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The JMA Quiz Series consist of a series of quiz, posted each month, in order to test the scientific knowledge along with other, EAACI-related information. 

The winners will be awarded with a Travel Grant for the 30th EAACI Congress which will take place in Turkey, 11-15 June 2011. 

Do not miss the opportunity and participate on the quiz now!
EAACI Focused Meetings provide you with the opportunity of in-depth understanding of specific topics and discussions within targeted medical communities.  The next EAACI Focused Meeting is Food Allergy and Anaphylaxis Meeting, FAAM 2011, which will take place in Venice, Italy, 17 - 19 February 2011. JMA's again have the opportunity to earn one of the 50 Travel Grants, worth of 300 Euros each, which have been allocated to EAACI Junior and Affiliate Junior Members who are presenting an abstract at this Meeting.  Thus, now is the opportunity to submit your abstract and earn a 300 euros Travel Grant. 

Click here for more information

Exciting symposia and poster prizes at the first EAACI ERAM-SERIN Congress in Brussels 

The EAACI JMA Working Group and the European Rhinologic Society Junior Board are organising two exciting symposia specifically for JMAs! These will take place during the next ERAM-SERIN Congress in Brussels, 4th to 6th November 2010. The symposia focus on the basic and clinical aspects of inflammatory diseases of the upper and lower airways.

JMAs enjoy the benefits of a reduced registration fee and the possibility of receiving travel grants. We will award prizes for the best posters in several categories on the final day of the congress. 

Looking forward to seeing you all in Brussels!

The JMA WG

EAACI JMA poster session winners:
  
Allergic immune response, Occupational and Hymenoptera allergy
Luliana Badiu

 

Asthma:  Epidemiology and Management
Smitha Nair
  
Asthma:  mechanisms
Melanie Albrecht
  
Clinical immunology and Urticaria/Angioedema
Zita Travnickova
  
Drug allergy:  Clinical aspects
Andreia Vasconcelos Pinela
  
Environment, allergens and allergy
Helen Brough
  
Food allergy & Laboratory tests for allergy
Vito Sabato
  
Food allergy:  Epidemiology and Mechanisms
Thomas Aldick
  
Immunity and sinonasal diseases
Stefanie Eyerich
  
Immunotherapies
Brinda Subbarayal
  
Miscellaneous
Paraskevi Maggina
  
Molecular allergology
Alina Neunkirchner
  
Peadiatrics
Kim van de Kant
  
Skin allergic diseases, Allergy prevention and Eosinophil/Mast cell disorders
Subhashree Mahapatra
  
  
EAACI JMA case report session winners:
  
Andreia Vasconcelos Pinela
  
David Spoerl
  
Diana Pérez

The Christmas Game for EAACI JMAs consists of a quiz type of questions about allergy, clinical immunology and EAACI-related issues, the answers of which can be traced either directly in the EAACI website, or in any of the Academy’s official publications, ie ALLERGY, PAI and the Newsletter, all accessible through the EAACI website as well.

The winners will be awarded with one copy of Middleton’s Allergy Principle and Practice 7th Edition or one copy of Rich’s Clinical Immunology Principle and Practice 3rd Edition.

The EAACI JMA Christmas Game 2009 Winners are:

Dr. Thatchai Kampitak – Thailand

Dr. Savino Sciascia - Italy

The British Society for Immunology (BSI) is launching Immunology in Action 2010 a competition to celebrate, through the beauty of images, the diversity of immunology.

To celebrate the Day of Immunology 2010, the BSI is running its first ever image competition, Immunology in Action, to explore the diversity of the subject in all its forms, and the impact it has on our lives.  The competition is open to all, from school children to patients to professors.  Images should explore an immunological theme: whether something found down the microscope; medicines and treatment; or field work or education.

However, this is not an exhaustive list.  Entries will be judged on their visual impact, originality and their ability to communicate immunology.  We encourage the use of imaginative and innovative means to communicate the impact of immunology.  Images will be judged by Tom Pringle (aka Dr Bunhead), Professor David Gray (University of Edinburgh, BSI) and Mark Henderson (The Times).  First prize is £1000 and there are a total of 12 prizes to be won. 

For more information about the competition please visit www.immunology.org/immunologyinaction2010
The QuizzTM Series are back, offering the chance to EAACI Juniors to win a Travel Grant to London 2010!

The JMA QuizzTM Series -initially launched in 2006 - consist of a new quiz, posted each month, in order to test the scientific knowledge along with other, EAACI-related information. Each quiz consists of 5 single or multiple-choice questions, the answers of which can be traced in the EAACI website, or in any one of the Academy’s publications, i.e. ALLERGY, PAI and the Newsletter, all accessible through the EAACI website (http://www.eaaci.net/).

The winners will awarded with a Travel Grant for the XXIX EAACI Congress that will take place in London, 05-09 June 2010.


The Winners of the 2010 QuizzTM Series are:

February 2010: Simona Lavinskiene
March 2010: Mauricio Flores Morales
April 2010: Sonja Bobic
May 2010: George Stavroulakis


Participation rules

1. Quizz™ Series is available to EAACI Junior members and Affiliates only, by using their EAACI username and password.

2. Each JMA will be permitted to participate 3 times per month.

3. Winners will be selected randomly among the ones who have answered correctly to all 5 questions of a given month’s Quizz™.

4. If the winner has been awarded another prize, award or travel grant for the same venue of the EAACI, the Quizz™ Series prize is automatically annuled and a second winner is randomly selected.
EAACI-JMA Activities

The Junior Members & Affiliates (JMAs) of the EAACI are a group of over 1100 clinicians and scientists under the age of 35 years.

During the last years, EAACI has developed specific activities and promotions to support and to increase the influence of the younger members:

• The JMA Membership fee is FREE and includes an on-line version of the EAACI official journal "Allergy" as well as the EAACI Newsletter

• Several EAACI Fellowships are every year awarded to JMAs to enable a period of scientific work in a foreignlaboratory. The fellowships ranges from 5000 to 20 000 € depending on the duration of the project.

• Every year educational summer/winter schools are arranged and numerous travel grants are provided to JMAs

• Educational symposia on specific topics are arranged by the EAACI Sections and travel grants are provided to JMAs

• Many travel grants are available for JMAs to attend the EAACI Annual Congresses and several JMA activities are arranged:

- a special JMA Poster Session, which is an informal session aimed to promote the work of JMAs and to facilitate contacts between EAACI members. Outstanding poster presentations are awarded poster prizes

- a JMA Forum which is a main session on a hot topic, chaired and organised by JMAs. - a JMA educational session were practical topics a ‘how to write a paper’, how to give a presentation’... are covered

- a JMA Case reports session were selected clinical cases are presented by JMAs. Outstanding case presentations are awarded case report prizes.

- 15 Practical courses which are co-chaired by one Senior EAACI member and one JMA and address practical themes of great interest to JMAs.

- a JMA Business Meeting where JMAs meet and discuss present and future

- a JMA corner where JMAs can meet each other and the JMA Committee

• JMA Committee was formed with a JMA Chair, who is a member of the Executive Committee, a JMA Webmaster and one JMA representative in each EAACI Section. All interested JMAs are welcome to work with the group and to apply for one of the posts when available.

• Collaboration between the JMAs and the EAACI official journal “Allergy” has resulted in the publication of “PhD thesis reviews”. as well as a review series based on the choices of JMAs. All JMAs are welcome with suggestions!

• A JMA Website is available to provide information and facilitate contacts with JMAs.

If you are under 35 years and interested in the field of Allergy and Clinical Immunology, please contact the EAACI Executive Office to become a member or visit our website, www.eaaci.net!

EAACI Executive Office, P.O. Box 24140, 104 51 Stockholm, Sweden
Tel: +46-8-459 66 23 Fax: +46-8-663 38 15

E-mail: executive.office@eaaci.org

Apply for the international fellow-in-training travel grant to attend the 2006 AAAAI Meeting held in Maiami, Florida.

The details and application for the International Fellow-in-Training Travel Grant is now available on line at AAAAI website/Members Section.

 

639

 

Details for the Annual Meeting itself is available at:

http://www.aaaai.org/members/annual_meeting/am2006/
Claude MOLINA* & Jacques GAYRAUD**

1. Pertussis and asthma
2. Anti-influenza vaccination of egg-allergic persons
3. Archive fungi (F) and occupational allergy
4. Exposition of asthmatic children to home fungal species
5. From rhinitis to asthma : the role of workplace humidity


1.  Pertussis and asthma

Theme: asthma, infection
Key words: asthma, pertussis, measles, anti-pertussis vaccination

The recent pertussis (P) outbreak in California, following that in Minnesota in 2004, despite vaccination, has induced C.R.Capilli of the Mayo Clinic (JACI 2012 129 4 957-963) to determine whether in a case-control population asthmatics (A) were more prone to contract P than non-asthmatics.

223 cases of P, identified in 2004 and 2005 by PCR (Polymerase Chain Reaction) on nasopharyngeal sampling on As, were studied but only 164 subjects were enrolled with 328 controls. 50% were male, 80% white, with a median age 14. 62 (38%) of them were suffering from A before contracting P as opposed to 85 (26%) of the 328 controls (OR 1.73  P=.013).

To sum up the statistical data of the study, it appears that within a population like the USA’s with a high prevalence of A, the risk for an asthmatic person of catching P is 17%.

This means that asthmatics constitute a ‘target’ group for anti-P vaccination, with boosters and recall every 10 years at least, even in adults, and associated with anti-tetanus and anti-diphtheria vaccination, as is the case in France with the traditional DTCOQ.

Another point of view : P seems to be, like measles (M), a risk factor for child asthma, as shown by a study conducted in the Australian island of Tasmania by J.A.Burgess et al. (Chest  March 2012 early view on-line) among 7-year old children. The authors recorded over a 37-year period from a school medical data base, cases of children’s respiratory infections and their possible association with incidental, persistent or established asthma, all supported by a statistical logistic regression analysis. They were able to conclude that, while most children’s infections protected them against the occurrence of adult A, as well as against chicken pox or rubella, P and M were, on the contrary, significantly associated with adolescent incidence of A for the latter and pre-adolescent incidence of the former. Another reason, according to the authors, for recommending vaccination against P and M to reduce the incidence of asthma.

2.  Anti-influenza vaccination of egg- allergic patients

Theme: allergy, vaccination
Key words: anti-flu vaccine, egg, ovalbumin

The administration to an egg-allergic person of the anti-influenza vaccine (AIV) coming from an egg-grown virus and ovalbumin-laden virus is considered with some reluctance by doctors and families, above all when the child or the adult has a history of serious anaphylaxis (An) caused by this allergen. Yet AIV is unquestionably beneficial for public health, is generally harmless, and egg allergies are rare.

Two researchers from Philadelphia, USA (I.Feung et J.M.Spergel JACI 2012 129 4 1157-1159) undertook a retrospective review of 56 An-suffering children monitored between 2007 and 2009, who received 119 vaccinations using the Sanofi-Pasteur AIV (H1N1 excepted). 113 first underwent vaccine prick-tests (SPTs); children under 3 years of age received a 0.25-ml dose, those over that age 0.50ml in 2 or 3 doses.

Two children had a vaccine reaction : one of them, aged 2, had 2 reactions, he had had a positive SPT before the 1st vaccination but was not affected the following year, while the other, aged 18 months, suffering from asthma and for whom the SPT was not considered useful, had a reaction which was both moderate and reversible by simple anti-histamines.

On the whole, the authors concluded that AIV was harmless for the egg-allergic who have suffered a more or less recent An episode (on average 2 years before AIV). Besides, at the same time, 520 egg-allergy sufferers, without A, had only limited local reactions.

The authors refer to a few cases found in publications, from which it appears that AIV can be administered without serious problems to the egg-allergic, including subjects having had an An reaction.

The ovalbumin content (O) incriminated does not seem to play a negative role, as high O dosage vaccines did not provoke an increase in the risk of A. The AIV used in this study had a median ovalbumin concentration higher than those of other brands of vaccine.

As to the preliminary SPTs, these present no great interest, and neither does dose fractioning in 2 or 3 injections.

Allergists may therefore reassure their patients and families as to the harmlessness of AIV: post-vaccination monitoring of a few minutes or hours is nevertheless a necessity.

3.  Archives, fungi (F) and occupational allergy

Theme: allergens, environment
Key words: fungi, archives, Penicillium Chrysogenum, Cladosporium sphaerospermum, Aspergillus versicolor

A French team of scientists from the Besancon University undertook an original survey on the possible contamination of the National Archives by fungi, trying to identify and quantify them through state-of-the-art techniques, to evaluate their concentration in the air and inside the documents, and finally to assess their effect on archivists’ and research assistants’ health, searching among other symptoms for allergic manifestations (S.Roussel et al Indoor Air 2012 22 2 early view). After an appeal on the National Archives website, the authors enrolled 10 volunteer centres for the survey.

2 techniques were used in the search for 50 or so F varieties: Air Impactor for the air, and Electrostatic Dust Collector for the archive zones.

2 methods were used and compared for F identification: culture-based analysis and quantitative PCR (Polymerase Chain Reaction). The criterion of 170 Colony Forming Units (CFU) per m3 was considered as potentially pathogen.

An inventory of symptoms suffered by subjects in contact with the archives was drawn up using a conventional self-report questionnaire distributed among the staff.

The results were as follows:

3 main F were isolated in terms of frequency and quantity : Penicillium Chrysogenum,  Cladosporium sphaerospermum and Aspergillus versicolor, with converging results for the two techniques (the PCRq also helped to isolate Stachybotris chartarum considered as a potent toxin generator). On the whole, archive contamination was found to be moderate. Median concentrations ranged between 30 and 465 CFU/m3, with 93% between low and medium : only 3% of the archives showed high concentrations.

As regards the question of health, subjects working in contaminated zones did not report more frequent allergy symptoms than their fellows. However, they did report headaches, eye and throat irritation, coughing and rhinorrhea. Only eye irritation was statistically significant.

These reassuring results corroborate observations made in rare similar studies conducted abroad, and which may concern a large number of subjects (over 1 million worldwide).

4.  Exposition of asthmatic children to home fungal species

Theme: asthma, environment
Key words: asthma, cladosporium, penicillium, aspergillus, basidiospores, epicoccum, pithomycea

Exposition to fungi (F) is known to play an important role in the development of asthma (A) and atopy, by increasing symptoms intensity and encouraging A exacerbation.

A group of American paediatricians from Kansas City focused on fungal species in the homes of asthmatic children, trying to identify them in a large number of Middle West homes, according to geographical location, seasons, and the presence of at least one asthmatic child (J.Meng et al Clin. Exp.Allergy 2012  21 March  accepted article).

Flats and houses enrolled in the study were part of a research project on home hygiene, which means that the more or less unsanitary ones were dropped and those with relatively comfortable conditions were given priority.

88 homes with one asthmatic child (aged 2-18) were then explored, particularly at the end of spring and in the autumn, when asthmatic and allergic subjects consult the doctor more frequently, and were compared to 85 control homes (with no asthmatic child), and during the influenza season depending on the frequency of paediatrician consultations.

The technique consisted in sampling fungal spores from the child’s bedroom and the living area, as well as in the outdoor environment, counting them per cubic metre of air, and cultivating them for CFU (Colony Forming Unit) identification and count.

Results reveal that 18 viable and potentially pathogenic species were isolated and 165 families out of 173 (97%) were host to at least one viable species.

Among them : Cladosporium in the first place, Penicillium, Aspergillus, Basidiospore, Epicoccum and  Pitomyces were identified more often and in higher concentration in homes with an asthmatic child than in control homes, even after adjustment for outdoor fungal spore concentration. The cultures confirm these observations after adjusting for seasonal factors. It is surprising to observe that Alternaria spores were not found more frequently in asthmatic homes than in controls. The responsibility of these fungi in the symptoms shown by the study asthmatics remains to be established through research already planned for the future (76% of them presented superior airway manifestations, 63% asthma-like symptoms, 43% skin signs). But we know that many of these F species are allergenic. This means that their detection followed by their elimination cannot but improve the treatment of asthma and benefit the asthmatic child.

5.  From rhinitis to asthma : the role of workplace humidity

Theme: asthma, environment
Key words: rhinitis, asthma, moulds, flooding, fungus index

It is well known that exposure to fungi in a damp environment increases the risk of allergic rhino-sinusitis, but there is little information on the progression of rhinitis towards asthma in an occupational context in a water-damaged building. American authors (J.H.Park et al Indoor air  avril 2012 early view) conducted 4 successive environmental and health surveys by questionnaires, in a 20-storey building in North East USA, built in 1985 and damaged by water flooding. Occupied in 1994, the building had been recognised as responsible for asthma cases and hypersensitivity pneumopathy among its occupants in the autumn of 2000, in relation with the inhalation of soil moulds. After several attempts to repair the damage in 2004, the authors monitored the evolution of 131 subjects between 2001 and 2007 initially suffering from rhinitis, compared to a control group of 361 other occupants.

Using logistic regression models they analysed the risk of asthma development among these two groups, adjusting for demographic data, possible smoking habits, duration of occupation of the premises and exposure to fungi, endotoxin and ergosterol expelled by fungal cell membranes.

The findings suggest that the rhino-sinusitis group were at least twice more likely to contract asthma than the control group (OR=2.2, CI95%=1.3-3.6). This risk was even higher when the rhino-sinusitis group was exposed to the building’s highest fungal concentration zones (OR=7.4, CI 2.8-19.9).

It is then possible to conclude with the authors that, in professional, water-damaged premises, the incidence of rhino-sinusitis among occupants may presage increased risk of asthma onset in the future.

An article in the same journal by a Japanese author (K.Abe  Indoor Air 2012 22 3 June 173-185 ) is therefore all the more interesting. It presents a fungus detector encapsulating as sensitizer either xerophilic fungus spores (Eurotium herbariorum or Aspergillus penicillioides) for use in not very damp premises, or hydrophilic fungus spores (Alternaria Alternata) in the case of extreme damp. This would mean that a fungus index could be set up, which would be of use to architects and owners of water-damaged business or residential premises, and in very different climates.


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Comments and questions welcome :

Pr. Claude Molina    and/or    Dr Jacques Gayraud
*claude.nelly.molina@orange.fr **j.gayraud@orange.fr
Claude MOLINA* & Jacques GAYRAUD**

1. Respiratory infection or allergy in infancy (or : Semiology rehabilitated by statistics)
2. Breastfeeding (BF) and allergy prevention – 1° : Epidemiologic data
3. Breastfeeding (BF) and allergy prevention – 2° :  Mechanisms
4. Nutrition and allergy : prebiotics and/or probiotics
5. Tuberculosis, BCG and allergy


1.    Respiratory infection or allergy in infancy (or : Semiology rehabilitated by statistics)

Theme: Asthma, infection
Key words: Asthma – Cough – Dyspnoea - Medoid

We know how difficult it is with coughing or breathless young children to differentiate between respiratory infection and allergy.

This is why a team of French researchers and paediatricians (Fanny Ranciere et al of the Health-Environment group : Isabelle. Momas : Ped.All. Immunol 2012 early view) undertook a very interesting and original study. They had previously monitored 2632 children of less than 1 year of age from a ‘Pollution and Asthma Risk’ cohort. Using the ‘medoid’ algorithm (Partitioning around medoids) which leads to a silhouette-graphed clustering, they had isolated 2 respiratory phenotypes : cough phenotype (CP) and dyspnoea phenotype (DP). They wanted to check whether these phenotypes were still valid at the age of 3, by following 2,084 children between 2003 and 2006 and clustering them according to symptoms, that is: sleep disturbing night cough, or dyspnoea. Purposefully, the term ‘wheezing’ was not used.

Parental questionnaires, family history of allergy, comorbidity, risk factors, domestic pollution, all the data analysed by multinomial logistic regression confirm the ‘medoid’ regrouping in 2 main profiles :
1)    CP : 14% of children, with dry night cough without dyspnoea, genetic factors of atopic predisposition, frequent allergic symptoms and presence of domestic allergens, as well as family problems such as parent separation or very ill mother.
2)    DP : 30% of subjects, with more severe symptoms, breathlessness disturbing sleep and daily life, day care centre attendance and infection risk factors, vulnerability to pathogens, domestic pollution (often chemical : tobacco, volatile organic components).

