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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

December 2014

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. M-cell-targeting vaccination: an effective and safe strategy that efficiently induces mucosal SIgA responses.

Shima H, Watanabe T, Fukuda S, Fukuoka SI, Ohara O, and Ohno H. A novel mucosal vaccine targeting Peyer's patch M cells induces protective antigen-specific IgA responses. International Immunology 2014; 26(11): 619-625. (doi:10.1093/intimm/dxu061)

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Editor’s comment: In this paper, the authors demonstrate that the antigen-delivering fusion protein, anti-GP2-SA, is an effective mucosal vaccine. Anti-GP2-SA is a streptavidin (SA) fused to the antigen-binding fragment region from a mAb against the antigen-uptake receptor specifically expressed on M cells – glycoprotein 2 GP2.

2. The concept of intrinsic or nonallergic asthma.

Peters SP. Asthma Phenotypes: nonallergic (intrinsic) asthma. JACI: In Practice 2014; 2(6): 650-652. (doi:http://dx.doi.org/10.1016/j.jaip.2014.09.006)

Abstract

Editor’s comment: The author reviewed the immunopathologic features of nonallergic asthma compared with allergic asthma and found several differences including a higher expression of RANTES in mucosa and bronchoalveolar lavage fluid, as well as a higher GM-CSF receptor alpha expression. Despite an appreciation of this clinical entity for many years, many of its clinical implications remain unclear.

3. Development of novel strategies for treatment of chronic atopic cough.

Ogawa H, Fujimura M, Ohkura N, and Makimura K. Atopic cough and fungal allergy. Journal of Thoracic Disease 2014; 6(Suppl 7): 689-698. (doi:10.3978/j.issn.2072-1439.2014.09.25)

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Editor’s comment: The authors’ detection of environmental mushroom spores (that should not be present) in the human airways in addition to the good clinical response of patients with chronic atopic cough to antifungal drugs, highlight the consideration of this as a potential cause of idiopathic cough.

4. Hypersensitivity/allergic diseases have not been considered a top-level category in the International Classification of Diseases.

Kase Tanno L, Calderon MA, Goldberg BJ, Akdis CA, Papadopoulos NG, and Demoly P. Categorization of allergic disorders in the new World Health Organization International Classification of Diseases. Clinical and Translational Allergy 2014; 4(42). (doi:10.1186/2045-7022-4-42)

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Editor’s comment: The authors performed a careful comparison of ICD-10 and 11 beta phase codes to identify gaps, areas of regression in allergy coding, and possible solutions, in collaboration with committees in charge of the ICD-11 revision. Their results highlight the need for either a new chapter specific to Hypersensitivity / Allergic Disorders (as in SNOMED CT) or a high level structure in the Immunology chapter in order to make classification more appropriate and usable.

5. Revision of the 2006 clinical practice guideline, “Diagnosis and Management of Bronchiolitis”.

Ralston SL, Lieberthal AS, Meissner C, Alverson BK, Baley JE et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics 2014; 134(5): e1474-e1502. (doi:10.1542/peds.2014-2742)

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Editor’s comment: The goal of this guideline was to provide an updated, evidence-based approach to the diagnosis, management, and prevention of bronchiolitis in children from 1 month through 23 months of age.

6. Detecting relevant allergens in polysensitized patients to improve the selection of allergens for immunotherapy.

Vidal C, Enrique E, Gonzalo, Moreno C, and Tabar AI. Diagnosis and allergen immunotherapy treatment of polysensitized patients with respiratory allergy in Spain: an Allergists' Consensus. Clinical and Translational Allergy 2014; 4(36). (doi:10.1186/2045-7022-4-36)

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Editor’s comment: The present study was designed to help allergists identify relevant allergens in polysensitized patients and to improve the selection of antigens in allergen immunotherapy in Spain. The authors found that although serum specific IgE against allergen sources adds value to skin prick testing, the addition of molecular diagnosis, when possible, appears the most helpful.

7. Fractional exhaled nitric oxide (FeNO) levels added to traditional asthma assessment tools influences decision making in the care of patients with asthma.

LaForce C, Brooks E, Herje N, Dorinsky P, and Rickard K. Impact of exhaled nitric oxide measurements on treatment decisions in an asthma specialty clinic. Annals of Allergy, Asthma & Immunology 2014; 113(6): 619-623. (doi:dx.doi.org/10.1016/j.anai.2014.06.013)

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Editor’s comment:  The authors concluded that in a group of asthmatic subjects who underwent extensive evaluation, including physical examination, spirometry, and symptom assessment using the Asthma Control Test, the addition of FeNO measurement further aided in the appropriate classification of airway inflammation in 50% of subjects.  This in turn had important long-term asthma management implications – most notably the potential to lower the costs and morbidity associated with asthma exacerbations.

8. Involvement of the airways in the context of inflammatory bowel diseases (IBD).

Papanikolaou I, Kagouridis K, and Papiris SA. Patterns of airway involvement in inflammatory bowel diseases. World Journal of Gastrointestinal Pathophysiology 2014; 5(4): 560-569. (doi:10.4291/wjgp.v5.i4.560)

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Editor’s comment: This review focused on the involvement of the airways in patients with inflammatory bowel disease (IBD). The authors proposed a diagnostic algorithm for the evaluation of respiratory disease in IBD and summarized the pulmonary-intestinal interrelationships in inflammatory bowel diseases.

9. Use of probiotics in particular clinical situations.

Floch MH. Recommendations for probiotic use in humans—A 2014 update. Pharmaceuticals 2014; 7(10): 999- 1007. (doi:10.3390/ph7100999)

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Editor’s comment: This article is the newest iteration of recommendations for use of probiotics in humans. It serves as an update to the 2011 recommendations, examining the literature regarding probiotic use in childhood and adult diarrhea, antibiotic-associated diarrhea, necrotizing enterocolitis, inflammatory bowel disorders, irritable bowel syndrome, and radiation enteritis, as well as allergic disorders.

10. Development of information services to offer personalized pollen-induced symptoms forecasts.

Voukantsis D, Berger U, Tzima F, Karatzas K, Jaeger S, and Bergmann KC. Personalized symptoms forecasting for pollen-induced allergic rhinitis sufferers. International Journal of Biometeorology 2014. (doi:10.1007/s00484-014-0905-6)

Abstract

Editor’s comment: The authors provided an example of combining data from different sources using advanced data engineering, in order to develop innovative e-health services with the capacity to provide more direct and personalized information to allergic rhinitis sufferers.