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January Medical Journal Review
一月医学杂志回顾
WAO Now: What's New in the World of WAO
今日WAO:WAO领域新进展

And In Other News . . .
其他新闻

January World Medical Journal Review

Prof. Richard F. Lockey, MD, and WAO Web Editor-in-Chief, reviewed premier January medical journal articles for practicing allergists.
Richard F. Lockey教授,医学博士,WAO网站主编,他为在业的变态反应科医生回顾了一月医学杂志的一些重要文章。

1. Rapid Effects of Inhaled Corticosteroids in Acute Asthma
Seventeen studies (470 adults and 663 children and adolescents) met the criteria for inclusion in this review of treatment with inhaled corticosteroids (ICS) within one to four hours of presentation of an asthma exacerbation. Final outcomes were admission and ED discharge rates. After the 2- to 4- hour protocol, a greater reduction of admission rate was observed in trials that used multiple doses of ICS, especially when compared with placebo (odds ratio{OR}, 0.30; 95% confidence interval {CI}, 0.16 to 0.55). ICS patients improve more rapidly when compared with placebo or systemic corticosteroids (SCS) increasing the probability of early ED discharge (OR 4.70; 95% CI, 2.97 to 7.42; p = 0.0001). Spirometric and clinical measures improved as early as 60 minutes with ICS. Benefits were obtained only when patients received multiple doses of ICS with ß-agonist compared with placebo or SCS. In conclusion, ICS used early in multiple doses administered in time intervals of < or = to 30 minutes over 90 to 120 minutes are especially beneficial. Editor's comment: High dose ICS plus ß-agonists used within four hours on multiple occasions for acute asthma effectively decreases morbidity from severe asthma exacerbations. Rodrigo GJ, Chest 2006; 130: 1301
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1.吸入皮质激素对急性哮喘的快速作用
本文对吸入皮质激素(ICS)对哮喘急性发作1至4小时的快速治疗作用作了回顾分析,共有17项研究(470名成年患者,663名儿童和青少年患者)符合标准被纳入本篇综述。所用评价指标包括入院率和急诊出院率。与安慰剂组相比,多次ICS给药组经过2至4小时治疗后入院率明显下降(比值比{OR},0.30;95%可信区间{CI},0.16至0.55)。与安慰剂组或系统使用皮质激素组(SCS)相比,ICS治疗组的症状改善更快,提高了早期急诊出院率的可能性(OR 4.70;95% CI,2.97至7.42;p = 0.0001)。肺功能和临床评估方面的改善最早见于ICS应用60分钟后。与安慰剂组或SCS组相比,只有当患者多次联合应用ICS和ß 受体激动剂时才能获得临床受益。总之,早期多次应用ICS(给药间隔小于等于30分钟,治疗时间90到120分钟)对急性哮喘的控制非常有益。编者按:在4小时内多次给予高剂量ICS联合ß受体激动剂可以有效减少重症哮喘急性发作的发病率。Rodrigo GJ, Chest 2006; 130: 1301

2. Effects of Continuing or Stopping Alendronate (A) After 5 Years of Treatment
One thousand and ninety-nine (1099) postmenopausal women with a mean of five years of prior A treatment were randomized to A, 5 mg/d (n = 329) or 10 mg/d (n = 333), or placebo (P) (n = 437) for five years. Compared with A, switching to P resulted in declines in bone mineral density (BMD) at the total hip (P< .001) and spine (P<.001), but mean levels remained at or were above pretreatment levels 10 years earlier. The cumulative risk for nonvertebral fractures was not significantly different between the two groups. Those on A had significantly lower risks of clinically recognized vertebral fractures (5.3% for P, 2.4% for A) but no significant reduction in morphometric vertebral fractures (11.3% for P, 9.8% for A). The authors suggest that the discontinuation of A after five years does not significantly increase the fracture risk, however, women at high risk of clinical vertebral fractures may benefit by continuation of A. Editor's comment: Physicians who treat asthma and allergic and immunologic diseases need to know how to diagnosis and treat osteopenia and osteoporosis. SG. Black DM, et al. JAMA 2006; 296: 2927. Editorial, Colón-Emeric C. JAMA 2006; 296: 2968.
译文:
2. 接受阿仑磷酸钠(Alendronate)治疗5年后,观察继续或中断给药对患者的影响
研究包括1099名绝经后妇女,曾平均接受约5年的阿仑磷酸钠(A)治疗,研究对象随机分为5 mg/日A治疗组(n = 329)或10 mg/日A治疗组(n = 333),以及安慰剂组(P)(n = 437),随访观察5年。与A组相比,安慰剂组全髋骨密度(BMD)下降(P< 0.001),脊椎骨密度亦下降(P<0.001),但两者与10年前水平相比未见降低。两组间发生非椎骨性骨折的累计风险无显著差异。研究显示A治疗组中临床性椎骨骨折风险明显降低(安慰剂组5.3%,A治疗组2.4%),但形态性椎骨骨折风险无明显降低(安慰剂组11.3%,A治疗组9.8%)。文章作者认为经过阿仑磷酸钠治疗5年后,中断继续给药并不明显增加骨折风险;但是,对于那些存在临床性椎骨骨折高风险的妇女,继续使用阿仑磷酸钠可能更加有益。编者按:从事哮喘和变应性、免疫性疾病诊治工作的临床医师需要了解如何诊断和治疗骨质减少症和骨质疏松症。SG. Black DM, et al. JAMA 2006; 296: 2927. Editorial, Colón-Emeric C. JAMA 2006; 296: 2968.

