August Medical Journal Review
Prof. Richard F. Lockey MD, WAO Web Editor-in-Chief, reviewed premiere August medical journal articles for practicing allergists. Read his top picks below and click the journal link to read article abstracts.
1. THE ABSENCE OF THE TRANSCRIPTION FACTOR CCAAT/ENHANCER BINDING PROTEN a (C/EBP a ) IS RESPONSIBLE FOR ENHANCED PROLIFERATION OF BRONCHIAL SMOOTH-MUSCLE CELLS IN ASTHMA. It explains the failure of glucocorticoids to inhibit proliferation in vitro. Roth M et al, N Engl J Med 2004;351:560.
2. PREDICTORS OF A SIGNIFICANT REDUCTION IN POSTBRONCHODILATOR FEV1 IN CHILDHOOD ASTHMA INCLUDE THOSE AT BASELINE WHO ARE YOUNGER, MALES, AND WITH HIGHER POSTBRONCHODILATOR FEV1% PREDICTED. The 26% who lost lung function were equally distributed among those who received budesonide, nedocromil, and placebo. Covar RA et al, Am J Respir Crit Care Med 2004;170:234.
3. CHRONIC URTICARIA DURATION ASSOCIATED WITH ITS SEVERITY, ANGIOEDEMA, AND A POSITIVE AUTOLOGOUS SERUM TEST AND ANTI-THYROID ANTIBODIES. Toubi E et al, Allergy 2004;59:869.
4. ADENOSINE 5'-MONOPHOSPHATE INDUCED AIRWAY NARROWING IN NON-ASTHMATIC SUBJECTS WITH NASAL POLYPOSIS. Increased concentrations of exhaled nitric oxide detected in both atopic and non-atopic subjects with nasal polyposis and no asthma. Bronchial inflammation is present in non-asthmatic subjects with nasal polyposis. Prieto L et al, Int Arch Allergy Immunol 2004;134:303.
5. IN CHILDREN, ASTHMA SEVERITY CLASSIFIED BY SYMPTOM FREQUENCY AND USE OF MEDICATION DID NOT CORRELATE WITH FEV1 CATEGORIES AS DEFINED BY THE NATIONAL ASTHMA EDUCATION AND PREVENTION PROGRAM GUIDELINES. Fev1 is generally normal, even in severe persistent childhood asthma, whereas Fev1/FVC declines as asthma severity increases. Bacharier LB et al, Am J Respir Crit Care Med 2004;170:426.
6. USE OF METERED-DOSE INHALER PLUS VALVED HOLDING CHAMBER MORE EFFECTIVE IN DECREASING HOSPITALIZATION AND IMPROVING CLINICAL ASTHMA SCORES THAN NEBULIZER TO DELIVER β-AGONISTS TO CHILDREN UNDER AGE 5 WITH MODERATE TO SEVERE ACUTE ASTHMA. RESULTS OF META-ANALYSIS OF 6 TRIALS. Castro-Rodriguez JA, Rodrigo GJ, J Pediatr 2004;145:172.
7. GENERAL REVIEW OF IMMUNOTHERAPY FOR NEW APPROACHES TO CANCER, TYPE I DIABETES, KIDNEY DISEASE, PSORIASIS, CHRONIC INFECTIONS, ALLERGIC DISEASES, TRANSPLANTATION, AUTOIMMUNITY, AND MULTIPLE SCLEROSIS. Must reading. Multiple authors, Science 2004;305:193-216.
8. EDITORIAL AND REVIEW ARTICLE – FIRST, ON INTERACTIONS BETWEEN RESPIRATORY VIRAL INFECTIONS AND ALLERGIC AIRWAY INFLAMMATION, AND SECOND, ON CELLULAR AND MOLECULAR MECHANISMS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Very good review articles on these subjects. Schwarze J and Johnston SL, Clin Exp Allergy 2004;34:1153.
Di Stefano A, et al, Clin Exp Allergy 2004;34:1156.
9. RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF SINGLE IM DOSE OF 160 MG DEPOTMETHYLPREDNISOLONE VS 8-DAY TAPERING OF A TOTAL DOSE OF 160 MG ORAL METHYLPREDNISOLONE IN ER ADULT ASTHMATIC PATIENTS. On discharge, follow-up relapse results identical. Lahn M et al, Chest 2004;126:362.
10. VENOM IMMUNOTHERAPY IN CHILDREN LEADS TO A SIGNIFICANTLY LOWER RISK OF SYSTEMIC REACTION TO STINGS EVEN 10 TO 20 YEARS AFTER TREATMENT STOPPED. PAPER CONFIRMS THAT THOSE WITH DERMATOLOGIC MANIFESTATIONS ONLY DO NOT NEED IMMUNOTHERAPY. Golden, DBK et al, N Engl J Med 2004, 351:668.
Interesting editorial by Gruchalla RS, N Engl J Med 2004, 351:707.
11. VIRAL INFECTIONS (PARTICULARLY, RSV) WERE THE DOMINANT RISK FACTOR FOR HOSPITALIZATION FROM ASTHMA BEFORE THREE YEARS OF AGE. IN COMPARISON, MOST CHILDREN WHO WERE HOSPITALIZED AGE 3 – 18 WERE ATOPIC (HAD HIGH IGE AND WERE SENSITIZED TO AT LEAST ONE INHALANT ALLERGEN). THIS WAS THOUGHT TO BE CRITICAL FOR AN ADVERSE RESPONSE TO VIRAL INFECTIONS CAUSED BY RHINOVIRUS. Heymann PW et al, JACI 2004, 114:239.
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