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WAO News & Notes

March Medical Journal Review(3月の医学雑誌レビュー)
WAO Member Society Spotlight(WAO所属学会紹介)
WAO Now: What's New in the World of WAO(WAO最新ニュース)
And In Other News . . .(その他のニュース)

March World Medical Journal Review (医学雑誌レビュー)

Prof. Richard F. Lockey, MD, WAO Web Editor-in-Chief, reviewed premier March medical journal articles for practicing allergists.南フロリダ大学ロッキー教授による3月の医学雑誌に掲載されたアレルギー関連の文献紹介です。

1. CD4+ INVARIANT T-CELL-RECEPTOR+ NATURAL KILLER T CELLS IN BRONCHIAL ASTHMA
Invariant natural killer T cells in humans are CD4+ with Va24-Ja18 receptors. They respond to glycolipid rather than peptide antigens. On activation they produce large quantities of interferon-? and IL-4. The authors found that 60% of pulmonary CD4+CD3+ cells in patients with moderate-to-severe persistent asthma were natural killer T cells, which expressed an invariant T-cell receptor and produced type 2 helper cytokines. Controls (normal and patients with sarcoidosis) had conventional CD4+CD3+ T cells, not natural killer T cells. Editor's comment: These findings call into question ? is it the Th2 T cell or the natural killer T cell that is involved in the pathogenesis of asthma? Akbari O, et al. N Engl J Med 2006; 354: 1117. Kay AB, Editorial: 1186.

ヒトNKT細胞は固定したT細胞受容体Vα24-Jα18をもっている。そして通常のT細胞の様にペプチド抗原ではなく、特定の糖脂質構造に反応して活性化し、インターフェロンγやIL-4を産生する。現在、NKT細胞を活性化する糖脂質としては知られているのはαガラクドシルセラミドという海綿に存在する物質のみである。Akbariらは喘息患者の気管支洗浄液や肺生検試料をもちいて肺に存在するCD3+CD4+T細胞のうち約60%がこのNKT細胞であることを見いだした。正常試料(T細胞の浸潤はほとんどない)やサルコイドーシス患者肺試料で同様にNKT細胞の有無を調べたが同定できなかった。喘息患者気管支肺胞洗浄液中のNKT細胞を試験管内でαガラクドシルセラミドにて刺激したところIL-4IL-13を産生したが、末梢血中の存在するNKT細胞の様にIFNγを産生することはなかった。訳者注:従来の報告では喘息患者において増加しているIL-4IL-13を産生するCD3+CD4+細胞はTh2細胞であると考えられていた。そしてTh2細胞はダニなどの抗原に特異的に反応して活性化されると想像されていた。今回の発表は喘息病態として最も本質的な概念を覆すものでまさに世紀の発見といえる。しかし、もし環境中や生体内に存在することが予測される未発見のNKT活性物質により非特異的に多くのNKT細胞が活性化された場合、大量のIL-4やIL-13が分泌されるのでIgE抗体が異常に増加するはずである。だが、この論文に記載されている症例のうち、数例はIgE抗体が低値の非アレルギー性喘息のようにみえる。そのような症例では肺にNKT細胞が集積しているだけで活性化はおきないのであろうか?もし、そうなら、どのような刺激で肺局所に集積し、生存を維持できるのであろうか?アレルギー性鼻炎鼻粘膜の炎症病態はアレルギー性喘息における炎症病態と近似していることが知られている。他の炎症細胞と同様に鼻粘膜でもNKT細胞の浸潤が認められるのであろうか?そもそもNKT細胞受容体の同定にもちいた抗体は抗原特異的Th2細胞の受容体と交差反応をおこすことはないと断言できるのであろうか?教科書的に認められるためには今後の厳密な検証が必要とされる。

2. s-ADRENERGIC RECEPTOR POLYMORPHISMS AND RESPONSE TO SALMETEROL
This study investigated whether genotype-specific effects occur when patients with asthma are treated with long-acting s-agonists and whether such effects are modified by concurrent inhaled corticosteroid (ICS) use. In two separate cohorts, the subjects were randomized to regular therapy with salmeterol while simultaneously discontinuing ICS therapy and in the second, randomized to regular therapy with salmeterol while continuing concomitant ICS. B16Arg/Arg compared to B16Gly/Gly subjects were found to have an impaired therapeutic response to salmeterol with or without concurrent ICS. Editor's comment: B16Arg/Arg subjects (approximately 1/6 of Caucasians and 1/5 of African Americans) may benefit from alternative asthma treatment strategies. Wechsler ME, et al. Am J Respir Crit Care Med 2006; 173: 519. Tattersfield AE, Harrison TW, Editorial: 473.

