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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

Posted: July 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. Highlighting the key common messages of the existing guidelines about asthma in childhood

Papadopoulos NG, Arakawa H, Carlsen K–H, Custovic A, Gern J et al. International consensus on (ICON) pediatric asthma. Allergy 2012; 67(8): 976–997.


Editor's comment: In this excellent review the authors conclude that increasing the accessibility and promoting the dissemination of core management principles, in parallel to efforts to incorporate evidence based medicine into guidelines, will improve the quality of life of children with asthma and reduce the burden of this contemporary epidemic.

2. Vitamin D levels modulation of the effect of inhaled corticosteroids on lung function and airway responsiveness in children

Wu AC, Tantisira K, Li L Fuhlbrigge AL, Weiss ST, Litonjua A, and for the Childhood Asthma Management Program Research Group. The effect of vitamin D and inhaled corticosteroid treatment on lung function in children. American Journal of Respiratory and Critical Care Medicine. 2012; Published online ahead of print on July 2012. doi: 10.1164/rccm.201202–0351OC


Editor's comment: The authors concluded that adequate levels of vitamin D in children treated with inhaled corticosteroids were associated with improved lung function in patients with mild to moderate persistent asthma. Monitoring vitamin D levels and/or supplementing with vitamin D should be considered during inhaled corticosteroid treatment of children with asthma.

3. Surprising findings regarding nut sensitisation and infant feeding practices

Paton J, Kljakovic M, Ciszek K, Ding P. Infant feeding practices and nut allergy over time in Australian school entrant children. International Journal of Pediatrics 2012; Article ID 675724, 5 pages doi:10.1155/2012/675724

Full Text, Open Access

Editor's comment: The authors found that children who were breast fed in the first six months of life were at an increased risk of developing a parent–reported nut allergy. In contrast, a protective effect was found in children who were fed foods other than breast milk in the first six months of life.

4. Sleep quality is altered in allergic rhinitis patients.

Colás C, Galera H, Añibarro B, Soler R, Navarro A, Jáuregui I, Peláez A. Disease severity impairs sleep quality in allergic rhinitis (The SOMNIAAR study). Clinical & Experimental Allergy 2012; 42(7): 1080–1087. doi: 10.1111/j.1365–2222.2011.03935.x


Editor's comment: In a prospective, observational, multicentre survey of allergic rhinitis in Spain, employing the Total Symptoms Score (TSS), specific QOL by the Rhinitis Quality of Life Questionnaire (RQLQ), sleep quality by Pittsburgh scale, and diurnal somnolence using a scale based on Epworth's, the authors concluded that sleep impairment is common in allergic rhinitis. Impairment is more marked in more severe cases. Nasal obstruction and concomitant asthma can be contributing factors.

5. Clinical manifestations in children with acute and chronic rhinosinusitis

Poachanukoon O, Nanthapisal S, Chaumrattanakul U. Pediatric acute and chronic rhinosinusitis: comparison of clinical characteristics and outcome of treatment. Asian Pacific Journal of Allergy and Immunology 2012; 30(2):146–151.

Full Text PDF, Open Access

Editor's comment: The authors reported that the most common complaints in acute and chronic rhinosinusitis were cough and rhinorrhea. There was no significant difference in symptoms between acute and chronic groups, except for periorbital pain and sleep apnea which were found more frequently in the chronic group.

6. Specific mold exposures are associated with childhood asthma development

Reponen T, Lockey J, Bernstein DI, Vesper SJ, Levin L et al. Infant origins of childhood asthma associated with specific molds. The Journal of Allergy and Clinical Immunology 2012; Article in Press, Corrected Proof. doi:10.1016/j.jaci.2012.05.030


Editor's comment: Evidence is increasing that mold might be a trigger for the development of asthma. The authors, using a DNA–based method of mold analysis and multiple modeling and statistical approaches, demonstrated that 3 mold species, Aspergillus ochraceus, Aspergillus unguis and Penicillium variabile, were significantly associated with asthma development.

