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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

March 2014

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, Editor, WAO Reviews – Editors’ Choice.

1. Drug desensitization to chemotherapeutic agents and monoclonal antibodies.

Hong DI, Dioun AF. Indications, protocols, and outcomes of drug desensitizations for chemotherapy and monoclonal antibodies in adults and children. The Journal of Allergy and Clinical Immunology: In Practice 2014; 2(1): 13-19. (doi:10.1016/j.jaip.2013.11.007)

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Editor’s comment: The authors reviewed the steps involved in the evaluation of hypersensitivity reactions to chemotherapeutic agents and monoclonal antibodies. They discussed the factors to consider before making a decision to desensitize, the implementation of desensitization protocols, and the outcomes of such procedures.

2. Occupational asthma is potentially preventable in most cases.

Tarlo SM and Lemiere C. Occupational asthma. The New England Journal of Medicine 2014; 370: 640-649. (doi:10.1056/NEJMra1301758)


Editor’s comment: This review focuses on current data about occupational asthma, defined as asthma due to conditions attributable to work exposures and not to causes outside the workplace.

3. Improving the health of our patients with severe asthma.

Fan Chung K, Wenzel SE, Brozek JL, Bush A, Castro M et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. European Respiratory Journal 2013; published online before print, 12 December. (doi:10.1183/09031936.00202013)


Editor’s comment: Supported by the American Thoracic Society and the European Respiratory Society, a task force reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults.

4. Diagnosis of drug and narcotic allergy.

Swerts S, Van Gasse A, Leysen J, Faber M, Sabato V et al. Allergy to illicit drugs and narcotics. Clinical & Experimental Allergy 2014; 44(3): 307-318. (doi:10.1111/cea.12177)


Editor’s comment: : This comprehensive review focuses on the different classes of drugs that tend to be abused. It reviews allergic reactions to these drugs which include: central nervous system depressants (such as cannabis, opioids and kava), stimulants (cocaine, amphetamines, khat and ephedra), and hallucinogens such as ketamine and nutmeg.

5. Tobacco smoke exposure and rates of readmission for children hospitalized for asthma.

Howrylak JA, Spanier AJ, Huang B, Peake RWA, Kellogg MD, Sauers H, Kahn RS. Cotinine in children admitted for asthma and readmission. Pediatrics 2014; published online before print (20 January). (doi:10.1542/peds.2013-2422)

Abstract (Free PDF Available)

Editor’s comment: The authors found that detectable serum and salivary cotinine is common among children admitted for asthma and is associated with readmission. This finding may enhance clinical care for children at increased risk of asthma morbidity.

6. Poor hygiene and farming exposures on the prevalence of atopy.

Cooper PJ, Vaca M, Rodriguez A, Chico ME, Santos DN, Rodrigues LC, Barreto ML. Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador. Thorax 2014; 69(3): 232-239. (doi:10.1136/thoraxjnl-2013-203818)

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Editor’s comment: Environmental exposures indicative of poor hygiene or farming have variable effects on atopy and the risk of respiratory symptoms in urban and rural children in a developing country.

7. Anti-inflammatory mediators in wheezy infants.

Eke Gungor H, Tahan F, Gokahmetoglu S, Saraymen B. Decreased levels of lipoxin A4 (LXA4) and annexin A1(ANXA1) in wheezy infants. International Archives of Allergy and Immunology 2014; 163: 193-197. (doi:10.1159/00035490)


Editor’s comment: This is the first study demonstrating lower levels of lLXA4 and ANXA1 in wheezy infants. The authors concluded that a reduction in the endogenous biosynthesis of LXA4 and ANXA1 sis may be one of the reasons for airway inflammation.

8. Combined defects in both T- and B-cells may account for common variable immunodeficiency (CVID).

Berrón-Ruiz L, López-Herrera G, Vargas-Hernández A, Mogica-Martínez D, García-Latorre E et al. Lymphocytes and B-cell abnormalities in patients with common variable immunodeficiency (CVID). Allergologia et Immunopathologia 2014; 42(1). (doi:10.1016/j.aller.2012.07.016)


Editor’s comment: The diverse and widespread distribution of T and B-cell defects further highlights the heterogeneity present among CVID patients and indicates that multiple factors likely play a role in generating the CVID phenotype.

9. First test of the hypothesis that innate cytokine production in infancy following pattern recognition receptor (PRR) stimulation varies across continents.

Smolen KK, Ruck CE, Fortuno ES, Ho K, Dimitriu P et al. Pattern recognition receptor-mediated cytokine response in infants across 4 continents. The Journal of Allergy and Clinical Immunology 2014; 133(3): 818-826.e4. (doi:10.1016/j.jaci.2013/09/038)

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Editor’s comment: The authors concluded that substantial differences in innate cytokine responses to PRR stimulation exist among different populations of infants.

10. Changes in feeding practice since recently revised Australian allergy guidelines removed recommendations to delay allergenic solids.

Tey D, Allen KJ, Peters RL, Koplin JJ, Tang MLK et al. Population response to change in infant feeding guidelines for allergy prevention. The Journal of Allergy and Clinical Immunology 2014; 133(2): 476-484 (doi:10.1016/j.jaci.2013.11.019)


Editor’s comment: : The authors observed that updated Australian allergy guidelines are associated with reduced delay in introduction of solids, egg, and peanut, and an increase in partially hydrolyzed formula use among formula fed infants.

11. Air pollution and risk of asthma exacerbations and acute respiratory infections.

Esposito S, Tenconi R, Lelii M, Preti V, Nazzari E, Consolo S, Patria MF. Possible molecular mechanisms linking air pollution and asthma in children. BMC Pulmonary Medicine 2014; 14:31. (doi:10.1186/1471-2466-14-31)

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Editor’s comment: Although there seems to be an association between air pollution and an increased risk of asthma exacerbations and acute respiratory infections, further studies are needed in order to clarify the specific mechanism(s) underlying this association. Specifically there is a need to understand the role of different air pollutants, identify genetic polymorphisms that modify airway responses to pollution, and investigate the effectiveness of new preventive and/or therapeutic approaches for subjects with low antioxidant enzyme levels.

12. Discrepancy of penicillin allergy management between allergists and non-allergists.

Suetrong N and Klaewsongkram J. The differences and similarities between allergists and non-allergists for penicillin allergy management. Journal of Allergy 2014; 214183. (doi:10.1155/2014/214183)

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Editor’s comment: The different management of penicillin allergy between allergists and non-allergists was mainly observed in patients both with a history of severe non-immediate reactions and with a history of an immediate reaction. This was particularly true in the patients who had been skin-tested with penicillin reagents. Allergists are more willing to confirm penicillin allergic status, more likely to carefully administer penicillin after negative skin tests, and less concerned for the potential cross-reactivity with 3rd and 4th generation cephalosporins.

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