3. Long-Term Proton Pump Inhibitor (PPI) Therapy and Risk of Hip Fracture
This is a nested, case-control study using a research database from the United Kingdom . The cohort consisted of users of PPI therapy versus nonusers of acid suppression drugs older than 50 years. Similar nested, case-control analysis for histamine 2 receptor antagonists was performed. The adjusted odds ratio (AOR) for hip fractures associated with more than one year of PPI therapy was 1.44 (95% confidence interval [CI], 1.30-1.59). For long-term high dose PPIs (AOR, 2.65; 95% CI, 1.80-3.90; P<.001). The risk increased with duration of PPI therapy, i.e., up to four years. The authors conclude that PPI therapy significantly increases the risk of hip fracture, possibly secondary to acid suppression and decreased calcium absorption. Editor's comment: The risk-benefit of PPI therapy needs to be considered. Individuals with asthma commonly have gastroesophageal reflux disease. Using the lowest effective PPI dose and increasing consumption of dairy products, calcium supplements with meals, and vitamin D therapy make sense. Yang Y-X, et al. JAMA 2006; 296: 2947.
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3. 长期应用质子泵抑制剂(PPI)治疗与引发髋骨骨折的风险
这是一项嵌入式病例对照研究,所用调查数据库来自英国。研究对象为50岁以上,接受PPI治疗的患者和未使用抑酸剂的患者。研究同时还对H2受体拮抗剂进行了类似的嵌入式病例对照研究。接受1年以上PPI治疗相关的髋骨骨折的校正比值比(AOR)为1.44(95%可信区间[CI],1.30-1.59)。接受长期高剂量PPI治疗组的AOR为2.65,95% CI,1.80-3.90,P<0.001。随着PPI治疗延长,在4年的研究期内骨折的风险也随之增高。文章作者发现:使用PPI治疗可以显著增加髋骨骨折的风险,原因可能是胃酸分泌受抑以及钙吸收降低。编者按:在进行PPI治疗前需要考虑其风险收益比。鉴于哮喘患者通常存在胃食管返流疾病,使用最低有效剂量的PPI,增加奶制品的摄入,增加膳食补钙并给予维生素D治疗将是明智之举。Yang Y-X, et al. JAMA 2006; 296: 2947.

4. Asthma, influenza, and vaccination - Review
Influenza (I) viruses, like other viruses, exacerbate asthma (AS) and are frequently associated with hospitalization. Inactivated I vaccine (V) does not exacerbate AS. Likewise, medium- or high-dose inhaled or short-term systemic corticosteroids (CS) do not affect antibody responses to I A-antigens. High-dose inhaled CS may affect the response, but this is controversial. There is still a question of whether inactivated I V prevents the exacerbation of asthma. Live attenuated I V, given by nasal spray, is better accepted by children and is more efficacious. Universal I vaccination of all children will facilitate control of epidemic I and provide an infrastructure for control of future I pandemics. Editor's comment: I V is indicated for all asthmatics, and I V immunization of all children will facilitate control of this disease. Glezen W P, JACI 2006; 118: 1199.
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4. 关于哮喘,流感和疫苗接种的回顾分析
流感(I)病毒和其他病毒一样不但可以引起哮喘的急性发作(AS) 还常常与住院治疗相关。灭活流感疫苗不会引发哮喘急性发作。同样,中等剂量或高剂量吸入皮质激素以及短期全身应用皮质激素不会影响针对流感病毒抗原的抗体 应答。高剂量吸入皮质激素有可能会影响抗体应答,但这个观点目前仍存在争议。对于灭活流感疫苗是否能预防哮喘的急性发作目前存在疑问。鼻喷方式给予减毒活流感疫苗更容易为儿童所接受,效果也会更好得多。对所有儿童普遍进行流感疫苗接种将有益于对流感流行的控制,并为控制流感在今后可能发生的全国性流行奠定基础。编者按:建议对所有哮喘患者进行流感疫苗接种,对所有儿童进行流感疫苗接种将有益于对流感的控制。Glezen W P, JACI 2006; 118: 1199.

5. Anti-IL-5 (MEPOLIZUMAB) therapy for eosinophilic esophagitis
This is an open-label, phase I/II, safety and efficacy study of anti-IL -5 in four adult patients with eosinophilic esophagitis (EE) with longstanding dysphagia and esophageal strictures. They were given three infusions of anti-IL-5 without a change in current therapy. Peripheral blood eosinophils and percent of CCR3+ cells decreased by 6.4- and 7.9-fold (P<.05), respectively, as did mean and maximal esophageal eosinophilia, (P< .001) and (P<.05), respectively. Patients' clinical outcome and quality of life improved (P = .03) and therapy was tolerated. IL-5 may be a therapeutic option for EE. Editor's comment: More studies are needed with anti-IL-5 for EE. Stein ML, et al. J Allergy Clin Immunol 2006; 118: 1312.
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5.应用抗IL-5(MEPOLIZUMAB)治疗嗜酸细胞性食道炎
本试验为开放式、I/II期研究,观察对长期存在吞咽困难和食道狭窄症状的4名成年嗜酸细胞性食道炎(EE)患者应用抗IL-5的安全性和有效性。这些患者在维持原治疗方案的同时分别给予3次抗IL-5。结果发现:周围血嗜酸性粒细胞和CCR3+细胞比例分别下降6.4和7.9倍(P<0.05),食道嗜酸性粒细胞平均值和最大值也同时下降,P值分别< 0.001和<0.05。患者临床疗效和生活质量得到改善(P = 0.03),治疗耐受性良好。抗IL-5有可能成为嗜酸细胞性食道炎治疗手段之一。编者按:关于抗IL-5对EE的作用需要进行更多的研究。 Stein ML, et al. J Allergy Clin Immunol 2006; 118: 1312.

