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 Medical Journal Reviews 医学杂志回顾
Prof. Richard F. Lockey, MD,
WAO Web Editor-in-Chief, reviewed premier 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日前的医学杂志的一些重要文章。
1. INVARIANT NATURAL KILLER T CELLS (NK) IN ASTHMA (A) AND CHRONIC
OBSTRUCTIVE PULMONARY DISEASE (COPD)
These authors studied the frequency of NK in the airways of subjects with
mild (8 not treated with inhaled corticosteroids) and moderate (16 treated
with inhaled corticosteroids) A, 10 subjects with COPD and 10 controls. NK
were enumerated with flow cytometry with the use of
CD1d tetramers loaded with α-galactosylceramide
and antibodies specific to the NK receptor in samples of BAL, induced sputum,
and bronchial-biopsy specimens. Real-time PCR analysis was performed on bronchoalveolar-lavage cells for evidence of gene
expression of the NK receptor. The authors found that fewer than 2% of the T
cells obtained from all subjects were similar and no expression of messenger
RNA for the NK-receptor domains Vα24 and Vβ11 were present. NK are
found in low numbers in the airways of subjects with asthma, COPD, and
controls. Editor’s comment: More studies are needed to determine a possible
role for NK in asthma. Vijayanand P, et al. N Engl J Med 2007; 356: 1410. Editorial, Ho LP:
1466.
译文：
1. 在哮喘（A）和慢性阻塞性肺疾病（COPD）中的自然杀伤T细胞（NK）数量恒定不变
作者们对以下研究对象调查了气道中NK细胞的数量：8位轻度哮喘患者（未给予吸入皮质激素治疗），16位中度哮喘患者（已接受吸入皮质激素治疗），10 位COPD患者和10位健康对照个体。研究人员使用流式细胞仪、载有α-半乳糖神经酰胺和NK细胞受体特异性抗体的CD1d四聚物对支气管肺泡灌洗、诱导痰和支气管活检标本中的NK细胞进行计数。研究中通过对支气管肺泡灌洗液细胞进行实时PCR分析可以发现NK细胞受体基因表达的证据。作者发现：所有研究个体获得的T细胞数量相仿，均少于2%；NK细胞受体Vα24 和Vβ11区域的信使RNA未见表达。研究发现在哮喘组、COPD组和对照组个体的气道中的NK细胞数量都很低。编者按：关于NK细胞在哮喘中可能扮演的角色需要更多的研究来进行探讨。Vijayanand P, et
al. N Engl J Med 2007; 356: 1410. Editorial, Ho LP:
1466.
2. OPIATE THERAPY IN CHRONIC COUGH (CC)
27 patients with CC enrolled into a randomized
DBPC study using four weeks of slow-release morphine sulfate (MS) 5 mg 2X/day
and a corresponding period of matched placebo. An open-labeled extension of
the core study allowed dose escalation to MS 10 mg 2X/day. CC was assessed
using the Leicester Cough Questionnaire (LCQ), daily symptom diary and citric
acid cough challenge (CACC). A significant improvement of 3.2 points over
baseline was noted on the LCQ (p < 0.01). A rapid reduction of 40% in CC
scores was noted in subjects on slow-release MS ( p < 0.01). CACC test
results did not show any significant changes. Two-thirds of the 18 patients
in the extension study opted to increase the MS to 10 mg 2X/day, and at the
end of three mo, there was a similar improvement in
CC between the 5- and 10-mg groups. MS is an effective antitussive
in CC at doses of 5 to 10 mg twice daily. Editor’s comment: The risk
(side-effects, dependence and sedation) – benefits (decreased cough) have to
be weighed when prescribing MS for CC. Morice
AH, et al. Am J Respir Crit Care Med 2007; 175: 312.
译文：
2. 对慢性咳嗽（CC）应用鸦片类药物治疗
共有27位慢性咳嗽患者参加了这项随机双盲安慰剂对照研究：治疗组给予硫酸吗啡缓释片（MS）每日两次，每次5 mg ，共治疗4周；而对照组则给予对应的安慰剂。属于本中心研究的开放式扩展研究部分将MS 增量至10 mg每日两次。对于慢性咳嗽的评估主要使用Leicester咳嗽量表（LCQ），日间症状评分以及柠檬酸咳嗽激发试验（CACC）。LCQ评分显示治疗组较基线水平显著提高3.2分（p < 0.01）。接受缓释MS治疗组个体的慢性咳嗽评分迅速降低40%（p <
0.01）。对治疗组进行柠檬酸咳嗽激发试验未见有显著改变。扩展研究部分的18位患者中有2/3选择增加MS剂量至10 mg每日两次，经过三个月治疗，5 mg 和10 mg 不同剂量组的CC改善效果相似。给予CC患者每日两次5 mg 至10 mg MS可以有效镇咳。编者按：给予慢性咳嗽患者处方硫酸吗啡缓释片时需要评估风险利益比（药物副作用、依赖性和嗜睡性－镇咳效果）。Morice AH, et
al. Am J Respir Crit Care Med 2007; 175: 312.
3. OVERWEIGHT, OBESITY, AND INCIDENT ASTHMA–A
META-ANALYSIS OF PROSPECTIVE EPIDEMIOLOGIC STUDIES
This is an online bibliographic database search
for studies evaluating body mass index (BMI) and incident asthma in adults.
