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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

Posted: May 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. Effectiveness and safety of subcutaneous and sublingual immunotherapy for the treatment of allergic rhinitis and asthma.

Lin SY, Erekosima N, Suarez-Cuervo C, Ramanathan M, Kim JM, et al. Allergen-specific immunotherapy for the treatment of allergic rhinoconjunctivitis and/or asthma: Comparative Effectiveness Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US), 2013 March. (Comparative Effectiveness Reviews, No. 111.) Available from:

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Editor’s comment: This comparative effectiveness review describes the effectiveness and safety of subcutaneous immunotherapy and sublingual immunotherapy (off-label use of subcutaneous-aqueous allergens for sublingual desensitization) compared with other therapies for the treatment of allergic rhinoconjunctivitis and asthma.

2. Current scientific literature, best practices, and emerging issues facing children with food allergies.

Gupta RS, Dyer AA, Jain N, Greenhawt M. Childhood Food Allergies: Current Diagnosis, Treatment, and Management Strategies. Mayo Clinic Proceedings 2013; 88(5): 512-526.

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Editor’s comment: In this comprehensive review the authors assist clinicians in applying the NIAID guidelines to primary care practice.

3. Chronic pruritus may be caused by inflammatory skin diseases, systemic diseases, neuropathic conditions, and psychogenic disorders.

Yosipovitch G, Bernhard JD. Chronic Pruritus. New England Journal of Medicine. 2013; 368(17): 1625-1634.


Editor’s comment: The authors present a case vignette highlighting chronic pruritus. They follow that with a discussion of strategies for the assessment and treatment of this condition and offer clinical recommendations.

4. Potential effects of smoking and aging on healthy subjects and patients with asthma.

Nagasaki T, Matsumoto H. Influences of smoking and aging on allergic airway inflammation in asthma. Allergology International. 2013; Article in press. [doi:10.2332/allergolint.12-RA-0523]

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Editor’s comment: In this their review the authors expand our understanding of the effects of smoking and aging on asthma, adding a new perspective of an old issue.

5. Parental sucking of their infant’s pacifier may reduce the risk of allergy development.

Hesselmar B, Sjöberg F, Saalman R, Aberg N, Adelberth I, Wold AE. Pacifier cleaning practices and risk of allergy development. Pediatrics 2013; 131(6): Published online ahead of print. (doi:10.1542/peds.2012-3345)

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Editor’s comment: The authors investigated whether pacifier cleaning practices affected the risk of allergy development through immune stimulation by microbes transferred to the infant via the parent’s saliva. They found that children whose parents “cleaned” their pacifier by sucking it were less likely to have asthma, eczema and sensitization at 18 months of age than children whose parents who did not use this cleaning technique.

6. Food and exercise-induced anaphylaxis (FEIA) in patients with a diagnosis of oral allergy syndrome (OAS).

Chen JYF, Quirt J and Lee KJ. Proposed new mechanism for food and exercise induced anaphylaxis based on case studies. Allergy, Asthma & Clinical Immunology 2013; 9:11. (doi:10.1186/1710-1492-9-11)

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Editor’s comment: From the presentation of two cases of FEIA in patients with a diagnosis of OAS, the authors proposed a new mechanism of FEIA to oral allergens. They hypothesized that the inhibitory effects of exercise on gastric acid secretion decreases the digestion of oral allergens and preserves structural integrity, thereby allowing continued systemic absorption of the allergen whether it be profilins, lipid transfer proteins, or other antigenic determinants.

7. Weekly email reports on monitored use of inhaled short-acting bronchodilators improve asthma control.

Van Sickle D, Magzamen S, Truelove S. Remote monitoring of inhaled bronchodilator use and weekly feedback about asthma management: An open-group, short-term pilot study of the impact on asthma control. PLoS ONE 2013; 8(2):e55335. (doi:10.1371/journal.pone.0055335).

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Editor’s comment: The authors found that weekly email reports and access to online charts summarizing remote monitoring of inhaled bronchodilator frequency and location were associated with improved asthma control and a decline in day-to-day asthma symptoms.

8. Significant interaction between 17q21 genotypes and rhinovirus (HRV) wheezing illness in early life and the development of childhood-onset asthma.

Çaışkan M, Bochkov YA, Kreiner-Møller E et al. Rhinovirus Wheezing Illness and Genetic Risk of Childhood-Onset Asthma. New England Journal of Medicine 2013; 368(15): 1398-1407.


Editor’s comment: The authors found that variants at the 17q21 locus were associated with asthma in children who had had HRV wheezing illnesses.

9. Guidelines for the diagnosis, treatment, and follow-up of Schnitzler's syndrome.

Simon A, Asli B, Braun-Falco M, De Koning H, Fermand JP et al. Schnitzler's syndrome: diagnosis, treatment, and follow-up. Allergy. 2013; 68(5): 562-568. (doi:10.1111/all.12129)

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Editor’s comment: In this comprehensive review the authors establish criteria for the diagnosis of Schnitzler’s syndrome. They concluded that a diagnosis of Schnitzler's syndrome is considered definite in any patient with two obligate criteria: a recurrent urticarial rash and a monoclonal IgM gammopathy, and two of the following minor criteria: recurrent fever, objective signs of abnormal bone remodeling, elevated CRP level or leukocytosis, and a neutrophilic infiltrate on skin biopsy. It is considered probable if only 1 minor criterion is present.

10. Patterns of sensitization to common allergens and the association with age, gender, and clinical symptoms in children with allergic rhinitis.

Ide Bot CMA, Röder E, Pols DHJ, Bindels PJE, Gerth van Wijk R et al. Sensitisation patterns and association with age, gender, and clinical symptoms in children with allergic rhinitis in primary care: a cross-sectional study. Primary Care Respiratory Journal 2013; 22. Article in press, online ahead of print, March 2013. (


Editor’s comment: The authors concluded that polysensitization to multiple allergens occurs frequently in children with allergic rhinitis in general practice, and clinical symptoms are equally severe in polysensitized and monosensitized children.

11. Microbial sensitization in severe atopic dermatitis (AD).

Sonesson A, Bartosik J, Christiansen J, Roscher I, Nilsson F et al. Sensitization to skin-associated microorganisms in adult patients with atopic dermatitis is of importance for disease severity. Acta Dermato Venereologica 2013; 93(3): 340-345. (doi: 10.2340/00015555-1465)

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Editor’s comment: The authors demonstrated the occurrence of microbial sensitization in severe AD, and concluded that this observation calls for new and more detailed treatment strategies. They felt these strategies should be based on monitoring sensitization to all antigens, including mites and microbes (Malassezia, Candida and S. aureus).

12. Children may be more responsive to allergen-specific immunotherapy (SIT) than adults.

Lai X, Li J, Xiao X, Liu E, Zhang C et al. Specific IgG4 production during house dust mite immunotherapy among age, gender and allergic disease populations. International Archives of Allergy and Immunology 2013; 160(1): 37-46. (doi:10.1159/000339239)

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Editor’s comment: Children demonstrated more clinical and FEV1 improvement and higher levels of allergen-specific IgG4 during a shorter SIT period compared to adults. Rhinitis patients show a higher increase in specific IgG4 compared to patients with asthma symptoms. The increase of Der p-specific IgG4 reflects a specific response of the immune system to the SIT vaccine being administrated.

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