The Story of Angioedema: from Quincke to Bradykinin.
The term "swelling" has been used in the old scriptures to illustrate a change of normal figure and, as such, an expression of illness. It should be noted that in ancient times, human diseases were very often regarded a punishment from God. Hence, it is not surprising that one of the oldest tests for infidelity involved swelling as an inflicted punishment. The great Greek physician Hippocrates (377-460 BC), considered one of the most outstanding figures in the history of medicine and "Father of the Western Medicine," already used the term oídēma to describe swelling of organs. It took many centuries later until the first description of angioedema as a distinct medical entity was minted by Quinke in 1882. The historical progression in angioedema research has been characterized by intermittent "leaps" in interest and scientific achievements. As an example, it took 75 years from the accurate description of hereditary angioedema (HAE) by Osler (1888), until a group of researchers headed by Donaldson (1963) disclosed the central role of C1 inhibitor in angioedema pathophysiology. What followed was a result of a collective effort by many researchers and scientific groups who were able to elucidate the intricate connections between the implicated biochemical pathways. Still, scientific progress was hardly translated into effective therapy, and another 45 years had to elapse until the renewed interest in HAE was boosted by studies on the efficacy and safety of novel therapies about 10 years ago. In the twenty-first century, HAE ceased to be an "orphan disease" and its future is far more optimistic. It is better managed now by specialized angioedema centers, harmonized clinical guidelines, educational programs, laboratory services, and continued basic and clinical research. Patient associations worldwide are offering support and guidance, and governments and healthcare systems are gradually addressing patient and family needs.
Angioedema Center, Allergy & Clinical Immunology, Sheba Medical Center, Tel Hashomer, Ramat Gan, 52621, Israel. areshef@shaba.health.gov.il.
Avner
A
Reshef
Safra Pediatric Hospital, Sheba Medical Center, Tel Hashomer, Affiliated to Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
Mona
M
Kidon
Angioedema Center, Allergy & Clinical Immunology, Sheba Medical Center, Tel Hashomer, Ramat Gan, 52621, Israel.
Iris
I
Leibovich
D000799:Angioedema / Q000175:diagnosis / Q000209:etiology* / Q000266:history / Q000628:therapy; D000818:Animals; D001920:Bradykinin / Q000378:metabolism*; D003131:Combined Modality Therapy; D050718:Complement C1 Inhibitor Protein / Q000235:genetics / Q000378:metabolism / Q000627:therapeutic use; D005342:Fibrinolysis; D020022:Genetic Predisposition to Disease; D049668:History, 15th Century; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans; D018002:Receptors, Bradykinin / Q000378:metabolism; D016896:Treatment Outcome
D050718:Complement C1 Inhibitor Protein; D018002:Receptors, Bradykinin; D001920:Bradykinin
Angioedema; Bradykinin; Clinical guidelines; Complement; Fibrinolysis; History; Prodromes; Swelling