Medical Journal Reviews
Prof. Richard F. Lockey, MD, WAO Web Editor-in-Chief, and Guest Reviewer Gary Hellermann, PhD, reviewed premier medical journal articles for practicing allergists. Read their top 3 picks below and for the other 9 reviews, click here.
1. Palivizumab (P) prophylaxis, respiratory syncytial virus (RSV) and subsequent recurrent wheezing.
There is substantial evidence that lower respiratory tract infections of children with RSV within the first two years of life predispose them to wheezing. Preterm infants are at especially great risk of RSV bronchiolitis within the first year of life, and prophylaxis with the anti-RSV antibody P helps reduce their risk of respiratory infections. Whether or not this treatment translates into a reduction in subsequent wheezing is the subject of this study. Preterm infants (≤35 weeks gestation) without chronic lung disease were selected from 27 different sites according to whether they had received P or not. Recurrent wheezing was assessed monthly over a period of 24 months. The results show a significant reduction of about 50% in the incidence of recurrent wheezing in preterm infants receiving P. Editor’s comment: While palivizumab has a proven track record in reducing RSV infections in high risk infants, its cost precludes its widespread prophylactic use. The development of an effective RSV vaccine is still a desirable goal. Simoes EA et al. J Pediatr 2007; 151:34.
2. Effect of inhaled interleukin-5 (IL-5) on eosinophil (E) progenitors in the bronchi and bone marrow of asthmatic and non-asthmatic volunteers.
There is a shift in our understanding of the role of the E in asthma. They are now seen less as misguided pathogenic cells bent on creating an inflammatory condition and more as players in a complex scenario where many factors contribute to the condition. In this report, the role of E progenitor numbers in the bone marrow was examined in asthmatic vs non-asthmatic subjects. IL-5 induces the expansion and proliferation of Es in bone marrow and upregulates IL-5 receptor expression. Healthy and mild atopic asthmatic subjects were randomized into two groups, one of which received recombinant human IL-5 by inhalation and the other vehicle only. Spirometry was measured at baseline and 6 h after IL-5 inhalation. Blood samples were taken at 0, 6 and 24 h and at 24 h bronchial and bone marrow biopsies were done along with bronchoalveolar lavage. IL-5 significantly decreases the number of CD3+ E progenitor cells in the bone marrow of asthmatics and increases Es in bronchial mucosa of healthy persons. There was no effect on FEV1 or airway hyperreactivity. Editor’s comment: The demonstration of a signaling axis between IL-5 levels in the lung and eosinophil progenitor production in bone marrow suggests that more comparisons between local and systemic effects of inflammatory mediators need to be done. Menzies-Gow AN et al. Clin Exp Allergy 2007; 37:1023.
3. A GABAergic system in airway epithelium is essential for mucus overproduction in asthma.
Type II lung epithelial cells express the gamma-aminobutyric acid subtype A receptor (GABAAR) and this study shows that activation of GABAAR in OVA-sensitized/-challenged mice caused depolarization of these cells. Similar results were obtained using bronchial epithelial cells from human asthmatics. Cells from the asthmatic mice as well as humans show an increase in GABAARs upon allergen challenge that correlates with an increase in goblet cell hyperplasia and mucus production. Inhibition of GABAAR reduces goblet cells and mucus in mice. IL-13 is also upregulated in OVA-treated mice and human cells and represents a critical factor in allergic enhancement of GABAAR activity. Editor’s comment: This study is the first report of the existence of a GABAergic signaling pathway involved in mucus overproduction in asthma and may provide a new therapeutic target. Xiang Y-Y et al. Nature Medicine (Letters) 2007; 13:862.
To read the additional reviews, click here.
WAO Now: What's New in the World of WAO
World Allergy Congress (WAC) 2007 – Bangkok, Thailand
In addition to an excellent scientific program, we are pleased to offer outstanding social events at WAC 2007. Join us in experiencing some of the local culture, ethos and natural environment of Thailand.
2 December 2007
Welcome Reception* at the Queen Sirikit National Convention Center
3 December 2007
Award/Gala Dinner at the Royal Thai Navy Hall
5 December 2007
All-Congress Event* at the Rose Garden and Country Resort
*Included in the registration rate, all other social events and tours must be purchased separately.
WAO Short-Term Research Fellowship Award
Congratulations to Dr. Matteo Bonini, from Rome, Italy who has been awarded a WAO Short Term Research Fellowship to study with Prof. Stephen Durham at Imperial College, London.
The aim of the fellowship is to attend a European Centre of Excellence to acquire the basic methodology for epidemiological and clinical studies of allergic diseases in elite athletes and non competitive exercisers. This knowledge will then be applied in the framework of the GA²LEN Project with the final aim of establishing a harmonised protocol for diagnosis of allergy in exercisers as well as for outcome measures to be used in clinical trials worldwide.
