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June Medical Journal Review(医学雑誌レビュー)
WAO Member Society Spotlight
WAO Now: What's New in the World of WAO(最新ニュース)
And In Other News . . .(その他のニュース)

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

Mark C. Glaum, M.D., Ph.D., WAO Guest Editor, Assistant Professor of Medicine and Pediatrics, University of South Florida College of Medicine, reviewed premier June medical journal articles for practicing allergists.南フロリダ大学Mark C. Glaum助教授による6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. ACID SUPPRESSION IMPROVES BREATHING FUNCTION IN PERSISTENT ASTHMATICS WITH GASTROESOPHAGEAL REFLUX (GERD) AND NOCTURNAL SYMPTOMS
Subjects with moderate to severe persistent asthma (n=770) were randomized to receive esomeprazole 40mg twice daily or placebo. Subjects were stratified into 3 groups: GERD with nocturnal symptoms; GERD without nocturnal symptoms; and nocturnal symptoms without GERD. In subjects with GERD and nocturnal symptoms, the esomeprazole-treated group showed improved morning (p = 0.03) and evening (p = 0.012) peak expiratory flows as compared to placebo. No improvement was observed in subjects without both GERD and nocturnal symptoms. Editor's comment: Treatment of gastroesophageal reflux is an important component of asthma management in certain patients. Kiljander TO, Harding SM, Field SK, et al. Am J Respir Crit Care Med 2006; 173: 1091-97

胃食道逆流を伴う持続型の喘息患者に対して、制酸剤を使用すると呼吸機能および夜間の症状が有意に改善されたという臨床研究論文である。

2. CONTACT HYPERSENSITIVITY IS MEDIATED BY NATURAL KILLER (NK) CELLS IN THE ABSENCE OF T AND B LYMPHOCYTES
Contact hypersensitivity is considered to be a T cell-mediated prototypical type IV Gel and Coombs reaction to haptens. Unexpectedly, in mice devoid of T and B lymphocytes, a model of contact dermatitis was found to be inducible with 2,4-dinitrofluorobenzene and oxazolone. If mice were depleted of all lymphocytes (including NK cells), contact hypersensitivity could not be induced. Specific contact hypersensitivity could be reconstituted in such mice after adoptive transfer of NK cells from NK-competent, sensitized donors. Editor's comment: NK cells are previously unrecognized mediators of hapten-specific immunity. Please also see excellent accompanying editorials. O'Leary JG, Goodarzi M, Drayton DL, von Andrian UH. Nat Immunol 2006; 7(5): 507-16, Yokoyama WM; 437-9, Parham P. Nature 2006; 441(25): 415-16. No abstract is available.

接 触性皮膚炎などの過敏症はT細胞が関与する典型的なクームスとゲルのIV型アレルギー反応であると考えられてきた。ところが、予想に反して、T, B細胞を欠損したマウスにおいても2,4-dinitrofluorobenzene (しばしば使用されるハプテン)and oxazoloneによる接触性皮膚炎が観察された。しかし、NK細胞を含む全てのリンパ球を欠損した場合、この反応はおきず、そしてそのハプテンで感作 されたマウスにNK細胞を移植した場合に反応が回復した。

3. NOVEL BETA-2 RECEPTOR (B2) POLYMORPHISM IS ASSOCIATED WITH ASTHMA SEVERITY IN AFRICAN AMERICANS
Of 2,032 subjects recruited for a multicenter randomized, placebo-controlled, crossover safety study evaluating an inactivated influenza vaccine in patients with asthma, 517 patients consented to participate in a genetic sub-study to evaluate the association of particular B2 polymorphisms with asthma exacerbation rates and symptoms. Forty percent of African American asthmatics homozygous for a C523 allele experienced an asthma exacerbation in a two-week period following placebo vaccine injection as compared to 29% in heterozygotes (p = 0.018). Editor's comment: Further studies are warranted to evaluate associations between B2 variants and asthma phenotypes, particularly in minority populations. Lima, JJ, Holbrook, JT, Wang J, et al. Asthma 2006; 43:185-9

β2受容体の遺伝子多型はβ2刺激気管支拡張薬の反応性や副作用(過敏性の亢進)と関連していることが白人において証明されている。アフリカ系米国人にお いて存在するC523の遺伝子多型が新たに発見され、それがインフルエンザワクチン接種後の発作の頻度と相関していることを発見した。訳者注:インフルエンザワクチン接種とβ2受容体の遺伝子多型の因果関係については証明されていない。

