Dr. A.W.Frankland – A Life in Allergy Part 1
This is the first of a series of articles reviewing key aspects of Dr. Frankland’s 50 plus years working in allergy related research and treating patients from all walks of life, including politicians and celebrities, around the world.
Dr. Frankland has supported The Anaphylaxis Campaign since its foundation in 1994. The man who bought the Pollen Count to public attention and was a Founder of the Allergy Society (now the British Society for Allergy and Clinical Immunology, BSACI) caused in himself an anaphylactic reaction during the course of his research.
A reflection of the high esteem in which Dr. Frankland is held amongst allergy specialists and the importance of his work is reflected in the reprinting of many of his articles in Journals and Conference literature. Now in his 90s he makes sure that he attends the annual conference of the European Society of Allergy wherever it is held. At a previous Conference in Vienna the organisers put together a collection of articles from leading allergists including a paper published by Dr. Frankland, in the Lancet in 1954, entitled ‘Prophylaxis of summer Hay-fever and Asthma’, commemorating the importance of his role in the development of our knowledge about allergies in the 20th Century.
Dr. Frankland presents The William Frankland Award for Outstanding Services in the field of Clinical Allergy, which is awarded each year at the BSACI Annual Meeting. He was also a Judge of the King Faisal Prize, reflecting his long association with the Middle East.
Finding a special interest in Allergy
On leaving Oxford, Frankland went to do clinical work at St.Mary’s Hospital, London, but it was not until 1946 that he started working full time in the Allergy Department. In between came the war and six years in the Army, three and a half of which were spent as a Prisoner of War in Singapore, where he recalls he was struck by how desensitised the Japanese Prison Guards were to native insect bites and recalls ‘Medically, as a Prisoner of War, we saw conditions which are now unknown’.
Whilst working in dermatology back at St. Mary’s Hospital, he responded to a advertisement on the notice board for a part-time role in the Department of Allergic Disorders (founded in 1909) within The Wright-Fleming Institute (Frankland went on to write a chapter in Fleming’s book on penicillin and also other articles on penicillin from an aerobiological viewpoint). The position was working in the special clinics, which at the time were especially concerned with patients who suffered from seasonal hay fever.
He recalls – ‘I did not even know that I was atopic until doing some skin tests on myself – I found I reacted to grass pollens. I then remembered how, at the age of 9, I was teased by my identical twin brother that I could not help the local farmer make hay’.
Seeing over 6,000 patients a year, with seasonal symptoms, Frankland and his colleagues undertook a series of trials which proved that antihistamine tablets neither helped nor increased pollen asthma (Frankland and Gorrill, 1955). Over many years he was involved in immunotherapy, starting an immunological laboratory to try to characterise allergens and antibodies. Over the years between 25,000 and 30,000 patients injected themselves with pollen on a daily basis, without a death. Dr. Frankland became Director of the Allergy Department at St. Mary’s in 1962 and subsequently undertook research into insect allergy and latex allergy amongst other related conditions.
Dr. A.W.Frankland – A Life in Allergy Part 2
The first part of “A Life in Allergy” focused on the early part of Dr. Frankland’s career in the Department of Allergic Disorders within The Wright-Fleming Institute at St. Mary’s London following his time in the Army and as a Prisoner of War in the 1940s.
In this second part we look at his contribution in specific areas of allergy research.
Testing pollen and recording daily variations
It became clear in the early 1950s that antihistamine drugs were in Dr. Frankland’s words “not the cure-all that had been expected”.
In order to provide a supply of grass pollen, to test and treat patients with seasonal hay fever and primarily for research purposes, large quantities of pollen were required. In 1955 Dr. Frankland took over the running of the pollen farm (originally started by Dr. John Freeman in 1911), he continued to run the farm until 1969 when he left St. Mary’s, London.
“For research purposes very large amounts of pollen, particularly grasses, were used for immunochemical research (Frankland and Augustin 1962).” Frankland describes giving guided tours, around the pollen farm, in the summertime, to visitors from around the World, most specifically South Africa and the U.S.A. and how impressed they were, that in the summer, it was the largest pollen production plant in the world.
Frankland was keen to provide his patients in the London area with information about the daily variations of pollens and the date of onset or termination of pollination. Pollen counts were already being measured in Cardiff, Wales. On Frankland’s recommendation St. Mary’s employed a full-time botanist, allowing pollen counts to be produced using the volumetric method. Weekly London pollen counts were sent to members of the British Allergy Society from 1953 and the news media on a daily basis from 1963.
A great supporter of desensitisation, Frankland has noted that the rise in allergy can be linked to our increased cleanliness and the levels of hygiene in modern life. “We don’t set off our immune system early on, we are too clean. In the former East Germany for instance, with very poor work and housing conditions, people were less allergic”.
Insect Allergy – experiments in desensitisation
With the help of the London Tropical School of Medicine, who provided insects which Frankland could be sure he had never been bitten by before, he conducted a series of experiments to get a defined response. Frankland experimented on himself with the blood sucking insect Rhodnuis prolixus, which “caused me after it’s eight meal at weekly intervals, severe anaphylaxis” (Frankland 1955). Venom immunotherapy has been a model for allergists to find out what may be happening in immunotheraphy (Frankland and Lessof, 1980). According to Dr. Frankland, results from this research showed how many years injections would need to be given; this varies from person to person but on average results were shown in pollen immunotheraphy after three years and in venom after five years.
In the third part of this series we will look at Dr. Frankland’s significant contribution to the organisations which have raised the profile of allergy and spearheaded research into new treatments.
Dr. A.W.Frankland – A Life in Allergy Part 3
Dr. Frankland has made a significant contribution to a number of organisations which have raised the profile of allergy and spearheaded research into new treatments. As President of The Anaphylaxis Campaign he has been a strong supporter of our work and is happy to promote the benefits of joining our membership programme for clinical professionals.
A long association with key bodies, which have advanced research into and knowledge of allergy, began with his instigation of a preliminary meeting in 1948 of The British Association of Allergists. The meeting was advertised in the Lancet and the British Medical Journal. The two speakers included Sir Henry Dale, pharmacologist and Chairman of the Board at the Wellcome Trust and Dr. John Freeman.
In 1962 The Association became the British Allergy Society and Dr. Frankland was President, between 1963-1966. A need was perceived for widening the Society’s scope and Clinical Immunology was incorporated into the title in 1973. Dr. Frankland still has a keen interest in the work of the BSACI, as it is now.
Dr. Frankland was also President of The European Academy of Allergy and Clinical Immunology (EAACI) which was established in 1956 in Florence. Constitution and By-Laws were registered in Utrecht in 1957. The EAACI website states that “More than fifteen European triennial congresses and twenty five annual meetings have been held in various European cities since 1956, all providing substantial progress in knowledge and an opportunity for exchanging ideas and friendship”. The Anaphylaxis Campaign shared a stand with the BSACI at the 2010 EAACI Congress held at ExCel.
Having been a Founder Member (in 1970) and President of the International Association of Aerobiology, Frankland is also an honorary fellow of the Allergy Research Foundation. Other organisations Dr. Frankland supports include The Latex Allergy Support Group.
A grateful patient’s daughter recently painted Dr. Frankland’s portrait. The picture will hang in the Frankland Clinic at St.Mary’s.