WAO News and Notes - Medical Reviews
Volume 6, Issue 9 Reviews - September 2009
World Allergy Congress (WAC) 2009 - Buenos Aires, Argentina,  6-10 December 2009
Medical Journal Reviews

Juan Carlos Ivancevich, MD, in collaboration with Richard Lockey, MD, the WAO Web Editor-in-Chief, conducted these reviews of premier medical journal articles for practicing allergists. Read their top selections here, and link to the remaining reviews from the menu. You may also visit the Medical Journal Review section of the WAO Web site.

To read translations of past Medical Journal Reviews, click here.

1. Dose-response relationship of inhaled corticosteroids (ICS) and cataracts
A systematic review and meta-analysis is reported of four case-control studies of cataracts and ICS use, with a total of 46,638 cases and 146,378 controls. The primary outcome was risk of cataracts. There was a significant relationship between risk of cataracts and ICS dose, with a random effects pooled odds ratio for risk of cataracts per 1000 µg increase in daily beclomethasone dose of 1.25 (95% CI: 1.14-1.37). The risk of cataracts was increased by approximately 25% for each 1000 µg per day increase in the dose of beclomethasone or equivalent.
Editor's comment: These findings reinforce the importance of prescribing the least amount of an ICS to control asthma and screening for the presence of cataracts in older subjects with asthma and COPD.
Weatherall, M. et al., Dose-response relationship of inhaled corticosteroids and cataracts: A systematic review and meta-analysis, Respirology, 983-990, Published Online August 2, 2009. Abstract

ステロイド吸入薬と白内障との関連について調査した体系的レビューである。結論として一日1000μg使用した場合、リスクが25%増加するとのことであった。訳者注:筆者は以前白内障を患い手術を受けたが、手術は15分で終了し、その後の経過も順調である。白内障のリスクと喘息重症化リスクのバランスをよく考えるべきであろう。

2. Probiotic effects on incidence and duration of cold and influenza-like symptoms (ILS) in children
This DBPC (double-blind, placebo-controlled) study on 326 healthy children (3-5 years) reports on the effects of probiotic consumption during the winter season. Subjects were assigned randomly to receive placebo (N = 104), Lactobacillus acidophilus NCFM (North Carolina Food Microbiology) (N = 110), or L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07 (N = 112), treated twice daily for 6 months. Single and combination probiotics relative to placebo significantly reduced the incidence and duration of fever, cough and rhinorrhea, antibiotic use and days absent from child care.
Editor's comment: Daily dietary probiotic supplementation may be a safe and effective way to reduce cold and ILS symptoms in children 3 to 5 years of age.
Leyer G. et al., Probiotic Effects on Cold and Influenza-Like Symptom Incidence and Duration in Children, Pediatrics, 124(2):e172-e179. Abstract

アレルギー疾患に対するプロバイオティクスの効果に関しての報告は一致しないことも多いが、この報告ではインフルエンザ様症状に対して乳酸菌などのプロバイオティクス製剤が有効であったとしている。メカニズムに関しては検討されていない。

3. Unmet needs in severe chronic upper airway disease (SCUAD)
SCUAD defines patients whose symptoms are inadequately controlled despite optimal, i.e., effective, safe, and acceptable, pharmacologic treatment based on guidelines. These patients have an impaired quality-of-life, social function, sleep, and school/work performance. Severe uncontrolled allergic rhinitis, nonallergic rhinitis, chronic rhinosinusitis, aspirin exacerbated respiratory disease, and occupational airway diseases are defined as SCUADs. The group of experts who wrote this paper believes that SCUADs should be considered differently from mild chronic upper airway diseases. It reviews the state-of- the-art literature, highlighting gaps in knowledge, and proposes several areas for the better understanding, prevention, and management of SCUADs.
Editor's comment: This paper hopefully will prompt the pharmaceutical industry to increase research for SCUAD.
Bousquet J. et al., Unmet needs in severe chronic upper airway disease (SCUAD), JACI 24(3): 428-433. Abstract

喘息などの致死的な下気道疾患に比べ、慢性副鼻腔炎などの慢性重症上気道疾患は軽視されがちである。この総説に関しては慢性重症上気道疾患の治療の必要性について議論している。

All 10 reviews are posted in the literature review section of the WAO website.