4. SUBACUTE COUGH: IS IT A SEPARATE ENTITY?
One hundred eighty-four subjects diagnosed with subacute (lasting 3-8 weeks) cough were enrolled and treated prospectively using a clinical algorithm. Patients exhibiting clinical signs or symptoms of post-nasal drip or post-infectious cough were treated empirically with antihistamine/decongestant combination for 3 weeks. If no clinical improvement was noted, subjects were evaluated for airway hyperreactivity and, if sensitive, treated with inhaled corticosteroids. Of 184 subjects, 48% were found to have post-infectious cough, 33% had postnasal drip and only 16% had cough variant asthma that improved with inhaled corticosteroids. Editor's comment: Cough lasting 3-8 weeks is frequently post-infectious and self-limited. Kwon N, Oh M, Min T, et al. Chest 2006;129: 1142-7

亜急性咳嗽(3-8週間持続する咳嗽)という診断は一つの疾患概念ではないとする論文である。感染後の後鼻漏が関係して患者では抗ヒスタミン薬などの治療 が奏功するがステロイド吸入は無効であり、気道の過敏性が亢進している患者などステロイド吸入が有効な症例とは別な疾患グループである。

5. DEFICIENCY OF IgA AND IgG2 CORRELATES WITH ASTHMA SYMPTOMS AND LUNG FUNCTION
Severe and mild asthmatic adults (n= 31, ages 23-50) and 15 adult control patients were recruited to evaluate any association of low immunoglobulins with asthma symptoms, lung function and cellular markers of inflammation by endoscopic bronchial biopsy. Levels of IgG (p = 0.02) and IgA (p=0.006) were lower in severe asthmatics as compared to control subjects. Only low levels of IgA correlated with asthma symptoms and lung function (p<0.009), while levels of IgA and IgG positively correlated with numbers of tissue mast cells. Editor's comment: Alteration in levels of antibody production may be a marker of severe asthma phenotypes. Balzar S, Strand M, Nakano T, Wenzel SE. Int Arch Allergy Immunol 2006; 140:96-102

重症喘息患者では粘膜免疫に重要なIgAのレベルやTh1細胞が関係し細菌感染防御に重要なIgG2のレベルが低下していた。

6. SPECIFIC SPUTUM INFLAMMATORY MARKERS CORRELATE WITH LUNG FUNCTION IN CYSTIC FIBROSIS BUT NOT CHRONIC BRONCHITIS
Expectorated sputum samples were obtained from 15 subjects with ATS-defined chronic bronchitis and 16 subjects with cystic fibrosis (CF) confirmed by sweat chloride test. Spirometry was performed at time of sputum collection and again at a later time point. Sputum samples were analyzed for presence of IL-8, myeloperoxidase (MPO) and DNA content. Cough transportability (CTR) of sputum (measure of adhesiveness) was also evaluated by in vitro methods. In subjects with CF, sputum concentrations of IL-8 and MPO were inversely correlated with FEV1 (p=0.003), while IL-8 and DNA concentrations were inversely correlated with CTR (p<0.05). No correlation was observed in subjects with chronic bronchitis. Editor's comment: Sputum concentrations of IL-8, MPO and DNA may serve as markers of airway obstruction in CF. Kim J, Okamoto K, Rubin BK. Chest 2006;129: 1148-54

嚢胞性肺線維症患者では喀痰中のIL-8やmyeloperoxidase (MPO)の濃度と呼吸機能(一秒率)が逆相関していた。

7. POSITIVE ASSOCIATION BETWEEN AIR PARTICULATE LEVELS AND AIRWAY INFLAMMATION IN ASTHMATIC CHILDREN
Children with moderate to severe persistent asthma (n = 73) were followed prospectively over a two-year period. Daily concentrations of ambient fine particulates, daily use of bronchodilators, and levels of urinary leukotrienes were measured. Exposure to increased ambient particulates during the morning commute to school was associated with a 3.8% increase in bronchodilator use at school (p = 0.04). Stronger associations were noted in children with more severe asthma. Maximum morning particulate levels correlated with an average 6.2% increase in urinary leukotriene E 4 levels measured during school hours (p = 0.006) but not when levels were averaged over 24 hours. Editor's note: Exposure to ambient particulates may worsen airway inflammation and asthma symptoms in predisposed children. Also, see excellent accompanying editorial. Rabinovitch N, Strand M, Gelfand EW Am J Respir Crit Care Med 2006; 173:1098-1105, Delfino RJ, 173:1054-5

