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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

Posted: October 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. Novel pharmacogenetic determinants of the response to inhaled glucocorticoids.

Tantisira KG, Lasky-Su J, Harada M, Murphy A, Litonjua AA et al.† Genomewide Association between GLCCI1 and Response to Glucocorticoid Therapy in Asthma. New England Journal of Medicine 2011; 365:1173-1183.

Editorís comment: A functional SNP, rs37973, that decreases the expression of GLCCI1, a gene influencing the pharmacologic response to inhaled glucocorticoids, causes a diminished response to inhaled glucocorticoids in asthmatics.

2. Staphylococcus aureus biofilmĖassociated chronic rhinosinusitis.

Foreman A., Holtappels G., Psaltis AJ, Jervis-Bardy J, Field J, Wormald PJ, Bachert C. Adaptive immune responses in Staphylococcus aureus biofilmĖassociated chronic rhinosinusitis. Allergy 2011; 66(11):1449-1456.

Editorís comment: This interesting study demonstrates an association between the presence of staphylococcal biofilms and theTH2 immune response in chronic rhinosinusitis, confirming a previous assumption. Further studies are needed to elucidate the nature of this causal relationship.

3. Causal role for allergic sensitization in virus-induced wheezing and the development of asthma

Jackson DJ, Evans MD, Gangnon RE, Tisler CJ, Pappas TE et al. Evidence for a Causal Relationship Between Allergic Sensitization and Rhinovirus Wheezing in Early Life. American Journal of Respiratory and Critical Care Medicine 2011; published online ahead of print on September 29, 2011 as doi.10.1164/rccm.201104-0660OC.

Editorís comment: Using a longitudinal model in a well-characterized birth cohort, the authors clearly demonstrated that allergic sensitization increases the risk for rhinovirus (HRV) induced wheezing. To definitively prove causality one would need to prevent or modify allergic sensitization in early life and demonstrate a lower risk of subsequent HRV wheezing illnesses.

4. Applications of exhaled nitric oxide measurements in clinical practice.

Dweik RA, Boggs PB, Erzurum SC, Irvin CG, Leigh MW et al and on behalf of the American Thoracic Society Committee on Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications. An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications. American Journal of Respiratory and Critical Care Medicine 2011; 184: 602-615.

Editorís comment: A practical guide developed by the American Thoracic Society on the usefulness of the measurement of Feno in inflammatory diseases of the airways.

5. TNF released by tolerogenic CD11+CD8+ dendritic cells and† the development of tolerance to contact allergens.

Luckey U, Maurer M, Schmidt T, Lorenz N, Seebach B, Metz M, Steinbrink K et al. T cell killing by tolerogenic dendritic cells protects mice from allergy. Journal of Clinical Investigation 2011; 121(10): 3860

Editorís comment: These interesting experimental findings make clear a path for the induction of tolerance in allergic contact dermatitis, the most common occupational disease.

6. Highest prevalence of asthma among young people with diabetes.

Black MH, Anderson A, Bell RA, Dabelea D, Pihoker C et al. Prevalence of asthma and its association with glycemic control among youth with diabetes. Pediatrics 2011; 128(4):† e839-e847.

Editorís comment: Systemic inflammation could generate a complex relationship between lung function, body mass index and glycemic control among youth with diabetes. In type 1 diabetes, asthma could be associated with poor glycemic control, especially if the asthma is not treated.

7. The black race and African ancestry associated with increased risk of sensitization to food.

Kumar, R Tsai HJ, Hong X, Liu Xin, Wang G et al. Race, ancestry, and development of food-allergen sensitization in early childhood. Pediatrics 2011; 128(4): e821-e829.

Editorís comment: In this urban birth cohort it was found that black race and African ancestry was associated with an increased risk of sensitization to foods, especially peanuts. It remains to be determined whether this difference is associated with higher rates of clinical reactivity.

8. Role of antioxidant food additives in allergy and asthma epidemics.

Zaknun D, Schroecksnadel S, Kurz Ket, Fuchs Deitmar. Potential Role of Antioxidant Food Supplements, Preservatives and Colorants in the Pathogenesis of Allergy and Asthma. International Archives of Allergy and Immunology 2012; 157(2): 113-124.

