Volume 7, Issue 1 January 2010
I am honored to take the role of 2010-2011 President and to thank my predecessor, G. Walter Canonica, for his outstanding contribution to WAO during his Presidency. I look forward to continuing to work with Walter, as he assumes the role of Past-President, and my colleagues on the Executive Committee - Ruby Pawankar (President-Elect), Lanny Rosenwasser (Secretary-General) and Mario Sánchez-Borges (Treasurer), as well as the 2010-2011 Board of Directors.
During my presidency, I will work to promote research and education about Co-morbid Conditions of Asthma and other Allergic and Immunologic Diseases. I encourage a culture in which allergists/immunologists are first knowledgeable primary care physicians, internists, and pediatricians - and then specialists. Physicians so trained should be able to provide patients with more complete, cost-effective care for asthma and allergic and immunologic diseases. They should be able to diagnose and treat co-morbid conditions.
For example, today's allergists/immunologists should strive to achieve excellence in treating patients with obesity, rather than only referring them to other specialists. They should be able to treat gastroesophageal reflux disease (GERD), osteopenia and osteoporosis; give patients the appropriate vaccinations to prevent exacerbations of asthma; and diagnose and appropriately treat other co-morbid conditions associated with asthma and other allergic and immunologic problems.
Allergists/immunologists should understand that osteopenia and osteoporosis are common problems associated with chronic lung diseases and know how to prescribe appropriate amounts of calcium and vitamin D and, as necessary, bisphosphonates and other osteoporosis medications. Likewise, appropriate GERD treatment is essential, not only for positive asthma outcomes, but also to prevent other esophageal diseases and improve quality of life.
When considering rhinitis, different co-morbid problems affect the upper airway including laryngopharyngeal reflux, vocal cord dysfunction, and often sleep apnea. It is essential that allergists/immunologists perform rhinoscopy to rule out these suspected problems. It is more diagnostic and cost-effective than a CAT scan, does not irradiate the patient, and enhances the diagnostic skills of our specialty.
Allergists/immunologists similarly should understand which vaccinations are necessary for patients with asthma, COPD and various immunodeficiency problems. For example, asthmatics, particularly those with serious asthma, should receive the pneumococcal vaccine. They all should receive flu vaccines. It seems reasonable that glucocorticosteroid-dependent asthmatics should receive the herpes zoster vaccine. One immunization for tetanus, diphtheria, and whooping cough should be given between ages 19 and 65.
To advance the thinking on and practice of comorbidities, the first WAO International Scientific Conference 2010 in Dubai is in development and is devoted to the subject of "Asthma and Co-morbid Conditions". A world class faculty will lead this initiative under the supervision of G. Walter Canonica, Executive Chair of the Scientific Program Executive Committee along with Co-Chairs Eric Bateman, Stephen Holgate, and Robert Lemanske. The conference is scheduled for December 6 - 8, 2010 in Dubai, UAE. You will find additional information on the WAO website at http://www.worldallergy.org/2010dubai/. See you in Dubai.
Richard F. Lockey, M.D.