Immunology and allergology, like almost every other scientific field, are discovered and transmitted in English. Terminology in these fields comes almost entirely from neologisms with Latin or Greek roots that have been coined by English speakers, together with a growing number of words that have a purely English etymology and form. Correct Spanish translation of this terminology is of course essential to ensure correct knowledge transfer to our large Spanish-speaking scientific community.

But this does not happen in practice. The mainstream Spanish versions of terms that circulate in our community are translations that are rushed, unreasoned, inaccurate or deficient. As a result, Spanish-speaking allergy and immunology specialists - who are so meticulous with their scientific methods - use inconstant, imprecise language full of inferences, which can be quite misleading at times.

In my efforts to help amend this unfortunate situation, I have compiled this Diccionario inglés-español de alergología e inmunología clínica to provide a terminology corpus that is both medically and linguistically accurate. My aim is to describe the exact scientific meaning of each source term and then translate it into Spanish without losing any of its original meaning, while respecting target language principles. It represents a first step towards the ultimate goal of creating a standardised Spanish terminology, validated by immunology and allergy societies in Spanish-speaking countries.

Take a look back in history. The Royal Society was officially founded in 1660. Members of this very first scientific society were keen to publish well-written articles and they appointed the poet John Dryden to chair a committee that would supervise writing style and oversee the language that would be used to explain and communicate their ideas. Four hundred years later, let us continue the work of these seventeenth century scientific revolutionaries.

The fundamental premise of this dictionary is to examine and fully understand the source term, in order to define and characterise it accurately and completely. In many cases this means exploring its etymology, discovering who coined the term, when, and under what circumstances, and analysing the state of the art.

This level of understanding requires a theoretical and practical approach. Each entry therefore gives concise, up-to-date clinical and theoretical information to provide the reader a quick but accurate idea of the meaning of the term in question. In practice, every entry in this dictionary is a little piece of knowledge on allergy or immunology, a little piece in a big puzzle, and as whole it represents the foundation of current allergy and immunology knowledge. I applied a fragmentation process - a classical working method that is true to Aristotelianism - whereby I broke down the allergy and immunology curriculum and built it up again from another perspective.

This approach has resulted in a practical, up-to-date handbook for all doctors: allergy and immunology specialists, general physicians and other specialists who are interested in any aspect of the now almost omnipresent science of immunology in medicine. And it will, of course, help medical and biology students understand the basic concepts of this specialty.

Here are some examples of common doubts that this dictionary will solve: What is the difference between allergy, immunity, atopy and hypersensitivity? Are the terms leukocyte, granulocyte, myelocyte and polymorphonuclear synonymous? Is a B lymphocyte the same as a B cell? What different ways are there to translate ‘immune’ and how and when should they be used in Spanish? Are prostanoides and eicosanoides the same substance? Is there any difference between steroids, corticosteroids and corticoids? Are immunoglobulins and gammaglobulins synonymous? Can we use C1 inhibidor and inhibidor de C1 or tirosina-cinasa and tirosina cinasa interchangeably? What is a dominio, casete, biochip or proteína recombinante in Spanish?

There are many questions like these, and many others that we do not even realise we should be asking. The answers need to provide not only formal knowledge but also clearly defined ideas about the terms that we can use in Spanish when conducting research, communicating results and even treating patients.

After providing a clear idea of the meaning of an English term, the dictionary then suggests how to translate it into Spanish. Sometimes there is more than one option to choose from. By reading the whole entry, you will gain a better understanding of the meaning of the term, discover any relevant exceptions and learn which are the commonest errors encountered in Spanish translations. Your final choice will be the outcome of combined medical and linguistic reasoning, because the ultimate goal of this dictionary is to reflect on terminology meanings and decisions.

The characteristics of this dictionary make it a powerful tool for healthcare professionals and medical translators and writers who need to create immunology or allergology content in Spanish. The dictionary will provide these practitioners with translation solutions for complex terms such as EF-hand domain, regulated on activation, normal T-cell expressed and secreted cytokine (RANTES), terminal deoxynucleotidyl transferase mediated dUTP nick-end-labeling (TUNEL), Southern blotting, pleckstrin, missense mutations, prick and down-regulation, to name but a few.

Medical translators and writers will also be able to solve doubts about formal writing style: Which spelling is right, alergeno or alérgeno? Which is best, citokina, citocina or citoquina? Should I use der p1, Der p 1 or Der p 1? Does mediadores pre-formados need a hyphen? Do you say ganglio linfático or nodo linfático? Which is the preferred term, segmento génico or segmento genético? Should I use Plantago, plantago (in italics)or plantago (in roman type)? Would it be more appropriate to say época de floración or época de polinización? What is wrong with remodelado de la vía aérea? Is látex natural incorrect? Which spelling is right, gastroenteritis eosinófila or gastroenteritis eosinofílica? Are alérgenos mayores and alérgenos menores accepted terms?