Editorís comment: This review proposes that antioxidants added in high doses as preservatives and colorants may be playing a major role in the significant increase in the incidence of allergy and asthma observed during the past decades.

9. Relationship between atopic dermatitis, asthma, and filaggrin mutations.

Irvine AD, Irwin McLean WH, Leung DYM. Filaggrin Mutations Associated with Skin and Allergic Diseases. New England Journal of Medicine 2011; 365: 1315-1327.

Editorís comment: Excellent review of filaggrin mutations citing evidence that such mutations can increase the risk of the development of numerous conditions including atopic dermatitis (affecting 42% of all mutation carriers), contact allergy, asthma, hay fever and allergy to peanuts as well as influence the severity of asthma, alopecia areata and susceptibility to herpetic infection.

10. Evidence of clinical efficacy and tolerability of second-generation H1-antihistamines.

Kavosh ER, Khan DA. Second-Generation H1-Antihistamines in Chronic Urticaria: An Evidence-Based Review. American Journal of Clinical Dermatology 2011; 12(6): 361-376.

Editorís comment: An evidence-based review of the clinical efficacy and tolerability of second generation antihistamines available in the United States for the treatment of chronic urticaria. The authors employed the GRADE system to develop the strength of recommendations.

11. Fetal exposure to continue maternal smoking during pregnancy is associated with an increased risk of wheezing in preschool children.

Duijts L, Jaddoe VWV, van der Valk RJP, Henderson JA, Hofman A et al. Fetal exposure to maternal and paternal smoking and the risks of wheezing in preschool children. The Generation R Study. Chest 2011; published online before print September 29, 2011, doi: 10.1378/chest.11-0112.

Editorís comment: The association of maternal smoking during pregnancy with wheezing in preschool children was not explained by exposure to secondhand smoke after birth or small size for gestational age at birth.

12. Serum high sensitivity assays for C-reactive protein in asthmatic children with different grades of severity and control.

Deraz TE, Kamel TB, El-Kerdany TA, El-Ghazoly HMA. High-sensitivity C reactive protein as a biomarker for grading of childhood asthma in relation to clinical classification, induced sputum cellularity, and spirometry. Pediatric Pulmonology 2011; Early view, September 29, 2011, doi: 10.1002/ppul.21539.

Editorís comment: High sensitivity C-reactive protein can be considered as a new relatively non-invasive marker for different grades of asthma severity and control and can be used for indirect detection and monitoring of airway inflammation, disease severity, and response to steroid treatment in asthmatic children.

13. Relation between FEF25-75 and bronchial hyperreactivity and predictive ability of bronchial hyperreactivity in a pediatric population.

Ciprandi G, Tosca MA, Capasso M. Forced expiratory flow between 25 and 75% of vital capacity might be a predictive factor for bronchial hyperreactivity in children with allergic rhinitis, asthma, or both. Allergy and Asthma Proceedings 2011; 32(5): e22-e28(7).

Editorís comment: Low FEF25-75 values could suggest BHR in children. Diminished FEF25-75 values might predict severe BHR in children, mainly in those with allergic rhinitis.

14. Therapeutic potential of the inhibition of IL-5 with a humanized monoclonal antibody in serious nasal polyposis.

Gevaert P, Van Bruaene N, Cattaert T, Van Steen K, Van Zele T et al. Mepolizumab, a humanized antiĖIL-5 mAb, as a treatment option for severe nasal polyposis. Journal of Allergy and Clinical Immunology 2011; Article in press, 29 September 2011; doi: 10.1016/j.jaci.2011.07.056.

Editorís comment: Mepolizumab administered to patients with severe chronic rhinosinusitis with nasal polyps produced a significant reduction in nasal polyps size in 12 of 20 patients, as assessed by CT scans.

15. One in three patients with asthma who use inhaled glucocorticoids may not benefit from this treatment.

Drazen JM. A Step toward Personalized Asthma Treatment. New England Journal of Medicine 2011; 365: 1245-1246.


Editorís comment: An excellent editorial in NEJM about personalized medicine using two recent studies on asthma treatment to illustrate its potential benefit.

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