Life-Threatening Allergy – An Homage to Von Pirquet
Welcome to the World Allergy Forum Symposium and Introduction to "Life Threatening Allergy - An Homage to Von Pirquet"
Michael A. Kaliner
Welcome to the 29th Symposium in the World Allergy Forum Series, "Life-Threatening Allergy – An Homage to Von Pirquet". Today’s program focuses on anaphylaxis and its treatment. We believe that Dr. Von Pirquet would have enjoyed hearing our three superlative speakers and the current state of anaphylaxis. World Allergy Forum is the longest-running educational program of World Allergy Organization, and we are grateful for the unrestricted educational grant from Novartis, our longest running pharmaceutical partner, which enables us to bring you this program today.
I am lucky to preside over WAO at this time; the Organization has become very active in a wide range of activities, the leadership is extremely dynamic, and our position in the world of allergy is firmly established. Over the next two years, we plan a global agenda to strengthen allergy both for patients and allergists; we plan to make WAO more visible, of greater service to our member societies and establish strong and broad partnerships with our national and regional societies. Where we already have strong allergy societies, we will cooperate with them while always giving recognition to their skills and strengths. Where we have newer or less established societies, we will partner with and strengthen these fledgling groups through our Emerging Societies Program. In areas where there are no societies, WAO will help local allergists to make the governing bodies aware of the need for allergy and work to create an environment where allergy and asthma sufferers can get access to well-trained physicians.
As part of our goal to promote our specialty, in January 2006 the WAO Specialty and Training Council published the results of a survey of allergy needs and practices in member countries in our two journals, the Journal of the World Allergy Organization (JWAO), and the International Archives of Allergy and Immunology. This important document will be followed by the publication of a provisional WAO position statement entitled Requirements for Physician Training in Allergy:Key Clinical Competencies Appropriate for the Care of Patients with Allergic or Immunologic Diseases then later this year we will publish a third statement defining What is an Allergist.
We are actively planning the next World Allergy Congress, which will take place 2-6 December 2007 in Bangkok, Thailand. The meeting will have several unique features. It will begin with an international symposium on Immunotherapy cosponsored by WAO, EAACI and AAAAI. The meeting will run for 3 ½ days thereafter, ending with an overlapping international symposium on Food Allergy, cosponsored by the ACAAI and WAO.
A global organization will only be as good as its ability to communicate. WAO is fortunate to have Richard F. Lockey as Editor-in-Chief of the WAO Web site, and Johannes Ring as Editor of JWAO. The monthly email newsletter, WAO News and Notes, is designed to keep everyone informed of clinical advances in the field and to provide a ready means of rapid communications. If you are not receiving this free of charge communication, please contact us at www.worldallergy.org and share your email information.
As we look to the future, we recognize that allergy is a rapidly developing and expanding field, but that recognition of the importance of allergy is still underappreciated, and that the time when allergy is accepted as a subspecialty of medicine and pediatrics akin to cardiology and gastroenterology is still on the horizon. WAO is committed to strengthening allergy through active educational and research partnerships with our 74 member societies. In the end, the many millions of patients with asthma and allergy will benefit as the importance of allergic diseases is recognized and taught more widely.
With my best regards,
Michael A. Kaliner
Anthony J. Frew
Anaphylaxis is something of a Cinderella among the various conditions that allergists see and treat. As a potentially life-threatening condition, it is clearly important and should attract our attention both for research and management. And yet it seems to have a lower place in our thoughts and congresses than other allergic conditions such as asthma and rhinitis. Today’s symposium is part of an attempt to address that gap between clinical importance and congress coverage.
We know a lot about mast cell biology and the various mediators that are released when mast cells are activated, butsurprisingly little is known about why some patients develop generalized reactions after local exposure, while others just have local reactions. Sensitizing IgE antibodies are certainly necessary for most forms of anaphylaxis, but if that were all that was needed, everyone with hay fever would develop anaphylaxis during the pollen season. It seems clear that there must be other mechanisms that act as transducers, taking an initial local allergic reaction, and triggering a systemic response.
We know quite a lot about how to investigate patients who have sustained anaphylaxis but our management strategy remains based on accurate analysis of trigger factors, careful avoidance of these and provision of first aid, especially injectable epinephrine. These measures are vital and potentially life-saving, but wouldn’t it be good if we could find ways of switching off the response altogether? We can do this for insect venom hypersensitivity, in most cases, so perhaps we should look more closely at ways of desensitizing for food allergies and drug allergies.
Today’s World Allergy Forum symposium attempts to address these challenges, with the intention of raising awareness of this important condition, its mechanisms, treatment and epidemiology. The organizers hope that you find something useful here, and that you will join the discussion at the end of the presentations.
Anthony J. Frew