白人種においてβ2受容体の16番目のアミノ酸置換を伴う遺伝子多型がβ2刺激薬に対する感受性(脱反応性)に影響することが知られている(訳者注:日本人でも同多型は存在するがβ2刺激薬に対する感受性は白人種とは異なる=おそらく他のアミノ酸置換多型が影響する)。今回の研究では吸入ステロイドとの併用あるいは単独投与使用においてsalmeterolの喘息治療に対する効果が遺伝子多型により異なるかどうか検討されている。その結果、16番アミノ酸Arg/Arg(白人の5分の1)はsalmeterolの喘息症状に対する効果が有意に優っていたとしている。

3. THEOPHYLLINE AND CETIRIZINE IN PATIENTS WITH CHRONIC IDIOPATHIC URTICARIA (CIU)
This 6-month, double-blind, placebo-controlled parallel study of 134 (105 completed study) CIU subjects found that cetirizine plus theophylline (200 mg twice daily) was superior to cetirizine and placebo. Results, as measured by a visual analog scale and treatment effectiveness score, were statistically significant at certain points throughout the study. The authors conclude that theophylline was well tolerated and provided considerable additional benefit in the management of CIU. Editor's comment: We need all the help we can get with CIU. Theophylline for CIU? Kalogeromitros D, et al. Int Arch Allergy Immunol 2006; 139: 258.

ダブルブラインドでプラセボ対照による臨床試験により慢性特発性蕁麻疹CIUに対するテオフィリンの効果を検討したところ抗ヒスタミン薬 cetirizineに併用した場合、有意な改善がみられた。

4. EFFECT OF TIOTROPIUM ON EXACERBATIONS AND AIRFLOW IN COPD
This randomized, double-blind, parallel-group, 1-yr study compared the effect of tiotropium 18 μg once daily (n = 500) and placebo (n = 510) on exacerbations, associated health resource use (HRU) and airflow limitation in COPD patients. Tiotropium reduced exacerbations and HRU and improved airflow over 1 year . Editor's comment: Tiotropium is a drug of choice for patients with COPD. Dusser D, et al. Eur Respir J 2006; 27: 547.

慢性閉塞性肺疾患(COPD)に対するtiotropium(長時間作用型抗コリン気管支拡張薬)の臨床治験結果である。1年以上に及ぶ臨床症状の改善が有意に認められた。

5. T CELL-MEDIATED HYPERSENSITIVITY TO QUINOLONES: MECHANISMS AND CROSS-REACTIVITY
Six patients with delayed hypersensitivity skin reactions to ciprofloxacin, norfloxacin or moxifloxacin underwent in vivo patch testing and in vitro lymphocyte proliferation testing to study delayed-type hypersensitivity reactions to quinolones. Three of the six patient patch tests were positive after 24 and 48 h, and all patients had positive lymphocyte proliferation tests. The authors conclude that T cells are involved in delayed immune reactions to quinolones and that cross-reactivity among different quinolones is frequent. Editor's comment: Quinolones are very important broad spectrum antibiotics which can cause delayed type hypersensitivity reactions. Schmid DA, et al. Clin Exp Allergy 2006; 36; 59.

キノロン系抗生物質(ciprofloxacin, norfloxacin moxifloxacin)は遅延型アレルギー反応を生じることがあり、その診断はパッチテストおよびin vitroリンパ球刺激試験にて診断されることを示した。

6. SIDE-EFFECTS OF AQUEOUS SOLUTION WITH ALUMINUM HYDROXIDE ALLERGEN-SPECIFIC IMMUNOTHERAPY (SIT). A PROSPECTIVE MULTI-CENTRE STUDY
Four allergy centers in Denmark collected data from all patients initiating SIT in a three-year study to determine its safety. A total of 1,038 patients received treatment with 1,709 allergens (timothy, birch, mugwort, house dust mite, cat, and wasp and bee venoms), 23,047 injections in total. There were 582 systemic side-effects in 341 patients. Most were mild grade 2 reactions (78%) and grass vaccines were most likely to cause problems. The type of allergen, but not the patient or center, predicted side-effects. Gender or asthma did not influence the frequency of side-effects. Epinephrine was used for treatment in 2% of the side-effects. Editor's comment: This study indicates that aluminum hydroxide modified extracts are safe and that grass vaccines account for most side-effects. Asthma was not a risk factor. Winther L, et al. Clin Exp Allergy 2006; 36: 254. Frew AJ, Editorial: 251. No abstract is available for this article.

