Mount Sinai: Clinical Immunology "Firsts"

While the Division of Allergy and Clinical Immunology at the Mount Sinai Health System was founded in 1978, Mount Sinai’s involvement in the "young" science of Immunology actually began much earlier. The inventor of the Schick test was made by Bela Schick (1877 - 1967), a Hungarian-born American pediatrician who joined the Mount Sinai faculty. The Schick test was used to determine whether or not a person was susceptible to diphtheria. In the 1920s, Dr. Gregory Schwartzman first developed the concept of immune system hypersensitivity, which later became known as the "Schwartzman Phenomenon."

In 1930, Dr. Joseph Harkavy and his colleagues at Mount Sinai identified a new chemical substance that was released in allergic individuals. The substance wasn’t histamine, which would be identified later. Rather, it was what immunologists now call SRS-A, or slow-reacting substance of anaphylaxis. This is a chemical substance released during severe allergic reactions (anaphylactic shock, or anaphylaxis).

The release of SRS-A causes severe bronchoconstriction, and is a major factor in allergic asthma. Other symptoms of anaphylaxis include fainting, itching, hives (urticaria), swelling of the throat or other mucous membranes, and a sudden drop in blood pressure. Without immediate treatment, anaphylaxis may lead to death.

Dr. Harkavy was the first immunological researcher to link cigarette and cigar smoking to allergies and cardiovascular disease. This discovery showed that it was the tobacco leaf itself – and not nicotine – that acted as an antigen to cause allergic reactions in sensitive individuals. In 1941, while on the medical staff at Mount Sinai, Dr. Harkavy wrote a classic research paper on neurovascular responses in allergy. This landmark research, which gave rise to the term "Harkavy Syndrome," was applied to asthma treatment.

The Churg-Strauss syndrome (also known as "Allergic granulomatosis syndrome") was first described by Drs. Jacob Churg and Lotte Strauss at The Mount Sinai Hospital in New York City in 1951.  It is a rare disease characterized by medium and small blood vessel autoimmune vasculitis.