WAO Journal

World Allergy Organization Journal
September 2009, Volume 2, Issue 9
ISSN: 1939-4551

This Month in the Journal

今月のWAOジャーナルの紹介

NOTES OF ALLERGY WATCHERS

Expertise in Allergy and Immunology Can Aid Other Medical Specialties
S. Gunnar O. Johansson, MD, PhD
Sweden

ORIGINAL ARTICLES

Clinico-immunological Analysis of Eggplant Allergy Indicates Preponderance of Allergens in the Peel
Bheemanapalli N. Harish Babu, MSc (Agri); and Yeldur P. Venkatesh, PhD
India

なすのアレルギーに関する論文です。皮の部分にアレルゲンが多いようです。

Cross-allergenicity between Pollen Grains and Their Cytoplasmic Granules on Brown Norway Rats
Oussama R. Abou Chakra, PhD; Jean-Pierre Sutra, PhD; Françoise Rogerieux, MSc; Gabriel Peltre, PhD; Hélène Sénéchal, PhD; and Ghislaine Lacroix, PhD
France

Detection of Fungi in Indoor Environments and Fungus-specific IgE Sensitization in Allergic Children
Mitsuhiko Nambu, MD, PhD; Hisashi Kouno, MT; Maki Aihara-Tanaka, PhD; Hideharu Shirai; and Kosuke Takatori, DVM, PhD
Japan

天理よろづ病院南部光彦らの論文

REVIEW ARTICLE

Eosinophils in Chronic Urticaria: Supporting or Leading Actors?
Riccardo Asero, MD; Massimo Cugno, MD; and Alberto Tedeschi, MD
Italy

好酸球と慢性じんましんに関する総説


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Additional Journal Reviews
  1. Obesity, Waist Size, and Prevalence of Current Asthma in Cohort Study

    腹囲88cm以上の女性は成人発症喘息のリスクが高い。

  2. Hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults

    次亜塩素酸系漂白剤の使用頻度が多いほど、アレルゲン感作の頻度は少なかった。しかし、呼吸器症状は多かった。

  3. PS increases effect of TRP on childhood asthma incidence

    親のストレス程度(PS)が強い場合、子どもの交通量に関連した大気汚染(TRP)による喘息への影響は強い。

  4. Arginase: key enzyme in the pathophysiology of allergic asthma

    呼気中の一酸化窒素NO測定は喘息病態と関連することは周知のとおりであるが、NOには抗炎症作用もある。この総説ではアルギナーゼによりNOが減少し、ひいて気道リモデリングが増強するとおの立場で記述されている。

  5. T-helper Type 2-driven Inflammation Defines Major Subphenotypes of Asthma

    気道上皮の種々の分子発現パターンを分析したところ、IgE抗体陽性のアトピー喘息は、さらにTh2-high群とTh2-low群の2群に分類できることがわかった。

  6. Allergic status of schoolchildren with food allergy to eggs, milk or wheat in infancy

    小児期後期に発症する小麦、甲殻類、果物などに対するアレルギーは、乳幼児期に制限をしていた群では7.7倍のオッズ比で高かった(滋賀小児医療センター楠隆らによる論文)。

  7. HDM-SLIT - The Role for TGF-beta and Functional Regulatory T Cells

    ダニの舌下免疫療法は、臨床的に有効であり、IL-5産生T細胞も減少した。TGF-beta(制御性T細胞の増殖因子)受容体の遮断抗体を試験官内のIL-5などを産生するリンパ球増殖は低下した。制御性T細胞が重要である。

Your global community of learning and practice for allergy and immunology! www.worldallergy.org

Medical Book Review

Urticaria and Angioedema, Second Edition
Allen P. Kaplan, Malcolm W. Greaves (Editors)
Informa Healthcare, 2009
ISBN: 9781420077841
List Price: $299.00 USD
Available at: Barnes and Noble

Reviewer:
Roger W. Fox, MD
Professor of Medicine and Pediatrics
University of South Florida College of Medicine
Division of Allergy
Tampa, Florida USA

Description
This 455 page book entitled "Urticaria and Angioedema" has 25 Chapters. The international authorities and authors review the basic mechanisms and cellular interactions involved in this spectrum of disorders that manifest as urticaria and angioedema and how to diagnosis and treat them.

Purpose
A comprehensive compendium of clinically useful knowledge about urticaria and angioedema.

Audience
All specialists and healthcare professionals that see patients with these diseases.

Features
The chapters review the essential knowledge required to understand the pathophysiology of different forms of urticaria and angioedema as well as how to clinically evaluate and treat them.

Assessment
This textbook is essential for any physician who routinely evaluates and treats patients with these diseases, in particular, for allergists/immunologists and dermatologists.

Find more allergy book reviews on the WAO Website here.

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