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World Allergy Organization
WAO's mission: To be a global resource and advocate in the field of allergy, advancing excellence in clinical care through education, research and training as a world-wide alliance of allergy and clinical immunology societies.

WAO Reviews - Editors' Choice

Posted: March 2013

Articles are selected for their importance to clinicians who care for patients with asthma and allergic/immunologic diseases by Juan Carlos Ivancevich, MD, WAO Web Editor-in-Chief, and Phillip Lieberman, MD, WAO Reviews Editor.

1. Recent advancement in understanding primary immunodeficiencies.

Parvaneh N, Casanova JL, Notarangelo LD, Conley ML.  Primary immunodeficiencies: A rapidly evolving story. Journal of Allergy and Clinical Immunology. 2013; 131(2): 314-323.

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Editor’s comment: The International Union of Immunological Societies (IUIS) published an updated classification in 2011 of primary immunodeficiency diseases (PID) as part of their on-going work to collate and disseminate PID research findings reported worldwide. The authors now provide a compendium of reports published since the 2011 update. These newly published reports are categorized under combined immunodeficiencies, syndromes with associated immunodeficiencies, predominant antibody defects, immune dysregulation, congenital phagocytic defects, defects of innate immunity, and autoinflammatory disorders.

2. Underlying mechanisms of adult-onset asthma and identification of specific phenotypes.

de Nijs SB, Venekamp LN,  Bel EH. Adult-onset asthma: Is it really different? European Respiratory Review. 2013; 22(127): 44-45.

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Editor’s comment: This comprehensive review highlights and discusses literature on adult-onset asthma, with special focus on the differences between adult and childhood-onset asthma, risk factors for development, phenotypes of adult-onset asthma and new approaches for personalized management.

3. Methodology to assess and quantify the clinical effects of immunotherapy.

Shamji MH, Ljørring C, Würtzen PA. Predictive biomarkers of clinical efficacy of allergen-specific immunotherapy: how to proceed. Immunotherapy. 2013; 5(3): 203-206.

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Editor’s comment:  This excellent review discusses the validation of candidate biomarkers associated with effective immunotherapy.  It emphasizes the need to develop unconventional ways, such as challenge chambers or controlled provocation tests of individual organs, to clearly distinguish between strong and weak or early and late responders.

4. Potential application of a gas chromatograph/differential mobility spectrometer (GC/DMS) sensor for non-invasive and bedside diagnostics of asthma and asthma therapy monitoring.

Schivo M, Seichter F, Aksenov AA, Pasamontes A, Peirano DJ et al. A mobile instrumentation platform to distinguish airway disorders. Journal of Breath Research. 2013; 7(4): 1-9. (doi:10.1088/1752-7155/7/1/017113)

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Editor’s comment: The authors tested the hypothesis that a GC/DMS sensor could distinguish between clinically well-defined groups with airway disorders based on the volatile organic compounds (VOCs) obtained from exhaled breath. They found that VOC profiles distinguished asthma from healthy controls and also a subgroup of asthmatics taking the drug omalizumab from healthy controls. The VOC profiles could not distinguish between COPD and any of the other groups.

5. Open food ingestion challenge with natural milk combined with spirometry seems to be an adequate technique for the detection of milk allergy in asthmatics.

Pelikan Z. Asthmatic response to milk ingestion challenge in adults: A comparison of the open and double-blind challenges. International Archives of Allergy and Immunology. 2013; 161(2): 163-173. (doi:10.1159/000345130)

 Abstract
Free Supplementary Material

Editor’s comment:  In some adults with bronchial asthma and allergy to cow’s milk oral challenge with milk produces various asthmatic responses (immediate, late, dual late or delayed). The milk allergy can be confirmed by open or double-blind techniques, combined with spirometry. No significant differences were found between the open food ingestion challenge and the double-blind placebo-controlled food challenge results.

6. Biofilms are present in infectious rhinitis as well as in inflammatory and/or immune-mediated diseases.

Gelardi M, Passalacqua G, Fiorella ML, Quaranta N. Assessment of biofilm by nasal cytology in different forms of rhinitis and its functional correlations. European Annal of Allergy and Clinical Immunology. 2013; 45(1): 25-29.

