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World Allergy Organization
WAO's mission: To be a global resource and advocate in the field of allergy, advancing excellence in clinical care through education, research and training as a world-wide alliance of allergy and clinical immunology societies.

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WAO Medical Book Review

Posted: August 2014

Multidisciplinary Approaches to Allergies
Series: Advanced Topics in Science and Technology in China
Edited by Young Suck Ro
Edited by Gao Z-S, Shen H- H, Zheng M, Frewer LJ, Gilissen LJWJ
2012 Zhejiang University Press, Hangzhou and Springer-Verlag Berlin Heidelberg
ISBN: 978-3-642-31608-1 (hardcover)
eISBN: 978-3-642-31609-8 (digital)

List prices: ebook $159.00 Hard cover $209.00
Available from: Springer

Reviewer
Pankaj Salphale, MD
Department of Dermatology, RIPAS Hospital
Bandar Seri Begawan, Brunei

Description
Allergic skin and mucosal diseases can be enigmatic to clinicians. A systematic approach includes background knowledge of the patients’ symptoms, the living and working environments, the allergens likely to be encountered in daily life, and understanding of diagnostic modalities to confirm the allergy and appropriate therapies. Combining these aspects for optimal allergy management is crucial and proves to be a fruitful endeavor on the part of the physician with the benefit passed on to the patient. With many pathophysiological processes underlying allergy still unknown, lacunae exist in our understanding adding to the uncertainty of diagnosis and treatment. An exponential rise in the prevalence of allergic disorders contributes to impaired quality of life, loss of productive working hours, and escalating health care costs.

Multidisciplinary Approaches to Allergies is a culmination of the global collaborative efforts of expert clinicians, life sciences experts, and agriculture and food scientists who have collectively contributed to produce this compendium and have made a genuine effort to make the subject interesting by incorporating many different aspects of allergy.

Purpose
With major contributions from Chinese researchers, the book may serve as a representative presentation from developing economies with rapid urbanization where rhinitis, asthma, and allergic skin and mucosal disease patients are increasing in number. The Chinese perspective on allergy can be extrapolated to other countries who share similar environmental issues. The book emphasizes food and agriculture, medical, and environmental and consumer related research on allergies, which are key in innovating diagnostic and therapeutic alternatives.

Features
Multidisciplinary Approaches to Allergies is organized into six purpose defined sections, building up from the basics and adding a seamless flow of information as one reads through the text. It begins with the epidemiology of allergic diseases in China, the types of allergens encountered, and the immunopathogenesis of type I hypersensitivity reactions. An emphasis is placed upon the value of genomic research studies and bioinformatics tools in the field of allergy and on integrating the genetic data of an individual into clinical practice that could help predict the allergy risk. The primary and secondary allergy prevention strategies are discussed as cost-effective measures to tackle the growing epidemic. The multitude of allergen sources, and cross reactivity between various allergens is emphasized. As more information about allergen cross reactivity becomes available, an updated list of allergens is needed.

The book carries a thorough description of the active moities in the various seafood allergens and of the role of linear and conformational epitopes in inducing food allergy. The role of epitope characterization in inducing cross reactivity is mentioned. The various T cell and B cell epitope mapping techniques and strategies for production and utilization of  recombinant allergens are discussed with an aim to let the reader know of the importance of these research methods to better define an allergic reaction. Standardization methods for quantification and testing of allergens are mentioned to be vital in allergy research.

The subsequent portions of the book deal with the clinical aspects of allergy discussing the various diagnostic tests and the rapid assays for detecting serum IgE such as Immunocap rapid assay and allergy lateral flow assay. The second generation tests such as reverse enzyme allergosorbent test (REAST) have resulted in improved speed and accuracy of diagnosis. The often perplexing subject of food allergy is explained in great detail with reference to the effect of industrial processes on the alteration of allergenicity of the food. The section on pharmacy and therapy deals with allergen specific immunotherapy known to offer a long lasting improvement to the patient, and novel routes to administer the same is discussed. There is also discussion of  the upcoming approaches such as T cell epitope based peptide and toll like receptor based immunotherapy. The research and manufacture of hypoallergenic food products is a promising endeavor for the allergic individual. This compendium winds up with the discussion of environmental and social issues in relation to hygiene hypothesis and the role of helminth infections.

Assessment and Audience
This book is a comprehensive learning resource and may be an ideal companion for the practicing dermatologist, internist and/or general practitioner with special interest in allergy as well as the clinical and laboratory based allergologist, pulmonologist and  pediatrician looking for answers to vexing clinical problems. The detail oriented approach followed in this book makes it valuable reading material for those in search of answers to dilemmas in allergy diagnosis and management. This target audience and the wide disciplines aptly justify the book title.

Why read this book? How will it impact my practice?
This is a recommended book for a wide range of medical practices as it not only addresses  the clinical quandaries one may face but also gives an interesting insight into  the in the field of allergen development and novel treatment methods to which a treating clinician might not yet be familiar.