Independent observers extracted data from studies meeting predetermined
criteria [defined categories of normal weight (BMI < 25), overweight (BMI,
25-29.9), and obesity (BMI ≥ 30)]. Seven studies of 333,102 subjects
met inclusion criteria. Overweight and obesity conferred increased odds of
incident asthma, with an OR of 1.51 (95% CI, 1.27 – 1.80). A dose-response
effect was observed. The observations were present in both men (OR, 1.46; 95%
CI, 1.05 – 2.02) and women (OR, 1.68; 95% CI, 1.45 – 1.94; p = 0.232 for the
comparison). The authors conclude that overweight and obesity are a
dose-dependent risk in the odds of incident asthma. Editor’s comment: This
is the best review available indicating that overweight and obesity are risk
factors for asthma. Beuther DA, et al. Am J Resp Crit Care Med 2007; 175: 661.
译文：
3. 超重、肥胖和哮喘事件间的关系：一项前瞻性流行病学研究的荟萃分析
本文使用在线书目数据库对有关成人体重指数（BMI）和哮喘事件间关系的评估研究进行了检索。由独立观察员从所有符合预先设定标准〔定义分类：正常体重（BMI < 25），超重（BMI，25-29.9）以及肥胖（BMI ≥ 30）〕的研究中收集数据。七项研究中共有333,102名研究对象符合研究标准。研究显示：超重和肥胖个体的哮喘事件发生机率均有上升，OR为1.51（95% CI，1.27 – 1.80）。该现象具有量效关系。这一现象不但见于男性个体（OR，1.46；95% CI，1.05 – 2.02），同时也见于女性个体（OR，1.68；95% CI，1.45 – 1.94；与对照组相比p = 0.232）。文章结论：超重和肥胖是哮喘事件的危险因素，该关系具量效关系。编者按：这篇优秀综述为我们指出超重和肥胖是哮喘事件的危险因素。Beuther DA, et
al. Am J Resp Crit Care Med 2007; 175: 661.
4. SAFETY OF ANTI-IMMUNOGLOBULIN E
THERAPY WITH OMALIZUMAB (O) IN ALLERGIC PATIENTS AT RISK OF GEOHELMINTH
INFECTION (GI)
137 subjects (12 -30 years) at high risk of GI were included in a randomized
DBPC trial. All received pre-study anthelminthic
treatment followed by 52 weeks’ treatment with O or placebo (P). 50% (34/68)
of the O subjects experienced at least one intestinal GI vs. 41% (28/69) of P
subjects [OR 1.47, 95% CI 0.74 – 2.95, one-sided p = 0.14; OR (adjusted for
study visit, baseline infection status, gender and age) 2.2 (0.94 – 5.15);
one-sided p = 0.035], providing some evidence for a potential increased
incidence of this form of infection in subjects on this medication. Infection
severity and response to anthelminthics appeared to
be unaffected by O therapy. The authors conclude in this exploratory study
that O therapy may be associated with a modest increase in the incidence of
GI. However, such therapy was safe and well tolerated. Editor’s comment:
More information is needed to determine whether anti-IgE
therapy is associated with an increased risk of intestinal helminth infections. Cruz AA, et al. Clin Exp Allergy 2007; 37: 197.
译文：
4. 存在土源性蠕虫感染（GI）风险的过敏性疾病患者在接受OMALIZUMAB（O）进行抗免疫球蛋白E治疗过程中的安全性问题
共有137名存在GI风险的研究个体（12 -30岁）收入本项随机双盲安慰剂对照研究。所有研究个体在接受研究前抗寄生虫治疗后分别接受52周O或者安慰剂（P）的治疗。
接受O治疗的个体有50%（34/68）曾发生过至少一次肠内GI，而安慰剂组这一比例为41%（28/69）〔OR 1.47，95% CI 0.74 – 2.95，单边检验p =
0.14；OR（根据研究拜访、感染状况基线、性别和年龄进行修正）2.2（0.94 –
5.15）；单边检验p = 0.035〕，结果发现有证据显示接受O治疗有潜在增加蠕虫感染的风险。而感染的严重程度以及对抗寄生虫药物的治疗反应不受O治疗的影响。文章结论：这项初步研究显示O治疗可能与GI发生率的中度增高有关，但该治疗是安全的而且耐受性良好。编者按：为明确抗IgE治疗是否与肠内蠕虫感染风险的增高相关，还需要更多的研究资料加以支持。Cruz AA, et al. Clin Exp Allergy 2007; 37: 197.
5. SHORT-COURSE MONTELUKAST (M) FOR INTERMITTENT
ASTHMA (IA) IN CHILDREN–A RANDOMIZED CONTROLLED TRIAL
220 children (aged 2 – 14 yr) with IA were
randomized in this multicenter, DBPC clinical trial
over 12 months, 107 to M and 113 to placebo (P), to determine whether a short
course of M in children with IA would modify the severity of an asthma
episode. There were 681 treated episodes (
345 M, 336 P) provided by 202 patients. The M group
had 163 unscheduled health care resource utilizations for A compared with
228 in the P group (OR,
0.65; 95% CI, 0.47 – 0.89). There was a nonsignificant
reduction in specialist attendances and hospitalizations, duration of
episode, and ß-agonist and prednisolone use.