Thus, the 2 main symptoms of respiratory problems in 1- to 3-year old infants, i.e. cough and dyspnoea, when correctly analysed, help in discriminating between infection and allergy. Our Parisian colleagues should be thanked for having thus rehabilitated symptomatology, at a time of the apparent triumph of technology, and this, paradoxically, thanks to a cutting edge statistic tool.


2.    Breastfeeding (BF) and allergy prevention – 1° : Epidemiologic data

Theme: Atopy, atopy prevention
Key words: Breastfeeding – Asthma – Eczema - Infections

The role of breastfeeding in protection against allergic diseases is still arousing controversy : no less than 6 recent publications discuss it, mostly a confrontation between Europeans and Australians.

In ‘A tale of two cities’ (Brew et al: Ped.Allergy & lmmunol 2012 23 75-82), the authors confront the randomised data from 2 cohorts, one from Sidney (419 subjects) and the other from Stockholm (463), i.e. 882 subjects in whom the definitions for breastfeeding (at least for 3 months), asthma and allergy, were harmonized, and who were enrolled if they had at least one atopic or asthmatic parent and had a gestational age of more than 36 weeks.

After statistical analysis, it appeared that BF reduces the risk of asthma at the age of 4/5 and 8 years in children with family history of asthma. This effect is more marked in the Swedish than in the Australian cohort. It is also the opinion of some New Zealand authors (KM Silvers et al J. of Pediatrics 2012 January in press).

However a sceptical opinion can be found in a paper from Melbourne (Matheson et al : Clin & Exp. Allergy 2012 31 01 early view) which evokes an apparent protective effect of BF against asthma, but none against eczema or food allergy, nor any prevalence of sensitisation to airborne allergens. The authors believe that several confounders exist in the numerous epidemiologic studies, and wonder whether BF is not merely active in the prevention of infection, rather than actually reducing the risk of asthma. In the Australian cohort itself, BF may even act as risk factor for sensitisation to cow’s milk, eggs and peanuts at the age of 4/5 and, in both cohorts, at 8 years. Some authors had even suggested stopping it for under 1-year old children if some eczema or wheezing occurred, but the Melbourne authors found no evidence, in their joint study, that BF might have influenced any allergic manifestation.

On practical grounds, it is difficult for the clinician to adopt a dogmatic attitude in this matter, knowing however that in our Western countries it is recommended, depending on circumstances and environment, to breastfeed without exceeding 3 months.


3.    Breastfeeding (BF) and allergy prevention – 2° : Mechanisms

Theme: Atopy, atopy prevention
Key words: Maturation of innate immune responses – Cytokines – Polyunsaturated fatty acids

Epidemiologic data being not always convincing, BF supporters, including the WHO which recommends 3 to 6 months depending on the country, have tried to better define possible mechanisms.

Thus, a recent Anglo-Swiss study (C.M Dogaru et al. AJRCCM 2012 3 early view) of 1458 children, concludes that breast feeding has a favourable effect on the child’s future respiratory function by direct action on lung growth, particularly if the mother is asthmatic.

But a biology-focused Dutch group (M.G Belderbos et al : Ped.Allergy & Immunol 2012 2365-74), considering that the 1st month after birth is the most sensitive to environmental factors which can modulate the infant’s innate immune responses, undertook a prospective study of 291 healthy neonates (NN). They then statistically treated 6 exogenous factors (mode of delivery, BF, birth month, atopic siblings, passive smoking, pets), 7 types of total blood cells measured by flow cytometry (neutrophils, eosinophils, basophils, dentritic myeloid cells, monocytes, natural killers, T lymphocytes) and 9 types of cytokines induced by Toll-like receivers (TLRs 1 to 9) revealed by the ELISA technique.

On the whole, it can be said that BF was found to be the determining exogenous factor for neonatal immunity, with 5 associated parameters : the production of TLR7-induced IL10 cytokine which is 4 times lower than for a formula-fed NN, whereas the TLR3-induced cytokine IL12p70 is 2 to 3 times higher, a sign of fast immunity maturation. On the other hand, the reduction of this latter cytokine is associated to the caesarean mode of delivery and could express an asthma risk for the infant. So, it is the 1st month immunity maturation which appears to provide the protective effect of BF.

Let us also quote the Barcelona survey (Eva.Morales et al Clin.Exp.Allergy 2012 30 January) conducted by parental questionnaires, with 580 children submitted to predominant BF during the first 4 to 6 months and whose long-chain polyunsaturated fatty acids (LC-PUFA) were dosed in colostrum. With high levels, a reduction in risk of wheezing and atopic eczema in 7- to 14-month old children is observed, as well as a lower risk of gastroenteritis in the first 6 months. This may account for the possible role played by nutritional factors in the preventive effect of BF, which some authors also attribute to the presence of TGFβ in mother’s milk.


4.    Nutrition and allergy : prebiotics and/or probiotics

Theme: allergy prevention
Key words: Intestinal micro flora – Infection – Antibiotics – Fatty acids – Prebiotics - Probiotics

The significant role of Intestinal Microflora (IMF) in the modulation of immunity is well known, with any change in its composition likely to trigger inflammation or allergy. Such is the case of antibiotics which, administered to children of less than 1 year, lead to allergic sensitisation. The high frequency of urban as opposed to rural allergies is also often explained by the presence in the former of a more limited microbe range. Food or ingredients are also likely to affect IMF. This is the case for long-chain polyunsaturated fatty acids, but also for polyphenols and substances like prebiotics and probiotics, supposed to preserve or restore the microbial balance.

Prebiotics are carbohydrates, non-digestible by man, which, like inulin (produced by plants) or galacto-oligosaccharides, have a positive impact on IMF, by allowing the proliferation of bifido-bacterial type germs, the same germs that can be found in the breastfed baby. The International Association of Pre- and Probiotics has recorded more than 700 therapeutic trials with no formal conclusion, because the specific Prebiotic of a given microbial population is not known, neither the proper dosage.

As for Probiotics, which are living micro-organisms, these are under intensive research, both experimental and clinical, particularly in the food industry. One thinks particularly of yoghurts or other fermentation products, and of Lactobacillus (C.Wylliard  Nature 2011 479 S5-7). Many studies have been published of Lactobacillus casei administered to newborns in order to prevent eczema or asthma, or of Lactobacillus rhamnosus to infants or mothers before giving birth : more than 25 in 2008, randomised and often contradictory. In a recent Swiss paper (Wassenberg et al : Clin.Exp.Allergy 2011 4 565-573) the use of L.paracasei ST11 administered per os for one month in about 30 subjects, has shown some efficacy on the signs of pollen rhinitis. Other Japanese experiments were conducted successfully on mice with Clostridium (which has 46 different strains). But, on the whole and with the risk of playing the sorcerer’s apprentice, care must be taken in modifying or regulating IMF in order to combat or prevent allergic manifestations.


5.    Tuberculosis, BCG and allergy

Theme: allergy prevention
Key words: Tuberculosis – BCG (Bacille Calmette-Guerin) – Asthma - Eczema

An Anglo-Algerian epidemiologic retrospective randomised study, under the authority of the International Union against Tuberculosis and in the framework of the ISAAC study Phase 2 (C.Flohr et al Ped.Allergy & Immunol 2012 February early view), has attempted to discover whether previous tuberculosis (TB) or BCG vaccination in the first months of an infant could have a protective effect against the risk of allergy. 23,901 subjects, aged 8 to 12 and attending 20 different centres in developed and underdeveloped countries were the object of this study, conducted both by questionnaires and clinical examinations, concentrating on flexural eczema, and using skin prick tests. The odd ratios corresponding to a 95% confidence interval were calculated in the different centres according to the classical model. There were 245 TB cases and 66.3% of the children had received the BCG vaccine.

Findings showed that all allergic manifestations (asthma or wheezing, hay fever, signs of eczema) were significantly associated with TB the previous year. This was all the clearer for severe asthma and clinically established eczema. However, there is no association between TB and skin prick tests. As for BCG vaccination during the first year of life, it was in no way associated with subsequent allergic manifestation and does not seem to have a preventive effect against allergy.

All in all, this curious, positive association between TB and allergy does not, as the authors acknowledge, point to a causal relationship, but in view of the high number of subjects albeit in a cross-sectional study, it is possible to grant some value to this epidemiologic survey. It is above all interesting for those countries still struck by endemic tuberculosis.


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Comments and questions welcome :

Pr. Claude Molina    and/or    Dr Jacques Gayraud
*claude.nelly.molina@orange.fr **j.gayraud@orange.fr


Centre for Immune Regulation (CIR) is a research centre established as a Centre of Excellence by the Research Council of Norway at the University of Oslo and the Oslo University Hospital. CIR is also a FOCIS (Federation of Clinical Immunology Societies) Center of Excellence. Our scientific goal is to identify and investigate mechanisms of immune dysregulation that contribute to allergic and autoimmune disease to advance the development of therapeutics. CIR consists of five research groups and approximately 100 people. The research environment is very dynamic and there is extensive interaction between the groups. CIR has an educational program which includes seminar series and invited internationally renowned guest professors. For more information, see http://www.med.uio.no/cir/english/

For a term of four years, the duties of editor include:

• The Editor supervises all editorial content of the Journal. S/he serves to preserve the editorial integrity and substance of Clinical and Translational Allergy in cooperation with the Editorial Board and the Managing Editor.
• Appointing editorial board members.
• Soliciting for manuscripts and overseeing the review process.
• Establishing editorial guidelines for journal contributions.
• Reviewing article proofs.
• Working with Publisher to ensure timely publication of each manuscript
• Managing the electronic manuscript submission and review process.
• Promoting communication among the many individuals involved in the publication of the Journal.
• Proposing innovations in content, emphasis, and form.
The Paul-Ehrlich-Institut (PEI), Federal Institute for Vaccines and Biomedicines, is a world-renowned scientific institute devoted to
improving public health by ensuring the safety and efficacy of vaccines and biomedicines both in Germany and throughout the world.  PEI carries out its mission through scientific research and medicinal product regulation. Internationally competitive research is carried out in the fields of virology, microbiology, allergology, immunology, hematology and cell and gene therapy.

The following position is to be filled in the section "Clinical Allergology" within the division Allergology as soon as possible:

Medical Assessor (MD)
Closing date: 23 December 2011

The "Clinical Allergology" section is responsible for the assessment of pre-clinical and clinical data on test and therapy allergens resulting from
non-clinical studies and clinical trials. This also includes evaluation of national and European development programs.

Key responsibilities
Assessing pre-clinical and clinical data in clinical trial applications and in national and European marketing authorization applications for test or
therapeutic allergens in interdisciplinary project teams
Involvement in scientific and regulatory advice to manufacturers, pharmaceutical companies and sponsors of clinical trials on planning and
implementation of clinical development programs and clinical trials
Active participation in European regulatory procedures

Essential criteria for applying
Medically qualified and registered to practice within the European Community with the General Medical Council
With (or completing study towards) a relevant higher medical or scientific qualification
Excellent social, organisational and interpersonal skills and outstanding ability to work under pressure
Ability and readiness to work and communicate in interdisciplinary teams
IT skills appropriate for an information-based organisation and a fast-paced working environment (MS office applications, databases ...)
Good spoken and written communication skills in English (negotiation level)

The appointment will initially be for a limited period of five years.

The standard working week is currently 39 hours for employees in the public service of the Federal Republic of Germany; part-time employment
is also possible. The annual salary between € 45.000,00 and € 55.000,00 will be in accordance with German TVoD regulations (collective
bargaining agreement for employees in public service). If the provisions of German civil service code are fulfilled staff members may be granted
civil servant status.

Non-residents will be given assistance in finding accommodation. Relocation expenses and/or a special allowance for living away from your
present place of residence will be paid in compliance with the legal regulations. Disabled applicants shall be given preference if their skills and
qualifications are equivalent to those of non-disabled candidates. The Paul-Ehrlich-Institut is an equal opportunities employer and therefore
welcomes applications especially from women.

Please send your full application to:
Personnel Unit of the Paul-Ehrlich-Institut
Paul-Ehrlich-Strasse 51-59, 63225 Langen, Germany
www.pei.de

For further information contact:
E-Mail bewerbungen@pei.de
Phone +49 6103 77 1100
Please quote job reference 31/2011.


The European Academy of Allergy and Clinical Immunology is proud to have started its first open access journal in 2011 (Clinical & Translational Allergy: www.ctajournal.com). CTA is a peer reviewed scientific online-only journal publishing original work and reviews in any field of allergy.  After a successful startup stage, the Academy is now recruiting a new long-term Editor of the journal, with a four year term.  The journal has been online since February 2011, but was launched in June 2011. CTA is expected to be tracked by PubMed by the end of 2011, which is exceptionally quick for a newly launched scientific journal.

Description of Duties

The duties as editor of Clinical & Translational Allergy are:
The Editor supervises all editorial content of the Journal. S/he serves to preserve the editorial integrity and substance of Clinical & Translational Allergy in cooperation with the Editorial Board and the Managing Editor.
Appointing editorial board members.
Soliciting for manuscripts and overseeing the review process.
Establishing editorial guidelines for journal contributions.
Reviewing article proofs.
Working with Publisher to ensure timely publication of each manuscript
Managing the electronic manuscript submission and review process.
Promoting communication among the many individuals involved in the publication of the Journal.
Proposing innovations in content, emphasis, and form.
A limited honorarium is awarded an efficient editor at the end of each year, for the appreciation of the extra efforts made to maintain high quality and a rapid editorial process.

The Editor selection committee welcomes inquiries and applications for the position of Editor. Applicants should forward a letter of application and curriculum vitae by December 1st, 2011 to:
Michael Walker
EAACI Executive Director

Letters of application should include the following information:
1. A statement of interest in the position and unique contributions that could be made to the journal
2. Professional affiliations and CV including experience as an editor, editorial boards and reviewer
3. Publication list
4. Previous engagements with EAACI
EAACI Summit on Asthma Severity and Exacerbations
10 – 11 November 2011
Athens, Greece

The EAACI Asthma Section has identified that the critically important missing link in our asthma portfolio is in the area of severe asthma and asthma exacerbations. We will address this by developing an EAACI Statement on Asthma Exacerbations and Severity and by organising a summit linking together the endotype concept with severity and exacerbations, and will prepare and publish the report. Furthermore, it would be the perfect extension of the PRACTALL initiative on asthma endotypes.

The “EAACI Summit on Asthma Severity and Exacerbations” will take place 10 – 11 November 2011 in Athens, Greece (in the Grand Resort Lagonissi hotel - www.grandresort.gr). It will include 3 sessions on 4 main topics: asthma exacerbations; severe asthma; and early life predictors, genetics, epigenetics and management of severe asthma and asthma exacerbations. More than 20 invited experts will give their views on contentious topics. A number of key opinion leaders have confirmed their participation (please see the programme of the meeting).

25 Junior members will be invited to attend this summit and they will be awarded with travel grants to cover their expenses. The only criteria for the travel grant award will be the quality of the abstract presented (Abstract topics: severity, exacerbations, endotypes/phenotypes). Junior members will attend the round table discussions to witness the process of developing a consensus statement.



Abstract submission
will be open 1 - 30 September 2011.
Please click here to download abstract submission form.

This is the right time to mark the date in your calendar and work towards writing an abstract.

Please note that only invited speakers and 25 Asthma Section Junior members selected after abstract submission will attend this summit. There is no registration for this event – only invited participants.

We look forward to receiving your abstracts!
Yours sincerely,


Adnan Custovic                                                                        Cezmi Akdis
Organiser                                                                                 EAACI President
EAACI Asthma Section Chairperson
European Academy of Allergy Clinical Immunology is seeking new Executive Director

The European Academy of Allergy and Clinical Immunology, EAACI, is a non-profit association with more than 6’000 members with the aim :

to promote basic and clinical research in the field
collecting, assessing and disseminating scientific  information
functioning as a scientific reference body for other scientific, health
and political organizations
encouraging and providing training and continuous education
promoting good patient care in this important area of medicine.

Role of the Executive Director: Responsible for management and development of the EAACI Headquarters; responsible for the everyday business, and to provide administrative support for the EAACI Board of Officers and Executive Committee.

Desired Qualifications: University level education or equivalent professional degree, preferably in public health and administration. 10 years of experience in administration and management of alliances and/or associations. 

For further details, you may download the attachment (click here).
Dear members,

The Section and Interest Group elections are now open and will close on 1 April at midnight CET.  Click here to vote!c

For each Section or Interest Group, 7 positions are open for election and the procedure is the following:

1.    If the Chairperson and Secretary are eligible according to the EAACI bylaws (link) and willing to serve a second term, their slots are open for election without competition

2.    Current regular Board members who are eligible according to the EAACI bylaws (link) and willing to continue to serve compete for election by the constituency for 3 slots by the single transferable vote system (STV).

3.    Members nominated as candidates to become new Board members compete for election by the constituency for 2 slots, by simple majority vote, or STV, depending on the number or applications.

4.    In case the Chairperson, the Secretary or several current Board members are not eligible or willing to stand for re-election, their slots are open to competition for new members, as described above under paragraph 3.

5.    The Chairpersons and Secretaries of the Sections and Interest Groups will be elected by their respective Boards.

We will inform you in due time of the outcome of the elections.

We thank you in advance for your active participation in these elections.

With best regards

Nikos Papadopoulos
EAACI Secretary General



Juniors

The JMA Working Group (WG) is composed by young members (age<35 y.o.) representing Sections and Interest Groups, one Webmaster and one Chairperson.

This year part of the JMA working group will be renewed: Asthma, ENT and Pediatric sections' representative persons, and all Interest Groups' representative persons will be newly elected.

Moreover, the new Chairperson will be elected among previous working group members who applied for election.

Please give your preference for all JMA WG positions, choosing one of the candidates for each position.
Some positions have only one candidate; please give your support to the candidate voting for him/her even if he/she is the only candidate for that position: this will be interpreted as your support to him/her"

Best Regards,
The JMA Working Group










In 1911, Leonard Noon, followed closely by John Freeman, published the first reports on allergen immunotherapy in The Lancet. One century later, EAACI is celebrating this pioneering work in 2011.

EAACI is developing different initiatives, in order to highlight the importance of this initial work, which has rendered in the actual state of the art in allergen immunotherapy. EAACI’s key goal regarding the 100 year celebration in the immunotherapy field in 2011 is to achieve greater attention to immunotherapy, to reach out to more doctors and to get more patients treated appropriately.

One of the highlights of this campaign is to dedicate an EAACI Noon Award to a scientist/doctor/researcher who has made an outstanding contribution in the “Immunotherapy” field. This Award will be presented during the EAACI Congress 2011 in Istanbul.

If you are an EAACI Member and you would like to participate in nominating one candidate of choice, please send us your name, name of the person you care to nominate and the reason why you believe this candidate should receive the EAACI Noon Award (1 sentence) by latest Sunday, 20 February 2011 to cristina.achiaga@eaaci.net.
The international PhD and MD/PhD Program Inflammation and Immunity (IAI) announces new openings for graduate student positions awarded to the best candidates on a competitive basis.

Requirements:
•    Highly qualified applicants from all over the world are invited to apply provided that they are not older than 28 years. Age limit extensions are applicable for special private circumstances; please contact the coordinator for details.
•    All applicants should be fluent in written and spoken English (TOEFL certificate or others)
•    All applicants must hold a university degree latest by October 2010 and should fulfill the official admission criteria for PhD students at the MUW (see §2 of the Curriculum of the PhD-Studies). The university degree should qualify for the start of a PhD thesis in their home country and ideally should be equivalent to a European university diploma.
•    All applicants should have excellent academic track records and demonstrate strong enthusiasm and talent for research.

