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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

Posted: September 2011

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. Rapid drug desensitization as a safe and effective method to manage drug allergy.

Liu A, Fanning L, Chong H et al. Desensitization regimens for drug allergy: state of the art in the 21st century. Clinical & Experimental Allergy 2011; Early View.

Editor’s comment: Excellent review that discusses the last ten years of literature about rapid drug desensitization in the context of the authors’ experiences at the Brigham and Women’s Hospital Desensitization Program.

2. Key subsets of antigen presenting cells involved in the capture of antigen /allergen and tolerance induction during sublingual allergen-specific immunotherapy.

Mascarell L, Saint-Lu N, Moussu H et al. Oral macrophage-like cells play a key role in tolerance induction following sublingual immunotherapy of asthmatic mice. Muscosal Immunology 2011; July 20 (doi.10.1038/mi.2011.28).

Editor’s comment: In mice, among the various antigens presenting cell subsets macrophage like cells in oral tissues play a key role in tolerance induction following sublingual allergen-specific immunotherapy.

3. Human rhinoviruses-induced exacerbations in asthma are associated with neutrophilic inflammation.

Denlinger LC, Sorkness RL, Lee WM et al. Lower airway rhinovirus burden and the seasonal risk of asthma exacerbation. American Journal of Respiratory and Critical Care Medicine 2011; August 3, Published ahead of print (doi.10.1164/rccm.201103-05850C).

Editor’s comment: Although the authors have established that human rhinovirus infection is a very common cause of asthma exacerbations in adults, it remains to be determined how the infection interacts with allergic inflammation. The nature of this interaction is a rich area for further investigation.

4. Effects of human lung mast cells on the secretory and proliferative functions of airway smooth muscle cells.

Alkhouri H, Hollins F, Moir LM et al. Human lung mast cells modulate the functions of airway smooth muscle cells in asthma. Allergy 2011; 66(9):1231-1241.

Editor’s comment: Human lung mast products including proteases affect the functions and proliferation of bronchial smooth muscle cells. Mast cells may thus modulate their own recruitment as well as the activities of bronchial smooth muscle in asthma.

5. Exposure at work to dampness and molds is associated with the occurrence of new-onset asthma.

Karvala K, Toskala E, Luukkonen R et al. Prolonged exposure to damp and moldy workplaces and new-onset asthma. International Archives of Occupational and Environmental Health 2011; 84(7):713-721.

Editor’s comment: Asthma-like symptoms occur in relation to exposure to wet and moldy work environments and can later lead to the development of asthma, especially if the worker stays in the same environment.

6. Classification of chronic hand eczema and development of a diagnostic algorithm.

Molin S, Diepgen TL, Ruzicka T et al. Diagnosing chronic hand eczema by an algorithm: a tool for classification in clinical practice. Clinical and Experimental Dermatology 2011/36(6):595-601.

Editor’s comment: In clinical practice where the differential diagnosis of hand eczema impacts treatment, we need a clear understanding of the subtypes of eczema to allow us to employ optimal treatment strategies. The authors developed a useful algorithm to assist in the differential diagnosis of hand eczema.

7. Anti IL-13 effect was greater in patients who had circulating levels of periostin above the median and exhibited the high-Th2 asthma phenotype.

Corren J, Lemanske RF, Hanania RA et al. Lebrikizumab Treatment in Adults with Asthma. New England Journal of Medicine 2011; 365(12):1088-1098.
Available in PDF

Editor’s comment: IL-13 is a relevant target for asthma therapy, but it is only one of the pathways that can lead to the expression of an asthma phenotype. In this study Lebrikizumab(anti-IL 13) treatment was associated with improved lung function, and its benefit was most pronounced in patients with high pretreatment levels of serum periostin.

8. Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) might underestimate the proportion of children with uncontrolled asthma.

Koolen BB, Pijnenburg MWH, Brackel HJL et al. Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT). European Respiratory Journal 2011; 38(3):561-566.

Editor’s comment: C-ACT and ACT compared with GINA guidelines demonstrate good agreement, but might underestimate the proportion of children with uncontrolled asthma. Further studies are necessary to compare different control measurements and the predictive value for future exacerbations.

9. Topical steroid is a beneficial treatment for Chronic Rhinosinuitis without polyps

Snidvongs K, Kalish L, Sacks R et al. Topical steroid for chronic rhinosinusitis without polyps. Cochrane Database of Systematic Reviews 2011; Issue 9, Article No.: CD009274. DOI: 10.1002/14651858.CD009274.

Editor’s comment: This updated Cochrane review states that topical steroids may be included in a comprehensive treatment program for chronic rhinosinusitis without polyps. Studies show that this therapy exerts a beneficial effect on symptom control with little evidence of adverse effects.

10. Projecting future visits to the pediatric emergency department for asthma according to changes in ground level ozone.

Sheffield PE, Knowlton K , Carr JL et al. Modeling of Regional Climate Change Effects on Ground-Level Ozone and Childhood Asthma. American Journal of Preventive Medicine 2011; 41(3):251-257.

Editor’s comment: An interesting analysis of the possible use of climate change models and the measurement of ozone levels to predict morbidity and exacerbations in children with asthma.

11. Hearing loss and otoacoustic emission abnormalities in patients with allergic rhinitis.
Singha S, Nagarkara AN, Bansala S et al. Audiological manifestations of allergic rhinitis. The Journal of Laryngology & Otology 2011; 125(9):906-910.

Editor’s comment: This study shows there may be an alteration in hearing associated with allergic rhinitis, even in patients with no complaints of hearing loss.

12. High doses of zinc may shorten the duration of colds.

Hemilä H. Zinc lozenges may shorten the duration of colds:  A systematic review. The Open Respiratory Medicine Journal 2011; 5:51-58.
Full Text PDF

Editor’s comment: This systematic review and meta-analysis shows that daily zinc doses over 75 mg may have a significant effect on the duration of colds.

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