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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: December 2012

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. A high risk of undiagnosed asthma and COPD.

van Vugt S, Broekhuizen L, Zuithoff N, Butler C, Hood K et al. Airway obstruction and bronchodilator responsiveness in adults with acute cough. Annals of Family Medicine 2012; 10(6): 523-529. doi:10.1370/afm.1416

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Editor's comment: A significant proportion of adult patients with acute cough, without an established diagnosis of asthma or COPD, demonstrate airway obstruction or bronchodilator responsiveness, suggesting undetected asthma or COPD.

2. Supplementation with probiotics remains empirical in allergy medicine.

Fiocchi A, Burks W, Bahna S, Bielory L, Boyle RJ et al. Clinical use of probiotics in pediatric allergy (CUPPA): A World Allergy Organization position paper. World Allergy Organization Journal 2012; 5(11): 148-167.

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Editor's comment: In an extensive and comprehensive review, the authors concluded that probiotics do not have an established role in the prevention or treatment of allergy. No single probiotic supplement or class of supplements has been demonstrated to efficiently influence the course of any allergic manifestation or long-term disease or to be sufficient to do so.

3. Birth by caesarean section (C/S) is associated with asthma and atopic sensitization in childhood.

Kolokotroni O, Middleton N, Gavatha M, Lamnisos D, Priftis KN, Yiallouros PK. Asthma and atopy in children born by caesarean section: effect modification by family history of allergies - a population based cross-sectional study. BMC Pediatrics 2012; 12: 179. doi:10.1186/1471-2431-12-179

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Editor's comment: Caesarean section delivery is associated with the development of atopic sensitization and asthma. There was modest evidence that a family history of allergy may modify the effect of C/S delivery on atopy, but this was not the case for asthma outcomes.

4. A Useful source of information for the optimum management of urticaria and angioedema.

Sánchez-Borges M, Asero R, Ansotegui I, Baiardini I, Bernstein J et al. Diagnosis and treatment of urticaria and angioedema: A worldwide perspective. World Allergy Organization Journal 2012; 5(11): 125-147. doi:10.1097/WOX.0b013e3182758d6c

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Editor's comment: This Position Paper presents recommendations for the proper diagnosis and treatment of urticaria and angioedema. It reviews important advances in the elucidation of the pathogenesis of these conditions and discusses innovative diagnostic and therapeutic procedures for patients with these disorders.

5. Allergic and non-allergic chronic rhinitis demonstrate different inflammatory findings in the lower airway.

Kwon J-W, Kim T-W, Kim K-M, Jung J-W, Cho S-H et al. Differences in airway inflammation according to atopic status in patients with chronic rhinitis. Asia Pacific Allergy 2012; 2(4): 248-255. doi:10.5415/apallergy.2012.2.4.248

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Editor's comment: Non-allergic rhinitis and allergic rhinitis patients may have different forms of inflammation in their lower airways. Patients with non-allergic rhinitis have higher levels of IL-17A in sputum samples from the lower airways than do dust mite sensitive allergic rhinitis subjects.

6. Mast cells are involved in asthma and obesity.

Sismanopoulos N, Delivanis D -A, Mavrommati D, Hatziagelaki E, Conti P, Theoharides TC. Do mast cells link obesity and asthma? Allergy 2013; 68(1): 8-15. doi:10.1111/all.12043

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Editor's comment: The authors propose that mast cells are involved in both asthma and obesity by being the target and source of adipocytokines, 'alarmins' such as interleukin-9 and interleukin-33, and stress molecules including corticotropin-releasing hormone and neurotensin. All of these are secreted in response to the metabolic burden. They suggest that inhibition of mast cells may be an effective treatment for both asthma and obesity, implying a need for novel and effective mast cell inhibitors.

7. FeNO as a possible predictive marker for bronchial hyperreactivity in allergic rhinitis.

Cirillo I, Ricciardolo FLM, Medusei G, Signori A, Ciprandi G. Exhaled Nitric Oxide May Predict Bronchial Hyperreactivity in Patients with Allergic Rhinitis. International Archives of Allergy and Immunology 2013; 160: 322-328. doi:10.1159/000341675

Abstract

Editor's comment: This study provides evidence that FeNO is strongly related to the response to bronchodilation testing and may predict bronchodilation response in children with allergic rhinitis or asthma. Therefore, a simple FeNO measurement could suggest relevant information about bronchial reversibility.

8. Clinical clues and tips that help to identify autoinflammatory disorders in chronic urticaria.

Krause K, Grattan CE, Bindslev-Jensen C, Gattorno M, Kallinich T et al. How not to miss autoinflammatory diseases masquerading as urticaria. Allergy 2012; 67(12): 1465-1474. doi:10.1111/all.12030

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Editor's comment: The authors reviewed the urticarial rash as one of the most common and prominent symptoms of autoinflammatory disorders. They emphasize the importance of considering such disorders in patients presenting with chronic spontaneous urticaria. They also present clinical clues and tips that can help to identify autoinflammatory disorders in patients presenting with a chronic urticarial rash.

9. Oral food challenges performed in controlled settings by expert allergists are safe.

Calvani M, Berti I, Fiocchi A, Galli E, Giorgio V et al. Oral food challenge: safety, adherence to guidelines and predictive value of skin prick testing. Pediatric Allergy and Immunology 2012; 23(8): 754-760. doi:10.1111/pai.12016

Abstract

Editor's comment: The authors conducted a retrospective chart review of children undergoing oral food challenge at three allergy centers and concluded that oral food challenges performed in controlled settings by expert allergists are safe. The majority of children with a positive challenge developed only mild reactions.

10. Dampness and molds in the home are determinants of developing asthma.

Quansah R, Jaakkola MS, Hugg TT, Heikkinen SAM, Jaakkola JJK. Residential Dampness and Molds and the Risk of Developing Asthma: A Systematic Review and Meta-Analysis. PLoS ONE 2012; 7(11): e47526. doi:10.1371/journal.pone.0047526

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Editor's comment: The authors conducted a systematic literature search of PubMed database selecting cohort/longitudinal and incident case-control studies assessing the relation between mold/dampness and new asthma, and concluded that the evidence indicates that dampness and molds in the home are determinants of developing asthma.

11. The Immune Epitope Database (IEDB) is a freely available repository of epitope data.

Vaughan K, Peters B, Larche M, Pomes A, Broide D, Sette A. Strategies to query and display allergy-derived epitope data from the Immune Epitope Database. International Archives of Allergy and Immunology 2013; 160(4): 334-345. doi:10.1159/000343880

Abstract

Editor's comment: This review aims to demonstrate the utility of the Immune Epitope Database and its query strategies, including searching by epitope structure (peptidic/nonpeptidic), assay methodology, host, the allergen itself, or the organism from which the allergen was derived.

12. Detrimental diamine oxidase (DAO) activity in NSAID hypersensitivity.

Agúndez JAG, Ayuso P, Cornejo-García JA, Blanca M, Torres MJ et al. The Diamine Oxidase Gene Is Associated with Hypersensitivity Response to Non-Steroidal Anti-Inflammatory Drugs. PLoS ONE 2012; 7(11): e47571. doi:10.1371/journal.pone.0047571

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Editor's comment: The DAO polymorphism rs10156191, which causes impaired metabolism of circulating histamine, is overrepresented among patients with crossed-hypersensitivity to NSAIDs and is associated with the clinical response in such patients. Thus it could be used as a biomarker of response.