Application:
By September 15, 2010 (deadline) applicants should mail or email the completed application forms containing the following information to the IAI PhD Program office:

•    a detailed CV demonstrating competence and motivation for science
•    all undergraduate level certificates including university grades. Foreign documents must be sent as certified English translations
•    a summary of technical and scientific experiences
•    the synopsis of the diploma thesis
•    a list of publications and/or presentations at meetings
•    names and address of 2-3 referees who will separately have to send letters of recommendation and a completed questionnaire to the IAI PhD Program office (see details below)
•    indication of at least 2-3 preferred laboratories / projects within the IAI program (click here for details) and explanation for these choices. This statement of preference will be considered by the IAI faculty but is not regarded as a strict commitment by either side.

Only complete applications can be considered for the selection procedure.
Reapplications will not be considered.

Application forms can be downloaded directly from this website or are available from the IAI PhD Program office at:
IAI PhD Program
att Ms. Marianne Wang

Institute for Cancer Research
Medical University of Vienna
Borschkegasse 8a
A-1090 Vienna, Austria
Tel: +43-1-4277-65131
phd-iai@meduniwien.ac.at

Deadline:
Deadline for receipt of completed application and reference letters is September 15, 2010

Letter of recommendation:
Letters of recommendation are requested from at least two scientists who are familiar with the academic work of the candidate and who can judge their potential as a PhD student. Applicants must forward the enclosed questionnaire letter to the referees and ask them to send their letters of recommendation directly to the IAI PhD Program office at the above address in a closed envelope or by email.
Please note that we will be unable to process your application without letters of recommendation. These letters are therefore an essential part of the application, and it is the student’s responsibility to ensure that the referees write to us latest by September 15, 2010.

Selection procedure and admission:
Complete applications will be reviewed and ranked by a selection committee consisting of the IAI faculty. The short-listed candidates will receive invitations to visit our laboratories at the Medical University of Vienna for a 2-3 day period for interviews and information exchange. These interviews will take place in October 2010. Travel expenses will be reimbursed, and free accommodation will be provided. Offers of admission will be made to the successful candidates at the end of the interview period.

Benefits for students of the IAI PhD program:
Graduate students admitted to the IAI PhD program will have a regular employment with full social security coverage at the Medical University of Vienna and receive funding for at least 3 years according to the salary scheme of the Austrian Science Fund (FWF). Students will be assigned to a PhD thesis committee composed of the supervisor, one internal and one external advisor. Thesis research will be accompanied by an educational training program in the field of inflammation and immunity.
Additionally the PhD program will provide support for:

•    Travel expenses
•    Research stays abroad in collaborating international institutions / universities
•    Organization of special scientific workshops
•    Language courses
•    Special lectures on career awareness and soft skill trainings
•    Active involvement in teaching activities

Gender mainstreaming:
The IAI faculty aims at increasing the percentage of women in science. Qualified female students are therefore strongly encouraged to apply.


Download:
MUW Curriculum PhD Studies


33th EAACI Congress
Copenhagen, Denmark

549The European Commission has unveiled its plans for the Seventh Framework Programme (FP7), with a duration of seven years (2007 to 2013), a budget of 73 billion euro and a structure based on four specific programmes: Cooperation, Ideas, People and Capacities.

Within these four programmes, 'Cooperation' refers to collaborative transnational research activities; 'Ideas' covers basic research implemented through a European Research Council (ERC); 'People' includes Marie Curie actions and other initiatives; while 'Capacities' encompasses support to research infrastructures, regions of knowledge and small and medium sized enterprises (SMEs).

The proposals stress that collaborative research, under the Cooperation heading, 'will constitute the bulk and core of EU research funding'. Indeed, nearly 45 billion euro of the total 73 billion euro budget would be channelled towards this priority under the Commission's plans. As well as collaborative research, the Cooperation programme will cover Joint Technology Initiatives, coordination of national research programmes and international cooperation.

Nine thematic areas for collaborative research are specified:

health; food, agriculture and biotechnology; information and communication technologies (ICT); nanosciences, nanotechnologies, materials and new production technologies; energy; environment (including climate change); transport (including aeronautics); socio-economic sciences and the humanities;

and security and space research.

As with FP6, the largest of these thematic areas in budgetary terms is ICT, with a proposed allocation of 12.7 billion euro over seven years. Next comes health with nearly 8.4 billion euro, followed by nanosciences with just under 5 billion euro. The newly created security and space research priority is set to be the fifth largest, with a budget of 4 billion euro, while the other new thematic area, socio-economic sciences and the humanities, will be the smallest with a budget of 797 million euro.

As for the content of each priority, the proposals explain that at this stage the themes are broadly defined so that they can adapt to needs and opportunities as they arise during the lifetime of FP7. Under the ICT theme, for example, activities include the integration of technologies into personal environments and robotic systems, ICT for health, mobility and inclusion, and future and emerging technologies.

As expected, under the Ideas programme, the Commission foresees the funding of individual projects suggested by researchers on subjects of their choice. The programme will be implemented by an ERC independently of the rest of the Framework Programme, with a proposed budget over seven years of 12 billion euro.

Athens, Zurich,

The two major scientific organizations in the field of asthma, the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Allergy Asthma and Immunology (AAAAI) have reached consensus on optimal strategies to tackle asthma in childhood. The consensus text, acronymed PRACTALL, was published in the January issue of the journal Allergy1 and it is available from eaaci.net under Position Papers.

Asthma is the most common chronic disease in childhood with one every three children affected in many countries, and is still increasing. The PRACTALL publication provides practical recommendations to doctors that treat children with asthma, including ways for diagnosis, patient education, choice of medications and techniques for follow-up.

Professor Ulrich Wahn, Chairman of the writing committee and Head of the Department of Paediatric Pneumology and Immunology, at Charité-Humboldt University, Berlin, Germany said: “These new guidelines are the only up-to-date international guidelines that specifically focus on paediatric asthma. They should provide clinicians on both sides of the Atlantic with the tools to treat asthmatic children of all ages.”

A major breakthrough of PRACTALL is that it simplifies existing treatment algorithms, streamlining asthma therapy in 3 easy steps. It also points out differences between groups of patients, ‘phenotypes’, which may benefit from a different initial step.
Professor Nikos Papadopoulos, Vice-President of the EAACI and Head of the Allergy Department, 2nd Pediatric Clinic at the University of Athens, Greece, welcomed the publication of the PRACTALL document: “Guidelines for childhood asthma were a major unmet need. It is fortunate that a consensus of a wide panel of international experts was reached. We are now looking forward to the results of the implementation.”

The rapidly changing environment is probably behind the increased occurrence of asthma, which comes into the surface by simple everyday triggers, such as allergens, colds or exercise. At this time, the disease cannot be completely cured, although it may recede with time in many children. However, symptoms can be well-controlled permitting the young patient to enjoy a normal life.

The full paper is accesible through eaaci.net under Position Papers.

Click here to view/download the PRACTALL Consensus Report.

1. Bacharier LB, et al. Review article. Diagnosis and treatment of asthma in childhood – A PRACTALL consensus report. Allergy 2008; 2008: 63: 5–34.

1513

The new EAACI Executive Committee met for the first time in Amsterdam on Nov 23-25. In this meeting, brainstorming sessions on the future of EAACI were organized under the recently elected Vice-Presidents for Congresses (C. Akdis), Education (L. Delgado) and Communication (N. Papadopoulos). Important directions on the development of the Academy were analyzed; old and new members were satisfied and highly optimistic on the prospects of EAACI which is developing at rapid pace and major improvements envisioned.

The good spirits continued through the difficult task of setting the budget for 2008, confirming the pairing of strong science with healthy finances. Ex Com decisions will be followed-up by the Board of Officers in the next few months.

Most people tolerate aspirin very well. For others, however, aspirin and other non-steroidal anti-inflammatory drugs trigger allergy-like asthma, sinusitis or urticaria. Reactions can be as violent and life-threatening as asthma attacks and anaphylaxis. Hypersensitivity to aspirin has been observed since early 20th century. Today, it is one of the most common adverse reactions to a medicinal product. It is however largely under-diagnosed.

“We hope this position paper will enable physicians to proceed with diagnosis,” concludes Prof. Szczeklik, the main author of the paper. A long list of non-steroidal, anti-inflammatory drugs for common indications, such as headache, is contraindicated to hypersensitive patients. “A proper diagnosis will have a real benefit for them as they will be directed by their doctors to alternative medication that are completely safe to take, without any side-effect.”

According to a recent study, about 20% of asthmatic adults are hypersensitive to aspirin.

 

Click here to access the Publication!!

Individuals that suffer from allergy symptoms have increased possibilities to suffer from blood cancer sometime in the future. A link with allergy conditions and blood cancer has been recently detected, according to the findings of a study published in BMC Public Health last November. The study was carried out by the Karolinska Institutet, in Sweden and showed a high risk in people with hives to develop leukaemia in their adult life. The results also found an increased risk of non-Hodgkin's lymphoma among individuals who had eczema during childhood. However, the results do not apply to other allergic conditions as well, such as hay fever.

The research involved a sample of 16,539 twins that were followed for 31 years and recorded whether they were diagnosed with a blood cancer during that time. These individuals had all answered a questionnaire sent out by the Swedish Twin Registry in 1967, which included questions about allergies without being diagnosed for blood cancer.

According to the researchers, the problem lies in the chronic stimulation of the immune system caused by allergic conditions that leads to the formation of increased numbers of white blood cells and therefore increases the risk of cancer-causing mutations occurrence within the white-blood cell population. Despite the fact that these findings do not support the 'immune surveillance' hypothesis, they set an alarm to childhood eczema linkage with non-Hodging’s lymphoma sufferance in adults.

However, it is important to realise that the likelihood of any individual suffering from this condition is still remote. Non-Hodgkin's lymphoma only affects 0.03% of people in the USA.

Source: BioMed Central Limited

In the context of an open discussion regarding the Academy’s name and hosted by eaaci.net, we took the opportunity to record the views of our visitors:

60,2% of participants were JMAs, while their distribution among different specialties/research fields was: 69,9% Allergy, 1,9% Respiratory, 4,9% Pediatrics, 4,9% ENT, 1,9% Dermatology, 4,9% Immunology and 11,7% Other.

Moreover, the majority seems to adopt the Executive Committee’s proposal for changing “Allergology” to “Allergy” (56,7%) and including “Asthma” in the EAACI acronym (58,5%)

All proposals will be finally evaluated during the annual General Assembly, in Barcelona 2008.

1050The EAACI provides a European examination for Allergology and Clinical Immunology. It will take place for the first time at the EAACI meeting 2008 in Barcelona (June 7th). For more info see the EAACI homepage, where the relevant information will be provided and updated (www.eaaci.net/site/homepage.php). It will last about 90 minutes for ca. 80-100 MC-questions.

 

Scope of EAACI examination:

Following the initiative of UEMS to standardize the training curriculum of allergologists/clinical immunologists in Europe (Allergy 59:579-588, 2004), the EAACI examination aims to further improve the standards of our speciality by providing an European examination in Allergology and clinical Immunology. Such an examination could:

· help to harmonize the educational level of Allergology-Clinical Immunology through-out Europe,

· give an input for the standardization of the professional examinations for specialization in Allergology-Clinical Immunology among European national societies

· help small membership societies in the provision of a regular written examination at a constant high international level

· identify those colleagues able to fulfill the standards

 

The EAACI examination does not replace or substitute the currently existing national examinations that are regularly held by national societies. It is not a license to practice in a European country.


Admission to the examination:

The EAACI examination is open for members of the EAACI.

Mode of examination:
The examination will consist of a questionnaire with multiple-choice questions. It will comprise questions in Allergology (70%) and basic/ clinical Immunology (30%), all in English language. The questions will be carefully formulated and reviewed by an international board of experts in allergology and clinical immunology, together with a specialized, professional institution (institute for medical teaching, IML, Bern, www.iml.unibe.ch), which also supervises the evaluation of the examination.

The background of required knowledge will be based on the currently existing modern textbooks, preferably but not exclusively in English. Furthermore, a list of recent publications related to the possible questions will be provided (see homepage). The examination will not contain a practical part.

Costs of the examination*:
€ 250.- *reduction possible upon request
(if you are not a current EAACI member, you have to become one;). Click here to become a member of the EAACI.

Evaluation of the EAACI-examination:
The examination will be evaluated by the IML. Information about the achieved points will be provided within 4 weeks after the exam. A certificate will be provided if the examination was passed successfully.

Legal aspects:
The registration for the examination implies the acceptance that the result of the examination is ultimate and no legal debate of the final decision is possible.

Application
:
Time for application to the 1st EAACI examination in Barcelona (Saturday, June 7th, 2008, probably at 10.00) will be February 1st 2008 to April 15th, 2008

Click here to download the Application Form!!


Click here to download the Blueprint (a catalogue of topics to be learned for the exam)
Click here to download the List of Literature
Click here to download a Sample Question

If EAACI members would like to submit possible questions (multiple choice, 4 possible answers, with reference to a publication for the correct answer), they may do so by writing to the chairman of the task force werner.pichler@insel.ch

1679 1674

1678 1672

1676 1675

Sunday, 8 June 2008

JMA Poster session was held on Sunday evening at 19.00 until late, offering the chance to share ideas and discuss the results of latest research in allergy and clinical immunology. This exciting junior event attracted for discussions the most prominent scientists and aspiring young doctors and researchers from all over the world. 150 Posters were delivered with more upon request. The best posters were selected for poster prizes by a review committee of junior and senior scientists using a newly designed evaluation form.

16 Juniors were selected for the JMA Poster Prizes that will be awarded in a special ceremony on Tuesday, 10 June 2008, at the JMA Business Meeting, 17.30-19.00, Room 133/134.

1105Brussels, March 5, 2007

An extended survey revealing the potentially catastrophic impact of severe asthma on the lives of people across Europe has been published in the latest issue of leading scientific journal, Allergy.

According to the report, commissioned by The European Federation of Allergy and Airways Diseases Patients Associations (EFA), 90% of the 6 million people in Europe with severe asthma are not receiving optimum care, leading 1.5 million of them to live in “constant fear” that their next attack could be fatal.

The report, “The Limitations of Severe Asthma: the Results of a European Survey” exposes the devastating impact of the condition on the quality of life of patients and their families. Participants in the survey were asked what it means to live with the burden of severe asthma: results reveal that the symptoms of the condition not only limit patients’ lifestyles, with almost 70% unable to take part in physical activity, but also mean that one in five experience speechlimiting attacks at least once a week, leaving them unable to draw enough breath even to ask for help.

“The shocking irony of these findings is that severe asthma can be successfully managed if asthma guidelines are followed effectively. Yet, according to this study, most people with severe asthma in Europe are failing to receive adequate standards of care that reach recommended international GINA (Global Initiative for Asthma) treatment targets,” comments Professor Martyn Partridge, study author and Chair of Respiratory Medicine at the National Heart and Lung Institute.

The survey also indicates the fact that a great deal more needs to be done to ensure consistency in the standard of care. Asthma affects 30 million people across the continent and costs healthcare services approximately €17.7 billion a year– a cost which could be significantly reduced if access to effective patient centred care was a rule not a privilege across Europe. In Western Europe one person dies every hour as a result of severe asthma, but 90%of these deaths could be prevented with effective management of the disease.

10049 June 2008

Under the slogan “Clinical Features of Allergy: From Pediatrics to Geriatrics” the XXVII EAACI Congress is up and running in Barcelona, the capital of Catalonia, from 07-11 June 2008. According to the EAACI President, Pr Roy Gerth van Wijk, all EAACI annual meetings are scheduled to take place on the most relevant dates of the year when it comes to allergology in Europe. The Congress is addressed to all health care professionals who manage allergologies, either clinically or practically, aiming to share and exchange knowledge and experience of all the national societies as well as informing on the latest advances in the field of allergy and clinical immunology.

But why “from pediatrics to geriatrics”?
EAACI Congress President, Pr. Ignacio Ansotegui, explains that allergies affect people from the early stages of their life and continue until their late adult ages, inheriting a capacity to develop a specific allergic pathology, which is atopy.

More than 100 million people with allergies in Europe
The numbers are very impressive: over 100 million people only in Europe, suffer from an allergic disease, a number quite unthinkable some decades ago. The first causes of allergy were identified in 1873 and since then, allergic incidences have been recorded on a steadily increasing rate. A European study in 1926 showed that only 1% of the population was allergic when exposed to pollen, whereas in the mid 80s the percentage reached 10% resulting nowadays in 15-20% of the European citizens – mainly young people and adolescents - to be allergic to pollen. In an overview, the estimation numbers rise to 100 million of people in Europe, mostly children 25% - who are suffering from multiple allergic reactions and according to the scientists, the percentage will rise up to 50% until 2015.

The most prevalent allergic pathologies are respiratory diseases, rhinitis and asthma, however there is a global increase in all types of allergies. According to the experts, this rise means that allergic pathologies are becoming more and more important from a financial and healthcare perspective, as they lead the way to the general trend in the health market.

For more Press Releases, please go to the the official website http://www.eaaci2008.com/index.cfm.

1862The use of the biocide (DMF) dimethylfumarate that is mainly used in every day consumer products such as couches and shoes, is set to be banned across the EU.

On 30 January 2009, all Member States voted in favour of a draft European Commission Decision that will ensure that consumer products, such as leather furniture or footwear, containing the strongly sensitising (DMF) are not placed on the market in the EU. EU Consumer Affairs Commissioner Meglena Kuneva, said: "There can be no compromise on safety. I am pleased to see that that the RAPEX system has been functioning well to ensure dangerous goods containing DMF are quickly removed from the market. But we need to go further with urgent EU action to tackle the problem at source. An EU wide ban on the use of DMF in all consumer goods is designed to eliminate the serious health risks and in particular the severe allergic reactions suffered by some consumers when they are exposed to this chemical simply by using everyday leather goods."

The risk from DMF
Dimethylfumarate (DMF) is used by producers as a biocide to kill moulds that may cause furniture or shoe leather to deteriorate during storage and transportation in a humid climate. Placed in sachets, which are fixed inside the furniture or added to the footwear boxes, DMF evaporates and impregnates the leather, protecting it from moulds. However, it has been found to seriously affect consumers who were in contact with the products. DMF penetrated through the clothes onto the skin of many consumers1, where it caused painful dermatitis. The fact that in serious cases it is particularly difficult to treat adds to the damage. The presence of DMF is thus a serious risk.

The dangerous chemical initially raised concerns when notified by a number of Member State authorities through the EU rapid alert system for dangerous non-food consumer products (RAPEX).

The existing rules
DMF is already banned for use in the manufacture of goods in the EU, since biocidal products containing DMF are not authorised under the Biocides Directive (98/8/EC). However, manufacturers outside the EU may use these unauthorised biocides and then export their products to the EU. Today's Decision therefore protects EU consumers from the risk of DMF in imported products in the same way as they are protected at home.

Source: EU Press Release

1. Consumers in Britain, Finland, France, Poland and Sweden have suffered serious health problems ranging from itching, irritation, redness, burns and, in some cases, acute respiratory difficulty due to DMF.

1832On March 27, 2008, the USA Food & Drug Administration (FDA) announced that it was reviewing safety data through the "FDA Early Communication of an Ongoing Safety Review of Montelukast" that raised concerns about a possible association between the use of montelukast and behavior/mood changes, suicidality (suicidal thinking and behavior) and suicide. Right afterwards, FDA requested from manufacturers of products who are indicated for the treatment of asthma and/or allergic rhinitis, to act through the leukotriene pathway (montelukast, zafirlukast, zileuton) in order to submit adverse event data for suicidality adverse events as well as mood and behavioral-related adverse events from all available placebo-controlled clinical trials. According to FDA, the preliminary review was expected to take about 9 months. After that period, the conclusions and any resulting recommendations would be communicated to the public. FDA requested that Merck, Astra Zeneca, and Cornerstone Therapeutics use the Columbia Classification Algorithm of Suicide Assessment (C-CASA) to classify suicidal events.