New Educational Postings on the WAO Website
Ask the Expert – Exclusive Benefit to WAO Members
Ask the Expert is a new online tool available exclusively to WAO Members. Directed by Professors Cassim Motala and Ruby Pawankar, this online service provides the opportunity to pose educational, scientific and medical questions about allergy, asthma, and clinical immunology to one of the many WAO volunteer experts located throughout the world. We invite all WAO Members to become a part of this online service. To Ask the Expert, click here.
Call for Applications
Long-Term Research Fellowship
The World Allergy Organization (WAO) offers one Long-Term Research Fellowship, to commence in 2008. The Fellowship will support a junior allergist following an approved research program at a WAO proposed host center for up to two years. WAO will contribute a monthly stipend of $1,700 US and once-yearly travel expenses between the home country and the host center.
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 including a list of host centers may be downloaded here.
Applications must be received by WAO Secretariat no later than 30 September 2007
Upcoming WAO Educational Programs
September GLORIA™ Placement
Italian Society for Allergy and Clinical Immunology Annual Meeting
27-29 September 2007
International GLORIA Faculty:
Module 7: Angioedema
Module 8: Anaphylaxis
International GLORIA is supported through unrestricted educational grants from:
September Seminars & Conferences Placement
Annual Regional Meeting Chilean Society of Allergy and Immunology
28-29 September 2007
WAO Invited Lecturer:
Upcoming Worldwide Allergy Meetings
13th International Congress of Immunology
August 21-25, 2007
Rio de Janeiro, Brazil
Web site: www.immunorio2007.org.br
Turkish National Society of Allergy and Clinical Immunology
15th Annual Meeting
European Respiratory Society
Annual Congress 2007
September 15-19, 2007
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 firstname.lastname@example.org, noting "Free Journal Subscription" in the subject line, with the following details:
Last (Family) name
City, State/Province and postal code
Name of Member Society
And In Other News
Allergy Book Review
Primary Immunodeficiency Diseases—a Molecular and Genetic Approach, 2nd Ed.
Edited By: Hans D. Ochs, C. I. Edvard Smith and Jennifer Puck
List price: £ 96.00 (about $195.00)
Available From: Oxford University Press, 2007
Gary Hellermann, PhD
University of South Florida
Division of Allergy and Immunology
With more than 120 immunodeficiency disease (IDD) genes currently known and basic research continuing to add to this number, medical practitioners are faced with increasing difficulty in keeping up with the current status of IDD diagnosis and treatment. The first edition of this book, the first comprehensive survey of IDD, appeared in 1999 and was highly acclaimed for usefulness. This second edition presents an expanded group of IDDs and syndromes with a greater depth of knowledge and technology.
Genetic flaws affecting the immune response have been grouped into transcription factors, the T cell receptor and its signaling pathway, chemokines and chemokine receptors responsible for homing of lymphocytes to specific tissues, co-receptor molecules and several others. Increasing knowledge about the signaling pathways, accessory molecules and cells involved in T and B cell interactions provides us with more precise understanding of the molecular nature of IDDs. This knowledge permits the development of more specific and effective drugs and is helping to achieve the goal of customized therapy tailored to individual patients.
Despite the great advances in delineating IDDs at the molecular level, our ability to repair these defects is still limited. Early diagnosis helps persons with IDD but effective intervention will require continued energetic research efforts and this collection of 48 reviews provides the best current knowledge in the field.
The content is organized into three sections. An overview summarizes current understanding of T and B cell development, signaling pathways, cell trafficking and the genetic principles and technology involved. Part II encompasses the main body of the book and describes specific syndromes from the well-characterized common variable, X-linked severe combined immunodeficiency, DiGeorge and Wiskott-Aldrich to the rarer forms such as Omenn’s and CD 45 deficiency. Each review includes history and background of the disease, a detailed description of the molecular nature of the gene defect, examples of cases from the literature, strategies for accurate diagnosis, laboratory methods, current treatment regimens and evaluation of new therapies. There are also many figures, diagrams and illustrations as well as a comprehensive reference list.
The final section of the book involves assessment and treatment and attempts to show the best strategies for evaluating the immune system and getting the information necessary to make an accurate diagnosis and prognosis. The importance of the family history, key features in the physical exam, appropriate lab tests and effective approaches to specific immunodeficiency disorders are included in this section. The advantages and disadvantages of genetic testing and the future of gene therapy in correcting immunodeficiencies are also discussed. Conventional therapies, as well as bone marrow transplantation, are covered.
Assessment and Audience:
A comprehensive overview of primary IDD, its molecular basis, diagnosis and treatment is a massive undertaking and this book succeeds in providing that information in a usable form for the practicing physician, the laboratory researcher, and the student seeking an understanding of the pathology of IDD. This 2007 edition should meet the needs of immunologists for some time.
Find more allergy book reviews on the WAO Website here.