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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: June 2011

Welcome to the new WAO Reviews format! For several years, WAO members and other visitors to www.WorldAllergy.org have enjoyed the convenience of the WAO Reviews electronic newsletter, including its translation into Arabic, French, Japanese, Polish, Portuguese, Russian and Spanish.

As part of WAO's goal to continually provide members with the most valuable service, the WAO Web Editor-in-Chief has fashioned a new means of providing convenient access to the best knowledge available on the Internet. Each month readers can quickly view the Editor's Choice of current medical literature and quickly link to abstracts and articles to stay updated on new findings in allergy/immunology.

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

1. Bronchoconstriction without additional inflammation induces airway remodeling.

Grainge CL, Lau LCK, Ward JA, et al. Effect of Bronchoconstriction on Airway Remodeling in Asthma. New England Journal of Medicine 2011; 364(21): 2006-2015
Abstract

Editor's comment: This is an iconic article which identifies chronic bronchoconstriction as a cause of airway remodeling. Thus, in addition to controlling symptoms, preventing exacerbations, and targeting airway inflammation, bronchoconstriction should be controlled to prevent remodeling.

2. Antibiotics are prescribed at nearly 1 in 6 pediatric ambulatory care visits for asthma.

Paul IM, Maselli JH, Hersh AL et al. Antibiotic Prescribing During Pediatric Ambulatory Care Visits for Asthma, Pediatrics 2011; 127(6): 1014-1021
Full text | Summary at American Academy of Pediatrics

Editor's comment: Antibiotics continue to be inappropriately prescribed for children with asthma. Inappropriate antiobiotic prescribing in pediatric asthma may lead to avoidable adverse events and bacterial resistance.

3. Estimating the prevalence of chronic rhinosinusitis (CRS).

Hastan D, Fokkens WJ, Bachert C et al. Chronic rhinosinusitis in Europe - an underestimated disease. A GA2LEN study. Allergy 2011; Published online ahead of print, May 2011 [doi.org/10.1111/j.1398-9995.2011.02646.x]
Abstract | Summary at MedWire News

Editor's comment: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3O) criteria on the characteristics of chronic rhinosinusitis (CRS) have made it possible to conduct this important study which establises a high prevalence of CRS (10%) in Europe and demonstrates an association between smoking and CRS.

4. The largest study carried out in children with suspected betalactam hypersensitivity.

Ponvert C, Perrin Y, Bados-Albiero A et al. Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests. Pediatric Allergy and Immunology 2011; 22(4):411-418
Abstract | Summary at MDLinx

Editor's comment: In this large study carried out in children with suspected betalactam hypersensitivity, few children were truly allergic, and the likelihood of betalactam allergy increased with the earliness and/or the severity of the reactions.

5. Trends in atopic dermatitis (AD) disease severity scales and quality-of-life (QoL) instruments.

Rehal B, Armstrong A. 2011 Health Outcome Measures in Atopic Dermatitis: A Systematic Review of Trends in Disease Severity and Quality-of-Life Instruments 1985-2010. PLoS One 2011; 6(4):e17520. doi:10.1371/journal.pone.0017520
Full text

Editor's comment: According to this first systematic analysis of trends in the usage of outcomes measures in dermatological research, the selection of validated outcomes measures and the accurate measurement of disease dimensions will allow comparisons among dermatological studies.

6. Physical urticaria treated with omalizumab.

Metz M, Altrichter S, Ardelean E et al. Anti-Immunoglobulin E Treatment of Patients with Recalcitrant Physical Urticaria. International Archives of Allergy and Immunology 2011; 54(2):177-180.
Abstract

Editor's comment: The presented cases strongly suggest that omalizumab is an effective treatment in patients with recalcitrant physical urticaria not responding to standard treatment. Further research is necessary to clarify the mechanism of action of omalizumab in physical urticaria.

7. Protozoa in sputum is statistically associated with a clinical diagnosis of asthma.

van Woerden HC, Ratier-Cruz A, Aleshinloye OB, et al. Association between protozoa in sputum and asthma: A case-control study. Respiratory Medicine 2011; 105(6):877-884
Abstract
Summary at MDLinx

Editor's comment: Respiratory tract infection with protozoa could be a contributory factor in a subset of asthma patients.

8. Swimming did not increase the risk of asthma or allergic symptoms.

Tischer C, Chen CM, and J. Heinrich. Association between Domestic Mould and Mould Components, and Asthma and Allergy in Children: A Systematic Review. European Respiratory Journal 2011; Published online before print, May 3, 2011 [doi: 10.1183/09031936.00184010]
Abstract
Summary at Reuter's Life

Editor's comment: This first prospective longitudinal study suggests that swimming did not increase the risk of asthma or allergic symptoms in British children.

9. Damp and mouldy environments increase the risk for allergic respiratory health outcomes in children.

Irekwatanachai C, Teeratakulpisarn J, Suntornlohanakul S et al. Comparison of salbutamol efficacy in children- via the metered-dose inhaler (MDI) with Volumatic® spacer and via the dry powder inhaler, Easyhaler®, with the nebulizer - in mild to moderate asthma exacerbation: a multicenter, randomized study. Asian Pacific Journal of Allergy and Immunology 2011; 29(1):25-33.
Full text | PDF

Editor's comment: The findings of this review suggest that home environments with visible mould and mould spore exposure increase the risk for allergic respiratory health outcomes in children. However, the authors felt that further investigations are needed to examine the effects of exposure to mould derived components as the current literature is inconclusive. They noted that more research is needed on specific microbial markers in the home, in combination with new assessment techniques employing molecular methods.

10. Effective relief with salbutamol administered with different devices of mild to moderate severity acute asthma exacerbation in children.

Font-Ribera L, Villanueva CM, Nieuwenhuijsen M et al. Swimming Pool Attendance, Asthma, Allergies, and Lung Function in the Avon Longitudinal Study of Parents and Children Cohort. American Journal of Respiratory and Critical Care Medicine 2011; 183(5):582-588.
Abstract | Summary at JournalWatch

Editor's comment: Spacers are valid alternatives to the nebulizer for the treatment of asthma exacerbations in children.