Merck stands by the proven efficacy and safety of SINGULAIR, a medicine that has been prescribed to tens of millions of patients with asthma and allergic rhinitis for more than 10 years. Merck has submitted the information requested by the agency and is preparing to publish the data in a peer-reviewed medical journal. Merck agrees with the FDA's statement that the data from clinical trials do not suggest that SINGULAIR is associated with suicide or suicidal behavior, although these clinical trials were not designed specifically to examine neuropsychiatric events. In the suicidality analysis submitted to the FDA, which included 9,929 patients who received SINGULAIR and 7,780 patients who received placebo, there was one adjudicated event of suicidal ideation in one patient (an adult treated with SINGULAIR). There were no completed suicides, suicide attempts or preparatory acts toward suicidal behavior in the group who received SINGULAIR or the group who received placebo. In the behavior and mood change analysis, which included 11,673 patients who received SINGULAIR and 8,827 patients who received placebo, the incidence of patients with at least one behavior-related adverse experiences (BRAE) was 2.73 percent and 2.27 percent in the SINGULAIR and placebo groups, respectively (OR 1.12 (95 percent CI [0.93; 1.36])*.

 

The FDA is continuing to review these clinical trial data to assess other neuropsychiatric events, (mood and behavioral adverse events) related to drugs that act through the leukotriene pathway (montelukast, zafirlukast, zileuton). So far, FDA has not yet reached a definitive conclusion regarding the clinical trial data on mood and behavioral adverse events associated with montelukast, zafirlukast, and zileuton.

 

The FDA urges both healthcare professionals and patients to report side effects from the use of Singulair, Accolate, Zyflo, and Zyflo CR to the FDA's MedWatch Adverse Event Reporting program online at www.fda.gov/medwatch/report.htm.

 

For more information, please visit Merck Newsroom at http://www.merck.com/newsroom/

*Note: Odds ratio (OR) is a statistic to compare the rate of an event between two groups, and the confidence interval (CI) estimates whether those rates are similar or different. If 1.0 falls between the 95 CI values, there is 95 percent confidence that the rates seen in the two groups are not different.
58The 7th Framework Programme (2007-2013) is the new programme of the European Commission, set out to fund the research and technological development in Europe. The programme currently is under discussion with the European Parliament before being decided and adopted by the European Council. According to the Proposal for the new programme, the aims is to increase competitiveness for Europe and improve quality of life for its citizens, all under one “solid framework for research”.

The main parameters of the new programme are: Co-operation, Ideas, People and Capacities.

 

Co-operation: The Cooperation programme is designed to gain leadership in key scientific and technological areas by supporting cooperation between universities, industry, research centres and public authorities across the European Union as well as the rest of the world.

Ideas: The Ideas programme will establish a European Research Council, a pan-European mechanism to support truly creative scientists, engineers and scholars.

People: The People programme will strengthen the human resources available to science and research across Europe, both qualitatively and quantitatively. This can be achieved by stimulating people to pursue research careers, encouraging researchers to stay in Europe and attracting the “best brains” to Europe.

 

Capacities: The Capacities specific programme will enhance research and innovation capacity throughout Europe by the main element tools, such as new research infrastructure, support for small and medium-sized companies, developing ‘regions of knowledge’, unlocking research potential in convergence and outermost regions and improving the position of Science in Society.

 

In addition to the four key areas of action, the Commission has also adopted a complementary programme for setting out the future direction of its in-house research facilities, the DG Joint Research Centre (JRC). The main aim of the programme is the strengthening of the JRC’s ability to provide sound scientific and technical support to Commission services and Member States to allow them to develop appropriate responses to new challenges of crises, emergencies and major areas of policy development.


In due time, the European Commission will make a proposal relating to the Rules of participation in the various Specific Programmes.

 

Related web addresses:

FP7 Programme

http://europa.eu.int/comm/research/future/index_en.cfm

DG Research

http://europa.eu.int/comm/research/

DG Joint Research Centre

http://www.jrc.cec.eu.int


See also:

MEMO/05/335 and MEMO/05/336
Simplification in the 7th Framework Programme

1895A genetic defect discovered in mice could help scientists find out what is responsible for the large increase in allergic diseases noticed in recent years.

A group of researchers in Dundee, Ireland and Japan has agreed that the defect in mice leads to allergic inflammation, comparable to that seen in human eczema. They believe it confirms the importance of the filaggrin gene, which helps skin produce a protective barrier. The barrier stops allergens which lead to eczema and asthma entering the body. It also helps keep out the foreign bodies which can trigger hay fever and other allergies and prevents water loss from the skin.

Eczema can range from a slightly irritating patch of sore skin to more extreme cases where extensive areas may become inflamed and unbearably itchy. Children with the condition are more likely to subsequently develop other allergic conditions, in particular asthma, but also hay fever and others.

Previous work on the subject suggested that up to a half of cases of severe eczema in children were associated with genetic mutations in the filaggrin gene. The filaggrin gene defects are carried by more than 10% of the UK population.

Professor Irwin McLean, from Dundee University, said it was "amazing" to find a filaggrin gene defect in mice which was essentially identical to human mutations. "The filaggrin-deficient mice will allow us to identify key substances in the environment responsible for the huge increase in allergic disease. "These mice also represent a key to unlock new and improved therapies for eczema, asthma and allergies by targeting or supplementing the defective filaggrin gene.

Source: http://news.bbc.co.uk

1682Pr. Ignacio Ansotegui
President of the Local Organising Committee
XXVII EAACI Congress 2008

Chairman of EAACI Ethics Committee
Barcelona, Spain


Email:ignacio.ansotegui@belfasttrust.hscni.net

Venue: XXVII EAACI Congress, Barcelona, Spain
Date: Monday, 9 June 2008

The theme of the XXVII EAACI Congress is “Clinical Features of Allergy: From Pediatric to Geriatric”: Why did you choose this topic for this year’s congress?

Well, we had to consider allergy from different perspectives. Most allergy incidents start from infancy; however, we have met many cases where allergy occurs in late adult age, because people do not pay attention in early years and then, they pay the price for it. Our main aim was to approach this Congress from its clinical point of view, the life of allergic people from childhood to senescence, but at the same time, we need to understand the reasons why allergy occurs. We knew that the work that has been done on the basic part is one of a very high level and all these data have been also presented in this Congress.

 

What is your experience so far from this year’s Congress?

Well, Barcelona Congress is a very special case: it has got the largest programme whatsoever and as you are probably aware of, this congress has broken all records in all senses! 2000 abstracts, over 7600 delegates from 105 countries, 19 halls running simultaneously, 19 different activities that everybody will find what he wants, the biggest scientific programme ever. We also, took great care of the people that are new to the field of allergy and to the Academy by including Practical Courses. We also brought more opportunities for the Juniors, such as the new Case-Reports, JMA Poster Prize Awards and many more.

Actually, we tried to cover everything: if you look at the basic scientific programme, even in the Plenaries, you will see that we have separated the basic from the clinical aspects: And also the halls for basic aspects are all completely full. Because we have probably two kinds of people attending the congress: one is the clinicians who do not have many basic research facilities and the only work that they do everyday is seeing patients. Usually these people prefer to hear about new treatments, what to do, in general more practical issues. Then there is the second group, people that come from the lab or research, that usually do not see patients, they are most interested on why the allergy mechanisms work in certain ways, they are interested on expanding their knowledge, they are usually very focused and they prefer to listen to issues very focused, too. Finally, one of the secrets for the big success of this congress is that we published 95% of the final programme in the scientific preliminary programme; most of the programme was confirmed in advance, so people were able to decide early on to come to Barcelona.

 

According to hard facts, over 100 million people in Europe suffer from allergies, which indicates that allergy as a disease keeps rising on a steadily increasing rate: Do you think that people are aware of the problem’s magnitude?

No, definitely not. Probably the most prevalent allergy incidence is rhinitis, however people do not know that it is rhinitis. It is estimated that about 50% of the patients have rhinitis but they think that they just have a cold, so they do not go to the right place to face the problem. Allergy is a multifaceted problem that requires intervention from many different specialties. It is like an iceberg: one small external part that is visible and the biggest part is behind the water. Because if someone has rhinitis, or asthma he may also have urticaria or atopic dermatitis, and one of them may disappear, then come back…all these possibilities indicate the problem of allergy.

 

How, in your opinion, does the climate change affect chronic allergies?

Recent studies have shown that there could be a direct effect. It depends on where you are located. With the increase of approximately 2 degrees certain plants grow in places that did not use to or together with the contamination may induce earlier, longer and higher pollination rates. Furthermore, with the contamination, allergens become more aggressive.

 

In sum, what are the reasons in your opinion for the rapid allergy increase worldwide?

Allergy is definitely the non infectious epidemic of XXI century. The problem has not stopped but is still increasing, some of the reasons have already been mentioned: the contamination, the pollution, the global warming. We also have new allergens, we have plants, for example, that used to grow only in certain areas, like ragweed in the USA, but now are also growing in Europe causing problems. Other reasons may be that we live our lives with more stress, and more indoor activities, etc.

 

How do you see the future of allergy as a disease, and as a discipline?

Allergy is definitely a discipline and requires a systemic approach. Unfortunately some specialties are only focused on an organ without considering the global approach. Let me give you an example, ENTs: we have excellent ENTs, mainly regular attendees of EAACI meetings and congresses, with good knowledge and training on allergy but unfortunately not all ENTs have such interest on allergic processes. The latter look at the allergic rhinitis as a single problem without considering if the patient suffers also from asthma or if the patient suffered from atopic dermatitis at childhood. So allergy has to be considered as a systemic illness.

The prevalence of allergy is so high that together with the specialists we also need the participation of all resources at first care level. In order to have the same language in all health care levels the implementation of guidelines is very important. The EAACI is constantly working to disseminate the knowledge of Allergy, creating, promoting and implementing position papers and guidelines for a better diagnosis, management and treatment of allergic patients.

 

 

Irene Andriopoulou

Call for applications

1847

Pediatric Allergy and Immunology’ is an official journal of the European Academy of Allergy and Clinical Immunology (EAACI) and its Section on Pediatrics. The world’s leading journal in pediatric allergy, Pediatric Allergy and Immunology publishes original contributions and comprehensive reviews related to the understanding and treatment of immune deficiency and allergic inflammatory and infectious diseases in children. Please see http://www.wiley.com/bw/journal.asp?ref=0905-6157&site=1 for more.

EAACI and Wiley Blackwell are looking to appoint a new Editor-in-Chief who will work alongside the current Editor-in-Chief from October 2009 and then take over full editorial control in April 2010. The Editor-in-Chief will be appointed for four years in the first instance with the option of prolongation by mutual consent for another four years.

EAACI and Wiley Blackwell are aiming for a further development of Pediatric Allergy and Immunology as the world’s leading journal in pediatric allergy and seek an individual who will continue to encourage strong growth of the journal’s quality, reputation and scholarship. Interested applicants should have an understanding of the role the journal plays in the field and a vision for journal's future.

Candidates should submit a CV together with a letter of no more than two pages of A4 summarizing the following:

• Experience in editorial decision making
• Network and internationally recognized standing in the field
• Research experience
• Skills in editing and writing
• Plan for the management of the editorship and editorial office
• Other relevant experience and perceived strengths

Expressions of interest should reach the EAACI office by either mail or email, by no later than April 30, 2009.

Executive Office Sweden
c/o Executive Manager
C. OSTROM
P.O. Box 24140
S-104 51 STOCKHOLM
SWEDEN
Telephone: +46 8 459 66 23
Telefax: +46 8 663 38 15
Email: executive.office@eaaci.org

Questions should be directed to:
Nikolaos G. Papadopoulos, EAACI Vice President, Communication & Membership
Email: ngp@allergy.gr

Selected candidates will be invited for an interview on May 2009.

1770The Allergy and Asthma Symposium will be held in Bruges, Belgium from 28 to 29 May 2009, under the theme " Bridging Inate and Adaptive Immunity".

More information will be available shortly.

1747Adriano Mari
a.mari@panservice.it

Venue: XXVII EAACI Congress, Barcelona, Spain

The theme of this year’s Congress is “Clinical Features of Allergy: From Pediatric to Geriatric”: What do you think of the congress’ theme, from your experience so far?
I was very happy to hear that we are dealing with the two extremes of the human population. I am working in a centre where we receive information from a variety of ages, and we are using a diagnostic system for two years now that apply to anyone, it is efficient, regardless the age and condition of the patient. So, the theme of this year’s congress fits perfectly to our work.

So, allergy as a disease keeps rising on a steadily increasing rate: Do you think that people are well informed of the allergic disorders?
Yes and no. Yes, they know that the allergy problem exists, they are unaware however of the right approach to it. There are many ways, depending on the specialty and people keep receiving all kinds of information, different information. What they have to realize is that allergy is not a disease as much as a mechanism.

How, in your opinion, does the climate change affect chronical allergies?
I am not sure we can see in a very short time frame a connection between the climate change and the affection of chronical allergies. I would say that the chronicity is mostly linked to the allergic part of the story, it is linked to the continuous exposure to allergens, and everything else, like pollution, smoking, inflammation etc. But the basic thing we have to look into, is the new mechanisms of the disease, so whenever the mechanism stays there, the disease also stays there.

How do you see the future of allergy as a discipline?
What is disappointing is that we phase the largest population affected by a single disease. There is no other disease that is affecting 30% of the general population. At the same time we are the smallest group among the other specialties, so we need to be more active to support our approach. Generally speaking, I think I am positive because we are recently working hard on asthma, too. However, the sad fact is that we are also dealing with allergens, we seem to have forgotten that in time. For instance, if you go to infectivologists you will notice that they never forget that they have to deal with bacteria, viruses all the time. The starting point are the organisms that affect the patient. We have exactly the same relationship with the environment, but in the last 20 years we forgot that we deal with allergens, we forgot to increase our knowledge on that. The problem is that clinicians today are looking to molecular allergology mostly related to research, but as a doctor, I see that there are many applications that clinicians should change and should start working again under new frames, they should learn how to combine and start studying again, they should learn that the trigger is the allergic disease.

Regarding the EAACI annual Congress, which themes should be covered in the future by the EAACI Congresses?
I think that the program is really exhausting, all the topics are well covered, I do not think however that it is devoted to education. I would say that besides this large meeting there are other activities within the EAACI that are designed for that, such as the Allergy Schools focusing mainly on the young scientists.

One final question: Are there any current projects you are involved in with your specialty?

Many! In terms of the European funded projects, we are going to start the FAST project, a project dedicated to study the impact of molecule-based immunotherapy in food allergy. There are five clinical centres and many companies and research units also involved in that. What we do actually is that we explore immunotherapy for food allergy. This is the main project we have in our centre but we have also many more, smaller scale projects in defining molecular allergology as the proper tool for diagnosis.


 

 

Irene Andriopoulou
Wednesday, 11 June 2008

1714Apostolos Bossios
Dpt of Internal Medicine/Respiratory Medicine and Allergology,
Sahlgrenska Academy Göteborg University
Guldhedsgatan 10A SE-41345 Gothenburg Sweden
Tel: +46 31-3423336
Fax: +46 31-413290
e-mail: apostolos.bossios@gu.se

Venue: XXVII EAACI Congress, Barcelona, Spain

The theme of the XXVII EAACI Congress is “Clinical Features of Allergy: From Pediatric to Geriatric”: How do you approach this theme?
As you know probably, allergy is a potentially chronic disease, so it’s very important that allergic patients who have it from their birth to maintain a good medical attitude throughout their life. There are patients from all ages, from birth to teenagers, young and not so young… adults. Even more , if you consider that now elderly people are getting more and more I believe that this year’s theme is really an excellent choice, because we must learn how to properly treat these people from their infancy to their elderly life.

According to hard facts, over 100 million in Europe suffer from allergies, which indicates that allergy as a disease keeps rising on a steadily increasing rate: Do you think that people are well informed of the problem?

Not really, although as you said, it is a problem that keeps rising; I do not think people really understand what the problem is about. And here lies our task:

because at the end of the day, what you are doing research for? To help our patients. So it’s not enough just to talk about it in our meeting, but we have to circulate information, we must go out to the people, and actively involve them. So, I think that the new task that EAACI is taking, to make a public website is and inform a lot of people, it’s a excellent task and we must go for that.

 

Do you think that the climate changes affect chronical allergies?

That’s really a tough question to answer. I do not know really, of course there is a on going change in our climate, and in parallel allergies increase as well. We all as clinicians have experience a worsening in our patients status during “difficult” days in the cities and not only. We know for a fact that some aspects of the pollution, like ozon, are getting worse. So we think that there are elements from the climate that can have a direct effect on the allergy increase. However, it’s not easy to give a yes or no answer, I think. There are yet, more to learn there.

 

How do you see the future of allergy as disease, as discipline?

I am very optimistic about that. Despite the fact that more people are getting more and more allergic and allergies increase worldwide, more physicians and researchers are involved on their treatment. Colleagues that are becoming better educated and better prepared on how to deal with the problem. So especially as they deal with the problem from different views and scientific background make me very optimistic that in the near (?) future allergy will stop to be a so important health problem.

 

Have you got any other themes in mind for the future EAACI Congresses?
I think that the Local Organising Committee has done an excellent job, this is an excellent congress. Every time I have been to an EAACI Congress, since 2000in Lisboa, I must say that “this is better than the last one”. More people are attending, more basic science is involved, which is very important, more clinical research, so in all, it’s getting better and better. And I really have faith in them, I think that this is the way to go, to emerge more basic research with clinical science. I believe this the route we must follow.


Irene Andriopoulou
Monday, 9 June 2008

986 987 988

European public health experts are concerned because “allergic diseases” in all their different aspects – from hay fever to fatal attacks of asthma or reactions to peanuts – are not included in the health priorities of the EU research programme. While allergies are mentioned among the food research priorities, the absence of wider allergy problem as a top concern in health research agenda threatens to comprise overall progress in the understanding of this complex condition.

Paul van Cauwenberge, Coordinator of GA²LEN (Global Allergy and Asthma European Network), says that if the European Union does not make it a top concern in health research, researchers and practitioners may fail to contain the allergy epidemic. (1) “GA²LEN has helped to demonstrate the magnitude of this public health problem and begun to find the solutions,” says Prof. van Cauwenberge of the University of Ghent, Belgium. “But if allergic diseases are not included as a health priority in the next EU framework programme FP7 (2), we are much less likely to build the overall understanding we need to help control this epidemic through effective prevention and treatment.” (2)

More...
61EuroPREVALL, is an EU-funded, multidisciplinary, integrated project. It involves 15 European member-states, Bulgaria (a candidate country), Switzerland, Iceland, and Ghana. Of the 53 partners, there are 17 clinical organisations and 11 small-medium sized enterprises (SMEs).

EuroPREVALL aims to improve the quality of life for food allergic people, through extensive scientific research, integration of information and the development of tools for use by European food allergy scientists, health professionals, food and biotech industries and consumers – food allergic and non-food allergic.

 

Among the main targets of EuroPREVALL are:

  • Characterisation of the patterns and prevalence of food allergies across Europe in infants [birth cohort in 5 centres], children and adults [cross-sectional surveys in 10 centres]. These wider-population studies will be complemented by more detailed studies based on referrals to allergy clinics at 12 centres.
  • Use of samples and information from the surveys to identify risk factors (e.g. environmental, microbial or genetic) and novel predictive markers (e.g. biochemical and genetic) for food allergy, which will allow implementation of preventive measures (e.g. during pregnancy)
  • Development of serological methods based on purified food allergens (“component resolved diagnosis”), including conventional and novel formats – using post-genomics technologies – to improve the quality of food allergy diagnosis, reducing the need for food challenge tests
  • Investigation of how the food matrix affects allergenicity of foods, including food processing procedures, and development of new reference materials for food challenges, which are truly blind and based on real foods (e.g. confectionary).
  • Creation and application of instruments to determine the impact of food allergies on the quality of life and its economic cost for food allergic people and their families, workplace and employers, and healthcare.

Currently, EuroPREVALL is in negotiation with leading organisations in Canada, New Zealand and Australia in order to join the project. When this comes true, EuroPREVALL will constitute a world-wide effort for the benefit of food allergic people.