デンマークにおいて水酸化アルミニウムを添加した水溶液をもちいた花粉やダニ、ネコ、ハチ毒などの減感作注射が実施された。その結果、23,047回の注射において、582回の副作用が認められた。訳者注:水酸化アルミニウムはTh2細胞やIgE抗体を誘導するためのアジュバントとして動物実験にしばしばもちいられている。なぜ、このような危険な治験が認可され、多くの症例に実施されたのか理由が知りたいものである。

7. BUDESONIDE/FORMOTEROL IN A SINGLE INHALER
A six-month, randomized, double-blind, parallel-group study of 697 subjects, mean age 38 y, compared the effects of budesonide/formoterol (B/F) (80 μg/4.5 μg, two inhalations qd in the evening) plus B/F prn or budesonide (B) (160 μg, two inhalations qd in the evening) plus terbutaline (T) (0.4 mg) prn for maintenance or relief of mild-to-moderate asthma. Patients on B/F had higher morning PEF, less risk of severe exacerbation, and fewer hospitalizations/ED treatments. Increased efficacy with B/F was achieved with less ICS than in the B group (mean dose, 240 μg/d vs 320 μg/d, respectively) with 77% fewer oral steroid treatment days. The incidence and frequency of adverse events were similar. Editor's comment: Combination long-acting s2-agonists and ICS are better than ICS alone and in this study are equally safe. Rabe KF, et al. Chest 2006; 129: 246.

Budesonide/formoterolの合剤吸入の効果が検討された。結果はもちろん、有効であり、budesonide/吸入にterbutalineを加えた場合よりも優っていた。

8. EMERGENCY DEPARTMENT (ED) INTERVENTIONS TO IMPROVE CARE OF PATIENTS WITH ACUTE ASTHMA
Three?hundred and eighty-four patients (age 2 to 54 y) participated in a randomized, control trial to compare the effects of two interventions on primary care (PC) follow-up after ED treatment for asthma exacerbations. Baseline demographics, chronic asthma severity and access to care were similar in both groups. Intervention, including free medicine, transportation vouchers and appointment assistance significantly increased the likelihood that discharged asthma patients obtained PC follow-up but did not impact long-term outcomes. Editor's comment: Strategies to impact long-term asthma morbidity are needed for patients who utilized the ED for acute asthma. Baren JM, et al. Chest 2006; 129: 257.

救急外来における喘息治療のアフターケアサービスとして無料薬剤処方、交通券配布、次回予約の手伝いなどの介入を行ったところ、退院する患者の増加する傾向が見られたが長期的には影響がなかった。訳者注:いろいろな臨床治験があるものである。

9. INFLUENCE OF BODY MASS INDEX ON THE RESPONSE TO ASTHMA CONTROLLER AGENTS
A post hoc analysis pooled data from four, double-blind, placebo-controlled studies randomizing 3,073 moderate asthmatic adults to montelukast, beclomethasone, or placebo. End points included asthma control days, FEV1, s-agonist use and nocturnal awakening. Body mass index (BMI) classifications included normal, overweight, obese and continuous variables. Results indicate that the placebo response for all end points was generally lower with increasing BMI. Similarly, the response to the inhaled corticosteroid (ICS) decreased whereas the response to leukotriene antagonist remained stable. Editor's comment: Obesity may not only be a risk factor for asthma, particularly in women, but may also decrease response to ICS. Peters-Golden M, et al. Eur Respir J 2006; 27: 495.