大気中の微粒子のレベルと小児喘息患者の気道炎症(尿中のLTE4の排出量)や気管支拡張薬の使用量は正の相関を示した。

8. PINE DUST EXPOSURE MAY PREDISPOSE TO ATOPY AND DECREASED LUNG FUNCTION
New Zealand sawmill workers with (n = 59) and without (n = 167) asthma symptoms assessed by questionnaire were evaluated for personal inhaled dust exposure, percutaneous allergen skin test reactivity and pre/post work shift spirometry. High exposure to “green” pine dust (from fresh cut timbers) was associated with sensitization to >3 outdoor pollens (OR 3.1, p<0.05), while high exposure to "green" and "dry" (from kiln-dried timers) dust was associated with reductions in FEV1 and PEF. Editor's comment: Exposure to certain particulates may modulate allergen sensitization and airway function. Douwes J, McLean D, Slater T, et al. Eur Respir J 2006; May 17 (doi: 10.1183/09031936.06.00120305)

ニュージーランドの製材所で働く喘息症状のある人59名とない人167名について調査した結果、製材の松の材木のほこりに曝露される機会が多いほど、屋外のアレルゲンに感作されていることが判明した。

9. TASK FORCE REPORT ON SUBLINGUAL IMMUNOTHERAPY (SLIT)
This combined AAAAI/ACAAI task force report is a comprehensive review of the current evidence that supports the dosing, effectiveness and safety of sublingual immunotherapy. Other areas reviewed in this report include: the immunologic response to SLIT; changes in end organ inflammation; potential mechanisms and economics. Editor's comment: This report discusses the current literature regarding sublingual administration of immunotherapy and provides suggestions of where further studies are needed. Cox LS, Linnemann DL, Nolte H, et.al. J Allergy Clin Immunol 2006;117: 1021-35

米国アレルギー学会の舌下免疫療法検討委員会によるレビューと報告がJACIに掲載されている。

10. Review of Testing and Treatment in Hereditary Angioedema
This review focuses on the current status of genetic testing for hereditary angioedema, however, it also provides a concise review of mechanisms, evaluation and treatment of the disease. There are several useful algorithms and charts that clearly summarize the classification of hereditary and acquired angioedema, as well as laboratory evaluation, treatment and surgical prophylaxis for patients with this problem. Editor's comment: This review summarizes evaluation and treatment of hereditary and acquired angioedema in a clear, accessible format. Weiler CR, Van Dellen RG. Mayo Clin Proc 2006; 81(7): 958-72

遺伝性の血管浮腫に関する総説の紹介。


WAO Member Society Spotlight -Japanese Society of Allergology (JSA)

今月のWAOメンバー紹介は日本アレルギー学会の紹介が掲載されました。

The Japanese Society of Allergology (JSA) is pleased to announce that the forthcoming Fall Meeting, "Pursuing the Goal of Allergolgy – Elucidation of Pathologic Condition, Treatment and Prevention–" will be held at Tokyo International Forum in Tokyo, Japan on November 2-4, 2006. As a new initiative, the International Session, in which all presentations and discussions are conducted in English, is taking place. Its purpose is to promote the further internationalization of JSA so that JSA's biannual conferences will serve as the meeting ground for researchers from all over the world in the future. For more information on this conference, please contact allergy-56th@ped.dept.med.gunma-u.ac.jp. We welcome you to participate in our conference which will be attended by more than 3,000 Japanese researchers and will give them an opportunity to discuss their topics. The JSA members are looking forward to meeting you in Japan.