EuroPREVALL Website: www.europrevall.org

For further information, please contact:

Project Coordinator: Dr Clare Mills (ifr.europrevall@bbsrc.ac.uk)
Communications Manager for EuroPREVALL, Dr Siân Astley (sian.astley@bbsrc.ac.uk)
European Communications Manager at EuroPREVALL,
Institute of Food Research,
Norwich Research Park, Colney,
Norwich NR4 7UA (UK);
tel. + 44 (0)1603 255219;
fax. + 44 (0)1603 255168
1826After a week away from urban air pollution, children with mild persistent asthma begin to show dramatic changes in their respiratory health.

A study in the March issue of Pediatrics reports that just seven days after a group of school-age children left the city for a rural area, airway inflammation went down and lung function increased.

Previous studies have found that exposure to particulate matter from air pollution increases the use of asthma medicines and leads to more hospitalizations for asthma, according to background information in the current study. Other pollutants have been associated with a predisposition to respiratory infections, wheezing and a stronger reaction to inhaled allergens.

What had not been studied, according to the authors, was whether the negative response to air pollution is reversible. To try to answer that question, the researchers took 37 children who lived in an urban area in Italy and brought them to a rural hotel for a week of camp. All of the children had allergies and mild persistent asthma, though none were being treated at the time of the study.

Air pollution, pollen counts and meteorological conditions were monitored at both sites. The children underwent testing at both sites as well. The kids' tests included measures of allergic reactions - using nasal eosinophils, white blood cells linked to allergies - and lung function.

After a week in the rural environment, there was a fourfold decrease in nasal eosinophil levels and an increase in lung function, as measured by peak expiratory flow.

Source: Health Day, "Pediatrics" Journal, March 2009

1077The European Academy of Allergy and Clinical Immunology (EAACI) is the biggest European network of physicians and researchers interested in allergy, asthma and clinical immunology (www.eaaci.net).

EAACI is in the process of building up its headquarters in Zurich. For its media (website, newsletter, journals) and for its public campaigns it is looking for a young and technology savvy
Communication specialist (100%).

Candidates must :
- have a master in communication
- master the English language at mother tongue level
- have experience in the compilation of newsletters and as website editor
- enjoy working with new technologies.

The main tasks will be the following:

Website
• Get their contributions from the different editors
• Upload the contributions on the website
• Ensure the consistency of the website (up to date information; no wrong information, etc.)
• Relay with external technical consultant on matters pertaining to the website
• Write short texts (in English)
• If possible. design graphic elements (incl. flash contents)

Newsletter
• Get their contributions from the different editors
• Compile the contribution into a printable file

Journals
• Liaise with the editors

The successful candidate will also be involved in the preparation and implementation of EAACI’s annual public campaign (e.g. contact with journalists) , as well as in the design of the exhibitions EAACI shows in the framework of scientific conferences.

EAACI offers
• a challenging and varied activity in the framework of a small and highly motivated team
• good conditions of employment in a beautiful office in central Zurich

Are you interested? Then please mail your application to the following 2 addresses:
ngp@allergy.gr and brigitta.elbischger@eaaci.net by 30 April 2009, at the latest.

623JMA Chairperson

Luis Miguel Borrego

miguel.borrego@sapo.p

 

Venue: XXVII EAACI Congress, Barcelona, Spain

 

The theme of the XXVII EAACI Congress is “Clinical Features of Allergy: From Pediatric to Geriatric”: How do you approach this theme?

Allergies are becoming more prevalent nowadays and this is more common in pediatric patients, however there are a lot geriatric patients who are also allergic, for which allergy is an important problem for all ages.

 

According to hard facts, over 100 million in Europe suffer from allergies, which indicates that allergy as a disease keeps rising on a steadily increasing rate: Do you think that people are well informed of the problem?

In my opinion there has been a huge amount of work done by the EAACI, through the web, and in general, through all kinds of media, so people are becoming much more aware of allergy diseases.

 

Do you think that the climate changes affect chronical allergies?

It is recognized that pollution increases sensitization to allergens and severity of allergic diseases. Moreover, due to climate change, pollinic seasons became larger in the last years.

 

How do you see the future of allergy as disease, as discipline?

Allergy as a disease has been recognized during the last years as an important emerging problem. Therefore Allergy as a discipline will be for sure a very important and recognized discipline in the future.

 

Any themes in mind for the future EAACI Congresses?

Yes, I think it is very important to go with anti-immunity and allergy, primary immune diseases for example. It is very important also, to promote allergy in schools, because we know that there are a lot of children that suffer from allergy, and teachers have some difficulties to deal with children with allergy.

 

Thank you very much for your time and good luck with your busy program!

Irene Andriopoulou

The British Society for Allergy and Clinical Immunology (BSACI) published earlier in 2008 in the Journal "Clinical and Experimental Allergy", new guidelines on Rhinosinusitis and Polyposis.The publication is open access.

BSACI guidelines for the management of rhinosinusitis and nasal polyposis
GK Scadding; SR Durham; R Mirakian; NS Jones; AB Drake-Lee; D Ryan; TA Dixon; PAJ Huber and SM Nasser.
Link: http://www3.interscience.wiley.com/cgi-bin/fulltext/119410083/PDFSTART

Visit www.bsaci.org for more information.

1755The British Society for Allergy and Clinical Immunology (BSACI) published earlier in 2008 in the Journal "Clinical and Experimental Allergy", new guidelines on Chronic Rhinitis.The publication is open access.

BSACI guidelines for the management of allergic and non-allergic rhinitis
GK Scadding; SR Durham; R Mirakian; NS Jones; SC Leech; S Farooque; A Simpson; D Ryan; SM Walker; AT Clark; TA Dixon; SRA Jolles; N Siddique; P Cullinan; PH Howarth; SM Nasser.
Link: http://www3.interscience.wiley.com/cgi-bin/fulltext/119410075/PDFSTART

Visit www.bsaci.org for more information.

1724.MuraroM. Antonella Muraro

Department of Pediatrics

University of Padua

Via Giustiniani n 3

IT - 35128 PADOVA, Italy
E-mail: muraro@pediatria.unipd.it

Venue: XXVII EAACI Congress, Barcelona, Spain

 

The theme of the XXVII EAACI Congress is “Clinical Features of Allergy: From Pediatrics to Geriatrics”. What do you think are the steps that need to be followed in order to deal with allergy from pediatrics to geriatrics?

The main interest of this congress concerns the idea that an early diagnosis of allergy can prevent the development of chronic diseases. In addition, insights in basic research, as far as the induction of tolerance is concerned, have provided clues for the prevention of allergy sensitisation and of allergic diseases.

 

According to the statistics, over 100 million people in Europe suffer from allergies, which suggests that allergy is a disease which keeps rising at a steadily increasing rate: Do you think that people are well informed of the problem?

No, they aren’t. They are concerned, of course, especially those who have children who suffer from allergy, but they are not well informed, so they are eager to gather information on the latest scientific developments in allergy and learn more about the issue.

 

Do you think that climate change affects chronic allergies?

I do not think so, we can see that in some cases, substantial climate change can modify allergen characteristics or dissemination, for example, the way allergens are growing in some plants…. However, there is no evidence that the recent allergy epidemic is related to climate change.

 

How do you see the future of allergology as a discipline?

From a pediatric allergy perspective, I see the future of allergology as being extremely intriguing. We have an allergy epidemic, mainly in children. Therefore we need to tackle the symptoms in daily life and allergic emergencies in the community. There is a need to improve education concerning allergic diseases at the community level and to empower policies for those dealing with allergic patients and allergy on a global scale. This ultimately will achieve a proper acknowledgement of the role of the allergist in society.

 

Would you like to tell us about the current projects you are involved in?

Yes. The Section on Pediatrics is now working on some projects with the aim of achieving a uniform management of the allergic child across different categories of health professionals and across the different European countries. As an example, the project of implementing the recommendations of the Task Force on anaphylaxis in children encompasses working together with emergency physicians and primary care practitioners in several European countries. In tandem with this activity guidelines on the management of the allergic child at school are being prepared. This initiative has been developed jointly with GA2LEN and includes representatives from all the stakeholders and from the national countries. The aim is to raise awareness on this topic in order to encourage change of policies and to provide a safe environment for the food allergic and asthmatic child.

 

And one final question regarding the EAACI Congress: Have you got any themes in mind that should be covered in the future by the EAACI Congresses?

I would like to see a future congress addressing the need for a global approach to allergic diseases. In particular, with regards to the interaction between different specialists dealing with the allergic patient. Sometimes allergy is considered a “trivial” disease. Improvement of interaction among health professionals will increase awareness of severe allergic emergencies and a focus on patient’s actual clinical needs.

Irene Andriopoulou
Tuesday, 10 June 2008

“You can control your asthma”

World Allergy Day (WAD) is celebrated today, 8 July 2008, all around the globe. This event is an outgrowth of a project known as Prevention of allergies and allergic asthma, initiated jointly by WHO and WAO. The main aim of WAD initiative is to help increase worldwide awareness of allergy related problems and to disseminate well founded information about the prevention of allergies and the mitigation of their symptoms.

According to the president of the World Allergy Organization (WAO), Prof. Carlos E. Baena-Cagnani from Argentina, there are now approximately 300 million asthma patients, worldwide. In Germany only, up to 4.4 per cent of all adults and approximately three to seven per cent of all children and teenagers suffer from asthma, which is triggered by allergies in 85 per cent of all cases. Allergies are the epidemic of the 21st century, and we need to heighten worldwide awareness of these disorders,” stated also Prof. Baena-Cagnani. Chronic Allergic Respiratory diseases include allergic rhinitis, allergic rhinosinusitis, allergic asthma, allergic occupational asthma, allergic bronchopulmonary aspergillosis and other airway disorders caused by exposure to allergens.

Allergies are not a trivial disorder. Each year, over 180,000 people worldwide die from asthma. Hay fever gives rise to annual costs of approximately EUR16.5 billion worldwide, and in the US alone, the annual asthma bill runs to approximately EUR10.5 billion.

Within this context, continuous research and new therapies are urgently needed, as well as awareness raising on the epidemic of allergy, as the scope and real impact of allergic disorders are still underestimated and people are not fully aware of the problem.

Source: APP

1699Outdoor activity, such as fairs, picnics, festivals and other social gatherings can make spring and summer prime time for allergic reactions, warns the American Academy of Allergy, Asthma & Immunology (AAAAI).

According to an AAAAI member and associate director of the Division of Allergy & Immunology at Cincinnati Children's Hospital Medical Center, Dr. Amal H. Assa'ad, parents of children with peanut or tree-nut allergies need to be extra-cautious and constantly on the alert about the food served in fairs, festivals, picnics and other social events, as allergens may lie in wait, everywhere, hidden and mixed with all kinds of food. Forthis reason, it is suggested that an Epi-pen should be carried out at all times. People with nut allergies as well as people with allergies to cow's milk or eggs, for example, are of the most vulnerable to come up with an allergic reaction, since it is not possible to know just exactly what is in each delicacy offered.

Another danger zone is that of the restaurants - especially those serving Chinese food. The AAAAI points out that more and more restaurants are switching to peanut oil and soy oil because neither contains trans fats, but this, on the other hand, comprises a danger for people with peanut or soy allergies who may have reactions to these oils.

The most common symptoms of an allergic reaction to food are skin rash, vomiting, paleness, coughing and wheezing. However, first-time reactions usually don't occur out of the blue, since children typically have had other allergic symptoms such as eczema, in the past. The child may also have other food allergies that he is unaware of, or there may be other people in the family with food allergies.

The most important thing, according to the AAAAI representative, is the primary check for the suspected allergies by a board-certified allergist. "It is best that children or adults be evaluated and know for sure what they are allergic to and what they're not, so that they don't overreact if they really don't have an allergy to something and they don't underreact if they do."

Source: Reuters Health

102By Will Boggs, MD

The findings of a new study suggest that nasal allergies can cause chronic secretory otitis media, a condition involving persistent drainage of fluid from the ear that usually results from ear infections. Dr. Zdenek Pelikan, with the Allergy Research Foundation in Breda, the Netherlands, and associates investigated the possible role of nasal allergy in secretory otitis media in adults and determined if allergy testing in combination with ear examination can help diagnose the disorder.

 

Of 69 patients with secretory otitis media, 54 tested positive for possible nasal allergy, the researchers report in the Annals of Allergy, Asthma & Immunology. Most of the patients with a positive allergy test result had abnormal ear pressure when tested. Conversely, in a separate group of 42 patients who had nasal allergy, but not secretory otitis media, all of the ear pressures were normal. "Results of our study show that chronic secretory otitis media can also be caused by nasal allergy, at least in some cases, and it can occur also in adult patients," Pelikan concluded. "Diagnostic confirmation of this relationship may result in more (secretory otitis media) treatment focused on the nasal allergy."


Journal: Annals of Allergy, Asthma, and Immunology, November 2007

Source: NEW YORK (Reuters Health)

10957.5 billion euros is going to be the amount poured into the scientific research over the next six years as it was announced by The European Union on 02/28 in Berlin.

German Chancellor Angela Merkel said serious shortages of trained personnel loomed in areas such as energy and climate during the inaugural conference of the European Research Council and she added that EU needed an additional 700,000 researchers, with Germany lacking engineers in particular.
Merkel also pointed to Germany as an example of lagging performance in higher education.

The ERC, with its headquarters in Brussels, has been set up as a forum for experts to fund innovative projects across Europe.
Merkel said the goal set by EU heads of government to allot 3 per cent of gross domestic product (GDP) to research and development was "ambitious," but nevertheless correct.

The chancellor, whose country holds the rotating EU presidency, cautioned that it might not be possible to meet the targets on time. Germany currently spends 2.5 per cent of GDP on research and development.

Speaking to German television, ERC General Secretary Ernst-Ludwig Winnacker said many young scientists saw little future in Europe and left for the United States. He noted that at German universities only 4 per cent of professors were of foreign origin, whereas in Zurich the figure was 60 per cent.

1069Thomson Scientific Web Content Editors , following careful evaluation criteria and high selection standards, have identified EAACI as an important resource for researchers, scientists, and scholars. This honorary title puts eaaci.net in the front line of the most high-quality material publishing sites on the Web among a selection of scholarly web sites complementing the journal coverage in Current Contents Connect®, the Web of Science®, and other ISI Web of Knowledge applications.

ISI Web of Knowledge is a platform built on a foundation of quality that includes stringent and objective content selection standards, unmatched depth of backfiles, and true cited reference searching. The high-quality content available to researchers includes data from more than 22,000 journals, 23 million patents, 12,000 conference proceedings, 5,000 books, 2 million chemical structures, and 5,500 scholarly web sites.

The Web Content Editors use a process of manual searches and automated Web agents to retrieve potential sites. The Web Content Editors then review sites that have content relevant to the scholarly community.

Built upon a well-established selection process, the multidisciplinary Thomson Scientific database is the foundation of every ISI Web of KnowledgeSM resource. Editors selecting content for these resources rely on various indicators, including citation analysis, journal publishing standards, and the confirmation of the application of peer review. With these tools, Thomson Scientific can assess the scholarly merit of the journals being evaluated for coverage.

Because of the power and popularity of the Internet, Thomson Scientific made the decision several years ago to complement the extensive bibliographic information by developing a collection of scholarly Web sites – Current Web Contents (CWC). In order to accomplish that, the Web Content Editors in the Editorial Development Department identify Web sites and evaluate them by determining how the Web site adheres to a number of selection criteria. These criteria include authority, accuracy, currency, navigation and design, applicability and content, scope, audience level, and quality of writing.

50On June 15, the European Parliament voted in favour of several amendments that classify allergy among the major diseases, towards which research should be directed.

During the development of the EU’s 7th framework program for research, discussion and negotiations between stakeholders have been taking place for several months. Among them, EAACI has brought forth a strong position, highlighting the importance of allergic diseases and the need for addressing them by intensive research. These arguments proved convincing, leading to the positive vote. It is now up to the Council of Ministers, which will take place in the next few weeks, to confirm the Parliament’s vote.

 

{tab=Sep 2008}

September 2008
Claude MOLINA and Franz MARRACHE

  • Puberty and Bronchial Hyperreactivity in young asthmatic patient
  • Maternal Food during Pregnancy and Risk of Childhood Asthma
  • Wheeze , Atopy and Bronchial Pathology
  • Hypersensitivity to Chemotherapy: desensitisation technique
  • Arginine Metabolism and Asthma

Puberty and Bronchial Hyperreactivity in the young asthmatic patient
Although Asthma affects mainly males in early childhood, it is a disease primarily of girls in adolescence. Since bronchial hyper reactivity is an important component of Asthma throughout life, it is interesting to know how such reactivity evolves, particularly spanning puberty. A group of American physicians, within the framework of multicentre treatment programme for childhood asthma, attempted to analyse this factor in a longitudinal epidemiological study that included 1041 , 5-12 year old children with moderate asthma and followed for a period of 8.6 +/- 1.8 years. (K.G Tantisira et al. Airway Responsiveness in Mild to moderate Childhood asthma. Am. J. Respir. Crit. Care Med. 2008; 178: 325-331).

The authors performed methacholine provocation tests in these patients, at the beginning of study, and yearly at 1 and up to 8 years, and evaluated PC 20 (the lowest dose inducing a 20% decrease in FEV1). 7.748 methacholine tests were carried out in order to determine the influence of sex and age on bronchial reactivity. The results were analysed using multiple linear regression tests with adjustment for confounding variables.

The principal conclusions of this important study were :
1) PC20 increases with age (thus, bronchial reactivity decreases) more clearly in boys older than 11 years than in girls (p¡Ü 0.001)
2) Reactivity significantly increases in girls after puberty, independently of any potential confounding factors

Overall, bronchial reactivity was more severe in girls than in boys and persists after puberty . The authors suggest the role of hormonal factors (but without any hormonal study in support of their hypothesis).

This interesting work is also a long term prospective study covering puberty and whose conclusions may be useful for considering changes in asthma therapy and prevention in the adolescent.

Maternal Food diet during Pregnancy and Risk of childhood Asthma
It is known that maternal food consumption during pregnancy may affect the development of airways in the child and promote a Th2-type response to allergens during foetal life, with the risk of subsequent development of allergies or asthma during childhood.

A group of Dutch researchers has therefore carried out a longitudinal, questionnaire-based study assessing the influence of the consumption of certain foodstuffs during pregnancy on the eventual development of asthma in children followed up between 1 and 8 years of age (M. Willers et al. Maternal food consumption during pregnancy and the longitudinal development of childhood asthma. Am. J. Respir. Crit. Care Med. 2008; 178 : 124-131). 4146 pregnant women (1327 atopic and 2819 non atopic) were submitted to a questionnaire about the frequency of their consumption of 1 to 8 principal food categories, particularly during the last month of pregnancy : fruits, vegetables fish, eggs, milk, nuts (including peanut), and peanut butter (commonly used in northern countries and which was included within the nuts group, in this study).

2832 children were followed up and the obtained data were complete.
The authors did not find any significant association between maternal food consumption and asthma in children. Nevertheless, consumption of fresh fruits seemed to protect children against the risks of asthma or allergies (borderline statistical significance), whereas daily ingestion of nuts increased the risk of asthma in comparison with an intermittent consumption.

The limitations of this study derive from the difficulties in the statistical interpretation of the data as well as from the various confounding factors such as life style, socio-professional class and region or country concerned. Thus, the study does not allow professionals to advise a precise food diet for the pregnant woman, apart from a diversified diet avoiding regular ingestion of a single food, particularly nuts.

Wheezing, Atopy and Bronchial Pathology
Various studies have shown that, in the atopic child, wheezing tends to persist into the adulthood, occasionally becoming asthma, whereas they generally regress during adolescence in non-atopic children.

In order to assess whether bronchial histology is different in these 2 types of individuals, the Italian authors from the Universities of Padua and Modena performed bronchial biopsies in 38 wheezing children, who had repetitive multitrigger episodes of cough, dyspnoea and wheezing, apart cold periods (18 were non atopic and aged between de 2 and 10 years, 20 were atopic and aged between 2 and 15 years, and 17 were healthy controls between 2 and 14 years old. (G.Turato et al. Non atopic children with multi-trigger wheezing have airway pathology comparable to atopic asthma. Am. J. Respir. Crit. Care Med. 2008 ; 178 : 476-482).

