis of summer hay-fever and asthma; controlled trial comparing crude grass pollen extracts with isolated main protein component. Lancet 1954;i:1055–1057. Frankland AW, Hughes WH, Gorrill RH: Autogenous bacterial vaccines in treatment of asthma. Br Med J 1955;2:941–944. Frankland AW: High and low dosage pollen extract treatment in summer hay fever and asthma. Acta Allergol 1955;9:183–187. Frankland AW, Parish WE: Anaphylactic sensitivity to human seminal fluid. Clin Allergy 1974;4: 249–253. Frankland AW: Latex-allergic children (review). Pediatr Allergy Immunol 1999;10:152–159.

Have you ever had a function as a President and/ or Secretary General of an allergological society? Secretary General of EAACI President of EAACI President of the British Society of Allergy & Clinical Immunology President of Section of Allergy & Immunology, Royal Society of Medicine Which position has had the greatest impact on your professional life? Consultant in Charge of the Allergy Department of St. Mary’s Hospital, Paddington, London (the largest Allergy Clinic in Europe)

Questions about your professional life What brought you to allergy? Chance. As a medical student I had been socially involved with Dr. John Freeman because of his and my interest in a very active shooting club at St. Mary’s Hospital. This interest in shooting was one of the reasons Freeman asked Leonard Noon to join him at St. Mary’s Hospital in 1906 and also why Freeman asked Sir Almroth Wright to employ Alexander Fleming (penicillin) to come to work at St. Mary’s Hospital. Downloaded by: Univ. of California San Diego 198.143.33.33 - 4/4/2016 1:49:28 AM

Year of birth 1912

What was your greatest achievement in allergy? (1) Publishing the first double-blind controlled trial in immunotherapy in an allergic disease in 1954; this paper was followed by many other controlled trials of immunotherapy in seasonal hay fever with or without associated asthma. Also, showing, in 1955, that autogenous bacterial vaccines in so-called infective asthma gave no specific help. (2) In 1951, starting the pollen count and giving daily records to news media from 1961. (3) Causing self-induced severe anaphylaxis from an insect (Rhodnius) in 1955. (4) When allergy is immunity gone wrong – investigating human seminal fluid causing anaphylaxis, in 1974. What was your greatest disappointment? The Allergy Department not being made part of the Immunology Department when it was eventually formed at my suggestion at St. Mary's Hospital. What was your most funny experience? Investigating a woman who was anaphylactically allergic to the semen of the man she wanted to marry. After leaving her husband and children, she admitted that in the subsequent 3 or 4 years she had had many partners. ‘I was on the pill and I had no problems with any of them. I am sure it will please you because you always like controls when investigating rare allergic problems, but those controls were not done for your benefit, only mine.’ We both laughed.

Personal Reflections

Who would you list among the top 10 allergists of the world? (Please only mention individuals already deceased.) Francis Rackemann, who I first met in Paris in 1958 and who I later stayed with at his home in Boston. He is remembered perhaps because of his description of asthma as extrinsic (allergic) or intrinsic. He also said of allergy that we should learn about ‘the gun which was loaded and the trigger which fired the charge’. Rackemann was a delightful man and a marvelous host. Secondly, Jack Pepys. I gave him his first parttime job at St. Mary’s Hospital when he arrived from South Africa. He was doing research using guinea pigs, which he was very allergic to! He was always full of new immunological ideas. Even 50 years ago his advice then, as now, should be followed: ‘If you are going to use the word “atopy”, you must define it and this definition must be immunological and not clinical.’ Thirdly, Carl Prausnitz Giles. Before his seminal report was published in 1921, allergic complaints were considered to be produced by poisons. Freeman referred to allergens as ‘idiotoxins’ all his life. Prausnitz, internationally known in Europe, finally came to England in 1935 and changed his name to Giles. He was a much-loved general practitioner for the last 5 years of his life. A very humble but a very erudite man. Who would you list among the top 10 living allergists? Prof. Steve Durham, Prof. Steve Holgate and Prof. Frank Austen.

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What do you see as the greatest problem for allergy in the next 10 years? There are many problems to overcome before we understand the mechanisms of organ allergic inflammation. What will be the next great breakthrough in allergy in the next 10 years? The sequencing of the human genome in 2003 has allowed us to see human genetic variation. Will this information allow a personalized treatment of many complaints, including the symptomatic and

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From whom (academic, teacher) did you learn the most? John Freeman to begin with but I soon disagreed with many of his views. During the last 6 decades there have been so many people that I have learnt from. They include Sir Henry Dale, Rosa Augustin, who also taught me basic immunochemistry, Dr. D.A. Williams (Cardiff), Dr. Egon Bruun (Copenhagen), Prof. Steve Durham (London), Prof. Steve Holgate (Southampton) and Prof. Tom Platt-Mills (USA).

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We will learn more about why some treatments help or harm individuals. We will learn about genes and cells. Specific lifestyle, dietary modifications and prophylactic treatment may be advised before a baby is born, but I suspect what will be found, and what every good clinician knows, is that we may all apparently be similar but in fact are all a little different, leading to treatments that are individualized.

Frankland

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specific treatment of systemic disease that allergy represents? Being involved more than 5 decades ago in purifying and standardizing allergens, our methodology was not very advanced compared with today. The bacteriologists and not the biologists dealt with infection. Stem cell therapy has been tried in over 100 different ailments and now nanomedicine is the process of diagnosing, treating and preventing disease injury using molecular knowledge of the human body.

Alfred William Frankland. London, UK.

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