Symptoms were reduced by 14% and nights awakened by 8.6% (p = 0.043), days
off from school or childcare by 37% and parent time off from work by 33% (p
< 0.0001 for both). The authors conclude that M introduced at the first
signs of an A episode results in a modest reduction in acute health care
resource utilization, symptoms, time off from school, and parental time off
from work in children with IA. 编者按：More studies are necessary to
determine the effects of M on viral respiratory tract infections,
particularly when M is used to prevent viral infections. Robertson CF, et al. Am J Respir Crit Care Med 2007; 175: 323.
译文：
5. 短期使用孟鲁司特（M）治疗儿童间歇性哮喘（IA）：随机对照研究
本项多中心，双盲安慰剂对照试验目的是探讨给予患儿短期使用M是否能改变哮喘发作的程度，共有220名2-14岁间歇性哮喘儿童入组，随机分至M治疗组（107名）和安慰剂组（113名）。整个研究过程中共有202名患儿出现681例次哮喘发作（
345 M，336 P）。M组共有163例次因哮喘非计划使用医疗保健资源，而安慰剂组为228例次（OR，0.65；95% CI，0.47 – 0.89）。结果显示专科就诊以及住院治疗、哮喘发作持续时间以及ß 受体激动剂和强敌松使用方面未见显著改善。经治疗，患儿症状改善14%，夜间憋醒减少8.6%（p =
0.043），学校或托儿所休假时间减少37%同时父母休事假照料孩子的时间减少33%（两者p < 0.0001）。文章总结：对间歇性哮喘儿童在发作先兆症状出现时使用M可以有效减少医疗保健资源的紧急使用，减轻患儿症状，减少患儿病假以及家长照料孩子所休事假的时间。编者按：需要更多的研究来明确M对病毒性呼吸道感染的作用，特别是M在预防病毒性感染方面的地位。Robertson CF, et al. Am J Respir Crit Care Med 2007; 175: 323.
6. PREVALENCE OF VIRAL RESPIRATORY TRACT INFECTIONS IN
CHILDREN WITH ASTHMA (A)
Respiratory specimens from children aged 2 to 17 years with A exacerbations
(case patients, n = 65) and with well-controlled A (control subjects, n =
77), frequency matched by age and season of enrollment, were tested for
rhinoviruses, enteroviruses, respiratory syncytial virus, human metapneumovirus,
coronaviruses 229E and OC43, parainfluenza
viruses 1 to 3, influenza viruses, adenoviruses, and human bocavirus. Respiratory viruses were associated with A exacerbations (63.1% in case patients vs. 23.4% in
control subjects; OR, 5.6; 95% CI, 2.7 – 11.6). Rhinoviruses were the most
prevalent viruses (60% among case patients vs. 18.2% among control subjects)
and the only ones significantly associated with exacerbations (OR, 6.8; 95%
CI, 3.2 – 14.5). The authors conclude that rhinoviruses should be a target
for therapies as a means to decrease asthma exacerbations. Editor’s comment: This article confirms
that rhinoviruses are the most important viruses associated with asthma
exacerbations in children. Khetsuriani N, et
al. JACI 2007; 119: 31.
译文：
6. 儿童哮喘（A）患者中病毒性呼吸道感染的患病率
呼吸道标本采自2-17岁儿童，包括哮喘发作组（研究组个体，n = 65）以及哮喘良好控制组（对照组个体，n = 77），对年龄和入组季节进行频数匹配，检测项目包括：鼻病毒，肠病毒，呼吸道合胞病毒，人偏肺病毒，冠状病毒229E和OC43，副流感病毒1-3，流感病毒，腺病毒，人博卡病毒。结果显示呼吸道病毒与哮喘发作相关（研究组63.1% vs. 对照组23.4%；OR，5.6；95% CI，2.7 –
11.6）。鼻病毒不但是最常见的病毒种类（研究组60% vs. 对照组18.2%），同时也是唯一与哮喘发作显著相关的病毒种类（OR，6.8；95% CI，3.2 – 14.5）。文章总结：以鼻病毒为治疗目标可以为减少哮喘发作提供又一手段。编者按：本文证实鼻病毒是与儿童哮喘发作相关的最重要的病毒。Khetsuriani N,
et al. JACI 2007; 119: 31.
7. CORRELATION BETWEEN BRONCHODILATOR RESPONSIVENESS
AND QUALITY OF LIFE (QOL) IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
63 subjects with COPD, mean age 71.7 yr, were
investigated to determine the relationship between reversibility and QOL.
Post-bronchodilator FEV1, % predicted, was positively correlated with both
the total scores of 2 different QOL questionnaires (p < .0001 and p <
0.006). For the most part, reversibility of FVC was also positively
correlated. The reversibility of FEV1 was neither correlated with the total
score nor any other items in the scales. The authors conclude that patients
who have a FVC that respond to a bronchodilator at rest might result in
improvement of QOL after Rx. Editor’s
comment: Bronchodilators probably improve the QOL in patients with COPD
primarily because of increased respiratory function. Omata
M, et al. Allergol Internatinal 2007; 56: 15.
