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WAO Medical Book Review

From Genes to Phenotypes - The Basis of Future Allergy Management
Proceedings of the 25th Symposium of the Collegium Internationale Allergologicum (Supplement 2, 2005 of Allergy & Clinical Immunology International - Journal of the World Allergy Organization)
Editors: H. L°wenstein, J.B. Bienenstock, J. Ring

List Price: $64.95 USD
Available from: Hogrefe & Huber

Reviewer: John B. Ziegler, MB BS, FRACP, MD, DipHEd, FAAAAI Head, Department of Immunology & Infectious Diseases Sydney Children's Hospital, RANDWICK NSW, Australia

The Collegium Internationale Allergologicum holds biennial meetings and invites about 200 allergy investigators for an informal gathering to discuss recent allergy research and future therapeutic options. This hard cover volume of 252 pages collects papers presented at the 2004 meeting held in Denmark, covering topics such as gene-environment interaction, T cell regulation, basic mechanisms of effector cell function, mast cells, psychoneuroallergology, asthma, food allergy, eczema, drug reactions, diagnostics and progress in pharmacotherapy, as well as nonspecific and specific immunotherapy.

The stated purpose, implied by the title, is to bridge the gap between genetics and mechanisms of allergic responses and office allergy practice. Evolving from the proceedings of a conference, however, the content is clearly determined by the interests and research programs of the participants with no clear themes emerging. The purpose is perhaps better described to allow allergy research groups to present recent findings and interests. The book does not present discussion of genotype-phenotype correlations, which the title seems to promise, but of course, none could really be expected for allergic diseases, which appear to be multigenic disorders.

This is not a reader-centered book. It does not provide a revue of any broad areas of allergy research, theory or practice. It does not describe current knowledge about genetic factors leading to allergic phenotypes. It does not describe allergic phenotypes. Its audience is not students, trainees or physicians in other disciplines seeking an update on current thinking. Rather, its audience is academic allergists, researchers working in allergy and practicing allergists and immunologists seeking a window on current research trends.

The book comprises about 70 papers of about 3-4 pages mostly presented in the format of journal articles with abstracts, methods, results, discussion and a short reference list. Some are short reviews presenting published work, though even this type of paper generally has fewer than 20 references. Unusual for a bound volume, it does not have a subject index. There is an author list and an index based on keywords (which are not necessarily standard terms) provided by authors. This has some unusual effects. An Australian contribution on latex immunotherapy is indexed under "latex allergy," "basophils," and "Hev b 6.01" but not "immunotherapy." Many of the terms are abbreviated names, for example, of cell surface molecules. Although its role is of great interest, few readers would search for IRp60 (a recently described inhibitory receptor on mast cells).

This book, published in 2006, presents papers presented in August 2004, so the reader does not benefit from the immediacy afforded to the delegates. The content is largely in the form of short scientific papers but is apparently not peer reviewed. In fact, there is usually insufficient methodological detail to allow critical appraisal. This, at first glance may be a weakness, but it is also a strength since it affords the opportunity, for example, to publish methods which, though not necessarily new technology, are novel approaches to problems in allergy research (basophil histamine release assay to detect circulating dietary allergens; CD63 expression as a marker for basophil activation). It allows for short reviews to encourage readers to enquire further into emerging areas (epitope diversity as a correlate of severity of food allergic reactions). It provides an opportunity to put forward hypotheses which remain largely untested but may prove to be very important (antibodies against membrane bound IgE spacer sequences to modulate IgE synthesis). All those wishing to keep abreast of current thinking in allergy will enjoy thumbing through this book. Many might prefer to spend that time on recent issues of peer-reviewed journals.