Numbers 6 & 7 were reviewed by Gary Hellermann, PhD, University of South Florida, Tampa, Florida
Gary Hellermann博士来自佛罗里达州坦帕市的南佛罗里达大学,以下第6和7篇文献由他进行回顾评述。

6. Epidermal RANKL controls regulatory T-cell numbers via activation of dendritic cells
RANKL, the ligand of RANK (receptor activator of NF-?B), is up-regulated in keratinocytes when skin is UV irradiated and binds to RANK expressed on dendritic cells of the skin, the Langerhans cells (LC). The evidence comes primarily from experiments on transgenic mice over-expressing RANKL, and these mice show 2-3 times greater systemic numbers of CD4+CD25+ T regulatory cells (Tregs) than the wild type. The Tregs from RANKL-transgenic mice suppress effector T cells and produce characteristic biomarkers such as IL-10. The authors conclude that the peripheral expansion of Tregs results from an increase in cutaneous RANKL, which stimulates LC via binding to RANK, to promote proliferation of Tregs. Editor's comment: Cutaneous stimulation of LC by increasing RANKL in the presence of a specific antigen may provide a new treatment for suppressing allergic inflammation. Loser K, et al. Nature Medicine 2006; 12: 1372.
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6. 表皮RANKL通过树突状细胞的活化来调控调节T细胞的数量
RANKL是NF-κB受体活化因子的配体,当皮肤受紫外线照射后角化细胞中RANKL上调并与皮肤中树突状细胞(即朗格汉斯细胞,LC)所表达的RANK 发生结合。研究所用材料为过表达RANKL转基因小鼠,结果显示:这些转基因小鼠与野生型小鼠相比,全身CD4+CD25+ 调节T细胞(Tregs)升高2至3倍。RANKL 转基因小鼠产生的Tregs可以抑制效应T细胞并产生特有的生物学产物,如IL-10。作者通过研究证实:表皮RANKL的增加会导致周围血Tregs数量的上升,其机制是通过配体与RANK结合对朗格汉斯细胞产生刺激,从而促进Tregs的增殖。编者按:存在某种特异性变应原时,通过增加RANKL 对朗格汉斯细胞的皮肤刺激也许能作为治疗变应性炎症的又一新手段。Loser K, et al. Nature Medicine 2006; 12: 1372.

7. Natural killer T Cells and CD8+ T Cells are dispensable for T Cell-dependent allergic airway inflammation (AAI)
Das et al compare the contribution of T helper type 2 (Th2) cells, natural killer T cells (NKT) and CD8+ T cells to AAI. Ovalbumin-sensitized transgenic mice with gene knockouts that eliminated CD4+ T cells show no eosinophil infiltrate or increased mucus in the lungs after ovalbumin challenge. However, mice deficient in NKT and CD8+ T cells had ovalbumin-induced AAI comparable to the wild type. Therefore, the authors conclude that NKT cells with or without memory CD8+ cells are not required for AAI. The authors of an earlier paper (Akbari et al.), which supports the role of NKT and DC8+ cells in AAI, reply that airway hyper-responsiveness (AHR) is a better measure of asthma than eosinophilia and mucus production and cite two studies supporting involvement of NKT cells in AHR. They point out that while allergen-specific Th2 cells are necessary in allergic rhinitis, the AHR characteristic of asthma appears to involve NKT cell regulation of other factors in the lower respiratory tract. Editor's comment: The complexity of the immune system is legendary, and the jury is still out on the relative contributions of all players. Das J, et al. Nature Medicine 2006; 12: 1345.
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7. 自然杀伤T细胞和CD8+T细胞不是产生T细胞依赖性变应性气道炎症(AAI)的必要条件
Das等比较了2型T辅助细胞(Th2),自然杀伤T细胞(NKT)和CD8+T细胞对变应性气道炎症的作用。经基因敲除的转基因小鼠不具备CD4+T细胞,使用这种小鼠制作卵清蛋白致敏模型并给予卵清蛋白进行激发,结果显示小鼠肺中未发现嗜酸性粒细胞浸润和粘液增多。但是,与野生型小鼠相比,NKT和CD8+T细胞缺失的转基因小鼠仍可经卵清蛋白诱导产生变应性气道炎症。因此,文章作者认为:NKT 伴有或不伴有CD8+记忆细胞不是产生AAI的必要条件。另有一篇稍早发表的文章(Akbari等)证实了NKT和CD8+细胞在AAI中的作用,认为与嗜酸细胞增多和粘液生成量相比,使用气道高反应性(AHR)这一指标能更好地对哮喘进行评估,该文章还引用了另两项研究支持NKT细胞参与了AHR的产生。文章作者指出:变应原特异性Th2细胞是产生变应性鼻炎的必要条件,有迹象表明下呼吸道NKT细胞对其他因素的调节作用参与了AHR的出现,后者恰恰是哮喘的重要特征。编者按:免疫系统错综复杂,该领域需要更多的深入研究。Das J, et al. Nature Medicine 2006; 12: 1345.

