Archives: Medical Journal Reviews
WAO Reviews - Editors' Choice
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 John J. Oppenheimer, MD - FACAAI - FAAAAI, WAO Reviews Editor.
1. Toll-like receptors (TLR) agonists and antagonists exhibit anti-asthma/allergic rhinitis effects.
Aryan Z, Holgate ST, Radzioch D and Rezaei N. A new era of targeting the ancient gatekeepers of the immune system: toll-Like agonists in the treatment of allergic rhinitis and asthma. International Archives of Allergy and Immunology 2014; 164(1): 46-63. (doi:10.1159/000362553)
Editor’s comment: The authors review the current literature and explore the potential development of agonists and antagonists of TLRs. It is hopeful that these future agents will provide major therapeutic tools to modulate the natural course of allergic disease.
2. Anaphylaxis: Mast cell activation and mast cell mediators on the cardiovascular system.
Triggiani M, Montagni M, Parente R, and Ridolo E. Anaphylaxis and cardiovascular diseases: a dangerous liaison. Current Opinion in Allergy & Clinical Immunology 2014; 14(4): 309-315. (doi:10.1097/ACI.0000000000000071)
Editor’s comment: This comprehensive review summarizes the most recent clinical and experimental data regarding cardiovascular involvement during anaphylaxis.
3. Antihistamines and level of cardiovascular safety.
Olasinska-Wisniewska A, Olasinski J, and Grajek S. Cardiovascular safety of antihistamines. Advances in Dermatology and Allergology / Post?py Dermatologii i Alergologii 2014; 31(3): 182-186. (doi:10.5114/pdia.2014.43191)
Editor’s comment: This review evaluates the new generation of antihistamine drugs in the context of QT interval prolongation risk.
4. Promising treatments for anterior ocular inflammatory disease.
Syed BA, Kumar S, and Bielory L. Current options and emerging therapies for anterior ocular inflammatory disease. Current Opinion in Allergy & Clinical Immunology 2014; 14(5): 485-489. (doi:10.1097/ACI.0000000000000097)
Editor’s comment: This article reviews the current available agents as well as medicines “in the pipeline” for the treatment of anterior ocular inflammatory disease (allergic conjunctivitis, uveitis and dry eye syndrome).
5. Operational classification and a practical diagnostic algorithm of irritant-induced asthma (IIA).
Vandenplas O, Wiszniewska M, Raulf M, de Blay F, van Wijk RG et al. EAACI position paper: irritant-induced asthma. Allergy 2014; 69(9): 1141-1153. (doi:10.1111/all.12448)
Editor’s comment: This document, prepared by a panel of experts, summarizes our current knowledge regarding the epidemiology, pathophysiology, diagnosis and management of irritant-induced asthma.
6. Effects of traffic-related pollution on the exacerbation of asthma and development of respiratory infections in children suffering from asthma or wheezing.
Esposito S, Galeone C, Lelii M, Longhi B, and Ascolese B et al. Impact of air pollution on respiratory diseases in children with recurrent wheezing or asthma. BMC Pulmonary Medicine 2014; 14:130. (doi:10.1186/1471-2466-14-130)
Editor’s comment: The authors found a significant association between traffic-related pollution and the development of asthma exacerbations as well as respiratory infections in children born to atopic parents and in those suffering from recurrent wheezing or asthma.
7. Inconsistent results reported in relation to the use of melatonin as a modulator in atopic conditions.
Marseglia L, D’Angelo G, Manti S, Salpietro C, Arrigo T, Barberi I, Reiter RJ, and Gitto E. Melatonin as an immunomodulatory agent in asthma and atopic eczema. International Journal of Molecular Sciences 2014; 15(8): 13482-13493. (doi:10.3390/ijms150813482)
Editor’s comment: This review summarizes what is known about the role of melatonin as an immunomodulatory agent in asthma and atopic eczema.
8. A humanized monoclonal antibody against interleukin-5 in patients with recurrent asthma exacerbations and evidence of eosinophilic inflammation.
Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM et al. Mepolizumab treatment in patients with severe eosinophilic asthma. New England Journal of Medicine 2014, published online before print, 8 September. (doi:10.1056/NEJMoa1403290)
Editor’s comment: This article further advances our understanding of this humanized monoclonal antibody (IgG1 κ type) which targets human IL-5 and prevents its interaction with the α-chain of the IL-5 receptor. In this study, the authors demonstrate that the use of mepolizumab either intravenously or subcutaneously in asthmatics with evidence of eosinophilic inflammation significantly reduced asthma exacerbations and was associated with improvements in markers of asthma control.
9. Addition of a sedating first-generation H1-antihistamine at night for chronic spontaneous urticaria (CSU) is not supported.
Staevska M, Gugutkova M, Lazarova C, Kralimarkova T, Dimitrov V, Zuberbier T, Church MK, and Popov TA. Night-time sedating H1-antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a randomized controlled trial. British Journal of Dermatology 2014; 71(1): 148-154. (doi:10.1111/bjd.12846)
Editor’s comment: In this paper the authors examined the potential deleterious effects of H1 antagonists and concluded that in light of the potential residual daytime sedation and resultant decrement on school performance, impaired productivity at work and, impaired driving of motor vehicles, it is better not to offer a sedating antihistamine at night for the treatment of CSU.
10. Prevalence of difficult-to-control severe asthma in Spanish children.
Plaza-Martín AM, Vennera MC, Galera J, and Herraez L. Prevalence and clinical profile of difficult-to-control severe asthma in children: results from pneumology and allergy hospital units in Spain. Allergologia et Immunopathologia 2014; 42(5). (doi:10.1016/j.aller.2014.02.003)
Editor’s comment: The authors demonstrate through this observational, cross-sectional, two-phase, multicenter study that approximately one in four asthmatic children with severe disease had difficult-to-control asthma with resultant increase in number of exacerbations, emergency room or unscheduled primary care visits. Interestingly, approximately one third of poorly controlled patients had their disease underestimated as they were classified by physicians as controlled asthmatics.
11. The development of the intestinal microbiota in the first years of life.
Wopereis H, Oozeer R, Knipping K, Belzer C, and Knol J. The first thousand days – intestinal microbiology of early life: establishing a symbiosis. Pediatric Allergy and Immunology 2014; 25(5): 428-438. (doi:10.1111/pai.12232)
Editor’s comment: This review provides an overview of the development of the intestinal microbiota including its bidirectional relationship with the immune system, and its impact both in health and disease (with emphasis on allergy in early life).
12. Association between postbronchodilator lung function, asthma, chronic rhinosinusitis (CRS), and atopy with age.
Obaseki D, Potts J, Joos G, Baelum J, Haahtela T et al. The relation of airway obstruction to asthma, chronic rhinosinusitis and age: results from a population survey of adults. Allergy 2014; 69(9): 1205-1214. (doi:10.1111/all.12447)
Editor’s comment: Using a large European sample the authors concluded that while people with asthma have a steeper decline in postbronchodilator lung function with age compared to normal controls, neither patients with CRS nor atopy alone demonstrated this decline.