7. Interaction between two essential proteins that control inflammation

Langlais D, Couture C, Balsalobre A, Drouin J. The Stat3/GR interaction code: Predictive value of direct/indirect DNA recruitment for transcription outcome. Molecular Cell 2012; 47(1): 38–49.


Editor's comment: Stat3 acts on pro–inflammatory gene targets. The glucocorticoid receptor (GR) interacts with Stat3 to control inflammation. GR can be found in almost every cell in the body and regulates genes that control development, metabolism, and inflammatory and immune response.

8. rDer p 2/1S: a safe hypoallergenic molecule to treat house dust mite allergy

Chen K–W, Blatt K, Thomas WR, Swoboda I, Valent P et al. Hypoallergenic Der p 1/Der p 2 combination vaccines for immunotherapy of house dust mite allergy. The Journal of Allergy and Clinical Immunology 2012; Article in Press, Corrected Proof July 2012. doi: 10.1016/j.jaci.2012.05.035


Editor's comment: rDer p 2/1S, a hybrid protein of reassembled Der p 1 and Der p 2 fragments, shows strongly reduced allergenicity, as well as diminished allergenic activity and IgE reactivity. It also contains all relevant T–cell epitopes needed for tolerance induction and can induce a robust protective allergen–specific IgG response. These features indicate that rDer p 2/1S may be a useful agent for immunotherapy.

9. Skin barrier preservation and allergen–specific immunotherapy in atopic dermatitis

Milani M. Approaching atopic dermatitis treatment differently: from skin barrier preservation to allergen–specific immunotherapy. Immunotherapy 2012; 4(6): 561–564. doi:10.2217/imt.12.47

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Editor's comment: This excellent and concise review of atopic dermatitis explores the pathogenesis of this disease. It discusses the role of barrier dysfunction and its restoration. It also reviews the potential of specific allergen immunotherapy as a therapeutic option.

10. Distinguishing between Churg–Strauss syndrome (CSS) and hypereosinophilic syndrome (HES)

Khoury P, Zagallo P, Talar–Williams C, Santos CS, Dinerman E, Holland NC, Klion AD. Serum biomarkers are similar in Churg–Strauss syndrome and hypereosinophilic syndrome. Allergy 2012; Early View, Published online ahead of print. doi: 10.1111/j.1398–9995.2012.02873.x


Editor's comment: The authors found a significant clinical overlap between anti–neutrophil antibodies (ANCA)–negative Churg–Strauss syndrome and platelet–derived growth factor receptor (PDGFR)–negative hypereosinophilic syndrome.

11. Allergy avoidance strategies during travel abroad

Barnett J, Botting N, Gowland M, Lucas JS. The strategies that peanut and nut–allergic consumers employ to remain safe when travelling abroad. Clinical and Translational Allergy 2012; 2:12. doi:10.1186/2045–7022–2–12

Provisional PDF, Open Access

Editor's comment: This is the first study to provide a detailed analysis of the strategies that peanut and nut allergic individuals use to remain safe when travelling abroad. Some individuals simply decided foreign travel too much of a risk and always vacationed locally. However, most took holidays abroad, planning carefully and employing self–imposed restrictions to reduce risk.

12. Frequency of meningococcal disease associated C5 and C6 gene mutations in South Africa

Owen EP, Leisegang, Whitelaw A, Simpson J, Baker S et al. Complement component C5 and C6 mutation screening indicated in meningococcal disease in South Africa. South African Medical Journal 2012; 102(6): 525–527.

Full Text, Open Access

Editor's comment: The authors concluded that C5D and C6Q0 mutations' increasing susceptibility to repeated meningococcal disease are not rare in South Africa, and strongly recommend diagnostic testing for complement C5 and C6 deficiency in the routine work–up of all meningococcal disease cases in this country.

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