October Medical Journal Review
by Richard F. Lockey, M.D., Editor-In-Chief
1. THE PROSTAGLANDIN D2 RECEPTOR GENE (PTGDR) IS ANOTHER CANDIDATE GENE FOR A ROLE IN SUSCEPTIBILITY TO ASTHMA IN YOUNG ADULTS. IT MEDIATES THE CHEMOTAXIS OF T CELLS THAT FOLLOWS THE DEGRANULATION OF MAST CELLS. Discovery of such genes permits the identification of polymorphisms which hopefully will lead to predictable responses to various forms of therapy. Oguma T, et al, N Engl J Med, 2004;351:1752 and editorial by Cookson W, et al, N Engl J Med, 2004; 351:1794.
2. IN A BIRTH COHORT OF 4089 CHILDREN, EXCLUSIVE BREAST-FEEDING FOR FOUR MONTHS OR MORE REDUCED RISK OF ASTHMA AT AGE FOUR (ODDS RATIO 0.72; 95% CI, 0.53-0.97). Three additional months or more of partial breast-feeding seemed to offer additional protection. Kull I, et al, J Allergy Clin Immunol 2004; 114:755.
3. RETROSPECTIVE, DATABASE, HISTORY OF CURRENT USE OF GASTRIC ACID-SUPPRESSIVE THERAPY AND THEIR ASSOCIATION WITH INCREASED RISK OF COMMUNITY-ACQUIRED PNEUMONIA. The incidence rates of pneumonia in non-users versus users were 0.6 and 2.45 per 100 person-years, respectively. Editor's comment: Risk benefit considerations are necessary since GERD is associated with other diseases including asthma, rhinitis, laryngitis, reflux-esophagitis, and esophageal dysplasia in Barrett esophagus. Laheij RJ, et al, JAMA 2004; 292:1955.
4. AVIAN INFLUENZA (H5H1) VIRUS OUTBREAKS IN ASIA CAUSED VAST MORTALITY IN POULTRY AND RESULTED IN 39 REPORTED CASES OF DIRECT BIRD-TO-HUMAN TRANSMISSION (25 FATALITIES). This study demonstrated that domestic cats are at risk of disease or death from H5N1 either because of feeding on infected poultry or wild birds or because of contact with other infected cats. Thus, cats potentially could spread H5N1 between poultry farms and from poultry to humans. Cats may also form an opportunity for this avian virus to adapt to mammals and thereby increase a risk of a human influenza pandemic. Kuiken T, et al, Science, 2004; 306:241
5. HOUSE DUST-MITE (HDM) IMPERMEABLE COVERS SIGNIFICANTLY DECREASE THE LEVELS OF HDM-ALLERGENS. Peak flow significantly increased during the intervention. Thus, HDM-allergen avoidance measures might have beneficial effects on allergen reduction and asthma outcome. van den Bemt L, et al, J Allergy Clin Immunol 2004; 114:858.
6. Blomia tropicalis IS A COMMON MITE FOUND THROUGHOUT THE WORLD, PARTICULARLY IN SUBTROPICAL AND TROPICAL AREAS. IT CONTAINS UNIQUE ALLERGENS AND SENSITIZATION IS COMMON. This editorial calls for inclusion of B. tropicalis for diagnosis and treatment of specific IgE mediated allergy. Fernandez-Caldas E, Lockey RF, Allergy 2004; 59:1161.
No abstract available
7. SPUTUM EOSINOPHIL PERCENTAGES AND EOSINOPHILIC CATIONIC PROTEIN (ECP) LEVELS WERE SIGNIFICANTLY AND EQUALY ELEVATED IN COUGH-VARIANT ASTHMA AND CLASSIC ASTHMA VERSUS CONTROLS. Either sputum parameter correlates significantly with methacholine PC20. Yoo Y, et al, Allergy 2004; 59:1055.
8. IN A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF A 186 SUBJECTS WITH SUMMER HAY FEVER, SUBLINGUAL IMMUNOTHERAPY (SLIT) WAS EFFECTIVE IN REDUCING RHINORRHEA AND SNEEZING ONLY AFTER TWO YEARS OF THERAPY. The cumulative annual dose was 6264 μg Lol p 1 and 3654 μg Dac μg 5. Smith H, et al, J Allergy Clin Immunol 2004; 114:831.
9. ANIMAL MODELS AND, IN PARTICULAR, MURINE MODELS OF ALLLERGIC AIRWAYS DISEASE HAVE BEEN KEY IN IDENTIFING UNDERLYING MECHANISUMS WHICH CAUSE ALLERGEN-INDUCDED INFLAMMATION. This paper reviews the importance of the mouse model in identifying the importance of T cells and TH2 cytokines in development of allergen-induced inflammation and airway hyperresponsiveness. Taube C, et al, Int Arch Allergy Immunol 2004; 135:173.
10. ASTHMA IS AN AIRWAYS DISEASE PROCESS AND THE AIRWAY CONTINUES TO THE MOST DISTAL STRUCTURE UNITS OF THE ALVEOLAR AREA. KNOWLEDGE OF THE ALTERATIONS OF THE SMALL AIRWAYS AND THE DISTAL LUNG IS NEEDED TO FULLY UNDERSTAND THE PATHOPHYSIOLOGY OF ASTHMA. Efficient steroid delivery to these structures may improve therapeutic responses and allow better asthma control. Martin RJ, Allergy Clin Immunol Int – J World Allergy Org, 2004; 16:202.