All pathological and histochemical criteria were similar in the 2 groups of children. When compared to healthy controls, patients had a statistically significant thickening of the basal membrane (p=0.0001), with an increased loss of the epithelium (p= 0.03 and p = 0.002, respectively). In the mucosa, there was also an increase of respectively angiogenesis, number of eosinophils, and expression of IL-4, all criteria statistically significant (only borderline significant for IL-5).
As in adults, a tendency towards the presence of more severe symptoms with a clearer decrease in FEV1 was observed in non atopic patients.

Thus, histological and histochemical changes were identical in wheezing children responsive to bronchodilators, and whose symptoms persisted, whether the child was atopic or not. So, when suggestive symptoms such multitrigger wheezing occur in non atopic children, the pathology is typical of asthma.

Hypersensitivity to Chemotherapy : desensitisation technique
In the presence of a hypersensitivity reaction to a chemotherapy drug, the doctor
faces a cruel dilemma : either to risk an anaphylactic reaction upon reintroduction of the product or to stop the treatment and use a less efficacious or ill tolerated drug.

A Boston university team (M.C. Castells et al. Hypersensitivity reactions to chemotherapy. J. Allergy Clin. Immunol. 2008 ; 122 : 574-580 ) developed a rapid and standardised desensitisation protocol in order to obtain at least temporary tolerance to 7 different drugs : carboplatin, cisplatin, oxaliplatin, paclixatel, liposomal doxorubicin, doxorubicin and, which is original in this work, a monoclonal antibody: rituximab.

98 patients were thus treated using a rapid 12-step protocol, administered intravenously or peritoneally. The first injections were performed at an Intensive Care Unit and subsequent injections were given in an outpatient setting.
Safety and efficacy of the protocol were proven in all the cases.

In fact, out of 413 desensitisations performed, 94% were concluded without any side-effects or only with minimal reactions. There were no anaphylactic reactions or deaths and all the patients received the full target dose.
Reactions were more commonly reported during the final steps of the procedure.
Intravenous and peritoneal routes were equally effective.

Such a type of protocol had already been utilised for desensitisation to platin in some isolated cases as we had mentioned in our December 2004 Allergy Newsletter (www.egora.fr).

The interest of this study lies in the extension of this technique to a large number of patients and its application to several chemotherapy drugs including a monoclonal antibody.

Arginine metabolism and Asthma
As unique donor of a N ion in the synthesis of Nitric Oxyde (NO) as well as key participant in the urea cycle, Arginin (Arg) and its metabolites namely ornithin and citrullin are linked to cell respiration and inflammation.
Physicians involved in the Severe Asthma research programme of the NHLBI, USA, put forward the hypothesis that bioavailability of Arg might be associated to the inflammation and bronchial problems in asthma and also account for its severity.
Such bioavailability was therefore assessed by plasma Arg. dosage, relative to its metabolites and to NO synthase inhibitors and by the arginase activity in serum. This was performed in 258 patients : 232 asthmatic patients out of which 84 were severe and 148 who were moderate as well as 26 controls Simultaneously, were also studied lung function and inflammation parameters, including the fraction of expired NO (FE NO), but also IgE, skin prick tests to allergens, blood eosinophilia, and eventually broncho-alveolar lavage fluid. (A. Lara. Alterations of the Arginine metabolome in Asthma Am. J. Respir. Crit. Care Med. 2008; 178 : 673-681).

Results were the following
Asthmatic patients had higher levels of Arg. bioavailability than healthy controls, but also an increased catabolism of Arg as shown by serum arginase activity and elevated levels of FE NO.

Inflammation parameters were related to bronchial obstruction, in a paradoxical way, in patients with moderate asthma but not in severe cases. By contrast, Arg bioavailability was related to bronchial obstruction in severe asthma, but not in moderate cases. This means that bioavailability of Arg is not a surrogate measure for inflammation (in contrast with FE NO) but it is strongly associated ,like arginase activity, with airflow abnormalities in severe asthma, and particularly with bronchial remodelling.

These results are all the more important that Arginase inhibitors are studied as protection against allergen induced bronchospasm in a experimental model of asthma in the guinea pig (H. Maarsing. Am. J. Respir. Crit. Care Med. 2008 ; 178 565-573) thereby opening new therapeutic avenues.

Source: CEFCAP

You may send your comments to these short news to: cme.inallergy.online@wanadoo.fr

{tab=Oct 2008}

October 2008
Claude MOLINA and Franz MARRACHE

  • «Inflammometry» in the treatment of Asthma
  • Determining factors for pet ownership: their relationship with Asthma & Allergy
  • Allergists face to Primary Immune Deficiencies (PID)
  • Genetic approach to Primary Immune Deficiencies
  • Genetics, Asthma, and Passive Smoking

« Inflammometry » in the treatment of Asthma
Bronchial inflammation is, with more or less variable obstruction, one of the components of asthma. Its assessment entitled « Inflammometry » (I.D. Pavord et al. Lancet 2008; 372: 1017-1018) cannot be performed either clinically, apart from exacerbation periods, or by spirometry even when associated with multiple daily peak flow recordings. Thus, these authors tried to found eosinophils in spontaneous or induced sputum as well as to measure the fraction of nitric oxide (NO) in exhaled air (FE NO) which is currently facilitated by practical and cheap monitoring devices. Association of these 2 techniques allow ascertaining indication for therapy as well as appreciating the efficacy of anti-inflammatory treatment with corticoïds. Indeed, the authors acknowledge that induced sputum is a demanding technique and cannot always be easily performed in asthmatic patients whose expectoration is often scarce.
In addition, even if FE NO concentration (between 25 and 50 ppm) correlates well with the presence of eosinophils and justifies the indication for and maintenance of corticotherapy, its validity is far from being unanimous. Thus, S.J. Szefler et al (Management of Asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner city adolescents and young adults : a randomised controlled trial : Lancet 2008; 372: 1065-1072)think it does not bring any benefit and rather may induce an unwarranted increase of inhaled corticosteroid doses.
Similarly, de De Jongste et al (Daily telemonitoring of exhaled NO and symptoms in the treatment of childhood asthma. Am. J. Respir. Crit. Care Med. 17 October 2008) note that a sophisticated equipment do not have any advantage over the standard technique.

In conclusion in the treatment and monitoring of asthma, the assessment of airway inflammation is an interesting complement to clinical aspects and lung function testing. However, the former cannot replace the latter and vice-versa.

Determining factors for pet ownership : their relationship with Asthma and Allergy
It is known that the presence of a pet (cats and dogs, in particular) is regarded by some authors as a risk factor for asthma and allergy, whereas others assign them a protective role. Such divergence of opinion might be due to a wrong interpretation in epidemiologic studies which do not take into account all confounding factors.

This highlights the interest in this meta-analysis of factors determining ownership of a cat or a dog. This study involved the monitoring of 12 European cohorts from 7 different countries, each one including between 485 and 4089 allergic (rhinitis, eczema) or asthmatic children, in a total of 25056 families.
Questionnaires used included questions on previous history of allergies and Asthma in the children and their parents, parental educational level, the number of children in the family, access to residence (ground floor) the presence of one or many pets (E. Eller et al. Meta-analysis of determinants for pet ownership in 12 European birth cohorts on asthma and allergies: A GA²LEN initiative. Allergy 2008; 63: 1491-1498).

In this study, 14.9% of the families had at least one cat, and 12% at least one dog. A family history of allergy significantly decreased the opportunity of owning a cat (OR 0.91; CI 95% 0.85-0.99) or a dog (OR 0.90 ; 0.86-0.94).
A high level of parental education also decreased such opportunity, which was more evident for cats than for dogs.
Apart from this, the older the children are, the lower the chances are for a family to own a cat. That was not seen in the case of dogs.
Finally, the convenience of ground access is a factor which favours owning a pet, whereas the number of children is not associated with its presence.

Thus, socio-demographic factors such as family history of allergy, a high parental educational level, home ground access, must be taken into consideration in all european statistical study that may wish to analyse the influence of pets on allergy or asthma in children.

Allergists face to Primary Immune Deficiencies (PID)
PID include approximately150 identified diseases, 120 of which are due to genetic defects. They are relatively rare, and their diagnosis depends upon the sagacity of the doctor and the laboratory support in the area or region concerned.
This highlights the interest of the general review dedicated to « Common variable immunodeficiency » by English-speaking authors (M. A. Park et al. Lancet 2008: 372 ; 489-502) corresponding to Hypo- or Agammaglobulinemia or Humoral PID of the French litterature. It represents 65% of PID and is characterised by repetitive bouts of sinus and pulmonary infections, affecting the young adult, male or female, and in whom one detects a clear decrease of serum levels of at least two immunoglobulins: IgA , IgG or IgM.
The allergist or pulmonologist may therefore have to face these patients with upper (sinusitis) or lower (pneumonia) airway infections which mimic asthma or chronic bronchitis, and which are due to Hemophilus influenzae or Mycoplasma and may justify antibiotics in primary care .
However, the association with other symptoms may draws attention :
Auto-immune manifestations : thrombocytopenic purpura or haemolytic anemia, Pulmonary complications such as bronchectasis or granulomatosis resembling sarcoidosis, or Gastro-intestinal problems similar to Crohn’s disease or coeliac disease, or Non-hodgkin Lymphoma.

The diagnosis comprises 3 steps :
1st step : F.B.C. (Full blood count) and determination of serum Immunoglobulins, as well as search for proteins in the urine (to exclude a nephrotic syndrome)
2nd step : Determination of serum levels of IgG sub-classes (IgG1 to IgG 4), anti-diphteria and anti-tetanus antibodies and haemagglutinins as well as an antibody response to Streptococcus Pneumoniae type polysaccharide vaccination.
In fact, the absence of antibodies requires replacement treatment with intravenous or sub-cutaneous Immunoglobulins, as suggested by M.L. Moore and J.M. Quinn (Annals of Allergy 2008; 101: 114-121).
It is also relevant at this stage to quantify, by flow cytometry, B and T Lymphocytes as well as Natural Killer cells, whereas the study of B sub-populations will be part of the 3rd step.
3rd step : essentially genetic studies (which will be discussed next)

Genetic approach to Primary Immune Deficiencies
In the case of PID described beforehand, genetic studies are rarely indicated since corresponding mutations are rare and not always clinically relevant. In 15% of the cases, particularly when Agammaglobulinemia is associated with an absence or a very low percentage of B Lymphocytes, involved genes have been described : ICOS (Inducible T cell Costimulator) in 9 patients, TNF superfamily : 13 B in 17 patients and 13 C in one patient, and CD19 in 4 patients. As for the other PID, mainly seen in infants and children, their prognosis is often severe, and they present with different clinical phenotypes.
When a phagocytic deficit or a chronic septic granulomatosis are suspected, one should do a neutrophil count, study their chemotactic response and their phagocytic capacity using a Nitro-Blue Tetrazolium or a Dihydro-Rhodamine stain and flow cytometry for detection of expression of CD11/CD18 before studying the gene.
When one suspects that cell Immunity is affected, analysis should initially include a flow cytometry study of the percentage of T lymphocytes, and Natural Killer cell subpopulations as well as an in vivo and in vitro analysis of T cell function.

Several detailed tables of the most frequent PID and implicated genes are published in the paper by H.K. Lehman et al (The use of commercially available genetic tests in immunodeficiency disorders. Ann. Allergy Asthma Immunol. 2008; 212-218) and include the addresses of Laboratories specializing in the study of these diseases in the US.

Such genetic studies must be performed after having obtained a written informed consent from the patients and/or their families. They are carried out in the blood or in oral scrapings, particularly in severely leucopenic patients (in whom the amount of necessary DNA may be insufficient in the blood) or in the case where a bone marrow transfer must be performed (which may contain donor blood cells).

In France, it is mainly at Hôpital Necker, in Paris, that after the internationally acknowledged contribution by C. Nezelof, the remarkable work by Alain Fischer on SCID (Severe Combined Immune Deficiencies, which are most often X-linked and potentially lethal) has applied gene therapy which has proven to be very efficacious, thanks to the introduction of genes using retroviral vectors(Thérapie génique des Déficits immunitaires Sévères. A. Fischer et al. Bull.Acad. Nat. Med. 2005; 189: 779-788)

Genetics , Asthma, and Passive Smoking
In a study involving the human genome, a group of French researchers had shown the association between certain genetic variations in chromosome 17q21 and an increased risk of Asthma. In order to elucidate this association, a larger study was performed involving various clinical phenotypes of the disease (Effect of 17q21 variants and smoking exposure in early onset asthma. E. Bouzigon et al. N. Eng. J. Med. 2008 359 19 November 6 1985-1994 ).

The methodology involved testing for 36 SNP (single nucleotide polymorphism) in the 17q21 region in 1511 asthmatic patients from 372 families. The age at onset of asthma and early passive exposure to tobacco smoke (from parents) were also taken into consideration.

11 SNP were significantly associated with Asthma, of which 3 were very strongly and 4 were strongly associated with an early-onset asthma (4 years old or younger). By contrast, no association was observed with late-onset asthma.

Furthermore, a very strong association was seen between 6 SNP and early-onset asthma when the children had been early exposed, to passive smoking. A specific genetic variant (re8069176) was associated with a 3-fold higher risk of asthma than other genotypes.

Therefore this excellent study shows the joint effect of genetic (chromosome 17q21, in this case) and environmental factors (here tobacco-smoke) upon the pathophysiology of asthma, in the context of passive smoking by the young child.

Source: CEFCAP

You may send comments on these brief news to: cme.inallergy.online@wanadoo.fr

{tab=Nov 2008}

November 2008

Claude MOLINA and Franz MARRACHE

  • Therapeutic innovation in Asthma
  • The beekeeper : a model of immunologic tolerance
  • Is anti-fungal treatment useful in Severe Asthma with sensitisation to Fungi ?
  • Mediterranean diet: Protective role for Wheezing in pre-school children ?

Therapeutic innovations in Asthma

1) Improvement of usual treatments
This excellent and comprehensive review (I. M. Adcock et al. New targets for drug development in Asthma. Lancet 2008; 372: 1073-1087) starts by highlighting that 90% of Asthma cases respond favourably to conventional therapy based upon inhaled corticosteroids and â2-agonists. Thus, the remainder consists of 5 to 10% of cases of severe Asthma, which are responsible for 50% of the costs associated with the disease and for which novel targets and new therapeutic approaches have to be developed. Monoclonal antibodies (mAb) have entered the therapeutic arsenal, with the anti-IgE Omalizumab which is successfully used in the severe allergic forms of asthma. However, research must understand the cellular and molecular mechanisms of these severe forms of Asthma, thereby suggesting the possibility of several different phenotypes of the disease.

The authors analyse the development of the ultra long acting â2-agonist, which may act rapidly, their effects lasting longer than 24h (carmoterol, indacaterol) and may be only taken once-a-day. Another approach is the attempt to avoid the side- effects of corticosteroids via the use of a pro-drug.
These ways include:
a) using the pro-drug which is only activated in the airways (ciclesonide)
b) dissociating corticosteroids from their different effects by modifying the activation of their receptor (transrepression)
c) by addition of a biochemical NO-donor group , which has been experimentally efficient
d) through utilisation of novel inhalers which deliver mono-dispersed particles with sparing effect, and equivalent efficacy.

One may also mention the anti-lipid mediator drugs such as anti-leucotrienes (Montelukast, Zileuton), not very effective but may eventually be tested in « neutrophilic » cases of Asthma since they inhibit neutrophil chemotaxis. Likewise,anti-prostaglandin PGD2 or anti-PAF drugs, are still at an experimental stage or at phase II of clinical trials. In any case, it is known that the inhibitory action upon a single mediator or receptor has little chances of being effective.

2) Therapeutic innovation in Asthma
The novel targets :
These are chemokines and their receptors, Th2-derived cytokines, transcription factors, enzymes and several immune cells. Chemokines are responsible for the recruitment of inflammatory cells into the airways. There are 4 families classified according to their cysteine radicals. Several receptors exist and one of them, CCR3 which recruits eosinophils is a preferential target .Their levels are increased in Asthma and inhibitory anti-sense oligonucleotides have already shown their efficacy in inhibiting eosinophil inflammation and bronchial hyperreactivity ( it is the case of TPI ASM8 from Topigen analysed in our February 2008 BUA).
However, other chemokines (CCL17, CCL22, CXCL8) may be important and their respective inhibitors are at an experimental stage or in phase II clinical trials.
Th2-derived cytokines have a role in chronic inflammation and airway modelling. If anti-IL-5 mAb have not been shown to be effective, blocking IL-4 and its á–subunit and IL-13 by Pitakinra (already mentioned in our BUA) has been shown to be an interesting approach, whereas anti-IL-13 as well as anti-IL-10 and anti-IL-12 mAb are currently being studied. Curiously, TNF-á has been shown to be a pro-inflammatory cytokine but its blockage was not associated with any clinical improvement of Asthma.
The authors also mention Suplatast tosilate which may inhibit IL-4 and IL-5 and has been slightly effective in a small clinical trial of moderate asthma.
Among the other targets
- phosphodiesterase inhibitors such as roflumilast and cilomilast, active by oral route, have side effects ,similar to those of theophylin, with nausea and vomiting;
- kinase inhibitors such as p38 MAPK, active by inhalation;
- transcription factors such as NFêB or IKK2 inhibitors useful in insensitive to corticosteroids asthma
- other nuclear factors such as PPAR (Peroxisome proliferator activated receptor) which, in association with corticosteroids may have an important anti-inflammatory role. Finally, the development of Immunotherapy targeting regulatory T cells (Treg) and Th17 cells, in combination with D3 vitamin and corticosteroids deserves to be mentioned.
This vast number of studies on biological or synthetic drugs, can be explained by the complexity of asthma mechanisms, but we must remind that targeting only one mediator, or receptor or enzyme is ineffective and meanwhile the development of distinct handprints of different subtypes of the disease, combination of therapies is clearly mandatory.

The beekeeper : a model of immunological tolerance
In an editorial in the Journal of Experimental Medicine (Published online November 10, 2008) Nicole Lebrasseur, quoting work from F. Meiler, observed with humour that better than a murine experimental model, the beekeeper fulfils an old Immunologist’s dream, by revealing that such an intrepid honey lover, kicks into action a group of T Lymphocytes which pass successively from an aggressive mode to a suppressive mode and vice-versa, just like Dr Jekyll and Mr Hyde.
In fact, due to the nature of their work, non allergic beekeepers receive when they collect honey, repetitive injections of high doses of bee venom antigens (a mean of 13 bee stings during the first week of the season is usual). In this 7 day period, the beekeepers develop tolerance which is associated with an inhibition of T cell responses, both in the skin (absence of late phase reaction) and in the blood (suppression of venom antigen-specific proliferation).

In fact, T cells which happily proliferate, in response to antigen, relax once the season starts and, instead of secreting Interferon-ã and IL 4 , by cytokine switch, start synthesising high levels of IL-10, which dampens immune reactions. These IL-10-producing regulatory T cells (Tr1) decrease the antigen-induced proliferation of other T cells in vitro. This T cell regulation continues as long as antigen exposure persists and return to in initial levels within 2 to 3 months after the season.

Such cytokine switch may require Histamine-related pathways; in fact, just like most allergens, bee venom sets off a release of histamine by mast cells and in vitro T cell studies show that the production of IL-10 and cell lethargy require the intervention of Histamine type 2 receptor (TGF-â does not seem to play an essential role in skin tolerance, in contrast with its action in mucosal tolerance).
It should be noted that such tolerance disappears at the end of the season, indicating a relatively transitory suppression of T cell activity. Afterwards, this cycle is repeated during the following season which allows one to reassure the beekeepers, if need be.

As far as bee venom-allergic individuals (who are generally deficient in IL-10) are concerned, there is no place for great enthusiasm about this finding since it shows that the success of allergen-specific immunotherapy entails a long and persevering maintenance of therapy.