译文：
7. 慢性肺阻塞疾病（COPD）中支气管扩张反应和生活质量（QOL）间的相互关系
本文对平均年龄71.7岁的63名COPD患者进行了调查，研究气道可逆性与QOL间的相互关系。吸入支气管扩张剂后的FEV1及其占预期值的百分比与两种QOL量表得到的总分均显示正相关（分别p < .0001和p <
0.006）。对于大多数患者，FVC的可逆性也与QOL正相关。但FEV1的可逆性既不与总分相关，也不与量表中的其他任何项目相关。文章总结：静息状态下使用支气管扩张剂后FVC有改善的COPD患者，如果应用该药将可以改善生活质量。
编者按：COPD患者通过使用支气管扩张剂而得到QOL的改善主要是因为该药可以改善患者的肺功能。Omata M, et al. Allergol Internatinal 2007; 56: 15.
8. ASYMMETRIC T LYMPHOCYTE DIVISION IN THE INITIATION
OF ADAPTIVE IMMUNE RESPONSES
Reviewed by Gary Hellermann, Ph.D.
T cell activation through interaction with MHC-peptide at the immunological
synapse is the key feature of adaptive immunity, but it is only part of the
picture. Activation also produces memory T cells that generate a rapid
response when faced with the same antigen. In this intriguing article, the
authors hypothesize that polarization of specific proteins between the
synapse and the opposite pole in T cells during prolonged contact with antigen-presenting
cells results in an asymmetric cell division producing two daughter
cells--one an effector T cell bearing markers from
the synapse side and the other a memory T cell with markers from the distal
pole. Editor’s comment: The reason for the extended interaction between T
cells and antigen-loaded dendritic cells appears to
be co-generation of effector and memory T cells by
asymmetric cell division. Chang JT et al. Science 2007, 315:1687. Editorial,
Littman DR, et
al.: 1673.
译文：
8. 在获得性免疫应答早期的T淋巴细胞非对称分化
本文由Gary Hellermann博士回顾
在免疫突触通过与MHC多肽相互作用而产生的T细胞活化是获得性免疫的关键特征，虽然这只是获得性免疫的一部分。该活化过程同时还能产生记忆T细胞，这类细胞负责在二次遇到相同抗原时迅速产生应答。在这篇引人入胜的文章里，作者假设在突触和T细胞对应侧之间的特异性蛋白质会随着与抗原呈递细胞接触的延长而出现分化，这导致T细胞也随之出现非对称分化，进而产生两类子细胞：效应T细胞--带有突触侧的标记，记忆T细胞--带有远端另一极的标记。编者按：T细胞和抗原致敏树突状细胞长期交互作用可能是非对称细胞分化同时产生效应T细胞和记忆T细胞的原因。
Chang JT et al. Science 2007, 315:1687. Editorial,
Littman DR, et
al.: 1673.
9. A POOLED ANALYSIS OF FEV1 DECLINE IN COPD PATIENTS
RANDOMIZED TO INHALED CORTICOSTEROIDS (ICS) OR PLACEBO (P)
This is a pooled study of patient-level data from seven long-term randomized
controlled trials of ICSs vs. P lasting ≥ 12
mo in patients with moderate-to-severe COPD. 3,911 randomized participants
(29.2% female) were included in the analysis. In the first six mo after randomization, ICS use was associated with a
significant mean (± SE) relative increase in FEV1 of 2.42 ± 0.19% compared
with P (p < 0.01). However, from 6 to 36 months, there was no significant
difference between P and ICS therapy in terms of FEV1 decline (-0.01 ± 0.09%;
p = 0.86). The authors conclude that ICS therapy is more effective in
ex-smokers than in current smokers with COPD and that women have larger
responses to ICS than men. However, this effect only lasts for approximately
six months, and thereafter, does not modify the decline in FEV1. Editor’s
comment: Is it possible there are phenotypes within this cohort with
reversible airways disease that responds better and over a longer period than
others who have minimal or no reversibility? Soriano
JB, et al. Chest 2007; 131: 682.
译文：
9. 关于COPD患者随机使用吸入性糖皮质激素（ICS）或安慰剂（P）后FEV1下降情况的合并分析
该合并分析收集了七项长期随机对照试验，对中重度COPD患者持续12个月以上使用ICS或者安慰剂的情况进行了观察。共有3,911随机化患者（其中女性占29.2%）收入本分析。随机化的前6个月，与安慰剂组相比，ICS治疗组FEV1出现明显增加2.42 ± 0.19%（p <
0.01）。然而，随后的6至36个月，有关FEV1下降方面P和ICS两组之间不再有显著性差异（-0.01 ± 0.09%；p =
0.86）。文章结论：相对于COPD吸烟患者，ICS治疗对于COPD非吸烟患者更加有效，同时对女性患者的治疗效果要优于男性患者。但是，这一效果仅仅持续大约6个月，超过6个月则不再改善FEV1的下降情况。编者按：与反应微弱或者非可逆性气道反应的患者相比，在一段时间内显现较好治疗反应的可逆性气道疾病患者是否因为有某些基因显型的参与？ Soriano JB, et al. Chest 2007; 131: 682.
10. EVIDENCE-BASED SELECTION OF INHALED CORTICOSTEROID
(ICS) FOR TREATMENT OF CHRONIC ASTHMA
This is an excellent evidence-based article on
the published literature comparing various ICSs.
There is considerable heterogeneity in the published results on these
medications and their efficacy, and side-effects depend on their formulation,
dosing, device used, and the subjects’ age, severity of asthma, and inhaler
technique. Each medication is reviewed and the pros and cons of using it
elaborated upon. The article is 12 pages with 137 citations. Editor’s
comment: This is a nice review on a subject of importance to every physician
who treats asthma.