以上、森川昭廣会長の下、東京国際フォーラムにおいて11月に開催される日本アレルギー学会秋季大会の紹介です。

Another significant announcement from JSA is that JSA's official English journal, "Allergology International" (AI), is available online. You are welcome to access the current issue (http://ai.jsaweb.jp/current.html) as well as the past issues (http://ai.jsaweb.jp/past.html). AI publishes peer-reviewed articles of scientific excellence in human and experimental allergology and related fields of research. The journal aims to further the international exchange of results and encourages authors from all countries to submit papers in the following categories: Original Articles, Case Reports, Short Communications, Letters to the Editors and Hypotheses. The journal is now accepting submissions of articles for possible publication. The acceptance for all papers is based on the quality and originality of the research and its significance to the journal's readership. Except where it otherwise states, manuscripts are peer-reviewed by at least two anonymous reviewers and the Editor. The original manuscript and three copies should be submitted to Editor-in-Chief, Allergology International, Japanese Society of Allergology, 7F Ishimizu Bld., 1-35-26 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. For further instructions regarding the submission of papers visit the website: http://ai.jsaweb.jp/

以上、Allergology Internationalの投稿呼びかけです。

Provided by: Hirohisa Saito
The Japanese Society of Allergology
URL: http://www.jsaweb.jp/
E-mail: info@jsaweb.jp


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

WAO Long-Term Research Fellowship

The World Allergy Organization (WAO) is offering a two-year Long-Term Research Fellowship, commencing late 2006. The Fellowship supports a junior allergist following an approved research program at a WAO proposed host center. A list of centers is included in the application. WAO will contribute a monthly stipend and yearly travel expenses.

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 with an academic department or clinical institute. Applicants must be active members of a WAO member society.

The Long-Term Fellowship 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.

WAOがサポートする長期研究フェローの募集です。アレルギーに関連した研究で博士号などを取得して5年以内の臨床医が優先されるそうです。

World Allergy Forum Held at the XXV Congress of the EAACI:

"Life-Threatening Allergy – An Homage to Von Pirquet"

Our superb international faculty was chaired by Michael A. Kaliner and Anthony Frew, and provided a worldwide update on life-threatening allergy conditions. The first speaker, Aziz Sheikh (Edinburgh, Scotland), presented an analysis of the epidemiology of anaphylaxis, and the presentation by Richard F. Lockey (Tampa, FL. U.S.A.) focused on the mechanisms of anaphylaxis. The symposium was concluded by F. Estelle R. Simons (Winnipeg, Canada), who discussed management of anaphylaxis.

Click here to view abstracts and slides and hear the presentations.

6月にウィーンで開催されたヨーロッパアレルギー学会期間中のWAO主催のフォーラムの紹介です。

WAO Conversations

We are pleased to announce a new WAO Conversation, an interview with Malcolm R. Sears. To hear Dr. Sears discuss current issues associated with beta agonists, click here.

今月のWAO Conversationはカナダのマクマスター大学のSears教授へのインタービューです。β刺激気管支拡張薬に関する歴史とステロイドとLABAの合剤など最近の 情報や考え方が述べられています。

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
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E-mail address
Name of Member Society


And In Other News (その他のニュース)

Allergy Book Review

Lung Function Testing
European Respiratory Monograph 2005
Editors: R Gosselink and H Stam

List price: $80.00 USD
Available from: Maney Publishing

Reviewer: Dr Janet Rimmer, MBBS, MD, FRACP. Woolcock Institute, University of Sydney, Australia

Description:
Lung function testing is an integral part of examination of the respiratory system. This monograph describes the main aspects of this evaluation process. Topics covered include spirometry, lung volumes, diffusion, control of breathing, muscle strength and sections on exercise testing. There are also sections on the less common areas such as forced oscillometry, testing in children and ICU patients. The basic methodology and interpretation is described and related to clinical disease states.

Purpose:
To provide an up-to date approach to the performance and interpretation of respiratory function testing for clinicians.

Audience:
This book can be used by clinicians and researchers who are interested in understanding the theory and equipment used for the assessment and continued monitoring of respiratory diseases. The basic science is quite complex so that the book is probably not useful for medical students.

Features:
This book is a very concise summary of the many different aspects of lung function. The reader needs to have an existing basic understanding of lung function to fully appreciate the text. It does cover the links between basic science, pathophysiology and clinical application which is a very useful approach. Each chapter provides an excellent summary of the main points.

Assessment:
Lung function testing is the 31st European Respiratory Monograph, a series which commenced in 1995. While others in the series have addressed isolated components of lung function testing in detail, the current monograph provides a very concise (206 pages) summary of most aspects of lung function testing. Its advantages are that it covers both well established and new methodology and that every chapter has a section focussing on clinical application

今月のアレルギー書籍の紹介はヨーロッパの呼吸器学会による最新のレビュー集です。

Find more allergy book reviews on the WAO Website here.

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 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。

World Allergy Organization (WAO)
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Milwaukee, WI 53202-3823
Email: info@worldallergy.org

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