Is Anti-fungal treatment useful in Severe Asthma with sensitisation to Fungi?
This is the question asked by the English authors from the University of Manchester as they analysed, in a randomised study, the response of asthmatic patients sensitised to one or various fungi, to Itraconazole (Randomized Controlled trial of Oral Antifungal treatment for severe asthma with fungal sensitization. D.W. Denning et al. Am.J.Resp.Crit.Care Med 2008, October 23).
58 subjets with severe asthma, treated with inhaled or oral corticosteroids (41% had already been hospitalised in the previous year) and having positive skin tests and/or specific IgE to one or various fungi: Penicillium, Candida, Cladosporium, Botrytis, Trychphyton, Alternaria, and Aspergillus (with the exception of subjets having precipitins against the latter) were recruited at 4 different hospitals. All the subjects had total serum IgE levels lower than 1000UI/ml.
Patients were treated either with Itraconazole orally (200mg/day) or with Placebo for 32 weeks and were subsequently followed for 16 weeks.
A standardised questionnaire with 32 items on Quality of Life of the asthmatic patient, followed by lung function testing, calculation of a rhinitis score and determination of total serum IgE levels were performed. Results were as follows:
At 32nd week, there was a significant improvement of the Quality of Life in nearly 2/3 of the cases (60%), when compared with the Placebo group. In fact, complete data were obtained from 41 subjects who have followed the treatment until the end of the study.
The Rhinitis score also improved, whereas it deteriorated in the Placebo group.
The levels of total serum IgE decreased significantly, dropping from 187 to 136 UI/ml, whereas they increased in the Placebo group, from 245 to 275 UI/ml.
Changes in lung function were modest: only morning peak expiratory flow significantly improved.
Overall, there were only a few cases of exacerbation of asthma (similar in both groups) which required an increase in the doses of corticosteroids or hospitalisation.
There were no severe side effects, but 7 subjects (5 of which were in the anti-fungal group) had to discontinue treatment.
The authors put forward some hypotheses to explain the favourable action of antifungal therapy (which progressively disappears after suspension of the latter): action on the eventual colonisation of airways by the fungi, synergy with corticosteroids, or direct stimulation of the immune system.

Mediterranean diet : Protective factor for Wheezing in pre-school children?
The Mediterranean diet (MD) is regarded in adults as protector for atherosclerosis and its cardio-vascular consequences. It is based upon increased ingestion of fruits and vegetables (anti-oxydants), n3- (fish oils) or n-6 (vegetable oil) polyunsaturated fatty acids, and a moderate ingestion of milk, meat, and avoidance of fast-food : hamburgers, fried foods, industrial cakes, pizzas…

A group of Spanish doctors had already shown that MD was a protective factor for allergy and asthma in children aged between 6 to 7 years (L. Garcia-Marcos et al. Thorax 2007; 62 : 503-508) and that, in contrast, obesity was a risk factor, particularly in girls. The same group (A. Castro-Rodriguez et al. J. Pediatrics 2008 ; 823-828) extended their epidemiological study to young children from 3 cities in the Southeast of Spain. They hand out questionnaires to the parents of 1784 children (mean age of 4 years), in searching children wheezing (asthma equivalent) in the previous year. The authors set up a score for MD according to the intake frequency of pro- and anti-MD foods.
A potent multivariate and logistic regression statistical analysis also incorporating family history of these children showed that, ingestion of Paracetamol, eczema, rhino-conjunctivitis and paternal asthma were significant risk factors for wheezing in children. In contrast, MD and the child’s older age were protective factors.

The authors acknowledge the difficulties in interpretation of these food questionnaires and cannot give advice on the amounts of such food necessary to ensure a protective effect. Therefore, they can only suggest a balance favouring pro-MD foods and pointing towards avoidance of risk foods.

Source: CEFCAP

You may send your comments to these short news to: cme.inallergy.online@wanadoo.fr

{tab=Jun 2008}

June 2008
Claude MOLINA and Franz MARRACHE

• Recent data on Peanut Allergy
• Multiple sensitisation to Pollens : its interpretation
• Persistence of Di-isocyanate-induced asthma
• Angioedema due to angiotensin -converting -enzyme inhibitors
• Bakers’ asthma: an alternative to challenge tests

Recent data on Peanut Allergy
A comprehensive review on this topic reminds us that it is a major health problem in developed countries (A. Wensley Burks. Peanut Allergy Lancet 2008; 371: 1538-1546). It is important to point out : the increasing frequency of this type of allergy, particularly among under 3 years of age children, the characteristic symptoms (cutaneous, respiratory, gastro-intestinal, anaphylactic) that may arise within a few seconds to 2 h after ingestion of some mg of protein (let us remember that a single grain is equivalent to 300mg) or, among older patients after a simple skin or mucosal contact (the famous fatal kiss: Wuhtrich 1997); the treatment of anaphylactic shock, the prevention by correct labelling of food products (12 allergens of the European Directive 2003) are also mentioned.
Nevertheless the quality of life of these allergic patients and their families is severely impaired by the permanent anguish of a possible anaphylactic reaction.
Among recent data, let us stress the identification and cloning of various allergens (Arachis hypogea) : 8 are known : Ara h 1 and 2: the major allergens which are storage glycoproteins, Arah 5 is a profilin, Arah 8 belongs to the PR10 family. However, whereas in the case of aeroallergens IgE binding is conformational, it is linear for epitopes on Arah 1, 2 and 3 allergens, which might explain the severity of clinical signs. The diagnosis is most often made on the basis of clinical history, skin prick tests and specific IgE (CAP-RAST) whose levels must be higher than 14 kU/l. In doubtful cases, it is possible to perform skin prick tests with recombinant allergens . Only rarely is it necessary to perform double blind, placebo controlled peanut challenges.
The recent development of transgenic plants that produce hypoallergenic peanuts or the introduction of anti-sense RNA copies of the allergen or even the degradation of post-translational messenger RNA should be highlighted (one can question whether it is still a peanut after all these manipulations).
Indeed there is not yet a preventive treatment having proven its efficacy and tolerance in humans. Trials that are currently ongoing with recombinant allergens and eventually sub-lingual immunotherapy may be promising (as has been done with hazelnuts). However the author thinks that we will have a valid treatment within 5 years.

Multiple sensitisation to Pollens : its interpretation
Allergist has frequently to face this situation, often asks how to interpret skin and biological tests and wonders about their pertinence. J.F. Fontaine (Reims) has attempted to answer to the problem, by studying the molecular basis of cross-reactions among pollens as well as between pollens and foodstuffs, showing the contribution of recombinant allergens. (Les recombinants des panallergènes polliniques; application à l’interprétation des polysensibilisations Rev.Fr.d’Allergol. et Immunol.Clin 2007 47 129-132) A multiple sensitisation may include an allergy to grass pollens (Phleo p1 or p5) in association to a cross-sensitisation to other vegetals (birch, for example). Allergy to birch is either symptomatic, eventually associated with an oral syndrome (due to the allergen Bet v1) or asymptomatic (due to Bet v2). The author therefore suggests that, in cases which are difficult to interpret, one should resort, besides the classical RAST tests, to the CAP-RAST technique (Pharmacia®) using recombinant allergens of the profilin family (rBet v2 or rPhleo p12) or of the polcalcin family : calcium-binding allergens (rBet v4 or Phl p7).

Thus, for example, the presence, in an individual who is allergic to grass pollens, of specific IgE to rBet v2- or rPhl p 12- IgE without sensitisation to rBet v1 means that a positive skin test to birch is in fact, a reaction to profilins . A hypersensitivity to grass, tree and weed pollens corresponds to a sensitisation to polcalcines (rPhl p7).
Another example is related to the presence, in individuals with pollinoses.
of Bet v2-specific IgE frequently responsible for pauci-symptomatic or biological sensitisations to various foodstuffs These different molecular families of allergens that are called “ pan-allergens”, and the corresponding vegetables and foodstuffs, are detailed in a well documented table which completes this interesting article.

Persistence of Di-isocyanate-induced asthma
The Finnish Institute for Occupational Diseases has analysed the outcome of 17 patients with diisocyanate (DIs)-induced asthma after cessation of exposure and administration of inhaled corticosteroids (P.L. Piirilä et al (Inflammation and functional outcome in diisocyanate-induced asthma after cessation of exposure. Allergy 2008: 63: 583-591.
Exposure to DIs had stopped, on average, 7 months before the beginning of the study, and all reexposure was excluded after diagnosis. A challenge test with DIs was carried out and was followed, 48h afterwards, by a check-up including: spirometry, bronchial challenge test with histamine, bronchial fibroscopy with biopsy, and bronchoalveolar lavage. It was followed by the prescription of budesonide ®, 1600 ìg/day, given again after 6 months and 2-3 years.
Fifteen healthy subjects made up the control group. At the end of the study there was a decrease or vanishing of bronchial hyper reactivity (BHR) in many patients, except 5 individuals.
Spirometry showed a progressive and significant reduction of forced vital capacity (FVC), and a nearly significant decrease in forced expiratory volume /second (FEV1), without any changes in total lung capacity (TLC).
These changes were independant of smoking habits of the patients.
In terms of histochemistry, the most important aspect was the return to normal of the numbers of lung mast cells and an increase in the number of macrophages. In addition, there was an increase in the levels of interleukin-6, interleukin-15 and TNF-á, whose source are macrophages, in patients with BHR.

Overall, this study showed that there was a decrease in Th2-type inflammation and an association between BHR and inflammation, linked to the production of pro-inflammatory cytokines mainly derived from macrophages.
This study allows us to understand that Dis-induced asthma, even upon cessation de l’exposition, may become perennial. Furthermore, it also demonstrates the absence of efficacy of inhaled corticosteroids, which underlines the need for therapeutically targeting the macrophage and its cytokines.

Angioedema due to angiotensin converting enzyme inhibitors
A retrospective, multicentre study involving 5 hospitals in US recorded the cases of Angioedema hospitalised in an Emergency Department following ingestion of drugs with cardiac and anti-hypertensive properties such as the angiotensin converting enzyme inhibitors (ACEI).
Between 2003 and 2005, 220 patients were thus identified and demographic and etiological data from each patient were analysed namely in statistical terms (Multicenter study of patients with angiotensin-converting enzyme inhibitor-induced angioedema who present to the emergency department. A. Banerji et al ; Ann. Allergy Asthma Immunol 2008; 100: 327-332).
Thirty percent of the cases of Angioedema diagnosed in these 5 centres were caused by ingestion of ACEI (95% CI : 26-34%).
The mean age of these mostly hypertensive patients was 60 years. There was a slight predominance of female patients; the prevalence of atopy was lower than in the general population (11% had asthma, 6% had food allergies, 4% had rhinitis, 1% has atopic dermatitis).
The most frequent clinical symptoms were : dyspnoea and swelling of lip, tongue and larynx.
Most patients had been treated with corticosteroids and anti-histamines ; 58% of them were discharged upon hospitalisation, but 11% had to be monitored in a specialised setting and 12% had to be admitted to an Intensive Care Unit, where intubation and ventilation was needed in 10 individuals . There was no death.

The involved drugs were Lisinopril® in 60% of cases, Enalapril ® in 12% of cases, and Benazepril® in 6% of cases . The patients had been on that medication for 6 months, on average (1 to 18 months). For most patients, that was the first episode of Angioedema.

The mechanism of this side-effect of these drugs may be related to the increased levels of bradykinin in the blood and it must be pointed out that clinical trials involving bradykinin receptor antagonists are currently ongoing, particularly for the treatment of Hereditary Angioedema.
The authors acknowledge the limits of interpretation of data in their study but insist upon the relative frequence of this etiology of Angioedema, and the severity of certain clinical forms.

Baker’s asthma: an alternative to challenge tests
V. van Kampen et al (Prediction of challenge test results by flour-specific IgE and skin prick test in symptomatic bakers. Allergy 2008; 63: 7: 897-902) attempted to see whether it was possible to predict challenge test results from the determination of specific IgE or skin prick tests, in flour-related baker’s asthma, like it has been done for other allergens, particularly food-related ones .
All 107 recruited individuals, who had oculo-nasal and/or bronchial manifestations, were submitted to bronchial and nasal challenge tests, serum specific IgE levels were determined and skin prick tests performed: 71 bakers were tested with wheat flour and 95 with rye flour. Positive and negative predictive values, as well as sensitivity and specificity were calculated for different concentrations of specific IgE and different sizes of skin prick test weals. A comparative analysis of IgE levels and weal size in relation to the challenge test, as well as sensitivity / specificity curves were carried out.

It became apparent that the minimal cut-off values, for a positive predictive value of 100%, were 2.32 kU/l of specific IgE (5 mm weal) for wheat, and 9.64 kU/l (4.5 mm weal) for rye. Although the combination of both techniques does not significantly raise the predictive values, their association is useful for quality control.
Indeed the determination of specific IgE is more sensitive, but the recommended lower threshold for skin prick tests seems to have a higher predictive value (particularly for rye flour).
Thus, these 2 criteria are good diagnostic markers among sensitised symptomatic bakers, which makes unnecessary the challenge test.

These texts has been translated in collaboration with L.TABORDA - Covilha (Portugal).

Source: CEFCAP

You may send your comments to these short news to: cme.inallergy.online@wanadoo.fr

 

{tab=Dec 2008}

Claude MOLINA and Franz MARRACHE

  • Can paracetamol be a cause of Asthma in children ?
  • Objective assessment of Cough in Asthma
  • Is Helicobacter pylori (HP) a preventive factor for Allergy ?
  • Parasitosis in children and Allergy
  • Birch-induced allergic Rhinoconjonctivitis treated with recombinant allergens

Can paracetamol be a cause of Asthma in children?
This is the guesswork of a large European survey: ISAAC in its phase 3 (Association between paracetamol use in infancy and childhood and risk of asthma, rhinoconjunctivitis and eczema. R. Beasley et al. Lancet 2008 ; 372 : 1039-1048). Indeed, since the 80s, paracetamol (P) completely replaced aspirin as anti-pyretic and analgesic in children. This is due to risk of asthma, triggered by aspirin, particularly in atopic children but also Rye’s syndrome (encephalopathy with epileptic attacks and ocular problems.
The authors tried to find out whether exposure to P during intra-uterine life, or the first year of life in infant, as well as at the age of 6-7 years and also in adult, increased the risk of Asthma and/or Allergy. 205,487 children 6-7 years old, from 73 centres in 31 countries were included in this study (questionnaire given to parents). The results showed (multivariate analysis) that the administration of P (at least once per month) during the 1st year of life was significantly associated (OR 1.46) with an increased risk of Asthma at 6 to 7 years of age. Furthermore, usual utilisation of P was associated, in a dose-dependent fashion, with a risk of asthma (OR 1.6 to 3.23, according to moderate or high drug dose, respectively). Morover, use of P during the 1st year and at 6-7 years of age was associated with an increased risk of rhinoconjunctivitis and eczema. Although impressed by the size of the sample and its multi-nationality, the methodology and the power of this statistical analysis, one cannot exclude recall bias (in the responses given by the parents to the questionnaire, translated into various languages), or reporting bias (use of other antipyretics or viral infection).
So the doubt persists. In fact, if the association is plausible, the causal relation between P and Asthma or Allergy cannot be stated, as the authors acknowledge.
Moreover, what antipyretic or analgesic drug one should use in the young child ?. Ibuprofen suggested by some authors does not gather unanimity. Aspirin has not said its last word. Thus, we think that P at moderate doses, because its efficacy and safety profile spanning 50 years, should continue to be the first choice for the treatment of fever and pain, even in allergic or atopic children.

Objective assessment of Cough in Asthma
Few studies have focused on the prevalence of cough in Asthma, and most of those are based on subjective criteria. Some authors suggest that 61% of asthmatic patients complain of cough. Whether it occurs during the night or day, whether it is productive or not, it is not the main symptom mentioned by asthmatic patients. The interesting work reported by P.A. Marsden et al, from Manchester ( JACI 2008 ; 122: 901-907) is the first which performed comparative study between subjective and objective criteria. These latter were obtained through ambulatory monitors allowing 24 hour-long recordings with a count unit : the number of seconds of cough per hour.

The methodology is original and precise: it included a questionnaire (Leicester) with 19 questions on physical, social and psychological aspects, a thorough study of asthma involving lung function studies, a test of bronchial reactivity, an analysis of FeNO, as well as reflex sensitivity through inhalation of citric acid. The subjective scores included an analogue visual scale graded from 1 to 100 and a frequency score graded from 1 to 5. 54 asthmatic subjects were included (these patients were not selected on the basis of their cough) and were compared with a similar number of healthy control subjects. Results were thoroughly analysed statistically.
The conclusions were surprising and very interesting: It is obvious that the frequency of cough was higher in asthmatic patients than in healthy subjects of similar age.
However, the median time spent by asthmatic patients coughing was little , averaging 2.6 seconds per hour (range: 0.0 to 14.0).
In patients with asthma, Cough was more frequent during the day than at night (3.9 seconds per hour versus 0.3 Overall or daytime cough rates were not significantly different between female and male patients. However, women spent more time coughing at night than men. In addition, cough rate showed a weak but significant positive correlation with the subjects age.
Objective time spent coughing was weak to moderately associated with subjective cough scores and visual analogue scales. but was not correlated with functional tests, namely bronchial reactivity, FeNO or reflex sensitivity to citric acid.
In contrast, objective time spent coughing was strongly correlated with scores of quality of life questionnaire. These notions underline the interest of objective cough recordings for all therapeutic interventions directed towards this Asthma symptom, but also for all cough-inducing causes. In this regard let us also remember a physical discipline : strioscopy, which studies the dynamics of gas flows; its application to the study of cough has shown that its generates warm air with a mean speed around 8 metres/second.

Is Helicobacter pylori (HP) a preventive factor for Allergy?
The inverse relationship between bacterial colonisation by HP and the presence of Asthma or Allergy reported by Chen and Blaser (J. Infect. Dis. 2008 ; 198 : 553-60) led some scientists to study the mechanism accounting for this possible protective effect. Thus, an Italian team (G. Del Prete et al. Immunosuppression of Th2 response in Trichinella spiralis (TS) infection by HP neutrophil-activating protein. JACI 2008 ; 122 : 908-913) infected various murine strains with the TS parasite, which triggered eosinophilia, and increases in the serum levels of total and specific IgE, as well as those of IL-4 and IL-5. In this model, the authors showed that in animals treated with Neutrophil activating protein (NAP) there was an anti-Th2 activity with a decrease in eosinophilia and in the plasma concentrations of IgE, IL-4 and IL-4, associated with an induction of IL-12 and INFã expression.
In addition, the simultaneous administration of an anti-Toll Like receptor 2 monoclonal antibody abrogated the immunosuppressive action of HP-derived NAP on Th2 activity as well as its Th1-inducing activity.

This HP-NAP-derived immunosuppressive activity was confirmed by Codolo et al belonging to the same working group(Cell Microbiol. 2008 August 15) who showed, in a murine model of ovalbumin-induced allergic asthma, that systemic and mucosal administration of recombinant NAP abrogated pulmonary eosinophilia, and reduced the serum levels of IgE and Th2 cytokines.

Thus, the HP- NAP / asthma antagonism, suggested by clinical observations and confirmed experimentally, deserves to be considered.
In this context, recombinant NAP might represent, in the future,
a novel strategy for prevention of Allergic disorders

Parasitosis in children and Allergy
A group of doctors from Latin America (Brazil and Ecuador), in collaboration with the London School of Hygiene and Tropical Medicine, UK, has tried to find if, like Hygiene hypothesis in developed countries, intestinal helminthic infestation during early childhood might account for a lower prevalence of allergic reactions and asthma later in childhood and intervene upon the immune system, to induce a lower allergen skin test reactivity.

The investigators have, therefore, selected 1055 children whose stool examination had shown, in another previous study, intestinal infestation with an helminth : Trichuris Trichiura (TT) in early childhood. Then they performed skin prick tests in these children, a few years later, with common aeroallergens and collected information on potential confounding variables in their statistical analysis (L. C. Rodrigues et al: Early infection with Trichuris trichiura and allergen skin test reactivity in later childhood. Clin. Exp. Allergy 2008 ; 38 : 1769-1777). The results are as follow: Children with heavy infections with TT in early childhood had a significantly reduced prevalence of allergen skin test reactivity in later childhood, even in the absence of intestinal infestation at the time of skin testing.