Abdullah
AK, et al. J Asthma 2007; 44: 1
译文：
10. 循证选择吸入性糖皮质激素（ICS）治疗慢性哮喘
这是一篇优秀的循证医学文章，作者通过对已发表文献的整理对不同吸入性糖皮质激素进行了比较。发表的文章显示各种药物存在相当大的差异，不同药物的疗效和副作用取决于其制剂配方、剂量、所使用的装置、使用个体的年龄、哮喘病情的严重程度以及药物的吸入技术。文章对每种药物均进行了详细回顾，对药物使用的利弊进行了详细阐述。本文长达12页，引用文章多达137篇。编者按：这篇精致的综述对每一位致力于哮喘治疗的医生而言都具有很高的参考价值。Abdullah AK, et al. J Asthma 2007; 44: 1
11. UPDATE IN ASTHMA 2006
Drs. Moore and Peters update asthma 2006. New concepts discussed include
long-acting beta-agonists, risk, and the genetics of the β2-adrenergic
receptor. They also review the pros and cons of whether early inhalational
corticosteroids prevent development of asthma in transient wheezing infants.
Anti-tumor necrosis factor-α is discussed as a potential new asthma
medication. In addition, gene-environment interactions, pharmacogenomics,
endotoxin and ozone, remodeling in asthma (vascular
remodeling and remodeling in children), and ADAM33, the gene that best
exemplifies the increasing significance of extracellular
matrix proteins and mesenchymal cells in asthma
pathogenesis, are discussed. Editor’s comment: Great review for physicians
who care for patients with asthma.
Moore
W et al. Am J Resp Crit Care Med 2007; 175: 649.
译文：
11. 2006年哮喘更新
Moore和Peters博士对2006年哮喘进展进行了更新。新的观点着重对长效β激动剂、用药风险以及β2肾上腺素能受体的遗传学做了讨论。作者还对早期使用吸入性糖皮质激素是否能阻止短暂喘息的婴幼儿发展为哮喘以及用药的利弊进行了回顾。文章还对未来有可能成为哮喘治疗新药的抗肿瘤坏死因子-α进行了讨论。此外，文章还对以下方面进行了讨论：基因－环境间相互作用，药物基因组学，内毒素和臭氧，哮喘重塑（血管重塑以及儿童期的重塑），以及
ADAM33，该基因是显示细胞外基质蛋白和间质细胞在哮喘发病机制中重要性的最佳例证。编者按： 本文对治疗哮喘患者的医生而言是一篇优秀的综述。
Moore W et al. Am J Resp Crit Care Med 2007; 175: 649.
WAO Now: What's New in the World of WAO
今日WAO：WAO领域新进展
 New
Synopsis Available
可使用的新大纲
A new synopsis on Pharmacotherapy for Allergic Diseases has been posted on
the WAO Web site. Authored by Dr. Saha Siddiqui, Prof. Peter Bradding,
and Prof, Stephen Holgate from the
UK
,
this synopsis reviews currently available therapies for the treatment of
allergic diseases, explaining their mechanisms of action, major side effects,
and general comments about their use. To read the synopsis, click
here.
最近在WAO网站上发布了一份关于变态反应疾病药物治疗学的新大纲。著者为来自英国的Dr. Saha Siddiqui，Prof. Peter Bradding以及Prof, Stephen Holgate，这份大纲回顾了目前变态反应疾病治疗方面所有可用的手段，阐述了各方法的作用机制、主要的副作用，并对他们的应用做了评述。如需阅读本大纲，请点击这里。
WAO's Allergen Specific Immunotherapy Document
WAO变应原特异性免疫治疗文件
The World Allergy Organization (WAO) convened a group
of experts to provide guidelines for the methodology of future immunotherapy
studies to ensure that patients are treated based on sound scientific
evidence and to minimize the risk of misusing limited financial resources for
scientific studies. The document summarizes the recommendations for study
design, patients’ selection, appropriate outcomes and statistical treatment
to be used in planning and performing clinical trials with specific immunotherapy.
世界变态反应组织（WAO）召集专家组对未来免疫治疗研究的方法学提供了指南，从而保证患者接受的治疗是基于健全的科学证据，并将错误使用科研研究有限资源的风险最小化。文件对特异性免疫治疗临床实验的设计和操作进行了有关科研设计、病例选择、恰当的结果、统计学治疗等概述。
The document was recently published in the March 2007
Issue of Allergy: European Journal of Allergy and Clinical Immunology
and is now available to you free from PubMed.
本文件最近于2007年3月发表，名为《Allergy: European Journal of Allergy and Clinical Immunology》，目前可以在PubMed上免费获得。
You may also access the document from WAO’s Allergic
Disease Resource Center.
您也可以访问WAO的变态反应疾病资源中心获得该文件。
New Interactive Case Review
最新互动式病例回顾
Take a moment to test your knowledge with the new Interactive
Case Review based on a Clinical Case Report - ACE Induced Angioedema by Dr. Byol Shin.
花点时间来测试你的知识吧！这里提供最新的互动式临床病例回顾来自Dr. Byol Shin 的临床病例报告-ACE导致的血管神经性水肿
Call for Applications
接受申请中
WAO Short-Term Research Fellowship 2007 Applications
The World Allergy Organization (WAO) offers three
Short-Term Research Fellowships, to commence in the latter half of 2007, to
support junior allergists to visit a center of their choice to learn a
research technique. The expected duration of each attachment is 2-3 weeks.
