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Thursday, 26 May 2016

Allergies

Within organisations there is often a 3 lines of defence model. IT support is a clear example: a 1st call to the helpdesk, then personal assistance from a IT support employee, and ultimately specialist involvement. In Banking, the 3 lines of defence model consists of front-office (business), back-office (eg, Risk Management), and specialists (eg, Internal Audit) (eg, IIAIRM, KPMGPwC).

The IRM site makes reference to a 3 lines of defence model, possibly originating in medicine, soccer or war. The soccer example is illustrating: the mid fielders are the 1st line, the so called defense is actually the 2nd line, while the keeper is the specialist and the final and 3rd line of defence. The medicine example may relate to (1) the public sale of over-the-counter drugs, (2) a house visit by a general doctor, and (3) hospital treatment by specialised doctors.

Our immune system also has a layered defense system (eg, linkWiki). One could even argue that our bodies also use a 3 lines of defence model against diseases. The 1st line of defence are the immune cells on our body's surface (eg, airway, eyes, nose, skin) reacting to pathogens (eg, bacteria, viruses, fungi and parasites) and resulting in allergies. The 2nd line of defence are the antibodies that "police" the body and signal the activation of mast cells in case of a repeat intruder. The 3rd line of defence is a specialised mast cell (eg, white blood cells) that "blasts out a barrage of chemicals". (Quartz)

This 1st line of defence - about allergies - is still a controversial theory. Since long, doctors are of the opinion that allergies represent diseases which thus need to be treated. Ruslan Medzhitov, Professor of Immunobiology at the Yale School of Medicine, is of the opinion that allergies are not diseases at all but just the way our body disposes of diseases (eg, diarrhea, sniffles, vomiting). Hence, fighting allergies with medicine may block, delay, or undermine your recovery.

Only in 1964, the 2nd line of defence model in our bodies came to light. Quartz: "A parasitologist named Bridget Ogilvie was investigating how the immune system repelled parasitic worms, and she noticed that rats infected with worms produced large amounts of what would later be called IgE. Subsequent studies revealed that the antibodies (ie, IgE) signaled the immune system to unleash a damaging assault on the worms".

This controversial 1st line of defence model theory is not new. Quartz: "Medzhitov [] found that the idea had surfaced from time to time over the years, only to be buried again. In 1991, for example, the evolutionary biologist Margie Profet argued that allergies fought toxins. Immunologists dismissed the idea, perhaps because Profet was an outsider". Essentially, another example of the Not Invented Here syndrome in Science. Also see part 1, part 2, and part 3 of my related NIH blogs.

Quartz: "Why do we get allergies? No one has a firm answer, but what is arguably, the leading theory suggests that allergies are a misfiring of a defense against parasitic worms. In the industrialized world, where such infections are rare, this system reacts in an exaggerated fashion to harmless targets, making us miserable in the process. Medzhitov thinks that’s wrong. Allergies are not simply a biological blunder. Instead, they’re an essential defense against noxious chemicals - a defence that has served our ancestors for tens of millions of years and continues to do so today. It’s a controversial theory, Medzhitov acknowledges". 

Paul Simon - Allergies (1983) - artist, lyrics, video, Wiki-1, Wiki-2

Allergies
Allergies
Something’s living on my skin
Doctor, please
Doctor, please
Open up, it’s me again
Maladies
Melodies
Allergies to dust and grain
Maladies
Remedies
Still these allergies remain
(I can’t breathe)


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