8. Validation of current joint AAAAI & ACAAI guidelines for antibody response to the 23 pneumococcal vaccine (PPV) using a population of HIV-infected children
This case-controlled study compared changes in PPV AB titers in 95 immunocompetent children versus 22 immunodeficient HIV-infected children, ages 2 to 15 years. Authors confirm the proposed recommendations of a 4-fold increase in titers after PPV immunization for at least 50% of the serotypes tested (6 out of 12) as adequate responses in children between 2 and 15 years. For children who have previously received the 7-pneumococcal conjugate vaccine, positive responses for two out of four serotypes not included in this vaccine are considered adequate. Editor's comment: This study outlines criteria to accurately identify children who lack optimal responses to one immunization with PPV. Kamchaisatian W, et al. JACI 2006; 118: 1336. Potential conflict of interest: authors are USF colleagues of RFL.
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8. 使用HIV感染儿童来验证AAAAI和ACAAI对接种23价肺炎球菌疫苗(PPV)后评价抗体应答的相关指南
这项病例对照研究观察了95名免疫正常儿童和22名免疫缺陷的HIV感染儿童,年龄2到15岁,对他们在接种肺炎球菌疫苗后的抗体滴度变化进行了比较。研究证实:如果在PPV 免疫接种后,至少50%检测血清型的抗体滴度呈4倍增高,则认为这些2到15岁儿童的免疫应答正常。对那些曾经接种过7价肺炎球菌疫苗的儿童,当该疫苗中未含有的4种血清型有2种呈阳性反应则认为反应正常。编者按:对那些进行PPV免疫接种后未获得最佳应答效果的儿童,本研究对如何正确判别效果概述了相关标准。Kamchaisatian W, et al. JACI 2006; 118: 1336. 潜在的利益冲突:本研究的多位作者是RFL的USF工作人员。

9. Does allergen-specific immunotherapy represent a therapeutic option for patients with atopic dermatitis (AD)?
This review article summarizes the evidence associated with house dust mite (HDM) allergens as an allergic trigger factor for AD. They offer evidence that the enzymatic activity of HDM facilitates allergenic penetration into the impaired, epidermal skin barrier of AD inducing both immediate- and delayed-type reactions which contribute to the impairment of AD. The authors review data on specific immunotherapy (SIT) and AD. They conclude that the value of SIT for treatment of AD is uncertain at this time. Editor's comment: This is must reading for all physicians who treat severe AD. More controlled studies are necessary on treatment efficacy of IT for AD. Bussmann C, et al. JACI 2006; 118: 1292.
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9. 特异性免疫治疗是否可作为特应性皮炎(AD)患者的治疗手段之一?
这篇综述针对“户尘螨(HDM)变应原是AD的变应性触发因子之一”的相关证据进行了总结。他们提出的证据表明:速发型和迟发型变态反应可以造成AD的皮肤损伤,而HDM的酶活性可以促进变应原对损伤表皮的渗透。作者对特异性免疫治疗(SIT)和特应性皮炎的资料进行了回顾。目前观点认为SIT对AD的治疗作用尚不确切。编者按:这篇文章一定是为治疗重症AD的医师量身而做。关于应用IT治疗AD方面还需要更多的对照研究。Bussmann C, et al. JACI 2006; 118: 1292.

10. Why do we develop food allergies?
This author reviews how the immune system detects the differences between food and pathogens in a systematic discussion on how food represents a special challenge for the immune system of the gut, which is designed to guard against invaders. In-utero immunologic responses, secretory immunoglobulin A and oral tolerance all contribute to the immunologic acceptance of multiple food antigens. The author reviews work that demonstrates that oral tolerance to food is directly linked to the development of CD25+ Treg cells. He goes on to state that the current increase of allergies in industrialized countries is a small price to pay for the remarkable reduction in infant mortality, provided by the intermission of pathogens through improved hygiene. Editors comment: A wonderful update on the pathogenesis of food allergy. Brandtzaeg P, American Scientist 2006; 95: 28.
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10. 我们为什么会产生食物过敏?
文章作者回顾了免疫系统如何分辨食物和病原体之间的区别,系统讨论了食物如何对防御外来入侵的胃肠免疫系统产生特异性刺激。胎儿期免疫应答,分泌型免疫球蛋白A以及口服耐受促成对多种食物抗原的免疫耐受。作者通过回顾证实:对食物的口服耐受与CD25+调节T细胞的生成直接相关。作者进一步指出:通过卫生条件改善减少了病原体的入侵,从而实现婴幼儿死亡率大幅降低,而当前变应性疾病在工业化国家的增长状况不过是实现这一目标所付出的低廉代价。编者按:这篇文章更新了食物过敏发病机制的相关知识,值得一读。Brandtzaeg P, American Scientist 2006; 95: 28.