WAO will contribute up to a maximum of $2,500 USD, to include travel and
accommodations, for each Short-Term Fellowship.
Priority will be given to junior clinicians within five years of award of the
most recent professional degree, who are specializing in allergy and who are
affiliated to an academic department or clinical institute. Applicants must
be current members of a WAO member society.
The Short-Term Fellowships will be applied to a project which meets one of
the WAO Research Priorities:
- Genetic factors
involved in the development of allergic disease and response to
treatment
- Allergen
characterization and standardization
- Clinical and
basic studies in allergy and asthma
Application forms may be downloaded here
Applications must be received by WAO head office
not later than 31 May 2007
WAO短期科研奖学金2007年度申请
世界变态反应组织（WAO）在2007年下半年开始提供三项短期科研奖学金以资助初年变态反应医师前往他们所向往的医学中心进修并学习科研技术。进修持续时间以2到3周为宜。WAO将会为每位奖学金获得者资助最高2500美元的奖学金，包括旅行费用和食宿费用。
奖学金优先授予那些在近5年内获得专业学位的初年变态反应医师，其专业为变态反应，并且隶属于医学院相关科室或临床研究院。申请者必须是目前WAO成员学会的会员。
短期科研奖学金的申请目的必须符合以下WAO科研优先项目之一：
*参与变应性疾病发病及其治疗反应的遗传学因素
*变应原的鉴定和标准化
*过敏性鼻炎和哮喘的临床及基础研究
申请表可以从此处下载：链接
申请必须在
2007年5月31日前送达WAO办公室
The WAO Henning Løwenstein
Research Award 2007
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 World Allergy Congress.
 For
application guidelines, visit http://www.alk.abello.com/ and click on "The WAO
Henning Løwenstein Research Award."
Deadline: 30 June 2007
WAO
2007年度Henning Løwenstein科研奖
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
World Allergy Congress (WAC) Travel Grants
世界变态反应大会（WAC）差旅费补助
WAO, in partnership with Schering-Plough
Corporation (SPC), the European Academy of Allergology
and Clinical Immunology (EAACI), and the American Academy of Allergy, Asthma and
Immunology (AAAAI), is sponsoring several Travel Grants for young scientists
to attend WAO’s World
Allergy Congress (WAC) in Bangkok, Thailand, 2-6 December 2007. For further
information, click here.
世界变态反应组织（WAO）与先灵葆雅有限公司（SPC），欧洲变态反应与临床免疫学会（EAACI），美国变态反应，哮喘与临床免疫学会（AAAAI）合作，为了资助年轻科学工作者能参加在WAO在泰国曼谷
2007年12月2日至6日期间举办的世界变态反应大会，特设立 了几项差旅费补助项目，点击这里。
You are invited to attend…
邀请您参加…
 WAF
Symposium: Immune Tolerance
XXVI EAACI Congress
Tuesday, 12 June 2007, 8:30 - 10:00
Göteborg Convention Centre, Room K2-K3
Göteborg, Sweden
Chairs主席:
Michael A. Kaliner, United
States
Anthony J. Frew,
United Kingdom
Concepts in tolerance induction in the lung
有关肺脏诱导耐受的观念
Dale Umetsu, United States
Modulation of IgE-related
diseases in children: atopic asthma as a paradigm
儿童中IgE相关性疾病的调节：以特应性哮喘作为范例
Patrick Holt, Australia
Can omalizumab synergize immunotherapy?
omalizumab是否可以用来协同免疫治疗？
Thomas Casale,
United States
World Allergy
Forum is supported through an unrestricted educational grant from
世界变态反应论坛得到以下公司无私的教育资助
 2007
World Allergy Congress Symposium: Masqueraders of Allergic Disease
2007世界变态反应大会论坛：变态反应疾病的伪装
XXVI EAACI Congress第26届EAACI大会
Tuesday, 12 June 2007, 15:30 – 17:00
2007年6月12日，星期二，15:30
– 17:00
Göteborg Convention Centre, Room K2-K3哥德堡会议中心，K2-K3房间
Göteborg, Sweden哥德堡，瑞典
Chair主席: Michael A. Kaliner,
United States
Conjunctivitis结膜炎
Connie Katelaris, Australia
Asthma哮喘
Ronald Dahl, Denmark
Rhinosinusitis鼻－鼻窦炎
Michael A.
Kaliner,
United States
June Educational Program Placements
6月份教学计划安排
 GLORIA Placements
GLORIA安排
The Asthma and Allergy Society of Virginia弗吉尼亚哮喘和变态反应学会
16-17 June 2007
2007年6月16-17日
Virginia Beach, Virginia
弗吉尼亚海滩，弗吉尼亚
US GLORIA Faculty美国GLORIA教员:
Ira Finegold
Presentation主讲:
Module 5: Treatment of Severe Asthma重症哮喘的治疗
Louisiana Society of Allergy, Asthma & Immunology
路易斯安那变态反应，哮喘和免疫学学会
23-24 June 2007
2007年6月23-24日
New Orleans, Louisiana
新奥尔良，路易斯安那
US GLORIA Faculty美国GLORIA教员:
Michael Blaiss
Presentations主讲:
Module 2: Allergic Conjunctivitis变应性结膜炎
Module 5: Treatment of Severe Asthma重症哮喘的治疗
GLORIA is
supported through unrestricted educational grants from:
GLORIA得到以下公司教育资助的支持
GLORIA Module 5: Treatment of Severe Asthma Now Available!