Abstract
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Editor’s comment: Biofilms were frequent in patients with infectious rhinitis (55.4%), adenoid hypertrophy (57.4%), nasal polyposis (24%), chronic rhinosinusitis (9.5%) and non-allergic rhinitis (7.6%). The presence of biofilms significantly correlates with the degree of nasal obstruction as assessed by rhinomanometry.

7. The majority of asthma exacerbations are related to respiratory virus infections, particularly rhinovirus.

Sykes A. Asthma and infections: An update on asthma exacerbations. Clinical Pulmonary Medicine. 2013; 20(2): 56-60. (doi:10.1097/CPM.0b013e318285c4e0)

Abstract

Editor’s comment: This excellent review summarizes the current literature on the role of viruses, defective interferon induction i, and the potential role for bacteria in asthma exacerbations.

8. An immunodiagnostic assay for allergy to Blomia tropicalis with recombinant allergens.

dos Anjos Carvalho K, Pompílio de Melo-Neto O, Barbalho Magalhães F, Marques Ponte JC, Borba Felipe FA et al. Blomia tropicalis Blo t 5 and Blo t 21 recombinant allergens might confer higher specificity to serodiagnostic assays than whole mite extract. BMC Immunology. 2013; 14, 11. (doi:10.1186/1471-2172-14-11)

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Editor’s comment: The rBlo t 5 and rBlo t 21 allergens contain important epitopes recognized by IgE antibodies of individuals allergic to B. tropicalis antigens. Assays with these recombinant allergens demonstrated lower IgE cross-reactivity with Ascaris lumbricoides antigens than those with crude mite extract. Thus, serodiagnostic assays employing recombinant rBlo t 5 and rBlo t 21 allergens are more specific than those using crude mite extract.

9. Understanding patient preferences to individualize better therapy for asthma and COPD.

Price D, Lee AJ, Sims EJ, Kemp L, Hillyer EV et al.  Characteristics of patients preferring once-daily controller therapy for asthma and COPD: a retrospective cohort study. Primary Care Respiratory Journal. 2013; Published online before print. (doi:10.4104/pcrj.2013.00017)

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Editor’s comment: Patients with asthma or COPD who reported concerns about their controller medication and poor medication adherence were more likely to prefer once-daily therapy than those with low or no medication concerns and good adherence.

10. Role of artificial sweeteners in allergic disease.

Maslova E, Strøm M, Olsen SF, Halldorsson TI. Consumption of artificially-sweetened soft drinks in pregnancy and risk of child asthma and allergic rhinitis. PLoS ONE. 2013; 8(2): e57261. (doi:10.1371/journal.pone.0057261)

Open access

Editor’s comment: The authors analyzed data from 60,466 women enrolled during pregnancy in the prospective longitudinal Danish National Birth Cohort between 1996 and 2003 to examine the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes. Their results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in the development of allergic disease in offspring.

11. What is currently known about the use of probiotics as dietary supplements in cow’s milk allergy (CMA)?

Berni Canani R, Di Costanzo M. Gut microbiota as potential therapeutic target for the treatment of cow’s milk allergy. Nutrients 2013; 5(3): 651-662. (doi:10.3390/nu5030651)

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Editor’s comment: A comprehensive review of the increasing evidence suggesting a role for select probiotics in prevention and/or treatment of CMA. They conclude data support the importance of a nutritional and immunologic approach to efficiently treat symptoms, as well as accelerate tolerance acquisition in children with CMA.

12. Omalizumab in the treatment of chronic idiopathic or spontaneous urticaria.

Maurer M, Rosén K, Hsieh HJ, Saini S, Grattan C et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. The New England Journal of Medicine. 2013; 368: 924-935. (doi:10.1056/NEJMoa1215372)

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Editor’s comment: Omalizumab administered as three doses of 150 mg or 300 mg at 4-week intervals significantly reduced symptoms, as compared with placebo, in patients with chronic idiopathic urticaria who remained symptomatic despite the use of approved doses of H1-antihistamines. Further work is needed before the exact role of omalizumab in the treatment of chronic idiopathic or spontaneous urticaria can be defined.