喘息治療薬に対する反応性と肥満指数(BMI)の関係についてpost hoc解析により分析した。その結果、BMIの高い患者ではプラセボに対する反応性が低かった。吸入ステロイド薬に対する反応性も弱かったが、ロイコトリエン受容体拮抗薬に対する反応性には変化がなかった。

10. PREVENTION OF OSTEOPOROSIS ASSOCIATED WITH CHRONIC GLUCOCORTICOID THERAPY
An article from the Archives of Dermatology is reviewed in the Journal of the American Medical Association. It outlines treatment options and current recommendations for dermatologists treating patients with systemic glucocorticosteroids. Editor's comment: What is good for the dermatologist is good for the allergist. Summey BT, Yosipovitch G. Arch Dermatol 2006; 142: 82. Commentary by: Heffernan MP, et al. JAMA 2006; 295: 1300.

ステロイド治療に合併する骨粗鬆症の予防に関する皮膚科の雑誌に掲載された論文をJAMAで紹介している。編集者注:皮膚科医にとってよいものはアレルギー科医にとってもよいことである。

11. ANAPHYLAXIS AND THE AMERICAN ACADEMY OF ALLERGY, ASTHMA, AND IMMUNOLOGY (AAAAI)
This wonderful review of the pioneers and milestones of anaphylaxis and remarkable accounting of the contributions that allergists/immunologists, throughout the world, have made to the understanding of the pathogenesis and treatment of anaphylaxis appears in JACI. Editor's comment: Allergists should be proud of their contributions to the understanding and treatment of this disease. Lieberman, PL, et al. J Allergy Clin Immunol 2006; 117: 478. No abstract is available for this article.

アナフィラキシーの治療に関する総説の紹介。編集者注:アレルギー科医は、著者らアナフィラキシー治療のパイオニアたちの仕事を誇りに思うべきである。

12. CONTINUING MEDICAL EDUCATION (CME) MINI-PRIMER ON ALLERGIC AND IMMUNOLOGIC DISEASES
This mini-primer contains chapters on: Overview of the Human Immune Response; Update on Primary Immunodeficiency Disease; Cytokines and Chemokines; Autoimmunity, Vasculitis, and Autoantibodies; IgE, Mast Cells, Basophils, and Eosinophils; Asthma: Factors Underlying Inception, Exacerbation, and Disease Progression; Control of Allergic Airway Inflammation Through Immunomodulation; Drug Allergy; Food Allergy; and Atopic Dermatitis. Credit can be obtained for 10 CME hours. Editor's comment: Must reading for CME and for physicians in training. Shearer WT, Leung D (eds). J Allergy Clin Immunol 2006; 117: S429. No abstract is available for this article.

これもJACIからの教科書的総説であり、専門医教育に重要であると編集者はいっている。

13. ALLERGEN CHALLENGE CHAMBERS
A supplement on "The Role of Allergen Challenge Chambers in the Evaluation of Anti-Allergic Medication: An International Consensus Paper." It provides an in-depth review of the role of allergen challenge chambers as a means to evaluate treatments for rhinitis. Editor's comment: Interesting reading on a complicated but very scientific subject. Day JH, et al. Clin and Exp Allergy Rev 2006; 6: 31.

アレルギー性鼻炎の評価のための小さな容器をもちいたアレルゲン負荷試験の方法に関する方法が記載された総説である。編集者注:複雑な方法であるが大変科学的である。

14. CONSULTATION AND REFERRAL GUIDELINES CITING THE EVIDENCE: HOW THE ALLERGIST/IMMUNOLOGIST CAN HELP
This is a 28 page document on how the allergist/immunologist can help in the diagnosis and treatment of ABPA; Anaphylaxis; Asthma Diagnosis; Asthma: Environmental Diagnosis and Management; Asthma Treatment: Immunotherapy; Asthma Treatment: Prevention of Morbidity; Asthma Treatment: Prevention of Mortality; Asthma Treatment: Adherence; Occupational Asthma; Conjunctivitis; Cough; Atopic Dermatitis; Contact Dermatitis; Drug Allergy; Food Allergy; Hypersensitivity Pneumonitis; Insect Hypersensitivity; Occupational Allergic Diseases; Rhinitis; Sinusitis; Urticaria and Angioedema. Editor's comment: Allergy is a small specialty. This supplement defines how the allergist/immunologist should be involved in the diagnosis and treatment of these diseases. Leung D, Schatz M (eds). J Allergy Clin Immunol 2006; 117: S495. No abstract is available for this article.