11. High prevalence of aeroallergen sensitization among infants of atopic parents
A birth cohort of infants was first identified from birth records and enrolled in this study if a parent reported allergic respiratory symptoms and had a positive skin prick test (SPT) to a common aeroallergen. At one-year, these infants were tested to the same 15 aeroallergens. Of 680 infants, 28 % were SPT positive to one or more aeroallergens and/or food and 18 % positive to one or more aeroallergens (9.7 %, pollen; 7.5 %, molds; 4.3 % house dust mite and/or cockroach; and 3.4% dog and/or cat). Sixty-six percent remained positive at 2-years. The authors conclude that infants born to atopic parents who are SPT positive are at increased risk for aeroallergen sensitization during infancy, which persists to age 2-years and suggest that SPT before age 2 may be indicated to identify such children. Editor's comment: Allergic sensitization starts early in life to both food and inhalant allergens. LeMasters G, et al. J Pediatrics 2006; 149:505. Potential conflict of interest: Drs.Grace LeMasters and James Lockey are relatives of RFL.
译文:
11. 具有特应性父母的婴幼儿对气传变应原致敏率高
通过对出生档案的调查,如果发现婴幼儿的父母具有变应性呼吸道症状同时皮肤点刺试验(SPT)显示对常见气传变应原有阳性反应,则将该婴幼儿纳入本研究。在1岁时,使用相同的15种气传变应原对这些婴幼儿进行皮试:在680名婴幼儿中,28 %对至少一种气传变应原和/或 食物变应原SPT阳性,18 % 对至少一种气传变应原阳性(花粉9.7 %,霉菌7.5 %,户尘螨和/或蟑螂4.3 %,狗和/或猫皮屑3.4%)。这些婴幼儿中有66%在2岁时仍保持阳性反应。结论:SPT阳性的特应性父母所生孩子在婴儿期对气传变应原发生致敏的风险增高,这种致敏状况可以持续到2岁,研究提示对2岁以内的婴幼儿可以使用SPT作为鉴别诊断手段。编者按:关于食物和吸入性变应原的变应性致敏始发于人生早期。 LeMasters G, et al. J Pediatrics 2006; 149:505. 潜在的利益冲突:Drs.Grace LeMasters和James Lockey是RFL的相关人员。

12. Immunologic response to administration of standardardized dog allergen extract at differing doses
Cluster immunotherapy was administered to 28 patients with dog allergy randomly assigned to placebo or an acetone-precipitated extract containing 0.6 µg, 3.0 µg, or 15 µg Can f 1 per 0.5 ml maintenance dose. Results show a significant dose-dependant response in suppression of titrated skin prick tests and delayed cutaneous responses. Dog-specific IgG4 increased significantly in both high-dose and low-dose therapy, and there was a dose-dependant suppression of secreted TNF- and increase in secreted TGF-ß. Likewise, there was a dose-dependant trend in suppression of secreted IL-4 with a significant decrease from baseline in the high-dose group. No changes occurred in symptom scores: lymphocyte proliferation; secreted IFN-γ , IL-10, or IL-5; or intracellular cytokine production. The lack of clinical response was attributed to a misunderstanding in the conduct of nasal challenges resulting in suboptimal dosing. The authors conclude that a maintenance dose of 15 µg of Can f 1 produces the greatest and most consistent immunologic response. Editor's comment: Immunotherapy with similar doses of Fel d 1 and Can f 1 produces similar immunologic responses. Lent AM, et al. JACI 2006; 118:1249.
译文:
12. 观察不同剂量标准化狗变应原浸液诱导的免疫应答
本研究共对28名狗过敏患者给予免疫治疗,这些病人随机分为安慰剂组或者丙酮沉淀变应原浸液治疗组(每0.5ml维持药液中分别含0.6 µg,3.0 µg或15 µg Can f)。在皮肤点刺试验终点滴定测定和迟发型皮肤反应方面,研究证实在免疫治疗组产生显著剂量依赖性抑制作用。在高剂量和低剂量治疗组中狗特异性IgG4均明显升高,同时呈剂量依赖性抑制TNF-α的分泌,而TGF-ß分泌呈剂量依赖性增多。同样,研究显示高剂量免疫治疗组中IL-4分泌受到剂量依赖性的抑制作用并且明显低于基线水平。治疗组在症状评分方面没有改善:淋巴细胞增殖, IFN-γ、IL-10或IL-5的分泌以及细胞内细胞因子生成。作者认为对鼻粘膜激发的理解错误导致研究所用治疗剂量并非最佳剂量,因此临床效果不佳。总之,Can f 1的15 µg 维持剂量可以产生最强和最持久的免疫应答。编者按:使用相似剂量的Fel d 1和Can f 1制剂进行免疫治疗可以产生相似的效果。Lent AM, et al. JACI 2006; 118:1249.


WAO Now: What's New in the World of WAO 今日WAO:WAO领域新进展

World Allergy ForumWorld Allergy Forum 世界变态反应论坛
"A Global Perspective on Genetics, the Environment and Allergy"
对遗传学,环境学和变态反应学的全球展望

2007 AAAAI Annual Meeting  2007AAAAI年会
Monday, February 26, 2007, 4:45 pm - 6:00 pm
San Diego Convention Center
Upper Level, Room 32 AB

Moderator主持人:
Thomas A. E. Platts-Mills, USA

Co-Moderator共同主持人:
Michael A. Kaliner, USA

Is Early Exposure to Allergen Protective?
变应原早期暴露具有保护作用?

Adnan Custovic, United Kingdom

How Does the Environment Influence Genetic Responses?
环境怎样影响遗传应答?