This dictionary was written by just one author, but in fact it is a compendium of many different bibliographic resources and contributions from a great number of medical and language professionals. In my dual profession as a practising allergy specialist and medical translator, I have spent the past 13 years slowly but surely unravelling terminology doubts that have arisen while studying, writing, translating and editing medical texts. During this process, I have consulted medical and language text books, articles from translation and medical journals, had discussions with all sorts of professionals, attended scientific talks and presentations at congresses and meetings, searched bibliographic databases and websites, and participated in translators’ forums. Therefore, it is safe to say that the solutions I propose for the nearly 2,500 English terms in this dictionary are not only my own, but also the compilation of solutions suggested by many people.

Despite all the benefits that the Internet brings us today, together with the wide distribution of relevant scientific journals, the process has been slow, because of the countless hours needed to research and reflect on these terms. Unfortunately, the dictionary is incomplete, because there are still many terms that I have yet to study and solve, and those that are already included will have to be updated constantly as science progresses. This flexible, active, online format will undoubtedly be ideal for this task.

The first criterion refers to the choice of terms to be included in the dictionary. I chose terms that were particularly appealing from a linguistic or conceptual perspective, not because of their relevance or importance in the fields of allergology and immunology. Otherwise, according to my calculations, it would be possible to compile a dictionary with 5,000 terms in allergology and immunology. However, the almost 2,500 that appear herein provide a fundamental curricular cornerstone that will help solve most of the doubts that arise in allergy and immunology specialists’ teaching, research and clinical work. In addition to the terms in these specialist fields, this Diccionario inglés-español de alergología e inmunología clínica also contains other terms from genetics, biochemistry, respiratory medicine, anatomy and other scientific areas. I included them because they are commonly used in the allergology and immunology literature and yet they are likely to be less well known.

  The fields of allergology and immunology are full of abbreviations. Considering the multitude of complex terms that populate this terminology, abbreviations are probably the lesser of two evils. In the case of molecules, substances, mediators, cytokines, receptors, assays and test parameters, I have decided to keep all abbreviations (initialisms and acronyms) in English. It would be complete chaos to abbreviate eosinophil cationic protein to PCE in Spanish (from proteína catiónica del eosinófilo) instead of accepting ECP, which is the universal abbreviation for this protein. English initialisms and acronyms have long been accepted as international abbreviations for these concepts. There are just two exceptions to this rule: I recommend using the Spanish abbreviations ADN and ARN for deoxyribonucleic acid and ribonucleic acid, rather than their English equivalents, DNA and RNA. This exception is explained by the special nature of these two molecules, which are the origin of life itself. Therefore, applying a more sentimental than scientific criterion, I believe we should use the Spanish abbreviations for these two organic acids, even though it violates the general criterion for abbreviations described above.

  All abbreviations are expanded in the dictionary itself, except for one, RAE, which stands for the Real Academia Española (Royal Spanish Academy). Any dictionary written in Spanish for Spanish speakers must always take into account the criterion of this institution, whose purpose, since it was founded in 1713, has been “to establish the form and meaning of Castilian words with all propriety, elegance and purity.” From this corner of specialised medical language, I would also like to contribute to this end. The RAE dictionary has been a constant reference point for me when researching non-specialised, general language, and I have always followed its recommendations unless there was a well-founded reason for not doing so, confirmed by other authors. However, for specialised language, we know that it is an unreliable resource, because most medical terms (and allergy and immunology terms in particular) are either missing or explained with formal and conceptual errors. However, the RAE dictionary has been an invaluable point of reference in my work.

  With regard to specialised language, I have been eminently guided by the Libro rojo by Fernando A. Navarro, also available here on Cosnautas. The Libro rojo is the leading Spanish dictionary in the medical field, and its criteria have provided a starting point for solving a large part of the linguistic doubts that arise in specialised medical language. For this reason, I believe that if medical professionals use but one terminology resource, it should be the Libro rojo.

  With regard to enzymes, I use the Spanish version of the Joint Commission on Biochemical Nomenclature of the International Union of Biochemistry and Molecular Biology (IUBMB) and International Union of Pure and Applied Chemistry (IUPAC), according to which, the enzyme substrate precedes the enzyme name. However, in Spanish, a hyphen is added between the substrate and the enzyme to denote the substrate-enzyme relationship and thus remove the adjectival appearance of the enzyme itself. For example, alcohol deshidrogenasa would infer an alcohol that exerts a dehydrogenase action, which is not the case. By joining the two terms with a hyphen (alcohol-deshidrogenasa), it is clear that the dehydrogenase acts on the alcohol. In many cases I have also included the systematic name, although in general this is used much less.

Names of all international institutions and organisations are written in English and in italics. The only exception is the World Health Organization (WHO), which is so important and widely known that I have used its established Spanish name, Organización Mundial de la Salud (OMS).

