ABSTRACT
In 1873, Dr Charles Blackley published his classic observations that linked
the aerobiology of pollens and fungi with the diseases of asthma and rhinitis. These studies had been initiated by observation that his hayfever could
be caused during winter by inhaling pollen from dried grass (1). Such
allergic diseases were uncommon at that time; now they are of epidemic
proportions, with a prevalence of up to 40% in some populations (2). To better understand the role that allergen exposures play in allergic
diseases, it is necessary to define and measure that exposure. While an acute
episode of rhinitis is an example of a simple dose-response relationship,
these relationships become more complex in the real world of acute and chronic exposures to a range of different sized particles, allergens, and mod-
ulating agents. In addition, mapping these relationships to clinical outcomes
involves exploring both gene/environment interactions and the acquired and
innate immune systems. Central to all this research are the simple questions
‘‘what exposure is occurring, and what role is it playing in the disease
process?’’ This leads to: ‘‘how can the agents be identified, characterized
and measured in ways that are relevant to understanding the disease?’’ This process is iterative; only by testing ideas about exposure against disease
models can the most appropriate ways be discovered. Although genomics
and proteomics are revolutionizing our molecular understanding of many
pathogenic processes, the important drivers and modulators of allergic
diseases are the environmental determinants. Thus, defining and under-
standing exposure is essential for the development of better strategies for
disease therapy, prevention and management. Some other recent reviews
of monitoring allergens include Refs (3-5).