GLORIA第5单元：重症哮喘的治疗 目前可供使用！
WAO is excited to announce the completion of the Treatment of Severe Asthma
Module, with is now available for download.
WAO郑重宣布已经完成“重症哮喘的治疗”章节的编撰，目前可供下载。
 Seminars & Conferences Placement
研讨会和会议安排
Mexican National Congress on Clinical Immunology and
Allergy墨西哥临床免疫和变态反应全国大会
27-30 June 2007
2007年6月27-30日
Cancun, Mexico
坎昆，墨西哥
WAO Invited Lecturer:
WAO受邀讲者：
Jay Portnoy
http://www.cmica.org/
 Emerging Societies Meeting - Cancun, Mexico
新兴学会的会议－墨西哥坎昆
WAO's first Emerging Societies Meeting (ESM) of 2007 will take place
during the LXI National Congress of Clinical Immunology and Allergy, 27-30
June
2007 in Cancun,
Mexico. The ESM is intended as a follow-up to the ESM that was held in Latin
America in 2006 and will include representatives from
Honduras, Guatemala, Cuba, El Salvador, Nicaragua
and
Martinique. This meeting is jointly
funded by the
American
College of Allergy, Asthma and Immunology, the
Mexican
College of Allergy, Asthma and
Clinical Immunology and the World Allergy Organization.
WAO在2007年度的第一次新兴学会会议（ESM）将于2007年6月27-30日在墨西哥坎昆的临床免疫和变态反应全国大会期间召开。本次大会作为2006年在拉丁美洲召开ESM的延续，将会有来自洪都拉斯、危地马拉、古巴、萨尔瓦多、尼加拉瓜和马提尼克等国的代表参加。这次会议将由美国变态反应、哮喘和免疫学会（ACAAI）、墨西哥变态反应、哮喘和临床免疫学会以及世界变态反应组织共同资助举办。
For more information on the
Mexican
College
of Allergy, Asthma and Clinical Immunology’s meeting 27-30 June 2007, please click here.
如果需要有关墨西哥变态反应，哮喘和临床免疫学学院在2007年6月27-30日会议的更多信息，请点击这里。
Sign up
for Online Journal Subscription -
WAO and Hogrefe & Huber Publishers are offering
a limited number of free online 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, online 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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在线杂志订阅申请－
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：
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国家
E-mail地址
成员学会的名称
And In Other News 其他新闻
Two
Allergy Book Reviews
两本变态反应学书评
Bronchial Asthma: A Guide for Practical Understanding and Treatment
Edited by: M Eric Gershwin, MD and Timothy E Albertson, MD, MPH, PhD.
ISBN: 1-58829-604-0
支气管哮喘:实践理解与治疗的指南
著者: M
Eric Gershwin, MD and Timothy E Albertson, MD, MPH, PhD.
ISBN: 1-58829-604-0
List price: $125.00 USD (hardcover and eBook)
$99.50 USD (paperback)
Available from: Humana Press
定价:
$125.00 美元 (精装本及电子版本)
$99.50美元(平装本)
订购网址: Humana Press
Reviewer书评作者:
Dr David C Sutherland, FRACP
Nineways Specialist Clinic, Broadmeadow,
NSW, Australia:
Description:
This is the 5th edition of a comprehensive guide to the diagnosis and
management of bronchial asthma. Previous editions have been well reviewed in
the medical press. The current edition provides an update of recent
developments and relatively new drug therapy, along with a greater use of
tables and charts, which are deemed to make the book more "user
friendly". The coverage of the topic is encyclopaedic,
with each chapter, and indeed sections within chapters, written so that they
will stand alone. This is both the strength and the weakness of this volume.
说明：
本书有关支气管哮喘诊断和治疗方面详尽指南的第5版。以往的旧版本已经对发表的医学信息进行了很好的回顾总结。目前这一版对新近的进展和相对比较新的药物治疗又进行了更新，由于本版更多使用了图表，使本书具备更好“用户友好”性。本书覆盖的题目涉及面广泛，每一章，事实上每一节都具有很强的独立性。这既是本书的长处，同时也是本书的弱点所在。
Purpose:
The textbook is designed to provide rapid access to
practical information regarding the diagnosis and management of bronchial
asthma, gleaned from an enormous number of scientific studies and reviews,
published over the last thirty years.
目的：
本书的撰写是为了使学生能够快速获取有关支气管哮喘诊断和治疗方面的实用信息，书中收集了在过去30年内发表的大量科研实验和综述。
Audience:
This volume is designed to provide practical information for generalists, and
for specialists other than chest physicians and allergists/immunologists, as
at least all clinicians will be required to manage this common condition, as
part of the total care of their patients.
读者：
本书主要为以下人群提供实用临床信息：全科医生，除胸科医生和变态反应医生/免疫医生外的其他专科医生。无论如何，所有临床医生都需要具备治疗这一常见疾病的能力，这将作为对患者整体医护工作的一部分。
Features:
The scope of the book is very comprehensive, ranging from basic immunology
and pulmonary physiology, through management issues and specific clinical
problems, to lifestyle issues. The format of the book allows rapid access to
information, through the use of “key points”, numerous tables and figures,
and summaries. Most of the chapters provide comprehensive,
and up-to-date lists of references.
