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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: September 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. Patients with severe asthma and potential benefit from added statin treatment.

Zeki AA, Oldham J, Wilson M, Fortenko O, Goyal V et al. Statin use and asthma control in patients with severe asthma. BMJ Open 2013; 3(8): e003314. (doi:10.1136/bmjopen-2013-003314)

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Editor’s comment: In a retrospective, cross-sectional, and observational study the authors found that patients with severe asthma who take a statin drug in addition to standard inhaler controller therapy have improved asthma symptoms. Improved Asthma Control Test score associated with statin use predicts a reduced risk of acute exacerbations and reduced need for rescue bronchodilator use. They concluded that statin use is associated with improved control of severe asthma.

2. Effects of probiotic supplementation on atopic sensitization and asthma/wheeze prevention in children.

Elazab N, Mendy A, Gasana J, Vieira ER, Quizon A, Forno E. Probiotic administration in early life, atopy, and asthma: A meta-analysis of clinical trials. Pediatrics 2013; 0246. Published online ahead of print, 19 August (doi:10.1542/peds.2013-0246)

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Editor’s comment: The authors performed a meta-analysis of randomized, placebo-controlled trials and concluded that prenatal and/or early-life probiotic administration reduces the risk of atopic sensitization and decreases the total IgE level in children but may not reduce the risk of asthma/wheeze.

3. Clinical biomarkers to assess the nature and severity of asthma.

Vijverberg SJH, Hilvering B, Raaijmakers JA, Lammers JW, Maitland-van der Zee AH, Koenderman L. Clinical utility of asthma biomarkers: from bench to bedside. Biologics: Targets and Therapy 2013; 7: 199-210. (doi:dx.doi.org/10.2147.BTT.S29976)

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Editor’s comment: Newly identified biomarkers can be integrated in a multidimensional approach to strengthen the diagnostic ability of a clinically applicable algorithm to phenotype asthma.

4. Clinical features and the influence of initial treatment modality on long-term control of chronic idiopathic urticaria (CIU).

Kim S, Baek S, Shin B, Yoon S-Y, Park SY et al. Influence of initial treatment modality on long-term control of chronic idiopathic urticaria. PLoS ONE 2013; 8(7): e69345. (doi:10.1371/journal.pone.0069345)

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Editor’s comment: This study provides insight into the clinical features of CIU patients in a tertiary referral hospital in Korea. The authors suggested, according to data obtained, that physicians should not routinely prescribe multiple H1-antihistamines, or oral corticosteroids, in patients who have CIU, unless they present with very severe symptoms.

5. Role of neurokinin-1 receptor (NK-1R) in the development of allergic rhinitis (AR) in rats.

Wang H, Zhang R, Wu J. Knockdown of neurokinin-1 receptor expression by small interfering RNA prevents the development of allergic rhinitis in rats. Information Research 2013. (doi:10.1007/s00011-013-0649-5)

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Editor’s comment: In the present study the authors found that induction of AR up-regulated NK-1R expression in the nasal mucosa of rats was associated with clinical symptoms and eosinophil-related nasal mucosal inflammation. Intranasal treatment with NK-1R-specific siRNA not only dramatically reduced the levels of NK-1R expression but also relieved AR-related clinical symptoms and nasal mucosal inflammation.

6. Biomarkers that reflect airway inflammation when inhaled corticosteriods (ICS) are decreased in stable asthmatic patients.

Kato G, Takahashi K, Izuhara K, Komiya K, Kimura S, Hayashi S. Markers that can reflect asthmatic activity before and after reduction of inhaled corticosteroids: A pilot study. Biomarker Insights 2013; 8: 97-105. (doi:10.4137/BMI.S12537)

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Editor’s comment: The authors concluded that higher eosinophils in peripheral blood and wider diurnal variation of PEF were predictive markers for unstable disease after ICS reduction. Serum periostin is another candidate for predictive marker.

7. Natural killer cell deficiency and immunodeficiencies that affect NK cells.

Orange JS. Natural killer cell deficiency. Journal of Allergy and Clinical Immunology 2013; 132(3): 515-525.

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Editor’s comment: This excellent review provides an overview of the substantive advances made in the understanding of NKD. It also recaps primary immunodeficiencies affecting NK cells and builds on previous reviews of this topic.

8. Systemic corticosteroids side effects can be minimized through careful patient monitoring and implementation of preventive measures.

Liu D, Ahmet A, Ward L, Krishnamoorthy P, Mandelcorn ED et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma and Clinical Immunology 2013; 9: 30. (doi:10.1186/1710-1492-9-30)

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Editor’s comment: This comprehensive article reviews adverse events due to systemic corticosteroid therapy and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors.

9. Clinical provocation studies performed with recombinant allergens.

Niederbergera V, Eckl-Dornab J and , Paulia G. Recombinant allergen-based provocation testing. Methods 2013; In press, uncorrected proof, online before print, August 2013.

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Editor’s comment: The authors describe important provocation methods (skin prick test, intradermal test, atopy patch test, nasal provocation, colonoscopic provocation test) and give an overview of the clinical provocation studies which have been performed with recombinant allergens for the evaluation of new vaccines with reduced allergenic potential and/or reduced allergen-specific T cell epitopes.

10. New therapeutic strategies of biological immune response modifiers for severe asthma.

Nakamura Y. Developmental current and future therapy for severe asthma. Inflammation & Allergy – Drug Targets 2013; 12(1): 54-60. (10.2174/187152111312010008)

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Editor’s comment: This comprehensive review about therapies using cytokine inhibitors for severe asthma provides a way to elucidate the role of individual cytokines in the pathogenesis and new approaches to identify asthma phenotypes.

11. Superantigens are critical in the causation of Staphylococcus aureus infective endocarditis, sepsis, and acute kidney injury.

Salgado-Pabón W, Breshears L, Spaulding AR, Merriman JA, Stach CS et al. Superantigens are critical for Staphylococcus aureus infective endocarditis, sepsis, and acute kidney injury. mBio 2013; 4(4): e00494-13. (doi:10.1128/mBio.00494-13)

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Editor’s comment: In this experimental study the authors demonstrated that superantigens are critical in the causation of Staphylococcus aureus infective endocarditis, sepsis, and acute kidney injury. They showed association results from both superantigenicity and direct toxic effects on endothelial cells.

12. Discoveries and lessons learned from the last century relating to the function of mast cells and basophils as effectors of the IgE system and the mediators they produce.

Blank U, Falcone FH, Nilsson G. The history of mast cell and basophil research – some lessons learnt from the last century. Allergy 2013; Published online before print. (doi:10.1111/all.12197)

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Editor’s comment: In this review, the authors retrace some of the important discoveries that have followed the description of the Praunsnitz and Küstner reaction, which showed that the factor responsible for anaphylaxis could be transferred from one individual to the other. In particular, they describe the discovery of IgE and the IgE receptors as well as the cell types and mediators responsible for the anaphylactic reaction.