Robert F. Lemanske Jr., USA

Environmental Intervention in the Management of Allergic Diseases
变应性疾病控制中的环境干涉

Erika Von Mutius, Germany
Sponsored by Novartis


gloria2007 March GLORIA Placements
2007年3月份 的GLORIA计划


Scientific Meeting of the Association of Allergology and Clinical Immunology of Serbia and Montenegro
塞尔维亚及黑山变态反应和临床免疫学学会科学大会

22-24 March 2007
Belgrade, Serbia
International GLORIA Faculty国际GLORIA教员:
Todor Popov
Presentations主讲:
Module 7: Angioedema血管神经性水肿
Module 9: Diagnosis of IgE Sensitization 关于IgE致敏的诊断

South Carolina Society of Allergy, Asthma, and Immunology
南卡罗莱纳州变态反应,哮喘和免疫学学会

March 23-25, 2007
Charleston, South Carolina
US GLORIA Faculty美国GLORIA教员:
Allen P. Kaplan
Presentations主讲:
Module 2: Allergic Conjunctivitis变应性结膜炎
Module 8: Anaphylaxis严重过敏反应

GLORIA is supported through unrestricted educational grants from:
GLORIA得到以下公司教育资助的支持

alcon
dey
dyax & genzyme
nutricia  shs
schering-plough

 

The WAO Henning Løwenstein Research Award 2007
Call for Applications

The WAO Henning Løwenstein Research Award is a biennial award given to a young scientist who has shown excellence within the field of allergy. WAO and ALK-Abelló will present the award at the World Allergy Congress in Bangkok, 2-6 December 2007.

The winner will receive EURO 20,000 together with a travel grant to attend the Congress.

For application guidelines visit http://www.alk-abello.com/ and click on "The WAO Henning Løwenstein Research Award."

WAO 2007年度Henning Løwenstein科研奖
接受申请中

WAO Henning Løwenstein 科研奖每2年颁发一次,将授予在变态反应领域做出卓越贡献的年轻科学家。WAO和ALK公司将在2007年12月2-6日曼谷召开的世界变态反应大会上向获得者颁发本次奖项。

科研奖获得者将获得20,000欧元奖励,同时将被资助参加本次世界变态反应大会

访问这里 http://www.alk-abello.com/ 并点击"The WAO Henning Løwenstein 科研奖"即可获得申请指南
截止日期: 2007年6月30日


New Synopsis
Drug Allergies are the focus of the latest educational synopsis to be posted on the WAO Web site. Written by Bernard Thong, MBBS, MRCP (UK), FAAAAI, with contributions from Cassim Motala, MD FCPAED(SA) FACAAI FAAAAI , and Daniel Vervloet, MD FAAAAI, the synopsis provides a comprehensive overview of immunological and non-immunological adverse drug reactions. To read this new synopsis in WAO's Allergic Diseases Resource Center, click here.
新大纲
即将在WAO网站上公布的是最新教学大纲,内容主要围绕药物变态反应。大纲撰写者是Bernard Thong MBBS,(英国)皇家内科医师学会会员,AAAAI会员;还有两位医生为本书作了大量工作:Cassim Motala MD,FCPAED(SA),FACAAI,FAAAAI,以及Daniel Vervloet MD,FAAAAI。本大纲对免疫性和非免疫性药物不良反应进行了全面概括。如有兴趣,可来WAO变应性疾病资源中心阅读该新大纲,点击这里


WAO Conversations:
We have the pleasure of announcing four new interviews with well-respected allergists. Take a moment to listen to them sharing their extensive knowledge.
我们很高兴地宣布下面推出对四位著名变态反应学专家的访谈记录。邀请您来分享他们广袤的知识。

  • Prof. Stephen Durham - Mechanisms of Immunotherapy 免疫治疗的机制
  • Dr. Thomas Platts-Mills - Indoor Allergen Control 对室内变应原的控制
  • Prof. Carlos Baena-Cagnani - History and Vision of the World Allergy Organization 世界变态反应组织的历史与将来
  • Dr. Harold Nelson - How do you properly mix Allergen Vaccines? 怎样才能恰当的混合变应原疫苗?

El-Ghoneimy Short-Term Fellowship Report
Dr. Dalia El-Ghoneimy from Cairo, Egypt , spent her WAO Short-Term Research Fellowship in the laboratory of Prof. G. Walter Canonica in Genoa, Italy , studying skin prick testing in the early diagnosis of atopy in infants and children and immunotherapeutic modalities. The objective of her fellowship was to receive the necessary training to enable her to identify the major allergens to which infants in Egypt are sensitized and the possible immunotherapeutic interventions needed. To read Dr. El-Ghoneimy's report on her fellowship, click here.
El-Ghoneimy短期奖学金报告
Dalia El-Ghoneimy医生来自埃及开罗,她利用WAO资助的短期科研奖学金在意大利热那亚G. Walter Canonica教授的实验室完成了短期进修,学习内容包括:使用皮肤点刺技术对婴幼儿和儿童特应性疾病进行早期诊断以及免疫治疗。她进修的目的在于获得必要训练来鉴定埃及婴幼儿致敏的主要变应原并进行可能的免疫治疗干预。如有兴趣,可点击这里阅读 El-Ghoneimy医生的研究奖学金报告。


Sign up for On-Line Journal Subscription -
WAO and Hogrefe & Huber Publishers are offering a limited number of free on-line subscriptions to Allergy & Clinical Immunology International - Journal of the World Allergy Organization for members in developing countries. If you are interested in receiving a complimentary, on-line subscription, please send an e-mail to info@worldallergy.org, noting "Free Journal Subscription" in the subject line, with the following details:

First name
Last name
Postal address
City, State/Province and postal code
Country
E-mail address
Name of Member Society

WAO和Hogrefe & Huber出版公司现为发展中国家的会员提供有限数量的《Allergy & Clinical Immunology International - Journal of the World Allergy Organization》免费在线订阅服务。如果您希望得到这份杂志的免费赠阅的电子版,请给我们发送e-mail至info@worldallergy.org,注意在信件的主题栏写“Free Journal Subscription”,并详细注明以下资料:

名字
姓氏
邮政地址
市,州/省和邮政编码
国家
E-mail地址
成员学会的名称


And In Other News 其他新闻

Allergy Book Reviews
变态反应学书评


Allergy in Practice
实用变态反应学

Author: Johannes Ring
Editor: Marion Philipp
ISBN #: 978-3-540-00219-2

List price: $129.00 USD
定价:129.00美元
Available from: Springer Berlin Heidelberg
订购网址:Springer Berlin Heidelberg

NOTE: The book, Allergy in Practice, was reviewed by two different reviewers, as follows.
注释:下面分别由两位书评作者对《实用变态反应学》进行了评价。

First review of Allergy in Practice
Reviewer: Ron Purcell, MD
University of South Florida College of Medicine and James A. Haley
Veterans Hospital, Tampa, FL, USA
《实用变态反应学》第一位书评作者
书评作者:Ron Purcell, MD
南佛罗里达大学医学院, 以及James A. Haley
荣民医院,坦帕,佛罗里达州,美国

Description:
Allergy in Practice is a concise yet remarkably thorough overview of allergic disease and provides the reader with a basic understanding of the physiology, diagnosis, and treatment of commonly encountered allergic conditions. This is an updated version of the 2nd edition printed in 1988 and reflects the many changes in the field over the past 20 years.
说明:
《实用变态反应学》一书虽然内容简洁,但对变应性疾病概况进行了全面覆盖,使读者能够初步了解常见变应性疾病的生理学、诊断学和治疗学内容。本书是1988年发行第二版的更新版本,反应了这20年在该领域的进展。

Purpose:
This book is written to provide the reader with a better understanding of the recognition and treatment of allergic diseases commonly encountered in the clinical setting. It does not cover immunodeficiency, rheumatology or other immunologic conditions except as they relate specifically to allergy.
目的:
本书可以使读者较好的了解临床工作中常见变态反应疾病的鉴别和治疗。本书内容未涉及免疫缺陷疾病和风湿病,亦未涵盖变态反应之外的其他免疫疾病。

Audience:
Medical students, physicians in training, and other health care professionals looking for an introduction to the clinical practice of allergy will find this to be an excellent resource. It also serves well as a reference for health care professionals who want rapid access to clinically useful information regarding the field of allergy.
读者:
需要实用临床变态反应学入门知识的医学生,内科进修医生,以及其他的卫生保健专业人士。他们将会在本书找到满意的内容。如果卫生保健专业人士需要快速掌握变态反应领域有用的临床信息,本书同样能起到参考的作用。

Features:
Without a doubt, the book's strong point is the author's exceptional ability to present information in a concise, straightforward manner. Despite being only 276 pages and measuring 25 X 17 cm, the book covers nearly every aspect of allergy in such a way that the reader can quickly grasp even difficult concepts. Each section is clearly delineated and rarely exceeds two pages; many are only one or two paragraphs. Despite this brevity, explanations are thorough and complete. The clinical sections are organized logically and make generous use of tables, so differential diagnosis, common physical findings, and other practical information can be quickly accessed. Extensive cross referencing of sections allows the reader to easily locate related concepts or conditions. Additional chapters covering allergen immunotherapy and diagnostic techniques, such as skin testing, provide insight into how these are accomplished by specialists trained in these procedures.
特色:
毫无疑问,本书长处在于:该书作者具备将相关知识以简洁易懂的方式展示给大家的能力。尽管全书总共276页,25× 17cm大 小,但是书中涵盖了几乎所有的变应性疾病,读者可以利用本书迅速掌握不同难易程度的内容。每章内容叙述清晰,而且篇幅基本控制在两页以内;许多章节甚至仅 用一到两段文字加以描述。尽管本书如此简洁,但同时做到了解释清晰翔实。书中有关临床章节的组织逻辑性强,并运用了大量表格,因此读者可以迅速了解有关鉴 别诊断、体检发现以及临床实践等方面的内容。广泛交叉的各章参考文献能够帮助读者迅速明确有关概念。附加章节的内容包括变应原免疫治疗和诊断技术,例如皮 肤试验,该章帮助读者了解专业人士如何完成这些诊治项目。

Assessment:
Anyone wishing to increase their understanding of the diagnosis and management of allergic disease in a concise, readable format will find this to be an excellent resource.
评价:
对那些希望拓宽自身对变应性疾病诊断和治疗知识的读者,本书内容简明,可读性强,可以为读者提供满意的内容。

Second review of Allergy in Practice
Reviewer: Salvador Gala, MB BS PhD
University of Sydney
《实用变态反应学》第二位书评作者
书评作者:Salvador Gala, MB BS PhD
悉尼大学

Description:
Prof. Ring states his book evolved from a series of information leaflets and short chapters for residents rotating through his Allergy Division. Thus, the underlying theme reflecting a detailed but concise introduction to allergic disease is evident throughout Allergy in Practice. There are the standard chapters on allergic mechanisms, clinical evaluation, diagnostic tests and therapy. However, grouping of allergic disorders within the main body of the text is predominantly according to the Gell and Coombs classification, wherein clinical information appears within a scheme of pathophysiology. Nevertheless, this approach works quite well; the reviewer was easily able to navigate throughout the different subsections of the book when searching for specific pieces of information. As the sole author, Prof. Ring eschews those problems of excess, irrelevant detail and redundancy so commonly observed in multi-authored comprehensive texts.
说明:
Ring教授指出本书的前身是一系列为轮转住院医生准备的单张讲义和简要章节。因此,《实用变态反应学》一书所包含的变应性疾病相关主题内容翔实又不失简洁。书中章节涵盖以下方面:变态反应机制,临床评估,诊断技术和治疗方法。本书对变应性疾病的归类使用了Gell & Coombs分类法,临床方面的介绍则使用了病理生理学框架。可以说作者这一处理方法非常有效;读者借此可以自如地在书中不同章节搜寻某一特定内容。作为本书的唯一作者,Ring教授成功的避免在书中出现多余或无关冗长的内容,这些问题在多位作者合作的教科书中很容易遇到。