Finally, some dictionary entries are singular and some are plural. The difference lies in a conceptual criterion, because in immunology many terms relate to substance groups or families. It is therefore more logical to use the plural in these cases. Examples of such terms are addressins, Bet v 1 homologues, defensins and B7 molecules. On the other hand, other terms, such as interleukin, cytokine and immunoglobulin, also represent groups of substances, but semantically they have a singular form too, so I have entered them as such in the dictionary.

Juan Manuel Igea Aznar’s family came from Navarre, but Juan Manuel was born and educated in Madrid, where he received his doctorate in 1992. He now lives and works in Salamanca, where he has spent the past 20 years combining his clinical practice as an allergy specialist with his work as a medical translator and reviser. He has published numerous articles and papers on allergology and translation in international and national journals; he also gives courses and speaks at congresses. He has worked for prestigious publishing houses, translating dozens of books and hundreds of articles in different medical fields, and in immunology and allergology in particular. He is co-author of several book chapters and sole author of “La alergia: la epidemia del siglo XXI” (2005), “Diccionario inglés-español de alergología e inmunología clínica (1ª ed.)” (2008) and “La toxina polínica hervida y el origen de la inmunoterapia” (2010). He has been chair of the Sociedad Castellano-Leonesa de Alergología e Inmunología Clínica (SCLAIC), member of the Latex Allergy Committee of the Sociedad Española de Alergología e Inmunología Clínica (SEAIC) and coordinator of the Medical and Scientific Advisory Group on Latex Allergy of the Asociación Española de Personas con Alergia a Alimentos y Látex (AEPNAA). Through a new publisher’s imprint, founded to revive and translate books on medicine of exceptional historical relevance, Juan Manuel has translated books such as “An Inquiry into the Causes and Effects of the Variolae Vaccinae” (1798) by Edward Jenner and “Experimental Researches on the Causes and Nature of Catarrhus aestivus” (1873) by Charles Blackley. Juan Manuel is driven by his ongoing mission to work towards harmony between science and humanities, and he finds that scientific language study is an ideal method to realise this process.

“To María, because this mix of medicine and language is rather like the two of us”

I have two key mentors in the world of medical terminology. Pablo Mugüerza Pecker first introduced me to this professional sphere and taught me how important it was to look after words. His constant presence and work are still a great source of inspiration to me. Later, the first edition of Diccionario crítico de dudas inglés-español de medicina by Fernando A. Navarro, spurred me to write this dictionary focused on my specialty. Fernando not only shares his in-depth knowledge of scientific language, but does so with extraordinary generosity. Over the years, he has guided me along the twisting road of linguistics, an area where I feel less surefooted than in medicine. 

In addition, I am sincerely indebted to the medical translators’ group, MedTrad, and to Tremédica, which publishes the online medical translation journal Panace@. Many terms included in this dictionary have been discussed in these forums, and the solutions provided have been proposed by forum members. I am particularly grateful to Bertha Gutiérrez Rodilla, María Verónica Saladrigas, M. Gonzalo Clarós, Lucía M. Singer, Cristina Márquez Arroyo, Laura Munoa, Enrique Saldaña, Antonio Díez Herranz, Tomás Pérez Pazos, Héctor Quiñones, María José Hernández, Javier Hellín and Llorenç Serrahima, to name but a few from a long list. I would also like to thank other professionals who no longer belong to MedTrad, such as María Luisa Clark, Gustavo Silva and Ignacio Navascués, who have taught me a great deal. Among all these colleagues, my very special thanks to the Salamanca MedTrad group, for their friendship and many hours of fascinating discussions: Pilar Álvarez, Francisco Cortés, Ignacio Dávila, José Antonio de la Riva, Pilar Elena, César Espinel, Clara Maltrás, María Jesús Mancho and Carmen Quijada, as well as Bertha and Fernando mentioned above. And I would particularly like to acknowledge Francisco Cortés, lead author of Dicciomed, Historical and Etymological Dictionary of Medicine and Biology, which served as the etymological guide for my dictionary.

I must also mention all my allergology colleagues - registrars and consultants - at Ramón y Cajal Hospital, Madrid, who taught me the foundations of allergology and immunology during my early years of training. I am sincerely grateful to José Antonio Compaired, Javier Cuesta, Ignacio Dávila, Belén de la Hoz, Nekane Díaz Alonso, Montserrat Fernández Rivas, Juan Fraj, Milagros Lázaro, Apolinar Lezáun, Carmen Marcos, Santiago Quirce and Jesús Puyana.

A special mention for Roberto Pelta, allergy specialist, homeopath, humanist and writer, with whom I share the excitement of looking at medicine from a humanist’s perspective, and whose written work has been so helpful in my search for the origins of many terms in allergy and immunology.

And, of course, my infinite thanks to my son Marcos, my mother Isabel and my brother Basilio, for their unfailing support and care, which is the true sustenance of my daily work.

Juan Manuel Igea Aznar

Salamanca, 5 November 2013