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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

Posted: November 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. A century of progress since the initial description of the physiologic and pathologic roles of histamine and 70 years since the introduction of H1-antihistamines for clinical use.

Simons FER, Simons KJ. Histamine and H1-antihistamines: Celebrating a century of progress. Journal of Allergy and Clinical Immunology 2011; published online before print, 31 October 2011 (10.1016/j.jaci.2011.09.005).


Editor's comment: This excellent review discusses the physiologic effects of histamine and clinically relevant information about the molecular mechanisms of action of H1-antihistamines as inverse agonists with immunoregulatory effects.

2. Prevalence and sensitizing agents/triggers and factors associated with allergic rhinoconjunctivitis in several countries in Africa, the Asia-Pacific region, Australia, Eastern Europe, Latin America, Middle East and Turkey.

Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clinical & Experimental Allergy. 2011; Early View (doi: 10.1111/j.1365-2222.2011.03891.x).


Editor's comment: The authors reviewed the prevalence and triggers/factors associated with allergic rhinitis (AR) or allergic rhinoconjunctivitis (AR/C) in countries beyond western-Europe and North America. Their findings suggest that there is a greater diversity in prevalence of AR or AR/C in populations in these regions in contrast to USA and Europe. This review provides a comprehensive database of the important allergens and triggers which are likely to influence the prevalence and manifestations of AR in these diverse regions, where the prevalence of allergic rhinitis is increasing.

3. Recommendations on the use of skin prick tests in allergic rhinitis-conjunctivitis and asthma in daily practice.

Bousquet J, Heinzerling L, Bachert C, Papadopoulus NG, Bousquet PJ et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy 2011; Early View (doi: 10.1111/j.1398-9995.2011.02728.x).


Editor's comment: This pocket guide is the result of a consensus reached between members of the Global Allergy and Asthma European Network (GA2LEN) and Allergic Rhinitis and its Impact on Asthma (ARIA). The recommendations cover skin test methodology and interpretation, allergen extracts to be used, as well as indications in a variety of settings including pediatrics and developing countries.

4. Peptide immunotherapy (PIT) offers a potentially safer approach to allergen-specific immunotherapy.

Mackenzie KJ, Anderton SM, Schwarze J. Peptide immunotherapy for childhood allergy - addressing translational challenges. Clinical and Translational Allergy 2011; 1:13. (doi:10.1186/2045-7022-1-13)

Provisional Full Text, Open Access

Editor's comment: This very good review discusses the immunological mechanisms involved in Peptide Immunotherapy (PIT) and briefly discusses the results of PIT in adults. It also discusses challenges to the application of PIT in children.

5. Wheezing is associated with functional constipation in preschool children.

Kiefte-de Jong JC, Lebon A, Jaddoe VWV, Hofman A, de Jongste JC, Moll HA. Is there an association between wheezing and constipation in preschool children? Explanations from a longitudinal birth cohorte. BMJ Open 2011;2:e000237. doi:10.1136/bmjopen-2011-000237.

Full Text, Open Access

Editor's comment: The coexistence of functional constipation with wheezing in childhood is mainly explained by the child's exposure to infections and antibiotic use.

6. Mould or dampness exposure in early life is associated with the development of allergic disorders in children.

Tischer CG, Hohmann C, Thiering E et al. Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative. Allergy 2011; 66(12):1570-1579.


Editor's comment: Data from 31,742 children from eight ongoing European birth cohorts suggest that a moldy home environment in early life is associated with an increased risk of asthma in young children and allergic rhinitis symptoms in school-age children.

7. Tailored improvement of the housing of children with asthma.

Edwards RT, Neal RD, Linck P, Bruce N, Mullock L et al. Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial. British Journal of General Practice 2011; 61(592):e733-e741(9).


Editor's comment: This novel and pragmatic trial with integrated economic evaluation found that the installation of a ventilation system and central heating where necessary, in homes of children with moderate to severe asthma improves their parent reported respiratory quality of life, and is a cost-effective use of public resources.

8. Preschool-age children with nonallergic rhinitis present spontaneous remissions much frequently than those with allergic rhinitis.

Westman M, Stjärne P, Asarnoj A, Kull I, van Hage M, Wickman M, Toskala E. Natural course and comorbidities of allergic and nonallergic rhinitis in children. Journal of Allergy and Clinical Immunology 2011; online before print (10.1016/j.jaci.2011.09.036).


Editor's comment: The authors describe different prognoses for children with allergic and nonallergic rhinitis. Children with allergic rhinitis are more likely to have a persistent disease. Sensitization to inhaled allergens seems to precede symptoms of rhinitis.

9. Cellular and molecular mechanisms of oral tolerance induction to food and aeroallergens in human tonsils.

Palomares O, Rückert B, Jartti T, Kücüksezer UC, Puhakka T et al. Induction and maintenance of allergen-specific FOXP3+ Treg cells in human tonsils as potential first-line organs of oral tolerance. Journal of Allergy and Clinical Immunology 2011; published online ahead of print November 4, 2011 (doi: 10.1016/j.jaci.2011.09.031).


Editor's comment: The authors found an active role for Treg cells in allergen-specific T-cell unresponsiveness. T cells did not proliferate to common food and aeroallergens, but depletion of FOXP3+ Treg cells enabled the allergen-induced proliferation of tonsil T cells.

10. Effect of clarithromycin on IL-13-induced goblet cell hyperplasia and mucin hypersecretion in normal human bronchial epithelial (NHBE) cells.

Tanabe T, Kanoh S, Tsushima K et al. Clarithromycin Inhibits Interleukin-13-Induced Goblet Cell Hyperplasia in Human Airway Cells. American Journal of Respiratory Cell and Molecular Biology 2011; 45:1075-1083. Published online ahead of print June 3, 2011 (doi: 10.1165/2010-0327OC)


Editor's comment: The authors demonstrated that IL-13-induced goblet cell hyperplasia and mucus hypersecretion can be ameliorated using therapeutic concentrations of clarithromycin. This suggests a mechanism for macrolide immunomodulation in asthmatics and a potential therapeutic role for clarithromycin in persons who have asthma and mucus hypersecretion.

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