Purpose:
Allergy in Practice provides the trainee and non-specialist reader with a detailed but concise introduction to the field of allergy. Prof. Ring covers all major subject areas relevant to the basic science and clinical management of allergic disease. It is, in essence, a textbook - but written in a user-friendly style.
目的:
《实用变态反应学》为进修生和非专业读者对变态反应领域进行了翔实而简洁的介绍。Ring教授在书中对变应性疾病相关基础研究和临床治疗方面所有的主要内容均作了介绍。本书虽然是一本教科书,但采用的写作风格易于为读者掌握使用。

Audience:
Whilst easy to follow, Allergy in Practice is pitched at the specialist level. This book is, therefore, ideal as a study aid for allergy trainees and residents undertaking an allergy rotation and as a refresher for allergy specialists. Non-allergist physicians requiring specific information on allergic disorders will more readily find answers here, rather than trying to negotiate larger comprehensive allergy texts.
读者:
《实 用变态反应学》在适用于研究生的同时又具有一定专业水准。因此,本书不但是针对变态反应进修生和接受变态反应轮转住院医生的学习用书,同时也是变态反应专 业医师知识更新的途径之一。对于那些需要变应性疾病特定内容的非专业内科医师,相对于其他大型综合专业书籍,使用本书更能有助于帮助他们找到所需要的答 案。

Features:
The positive qualities to Allergy in Practice are plentiful. Descriptions of individual allergic disorders are detailed but concise. Those aspects of basic science chosen for review are all clinically relevant. High-quality color photography is included throughout the book to demonstrate important clinical, radiological and histological points within the main text. Prof. Ring makes frequent use of schematic multi-color diagrams to convey important concepts without, however, becoming entrenched in overly complicated detail. Lists and tables accompanying the text are useful for clinical reference because they achieve a balance between sufficient detail and conciseness. References are very selective and included on the basis of clinical relevance.
特色:
《实用变态反应学》优点非常多。书中对不同变应性疾病的介绍翔实又不失简洁。本书所选的基础研究内容都与临床相关。书中还采用了许多高质量彩色照片来说明临床学、影像学或组织学上的相关重要内容。Ring教授在书中避免使用过多复杂的描述,尽量运用多色示意图来向读者传达重要概念。运用列表和表格可以在详尽和简明之间取得平衡,从而使本书具有临床参考的实用性。书中参考目录经过作者的仔细筛选,主要基于临床的相关内容。

Does the book have any drawbacks? Its advantages are at the same time its limitations. The reader will still need access to comprehensive textbooks and journals for details of rare conditions, in-depth reviews, and more up-to-date information. Inclusion of an Appendix serves to partly address these issues by directing the reader towards additional sources of information.
那么,本书有没有缺点呢?应该说,它的优点同时也是它的局限之处。对于那些希望了解某些少见疾病的详细内容、进一步的回顾资料以及最新信息的读者,需要他们再去阅读一些综合教科书和期刊。本书附录中列出了部分刊物的名称,方便读者借以学习那些额外的内容。

Assessment:
Prof. Ring's publication represents a clinically useful, high-quality 'entry-level' allergy textbook. As summarized by Prof. Platts-Mills in his foreword to Allergy in Practice, Prof. Ring provides a comprehensive but well planned description of allergic disorders "that are either very common or just common." Allergy in Practice is designed for use as an introductory textbook, to be studied cover-to-cover and complemented by reading of current literature.
评价:
这本由Ring教授出版的读物具有临床实用性,是本高质量的“入门级”变态反应教科书。正如Platts-Mills 教授在书中前言所说的,Ring教授对“非常常见的、常见的”变应性疾病进行了全面、精心的介绍。《实用变态反应学》是一本介绍性读物,应该逐字逐页学习的同时辅以对当前文献的阅读学习。

Find more allergy book reviews on the WAO Website here.
WAO网站上其它的变态反应学书评见此处

The World Allergy Organization's mission is to build a global alliance of allergy societies to advance excellence in clinical care, research, education and training. Visit us on the Web at http://www.worldallergy.org/
世界变态反应组织的使命是建立一个全球性的变态反应学会联盟,不断推动临床、科研、教学与培训工作的进步。欢迎您浏览我们的网站: http://www.worldallergy.org/

World Allergy Organization (WAO)
Secretariat
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Milwaukee, WI 53202-3823
Email: info@worldallergy.org
世界变态反应组织(WAO)秘书处
555 E. Wells Street, Suite 1100
Milwaukee, WI 53202-3823
电子信箱:info@worldallergy.org

You have received this message because you are a member of a WAO Member Society, you have subscribed for the monthly e-letter or had previous contact with the World Allergy Organization. If you would prefer not to receive further messages from WAO, please reply to this message with REMOVE in the subject line.
您因如下原因收到此次通讯:您是世界变态反应协会会员,或者您曾向世界变态反应协会订阅过电子月刊,或者您以前曾与世界变态反应协会进行过有关联系。如果您不希望继续收到来自世界变态反应协会的信息,请以“删除”为主题回复此邮件。

Made possible through an unrestricted educational grant from Novartis.