特色：
该书涵盖范围非常广泛，涉及基础免疫学、肺脏生理学、治疗中遇到的问题和特殊的临床问题、以及生活方式问题。本书采用的格式可以使读者通过使用“关键点”，大量表格、图像和摘要迅速获取有用的信息。大多数章节都提供有全面、最新的参考目录。
Assessment:
This volume succeeds in its aim of providing practical, readily accessible, information
about the diagnosis and management of bronchial asthma for those without a
specialist interest in the area. However, this format means that the volume
is not designed to be read from cover to cover, and even within single
chapters, there is a great deal of repetition. This format does allow for the
inclusion of a great deal of detailed information which may be of interest to
individual clinicians, or perhaps relevant to the management of specific
patients, but not necessarily of interest to the general reader. Much of the
information (for example epidemiology, drug information, health delivery
issues and the management of asthma in "minorities") is directed to
the North American audience, and has less relevance to clinicians elsewhere.
评价：
本卷成功地为读者提供了有关支气管哮喘诊断和治疗方面很多实用方便的信息，这对于没有专科医生帮助的人群大有裨益。但是，这同时也意味着本书格式设计不适于从头到尾的通读，有时甚至在某一章节也存在着大量的重复信息。这种形式所包含的大量详细资料也许会被个别临床医生感兴趣，或者为医生在治疗特殊病人过程中所关注，但是对于大多数普通读者则不一定能激发出他们的兴趣。大量的信息（例如：流行病学，药物信息，医疗服务难题以及对“少数民族”哮喘治疗管理）主要针对北美读者，而对于其他地区的临床医生缺乏适用性。
Overall, this is a very useful resource text, and should be
included in all institutional libraries. The ease of access to detailed
information will make it an attractive resource for undergraduate and
postgraduate students outside of the areas of respiratory medicine and
allergy/immunology.
总体来说，这是一个非常有用的教材，应当为所有学校的图书馆所收藏。由于本书内容丰富，通俗易懂，对于非呼吸内科及变态反应/临床免疫领域的在校大学生和研究生而言有很强的吸引力。
Oxford Handbook of Clinical Immunology and Allergy
Edited by: Gavin Spickett
ISBN13: 9780198528661
ISBN10: 0198528663
临床免疫学和变态反应学牛津手册
著者:
Gavin Spickett
ISBN13: 9780198528661
ISBN10: 0198528663
List Price: $45.00 USD
Available from: Oxford University Press
定价:
$45.00 美元
订购网址: Oxford University Press
Reviewer书评作者:
Thomas Chacko, MD
Division of Allergy and Immunology
University of South Florida College of Medicine, Tampa, FL, USA
Description:
This handy pocket reference is a practical and clinically relevant guide for
the diagnosis and management of diseases in clinical immunology and allergy.
说明：
这本袖珍手册是一本有关临床免疫和变态反应疾病诊断和治疗方面的临床实用性指南。
Purpose:
It provides the physician and other healthcare professionals with a quick
reference and covers a wide range of clinical topics, basic laboratory tests,
and the latest advances in the field.
目的：
本书可以用于内科医生和其他医疗保健专业人士的快速查阅，它涵盖范围广泛，包括各种临床主题，基本实验室检查，以及该领域的最新进展。
Audience:
The book is geared toward the novice student, sub-specialty resident in
allergy and immunology, and other physicians who want a quick reference book
for high yield information.
读者：
本书主要面向初学阶段医学生，在变态反应和临床免疫分专业接受专科培训的住院医生，以及其他有信息需求并谋求一本快速参考书的内科医生。
Features:
The pocket handbook is divided into 2 sections. The first section covers
clinical diseases, including primary and secondary immunodeficiencies,
allergic diseases, autoimmunity, connective tissue diseases, and vasculitis. There are multiple tables within each chapter
but few treatment algorithms. Even rare diseases are highlighted with key
clinical points. The second section covers diagnostic tests, and summarizes
the methodology and pros and cons of each test.
特色：
本袖珍手册分为两部分：第一部分涉及临床疾病，包括原发性免疫缺陷和继发性免疫缺陷疾病，变应性疾病，自身免疫疾病，结缔组织疾病以及血管炎。除了治疗部分，每一章节均含有大量表格。本书甚至对罕见疾病都进行了临床要点的强调。第二部分囊括以下内容：诊断学检测，每种检测的方法学及其利弊所在。
Assessment:
This is an excellent pocket reference for clinical immunology and allergy.
The sections are arranged to allow for quick retrieval of key facts. It is
small and convenient to carry. Other sources are necessary for a more in
depth review of these topics, but this is a good start.
评价：
这是一本有关临床免疫和变态反应内容的优秀袖珍参考手册。书中章节的安排便于读者对关键点进行快速检索。本书体积小，携带方便。虽然读者有必要对于本书各主题作更深入的回顾复习，但本书不失为一个良好的开端。
In summary, the Oxford Handbook of Clinical Immunology
and Allergy will be particularly helpful to the student or physician who
wants a quick convenient resource to retrieve key facts, in a broad range of
topics, related to this field.
总的来说，对于那些希望在该专业领域对关键点进行快速便捷检索的医学生或者内科医生，临床免疫学和变态反应学牛津手册将显得特别有益。
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。
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