April World Medical Journal Review
Prof. Richard F. Lockey, MD, WAO Web Editor-in-Chief, reviewed premier April medical journal articles for practicing allergists. Read his top 3 picks below and for the other 8 reviews,
1. INCREASED GLUCOCORTICOID RECEPTOR ß ALTERS STEROID RESPONSE IN GLUCOCORTICOID-INSENSITIVE ASTHMA
BAL cells of 7 patients with glucocorticoid (GC)-sensitive asthma and 8 patients with GC-insensitive asthma were examined to define the functional role of glucocorticoid receptor (GCR) ß (a splicing variant and dominant negative inhibitor of the classic GCRa) in controlling GCRa nuclear translocation and transactivation at a molecular level. Significantly reduced nuclear translocation of GCRa in response to GC was present in GC-insensitive asthma. These same subjects had significantly increased levels of cytoplasmic and nuclear GCRß. RNA silencing of GCRß mRNA in BAL macrophages from these same subjects enhanced dexamethasone-induced GCRa transactivation. Editor's comment: Measurable differences in GC receptor activity are present in GC-insensitive asthma. Goleva E, et al. Am J Respir Crit Care Med 2006; 173: 607.
2. THE EFFECT OF TELITHROMYCIN IN ACUTE EXACERBATIONS OF ASTHMA
A total of 278 adults with asthma were enrolled within 24 hours after an acute exacerbation requiring short-term medical care. They were randomly assigned to receive 10 days of oral telithromycin 800 mg daily or placebo in addition to usual care. The primary efficacy end points were a change from baseline over the treatment period in symptoms as recorded by the patient and A.M. peak expiratory flow (PEF). Presence of Chlamydophila pneumoniae or Mycoplasma pneumoniae was assed by the polymerase chain reaction and culture. Patients on telithromycin had a significantly greater reduction of symptoms than those on placebo, but no significant difference in A.M. PEF. Sixty-one percent had evidence of infection with C. pneumoniae, M. pneumoniae or both, but there was no relationship between bacteriologic status and response to asthma treatment. Editor's comment: Are C. pneumoniae and, M. pneumoniae important in the pathogenenesis of asthma? Is the effect of telithromycin antibacterial or anti-inflammatory? Is the response to this antibiotic similar to other macrolides? The debate goes on! Johnston SF, et al. N Engl J Med 2006; 354: 1589. Little FF, (editorial), p.1632.
3. BUILDING HEALTH: AN EPIDEMIOLOGICAL STUDY OF "SICK BUILDING SYNDROME" (SBS)
SBS was studied in a cross sectional data analysis of the physical environment of a selection of buildings added to individual data from the Whitehall II study -- an ongoing health survey of office-based civil servants. A self-report questionnaire was used to capture 10 symptoms of SBS and psychosocial work stress. In total, 4,052 participants, 42-62 yrs, working in 44 buildings were included in the study. Positive, but non-significant, relations were found with airborne bacteria, inhalable dust, dry bulb temperature, relative humidity, and having some control over the local physical environment. Greater effects were found with features of the psychosocial work environment, including high job demands and low support. Only psychosocial work characteristics and control over the physical environment were independently associated with symptoms in the multivariate analysis. Editor's comment: "Sick Building Syndrome" is a misnomer. This syndrome would be better termed "Building Related Complaints." Marmot AF, et al. Occup Environ Med 2006; 63: 283.
To read the additional reviews, click here.
WAO Member Society Spotlight – Latin American Society of Allergy, Asthma and Immunology (SLAAI)
The Latin American Society of Allergy, Asthma and Immunology (SLAAI) is a non-profit organization that includes 19 National Societies from Latin America and the Iberian Peninsula (Spain and Portugal).
This year the Latin American Society of Allergy, Asthma and Immunology (LASAAI) will celebrate its 45th anniversary during the XIV Latin American Congress of Allergy, Asthma and Immunology (LACAAI). The LACAAI will be held on 17 – 20 August 2006 in Buenos Aires, Argentina, in collaboration with the XIX Congress of the Argentinean Allergy and Clinical Immunology Association (AACIA). This congress will be the greatest ever scientific meeting in Latin America. The expected attendance is 2,500 participants from not only the region but also from other parts of the world. Spanish is the official language of the congress although many of the sessions will be in English and simultaneous translation into Spanish will be provided.
