If they have a clear family history or a higher serum IgE level and an identifiable allergen, it is called atopic form, and otherwise it is called non-atopic (which is very incomplete). Asking about family history is necessary to check the human genetic system, but It is not enough to use serum IgE as a criterion for allergy, which increases even in other infectious and non-infectious conditions, and on the other hand, some people who are definitely allergic, but their IgE does not increase, even with a positive skin test, shows that the support It is not good.
The abnormal presence of eosinophils can be seen both in the tissue and in the serum and in both cases, and this classification is further questioned.
Definitely, future developments will detect other substances in the serum other than IgE, and we will have better and more complete or newer tests, and the identification of allergens in the form of a skin or serum test, which is for a limited number of a huge number of harmless substances (for some) in the world. that this limitation is very serious and in fact it can be said that the identification of allergens is still in the beginning. As a result, this division of atopy and non-atopy cannot be complete and on the other hand, as in every part of the body, both forms of the above disease We have, but they have the same treatment, it shows that the division is artificial and has remained uniform for years and has not helped significantly, and perhaps the format and mentality it has provided has caused us to neglect it.
We have atopic and non-atopic allergy diseases not only in the lung, but also in the skin and nose, etc., and the monopoly of the word allergy is not scientific in the form of atopy or only to a specific organ (nose) and factors such as infection, stress, exercise for atopy problems It creates problems for non-atopic patients as well, and in fact, the non-atopic form is part of the unknowns of allergy science today, and with all the advances in science, we must accept that we have many unknowns.
And what we call non-atopy and do not consider the work finished, perhaps it can be said that in fact, we have called the clear or simpler or more elementary part of allergy as atopy, which is a small part of the reality of allergy. Asthma is a group of allergic diseases in the lungs and We said that the lung is also because every other organ has atopic and non-atopic allergy diseases. Therefore, the form of non-atopic asthma is correct, not non-allergic asthma. will be
It can be said that we have non-atopic nasal allergy, urticaria or non-atopic eczema. Dear colleagues, there are many cases of these diseases that do not have high IgE, nor a positive skin test, and even besides anaphylaxis, we have a reality called anaphylactoid.
In fact, not all lung allergy diseases are called asthma, but specific cases of lung allergy are called, and in the upper part of the respiratory tract, we also have non-atopic allergies, and various diseases, and actually asthma is a collection of lung allergy diseases. and everyone believes that asthma is not a disease but one or more complexes.
The expression of atopic asthma or allergy does not indicate a disease, and it does not even have an effect on the drug treatment that is common today. Allergy is a large group of diseases and affects all parts of the human body and is not exclusive to the upper airways, but the form of asthma is exclusive to It has lower airways (lungs).
The question of asthma or allergy is more similar to questions like: Tuberculosis or infection? Is it pneumonia or an infection? Is it diabetes or endocrine disease? Is it schizophrenia or mental illness? Is it a fracture or an orthopedic form? So it is better to know that if the lung is involved, it is infectious or allergic or both, and if the leg of the allergy is in the middle, is it asthma or another allergy in the lung (such as farmers’ lung, etc.) and if it is asthma It is time to know whether it is atopy or not – the discussion of severity is another category. And very mild or very severe asthma may exist, whether atopic or non-atopic, as well as very mild or very severe nasal allergy, whether of the atopic type. We have it either non-atopic or for urticaria or severe eczema where the severity of the clinical symptoms of the attack and the number of frequency (attacks) and its duration together with the medical examination and spirometry itself is a good measure to determine the severity of the asthma disease and the coexistence of asthma with allergies in the nose. And the sinus or the skin is also seen a lot, which needs to be taken seriously and can even be taken as a factor for the deterioration of each of these conditions (in other words, the simultaneous involvement of several organ allergies).