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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

April 2014

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. IL-4, IL-13, and thymic stromal lymphopoietin play a key role in allergic disease.

Romeo MJ, Agrawal R, Pomés A, Woodfolk JA. A molecular perspective on TH2-promoting cytokine receptors in patients with allergic disease. The Journal of Allergy and Clinical Immunology 2014; 133(4): 952-960. (doi:10.1016/j.jaci.2013.08.006)

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Editor’s comment: The authors describe the characteristics of receptors for IL-4, IL-13, and thymic stromal lymphopoietin and their respective ligands from a structure-function perspective detailing the mechanisms of receptor complex assembly, the interrelated nature of these receptors, and their effect on allergic inflammation. They also highlight current and emerging treatments that target TH2-promoting receptor complexes.

2. Most asthma begins in the nose and involves allergy and infection..

Tarlo SM and Lemiere C. Occupational asthma. Scadding GK. Allergens, germs and asthma. The Clinical Respiratory Journal; 8(2); Accepted article, published online before print. (doi:10.1111/crj.12128).

Abstract (Uncorrected PDF Available)

Editor’s comment: The author explores asthma pathogenesis using data from upper and lower airways published in English language papers on human asthma and nasal polyp subjects from 1990 onwards selecting high quality studies in established journals. The combination of atopy and infection suggests new possibilities for therapy.

3. Prevalence of allergic sensitization in Canadian chronic rhinosinusitis patients.

Green BJ, Beezhold DH, Gallinger Z, Barron CS, Melvin R, Bledsoe TA, Kashon ML, Sussman GL. Allergic sensitization in Canadian chronic rhinosinusitis patients. Allergy Asthma & Clinical Immunology 2014; 10:15. 25 March 2014. (doi:10.1186/1710-1492-10-15).

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Editor’s comment: The authors used skin prick test and specific immunoglobulin E and G titers to regionally relevant allergens in order to determine the prevalence of allergic sensitization in chronic rhinosinusitis patients. Their results suggest that A. alternata sensitization is associated with chronic rhinosinusitis, and they additionally highlight the contribution of other regionally important allergens including cat and ragweed.

4. Airway inflammatory biomarkers as valuable tools in diagnosis and management of asthma.

Fatemi F, Sadroddiny E, Gheibi A , Farsani TM, and Kardar GA. Biomolecular markers in assessment and treatment of asthma. Respirology 2014; published online before print, 3 April. (doi:10.1111/resp.12284)

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Editor’s comment:In this comprehensive review the authors analyze molecular markers of airways inflammation that show promise in providing non-invasive techniques that might facilitate the detection of disease phenotypes as well as measure therapeutic efficacy.

5. Possible role of coagulation in chronic urticaria.

Tedeschi A, Kolkhir P, Asero R, Pogorelov D, Olisova O, Kochergin N, and Cugno M. Chronic urticaria and coagulation: pathophysiological and clinical aspects. Allergy 2014; published online before print, 27 March. (doi:10.1111/all.12389)

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Editor’s comment: This excellent review summarizes the available data on the possible contribution of coagulation to the pathophysiology of chronic urticaria focusing on clinical aspects and possible future therapeutic developments.

6. Dropout rates in sublingual immunotherapy controlled studies.

Makatsori M, Scadding GW, Lombardo C, Bisoffi G, Ridolo E, Durham SR, and Senna G. Dropouts in sublingual allergen immunotherapy trials – a systematic review. Allergy 2014; 69(5):571-580. (doi:10.1111/all.12385)

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Editor’s comment: Dropout rates in sublingual immunotherapy controlled studies do not appear to be a major problem with a composite dropout percentage of 14% without differences for active compared to placebo-treated participants.

7. H2-antihistamines in anaphylaxis treatment.

Nurmatov UB, Rhatigan E, Simons ER, and Sheikh A. H2-antihistamines for the treatment of anaphylaxis with and without shock: a systematic review. Annals of Allergy, Asthma & Immunology 2014; 112(2): 126-131. (doi:10.1016/j.anai.2013.11.010)

Abstract

Editor’s comment: The authors performed a systematic review of randomized controlled trials and quasi-randomized controlled trials comparing H2-antihistamines with placebo or no intervention in patients with anaphylaxis. They failed to identify any eligible studies for inclusion. They concluded that well-designed randomized controlled trials investigating the role of H2-antihistamines in anaphylaxis treatment are urgently needed.

8. Impact of specific immunotherapy on Th17 response and Th1/Th2 changes in allergic rhinitis.

Li CW, Lu HG, Chen DH, Lin ZB, Wang DY, and Li TY. In vivo and in vitro studies of Th17 response to specific immunotherapy in house dust mite-induced allergic rhinitis patients. PLoS ONE 2014; 9(3): e91950. (doi:10.1371/journal.pone.0091950)

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Editor’s comment: The authors concluded that specific immunotherapy significantly inhibits Th17 mediated inflammation in allergic rhinitis and that IL17 may be a useful biomarker for both allergic rhinitis severity and specific immunotherapy therapeutic effect.

9. Live vaccines and the growing neglect of adherence to routine immunizations can be life-threatening to immunodeficient patients.

Shearer WT, Fleisher TA, Buckley RH, Ballas Z, Ballow M, Blaese RM, Bonilla FA et al. Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts. The Journal of Allergy and Clinical Immunology 2014; 133(4): 961-966. (doi:10.1016/j.jaci.2013.11.043)

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Editor’s comment: This is a report of the Medical Advisory Committee of the Immune Deficiency Foundation. The report is based on published literature and the collective experience of the committee members and is designed to deal with the transmission of infection to immunodeficient persons from vaccinated immune competent individuals.

10. Adverse or beneficial effects of drugs in large populations.

Andersen M. Research on drug safety and effectiveness using pharmacoepidemiological databases. Journal of Internal Medicine 2014; Accepted article, published online before print (doi:10.1111/joim.12235)

Abstract (Uncorrect PDF available)

Editor’s comment: This review discusses articles presenting information gleaned from pharmacoepidemiological databases. These articles were previously presented at a symposium sponsored by the Journal of Internal Medicine.

11. Patch testing for drug eruption has significant potential.

Ohtoshi S, Kitami Y, Sueki H, and Nakada T. Utility of patch testing for patients with drug eruption. Clinical and Experimental Dermatology 2014; 39(3): 279-283. (doi:10.1111/ced.12239)

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Editor’s comment: The authors concluded that patch testing is much safer than oral challenge or intracutaneous tests for the identification of a causative drug in patients with a drug eruption. Their results suggest that patch testing can be useful when contrast medium or an antiepileptic is suspected as the causative drug, and it can be relevant to patient management.

12. Significant relief of chronic cough after two weeks of treatment with montelukast.

Mincheva RK, Kralimarkova TZ, Rasheva M, Dimitrov Z, Nedeva D, Staevska M, Papochieva V et al. A real-life observational pilot study to evaluate the effects of two-week treatment with montelukast in patients with chronic cough. Cough 2014: 10(2). (doi:10.1186/1745-9974-10-2)

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Editor’s comment: The aim of this real-life pilot study was to assess the effect of montelukast in relieving cough symptoms in patients with chronic cough allegedly due to either upper airway cough syndrome or gastroesophageal reflux. Patients with cough due to upper airway cough syndrome or gastroesophageal reflux (GER) but not asthma reported significant relief of their symptoms after two weeks of treatment with montelukast.