The prevalence of asthma and other allergic disorders is very high in Latin America and is a substantial public health problem; therefore an updated program on allergic disorders for allergy specialists and also for general practictioners, pediatricians, and family doctors is needed. There is a high global burden of allergy and other related disorders, however, regional aspects will be also addressed.
The Scientific Program Committee chaired by Prof. Carlos E. Baena-Cagnani has developed an excellent scientific program that includes discussion on sensitization to universal and regional allergens and specific genetic and environmental factors associated with asthma and atopy in Latin American populations. The following programs will take place during the congress:
- WAO/ACAAI ESP: World Allergy Organization - Emerging Societies Program
- WAO GLORIA Symposium (Global Resources in Allergy)
- Global Asthma Patients and Physician survey (GAPP)
- American College of Allergy Asthma and Immunology
- 1st Argentinean and Latin American Meeting of Pediatric Allergy, Asthma & Immunology
Buenos Aires is the cultural capital of South America. There are many exciting places to visit while you are in Buenos Aires, and the official travel agency has prepared optional tours before and after the congress to unforgettable places such as Iguazu falls, Tierra del Fuego or Perito Moreno Glacier. The incomparably competitive prices for international luxury hotels, restaurants and shopping centers offer an additional attraction to make plans to attend the 14th LACAAI in August 2006.
LACAI Congress web site: http://www.slaai.org/congreso/
Moreno 909 (C1091AAS)
Ciudad de Buenos Aires, Argentina
Tel. / Fax: (54-11) 4334-7680 / 4331-7356
WAO Now: What's New in the World of WAO
A new synopsis on the Asprin Triad, authored by an international expert in this area, is posted on the WAO Web site this month. To read the latest views on this complex clinical problem, click here.
World Allergy Forum
The diagnosis and management of anaphylaxis is a major concern for allergists worldwide. Anaphylaxis has been selected as the topic for the next World Allergy Forum Symposium scheduled for Sunday, 11 June 2006 - 13:30 – 15:15, during the European Academy of Allergology and Clinical Immunology (EAACI), Annual Scientific Meeting, Vienna, Austria.
Michael A. Kaliner, President, WAO and Anthony J. Frew, EAACI President, will chair the program of renowned international speakers.
Life-Threatening Allergy – An Homage to Von Pirquet
Epidemiology of Anaphylaxis
Aziz Sheikh, The University of Edinburgh
Mechanisms of Anaphylaxis
Richard F. Lockey, University of South Florida College of Medicine
Tampa, Florida, U.S.A.
Management of Anaphylaxis
F. Estelle R. Simons, University of Manitoba
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 firstname.lastname@example.org, noting "Free Journal Subscription" in the subject line, with the following details:
City, State/Province and postal code
Name of Member Society
And In Other News
Allergy Book Review
Applying Genomic and Proteomic Microarray Technology in Drug Discovery
Robert S. Matson
CRC Press, ISBN 0-8493-1469-0
List price: $119.95
Available from: CRC Press
Reviewer: Gary Hellermann
University of South Florida College of Medicine, Tampa, Florida
We hear a lot about microarrays as research and diagnostic tools, but they are also utilized in the search for new drugs. Microarrays generate a picture of the molecular processes in a specific cell or tissue and this unique window allows drug researchers to directly see the effects of a test agent. Microarrays are one of those enabling technologies, like the polymerase chain reaction, that open a vast realm of possibilities in medical diagnostics and drug development, and this book provides a comprehensive and practical text for this exciting new field.
The purpose of this book is to provide a thorough understanding of the technology of microarrays and to evaluate their usefulness in developing new approaches to biomedical problem-solving.
Scientists and pharmaceutical researchers, bioinformaticians and technologists, students and teachers will all find this book a helpful source of information about a field that is rapidly becoming one of the mainstays of medicine now and in the future.
The book's 243 pages are divided into six chapters that cover the history, technology and application of DNA and protein microarrays. Each chapter has pertinent references for additional study in specific areas. The chapters are especially well illustrated with diagrams, photos, tables and graphs that highlight the important points and enhance understanding of the text. DNA microarrays are the best-studied system, but protein-based arrays are strong contenders for new uses along with other array types employing antibodies, carbohydrates, small molecules and even cells and tissues. Uses in clinical trials, prediction, diagnosis, prognosis and treatment are practically limitless.
Find more allergy book reviews on the WAO Website here.