JACIからの教科書的総説で、アレルギー科医が種々のアレルギー疾患症状についての相談を受けたときの科学的な対応について体系的に記載されている。


WAO Member Society Spotlight (所属学会紹介)- The Polish Society of Allergology

今月のWAOメンバー紹介はポーランドのアレルギー学会の紹介です。

Polish Society of Allergology (Polskie Towarzystwo Alergologiczne ? PTA) is a non-profit organization devoted to the promotion of basic and clinical research, encouragement of training and continuous education in allergy and clinical immunology, and promotion of allergology as a public health care problem. The PTA was founded in 1983 as a natural consequence of the steadily growing number of allergists gathered in the Allergy Interest Section of the Polish Medical Society. The Allergy Section within the Polish Medical Society was formed in 1964. It was mainly linked to internal medicine but subsequently spread to pediatrics, pulmonary medicine, laryngology and dermatology. The active engagement of the Allergy Interest Section of the Polish Medical Society resulted in allergy being established as an independent medical sub-speciality in Poland. In 1973, the first allergy examination was passed, and allergy specialization was awarded. The first academic allergy centers were founded in 1970 in Krakow headed by Prof. A. Szczeklik and in Bialystok headed by Prof. S. Chyrek-Borowska.

大変歴史のある学会で1964年に発足し、1973年には専門医が誕生しているそうである。

The PTA as an independent organization has been rapidly growing since 1983, and now has more than 1,000 members. The members of the PTA are specialists in different fields of medicine, including internal medicine, pediatrics, laryngology and dermatology. Three journals supported by the PTA are: Alergia Astma Immunologia, International Review of Allergology and Clinical Immunology and Pneumonologia i Alergologia Polska.

Every three years the PTA organizes a National Congress. The next National Congress will take place in Wisla in 2006. During each National Congress, the new president and executive committee are elected. The current president of the PTA is Prof. Marek Kowalski, and the president elect is Prof. Piotr Kuna.

Many members of the PTA belong to the EAACI, WAO and many other international societies. PTA, as an organization, cooperates with WAO and EAACI in the organization of joint meetings and educational programs. In 1997, a joint meeting of the PTA and EAACI was held in Katowice, while in 1999, the first Eastern Europe EAACI Summer School took place in Bialystok. In July 2004, the PTA organized a symposium with the American College of Allergy, Asthma and Immunology in Krakow.

Several meetings supported by the PTA each year are visited by delegates from other international organizations. In 2005, WAO representatives participated in the annual meeting in Lodz.

The main goals of the PTA are:

  • maintain a high level of health care for allergic patients
  • support scientific research in allergy and clinical immunology
  • promote educational programs for patients and physicians
  • support young allergists in their basic and clinical research
  • promote international cooperation

Contributed by Krzysztof Kowal, MD, on behalf of the PTA


WAO Now: What's New in the World of WAO (最新ニュース)

2006 Seminars & Conferences Placements Announced

2006年に開催予定のWAO関連会議の紹介です。

Seminars & Conferences, WAO's newest educational program, offers member societies the opportunity to apply for an international lecturer, who they would not otherwise be able to afford to invite to their annual allergy meeting. The 2006 placements include:

7th Malaysian Congress of Allergy and Immunology
WAO Invited Lecturer: Cassim Motala
10-12 March 2006
Kuala Lumpur, Malaysia

IX International Congress of the Polish Society of Allergology
WAO Invited Lecturer: Todor Popov
10-13 May 2006
Golebiewski, Poland

XVI Congress of the Venezuelan Society of Allergy and Immunology
WAO Invited Lecturer: Carlos E. Baena-Cagnani
May 17-20, 2006
Isla de Margarita, Venezuela

17th Australasian Society of Clinical Immunology and Allergy Annual Scientific Meeting
WAO Invited Lecturer: Ronald Dahl
7-10 September 2006
Manly Beach, New South Wales, Australia

ALL-4-Kids Congress: Joint Meeting of Allergy Society of South Africa & the South African Pediatric Association
WAO Invited Lecturer: Michael A. Kaliner
7-11 September 2006
South Africa

To apply for a WAO Invited Lecturer in 2007, please fill out the online application.

Global Alliance Against Chronic Respiratory Disease (GARD)

Carlos Baena-Cagnani, WAO Past-President, and G. Walter Canonica, WAO President-Elect, represented the World Allergy Organization at the Beijing launch of the Global Alliance Against Chronic Respiratory Disease (GARD), 28 March 2006. GARD is a voluntary alliance of 41 internationally recognized organizations, institutions, and agencies from both developing and developed countries aimed at sharing expertise, identifying problems, promoting solutions, coordinating activities and working towards the common goal of fighting chronic respiratory diseases. Responsibility for different areas of development is vested in Working Groups. G. Walter Canonica Co-Chairs the Allergy Diagnosis Working Group, while Carlos Baena-Cagnani is Chair of the Pediatrics Working Group. Allergy is recognized by the GARD coalition as a major cause of respiratory illness, and WAO will work tirelessly within GARD to promote the prevention, early diagnosis and treatment of allergic respiratory disease on a global basis. Other eminent members of the WAO Board of Directors in Beijing for the GARD Launch were Jean Bousquet, GARD Chair and Ronald Dahl, Co-Chair, F. Estelle R. Simons, Ruby Pawankar and Takeshi Fukuda. More information about GARD is available from the WHO Web site.

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:

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And In Other News (その他のニュース)

Allergy Book Review

New Perspectives in Monitoring Lung Inflammation: Analysis of Exhaled Breath Condensate
Paolo Montuschi
2005 CRC Press

今月は吸気中の分泌液を濃縮して肺炎症をモニターする方法が詳しく記載されている本の紹介です。

List Price: $119.95 USD
Available from: http://www.crcpress.com/shopping_cart/products/ product_detail.asp?sku=TF1734&parent_id=1192&pc=

Reviewer: Mark C. Glaum, MD, PhD
Assistant Professor of Medicine and Pediatrics
University of South Florida

Description:
In recent years, much attention has focused on the potential use of airway inflammatory markers to guide the diagnosis and management of chronic lung disease. Until now there have been few, if any, primary texts that concentrate discussion on the methodology and application of these technologies in adults and children. This textbook reviews the current state of art in the methodology and reliability of non-invasive measurement of airway inflammation through exhaled breath condensate. The text provides background and rationale for the evaluation of several important markers of airway inflammation that may have useful clinical applications in the evaluation and treatment of lung disease.

非侵襲的な肺炎症のモニター法として呼気に含まれる水蒸気を濃縮し、メディエーターやサイトカインを測定する方法が開発され注目されている。この本はその背景や開発経緯、そしていくつかの重要なマーカーについての経験例が報告されている。

Purpose:
The purpose is to provide the researcher and clinician with a concise review of data that supports use of exhaled breath condensate as a tool to monitor airway inflammation. The information is presented in a clear, organized manner that allows for quick retrieval of key facts.

この本の目的は研究者や臨床医がこの方法の概略と鍵となるデータを把握するためのものである。

Audience:
The textbook is targeted to researchers and clinicians interested in chronic inflammatory lung diseases. Specialists most likely to utilize this resource include pulmonologists and allergists who routinely care for patients with asthma as well as other chronic lung diseases.

対象は肺の炎症に興味のある研究者と臨床医である。

Features:
The initial chapters describe in detail, methodological issues in the collection of exhaled breath condensate. Subsequent chapters focus on the measurement of key airway inflammatory markers. Application of this technology in children is discussed in its own chapter. Each chapter begins with a table of contents showing the organization of presented material. Charts and tables are well designed and clearly presented. Chapters conclude with suggestions for further reading including well-annotated, timely references. The concluding chapters of the book discuss potential implications of exhaled breath condensate analysis in the diagnosis and management of lung diseases.

各章においてその方法の将来的な適応について簡潔に記載されている。

Assessment:
Technological advances in the non-invasive measurement of airway inflammatory markers will likely revolutionize the way in which lung diseases are diagnosed and managed. Objective means to measure airway inflammation will allow for precisely guided adjustments in airway disease management not currently possible with commonly available methods. New Perspectives in Monitoring Lung Inflammation: Analysis of Exhaled Breath Condensate provides an excellent introduction to this emerging technology and is a must-have for clinicians and researchers who strive to be at the forefront of innovations in the diagnosis and management of chronic lung disease.

このような微量な試料をもちいた測定方法を可能にした技術的進歩はまさに革命的である。

Find more allergy book reviews on the WAO Website here.

WAO's mission is 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. Visit us on the Web at www.worldallergy.org

WAO世界アレルギー機構は世界中のアレルギー学会の連携をはかり、臨床、研究、教育等の向上と充実を目指すことを使命としています。是非、www.worldallergy.orgにアクセスして下さい。


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