Thus, for these authors and in emerging countries, massive infestation with TT
in early childhood seems to play a protective role against skin reactivity to aeroallergens. Novel treatments programming immune regulation in the early child by mimicking the effects of the TT parasite might offer a new research avenue for the prevention of allergic diseases.

The chapter of correlatins between Parasites and Allergy, which is quite complex and has been the subject of many but not always concordant results, , is thus enriched with an innovative study showing an unexpected positive relationship.

Birch-induced allergic Rhinoconjonctivitis treated with recombinant allergens
The European task force of Recombinant allergens, led by Gabrielle Pauli (Strasbourg) reports a randomised, multicenter, study on birch-induced allergic rhinoconjunctivitis treated by the recombinant (r) allergen (JACI 2008;122: 951-960). Three types of allergens were compared: rBet v1, a patented birch pollen extract ; nBet v1, a purified natural allergen and a placebo group. 134 adult subjects participated in this study. They were given a weekly injection of the product for 12 weeks, followed by a monthly maintenance administration of 15µ Bet v1 for 2 years (2004 and 2005). All subjects were followed up on a regular basis in clinical and biological terms : 33 subjects on rBet v1, 29 on nBet v1, 29 on Birch pollen extracts and 36 on Placebo.
Results were as follows:
A significant reduction in about 50% of symptoms, rescue medication and cutaneous sensitivities in the 3 treated groups, as compared with the placebo.
group. Clinical improvement was accompanied by an increase in the levels of Bet v1-specific IgG, which was higher in the Recombinant Bet v1 group.
No new IgE specificities were observed in the rBet v1 and nBet v1 groups, whereas there were 3 in the one treated with pollen extract. There were no severe side effects in the Recombinant group. This study thus confirmed the efficacy and safety of recombinant allergens for the treatment of birch pollinosis and the skill of genetic recombination DNA technology for the manufacture of allergen extracts for vaccines.

A novel approach for conversion of allergens as vaccines is the dissociation of allergen molecule between IgE and IgG immunologic activity. This approach was carried out in an animal model by N. Mothes-Luksch et al (Disruption of allergenic activity of the major grass pollen allergen Phl p2 by reasembly as a mosaic protein. J. Immunol. 2008 ; 181 : 4864-4873) who fragmented Phleum allergen into peptides of similar length, then re-assembled them in a different order, which lead the mosaic protein so expressed to the loss of its tridimensional structure, its capacity to bind IgE, and its allergenic activity whereas induced high levels of IgG molecules bind to Phl p2 blocks its binding to IgE.

Source: CEFCAP

You may send comments on these brief news to: cme.inallergy.online@wanadoo.fr

 

{tab=May 2008}

Claude MOLINA and Franz MARRACHE

• Severe asthma in children and bronchial remodelling
• Justification for Sub-Lingual Immunotherapy (SLIT)
• IgE, atopic eczema and food allergy
• The various facets of asthma in Olympic athletes
• Impact of stress upon asthmatic adolescents

Severe asthma in children and bronchial remodelling:
A French hospital-university team (Lille/Paris) compared structural changes in bronchi after the occurrence (or not) of a bronchial obstructive syndrome in children with severe Asthma (according to American Thoracic Society criteria). (Airway remodeling is correlated with obstruction in children with severe asthma : I.Tillie-Leblond et al Allergy 2008 63 May 533-541). For this study, 25 children aged between 5 and 14 years were recruited : 15 had bronchial obstruction (FEV1 lower than 80% of predicted and not responding to bronchodilators) and 10 did not have bronchial obstruction. A bronchial biopsy was taken and thoroughly examined using immuno-histochemistry . It was concluded that a large number of features were the same in the 2 groups : that applied to basal membrane thickening, epithelial integrity (analysed using EGF and EGF-R markers), collagen I and III deposition in the mucosa (using TGF-â as a marker), the number of eosinophils or neutrophils in the bronchi or gland thickness.In contrast, there was a statistically significant correlation between bronchial obstruction, the thickness of the smooth muscle wall (with increased expression of the MLCK: Muscular Light Chain Kinase enzyme, which reflects contractility) and the extension of the vascular network within the bronchi (as determined by expression of CD31) .Thus, the hypothesis of bronchial remodelling as a consequence of chronic inflammation remains uncertain, given that the age of Asthma in these children did not affect the results. It should also be stressed that structural changes predominantly involving smooth muscle and vascular factors develop early in the natural course of this form of asthma and explain the low efficacy of corticosteroids. It is therefore adequate to envisage a revision of classical therapeutic targets in these severe forms of asthma in children (and subsequently in adults).

Justification of Sub-Lingual Immunotherapy (SLIT):
Three recent articles dedicated to SLIT justify its definitive adoption by the European allergic community, followed by the anglo-saxon one. In a general New England Journal of Medicine review on this issue, A.J. Frew (Sublingual Immunotherapy: NEJM 2008 22 May 358 2259-2264) discusses the indications, the mode of action and the effects of such therapy with its dosage, duration of treatment, its minor secondary effects, its yearly cost, but also its uncertainties concerning, among others, allergen standardisation in line with the absence of an international consensus. Nevertheless, although FDA has not yet approved this form of therapy, the British Society for Allergy and Clinical Immunology has acknowledged, since January 2008, its efficacy and safety for the treatment of pollen-induced allergic rhinitis and asthma. This method, which was initiated in Italy, is currently widely used in Europe. Authors from Madrid have had the idea of comparing the immunological effects of 2 immunotherapy methods: SLIT (11 patients) and SCIT (sub-cutaneous: 12 patients) in 23 house dust allergic children, after a 2 year-long follow up period : Antunez C. et al…2 years follow-up of immunological response in mite-allergic children ; comparaison with sub-cutaneous administration Pediatr.Allergy Immunol 2008 19 3 210-218. Clinical improvement was similar and a decrease in specific IgE /IgG4 ratio was observed from the 1st month onwards with SCIT, after 2 years with SLIT. The authors also observed, in the long run, an increase in CD4/CD8 ratio as well as a decrease in the production of TNF-á and IL-2.
In contrast, an increase in the CD4+CD25+ subpopulation and a decrease in CD8+CD25 subpopulation were only observed with SCIT, with a slight change in the INF-ã/IL-4 ratio, reflecting a re-orientation from a Th2 response to a Th1 one.
There seems to be a slight difference in the immunological response in the peripheral blood during SCIT. In contrast, is there a mucosal protection with SLIT? That is what the authors suggest. And the recent observation by K.C. Bergmann et H. Wolf: Effect of Pollen-specific SLIT on Oral Allergy Syndrome: an observational study WAO Journal May 2008 1(5) 79-84 seems to confirm this hypothesis. For this study, 102 patients with pollen-induced allergic rhinitis, 9 out 10 had a more or less intense oral syndrome to food allergens associated with pollen allergens (such as apple-birch, Artemisia - celery, tomato – grass pollen). They were treated with SLIT for 1 year. The oral allergy syndrome improved in 3/4 of the cases concurrently with an improvement of rhinitis. According to J. Ring (journal editor) this is encouraging in terms of foreseeing a possible future treatment of food allergies by SLIT.

IgE, atopic eczema and food allergy
An international group of paediatric allergists (Early Prevention of Asthma and Allergy in Child study group) investigated IgE responses in young children with atopic eczema (IgE antibody responses in young children with atopic dermatitis U.Wahn et al Pediatr.Allergy Immunol 2008 19 332-336). In this study, 2184 infants, between 13 and 24 months of age, with atopic eczema (Scorad 5-59, representing a moderate eczema score) were tested with the 8 most common allergens. Results showed that 18.7% were sensitised to a single allergen, and 36.8% were polysensitised. The frequency of positive IgE responses to aeroallergens and foodallergens (>0.35 kU/l) correlated with the severity of the cutaneous manifestations. Among these young children, a minority had elevated food allergen-specific IgE levels, which would suggest that there is an increased risk of acute clinical reactions to these allergens (7% to egg, 3% to cow’s milk, 4% to peanut). These observations confirm classical data namely the prevalence of IgE responses to food allergens which is highest during the first year of life whereas respiratory allergens develops between 1 and 2 years of age or later. The approach of this association between atopic eczema /food allergy is discussed in the review about this issue by F. Rancé, from Toulouse (France) (Food Allergy in children suffering from atopic eczema Rancé F. Pediatr.Allergy Immunol.2008 19 279-284) ; 2 cases are discussed as an example: one of the cases is a young child with early onset and severe eczema in whom a food diet excluding suspected allergens improved cutaneous lesions; the second case is that of an older child in whom such diet might have deleterious effects on growth without any improvement of the cutaneous state.

This article is followed by a MCQ type questionnaire such as those build-up for Continuous Medical Education (CME).

The various facets of asthma in Olympic athletes
The experience of the athletes of the Finnish Olympic team was analysed in the publication by Haahtela T. et al (Mecanisms of asthma in Olympic athletes – Practical implication. Allergy. 2008 Jun;63(6):685-9).
Extreme exercise conditions among elite athletes may be the source of respiratory manifestations. So, in short duration speed and power efforts or endurance tests in swimmers and long distance skiers, hyperventilation (≥ 200 l/m) has a cooling and drying effect on the airways, and also stimulates vagal nerve endings and bronchoconstriction. Among swimmers, aspiration of a large number of droplets of water full of chemical products (chlorinated products, in particular) induces, by irritation, a vagally-mediated bronchoconstriction as well as bronchial hyperreactivity. Hyperventilation is also associated with the inhalation of important amounts of allergens, domestic aeroallergens and/or pollens depending on the environment (indoor or outdoor exercise), and constitutes, a risk factor for atopy and asthma as reflected by the increase in prevalence of IgE-dependent manifestations among young athletes. The mechanisms vary according to the sport and individual athlete, depending on the aetiology but also on clinical phenotypes. At least two phenotypes are evident, thereby reflecting the existence of distinct mechanisms : the phenotype of early onset infant asthma, which is atopic and combines hyperreactivity to metacholine and an eosinophilic inflammation of the airways with an increase in exhaled NO ; and the other phenotype which includes late onset manifestations (developing during the sports career), bronchial hyperreactivity with the isocapneic hyperventilation test, and not necessarily with metacholine challenge, and which is not associated with markers of atopy.
A mixed type of bronchial inflammation, both eosinophilic and neutrophilic seems to specifically affect swimmers, ice hockey players and long distance skiers. In this case, inflammation may be both allergic and irritant.
It should be stressed that asthma in athletes is under- or over-diagnosed and is therefore an important source of therapeutic problems.
In general, in order to assess the temporal link between asthma and competition sports practise, one must take into account individual predisposition, environmental factors, and the intensity of training.
See at www.cefcap.com the file on Allergy and Sport and the file on Asthma in 2005 Updates.

Impact of stress on asthmatic adolescents
Recent studies suggesting that psychosocial factors may have an impact on asthma, account for the work of Turyk ME et al (Stressful life events and asthma in adolescent. Pediatr. Allergy Immunol. 2008 19:255-263).
The 2026 participants, high school students from Catholic Private Schools of Chicago as well as from State public schools, were aged between 12 and 14 years. Diagnosis of asthma and information on types and number of stressful events, during the previous 12 months, were the object of an anonymous questionnaire.
This questionnaire included a 15-item stressful life events inventory that encompassed traditional items featuring in established life event instruments, family life elements, sources of ill being, relationship and school difficulties and items relating to inner city youths such as gang violence, stabbings and shootings.
Anonymity of the questionnaire, facilitated the collection of information regarding drug use. Of all the participants, there were 315 asthmatic adolescents 1711 non-asthmatic, served as a control group. Overall, asthma was significantly associated with the number of stressful events faced by urban adolescents. Similar results were observed for respiratory symptoms and the other markers of morbidity : school absenteeism, hospitalisations, and physician visits due to asthma.
These associations were independent of exposure to tobacco smoking in the family, use of inhaled substances, sociodemographic factors, or home dampness.
On their own, these results do not allow to conclude to a formal cause-effect link between asthma and stress. However, by analysing and listing the effects of stressful events, the clinician may be helped in terms of preventive and therapeutic approach to the disease among these adolescents.

These texts has been translated by L.TABORDA Covilha (Portugal).

Source: CEFCAP

You may send your comments to these short news to: cme.inallergy.online@wanadoo.fr

 

{tab=Apr 2008}

Claude MOLINA and Franz MARRACHE
Paris (France)

  • Occupational respiratory allergy in apprentices and Atopy
  • Insight into the pathophysiology of asthma and bronchial hyperreactivity
  • Asthma during pregnancy and congenital malformations
  • Bêta-blockers and asthma :
  • Are beta-blockers useful in Asthmatic patients ?
  • Are beta-blockers a good option in elderly asthmatic patients ?
  • Can all proteins become allergens ?

Occupational respiratory allergy in apprentices and Atopy :

The team of JL Malo, in Montreal, specialised in occupational allergy and asthma, has carried out a long term (8 years) study on the outcomes of 408 apprentices exposed to high molecular weight allergens, such as flour, latex, and laboratory animal allergens (Long term outcomes in a prospective cohort of apprentices exposed to high-molecular-weight agents : American J. Resp. Crit Care Medicine 20008 177 871-879 D.Gautrin et al). The objectives of the study were to assess the frequency of new and persisting sensitisation, rhino-conjunctival symptoms and bronchial hyperresponsiveness in relation with job history after ending apprenticeship and to examine characteristics significantly associated with the incidence and remission of these outcomes.

A respiratory symptom questionnaire, skin prick-tests with the suspected allergens, spirometry and metacholine challenge test were used for this study together with an appropriate statistical analysis. Within the group of individuals who, at a given time of the observation period of the study, held a job related to their apprenticeship (78% of the cases) the incidence of sensitisation, rhino-conjunctival symptoms, bronchial symptoms or bronchial hyperreactivity was, respectively, 1.3, 1.7, 0.7 and 2.0 per 100 person-years. Within the group of individuals who started a job different from that of their apprenticeship, a remission was observed respectively in 18.5, 9.6, 9.6 and 12.4 per 100 person-years. The authors stressed that allergic reactions acquired during apprenticeship did not dissuade individuals from engaging in an activity in the same field (8 out of 10) and they don’t seem to have regretted it since, overall, the incidence of allergic manifestations was lower during the work period than during their apprenticeship. In addition, a high proportion of individuals who started an activity different from the one they had during their apprenticeship had a remission of symptoms. This is a particularly interesting result for atopic individuals who are normally advised to avoid careers where they may be exposed to the inhalation of high molecular weight particles (Laboratory Animal Caretaker or Dental Hygienist or Baker). As mentioned in the editorial of the review, this may be the “end of the tunnel” in this context for atopic individuals.

Insight into pathophysiology of asthma and bronchial hyperreactivity
In a previously work GL. Chupp et al, observed that the serum and pulmonary levels of a component of human cartilage, YKL-40 protein, also known as chitinase 3-like 1 protein, was correlated with asthma severity and bronchial remodeling.

The genetic aspects of this finding is related in a recent publication (Ober et al : Effect of variation in CHI3L1 on serum YKL-40 level, risk of asthma and lung function ( NEJM 2008; 358 : 1682-91,).

The study involves 1893 individuals from various populations: 753 Hutterite farmers, a sect of German descent living in South Dakota, Two control groups of European descent, with one including 638 children living in Freiburg, and the other 296 adults and children living in Chicago, as well as 206 children from Wisconsin, of European descent at high risk of asthma, belonging to COAST (Childhood Origins of Asthma Cohort Study),.

Links between the genetic polymorphism found at the CHIL3 (SNP – 131 C→G) susceptibility locus and the serum levels of chitinase-3 like 1 (YKL-40) protein were investigated.

Within the Hutterite population, increased YKL-40 levels were conditioned by the – 131 C allele (found in CC and CG genotypes) which was correlated with asthma, bronchial hyperreactivity, and lung function changes, in contrast with the protection afforded by the -131G allele. The -131C allele also allowed the prediction of asthma within the two control cohorts at Freiburg and Chicago.

In addition, within the group of children from the COAST study, analysis of CHI3L1 SNPs allowed to predict the levels of YKL-40 in the cord blood and as well as in peripheral blood, until children were 5 years old.

Given the proliferation of genetic studies in asthma, these findings need for large epidemiological studies to be confirmed. However it may be observed that the switch at a single amino acid within the terminal portion of the CHI3L1 gene is associated to disease or to protection against asthma.

In spite of absence of correlation between the levels of YKL-40 and asthma beyond 6 years of age, or between YKL 40 and atopy, this work opens the way to research projects on pathophysiology of asthma and bronchial hyperreactivity.

 

Are beta-blockers useful in Asthmatic patients ?

This is an apparently paradoxical question since it is known that they are clinically contra-indicated in asthmatic patients where they may cause acute bronchospasm.

However, the concept of such antagonism as defined by Sir James Black (Medicine Nobel Prize 1972) between â2-agonists such as Salbutamol and Beta-blockers (Bbls) has been discarded by a recent experimental study (L.P.Nguyen et al :Chronic exposure to beta-blockers attenuates inflammation and mucin content in a murine asthma model Am.J.Cell.Mol.Biol 2008 38 256-262).

Chronic administration of beta-blockers for 7 to 28 days, in a mouse model of ovalbumin-induced asthma, decreased bronchial hyperreactivity, reduced eosinophilic inflammation, decreased IL-13, IL-10, IL-5 and TGF-â1 secretion and reduced mucin content within the bronchial epithelium. This was achieved using 2 types of Bbls : a non selective one : Nadolol (Corgard®) and a selective one : ICI 118551 (not yet sold in pharmacy) .

Can we extrapolate these results to humans?

Various recent studies on the effects of Propranolol (®) and Metoprolol (®) in asthmatic or COPD patients with heart failure have shown deleterious side-effects on their respiratory status. Only Celiprolol (Celectol(®)) and, possibly Nadolol would be relatively tolerated by asthmatic patients, maybe at low doses in mild asthma and in prolonged administration. However, in any case, it is necessary to assess benefit/risk ratios. This implies a close collaboration between allergo-pulmonology and cardiology specialists. In practical terms it is still advisable to avoid Bbls in asthmatic patients, even by ocular route (as one of us had the opportunity to note in a patient). The taboo is still valid!

 

Are beta-blockers a good option in elderly asthmatic patients ?

In order to try and answer this other question, a meta-analysis including 29 prospective studies was performed in 2002 by Salpeter SR et al (Cardioselective beta-blockers in patients with reactive airway disease. a meta-analysis : Ann intern Med. 2002 ;137 :715-725). These authors did not observe any changes in FEV1, or in the clinical status, after the administration of beta-blockers (Bbls) in individuals with bronchial hyperreactivity. However beta-blocker administration did not exceed 4 weeks and the study only involved a limited number of patients 40 to 51 years old.

Another retrospective study (M.A. Rank et al: â blockers prescription in elderly patients with asthma. J Allergy Clin Immunol. 2008 Apr;121(4):1061-2.) included 390 individuals between 65 and 85 years of age, who were selected by randomisation between 2004 and 2006. All had asthma and coronary disease . 200 patients with isolated coronary disease, and similar age range, form the control group.

The authors aimed at answering four questions :

- Are Bbls prescriptions on the increase ?

- Are Bbls less frequently prescribed in elderly asthmatic patients ?

- Are doses prescribed to this type of patients lower ?

- Does the degree of asthma severity influence Bbls prescription ?

 

Taking as a reference the pilot study by Gottlieb et al, ((Effect of Beta-Blockade on Mortality among High-Risk and Low-Risk Patients after Myocardial Infarction….NEJM 1998339 :489-497), we can observe, , a clear increase in the rate of Bbls prescriptions, which went from 34% to 56%. Such prescriptions were, however, less frequent in the group of patients who had both coronary disease and asthma (45% versus 75%). In contrast, Bbls doses prescribed are equivalent in both groups, and prescription rates are independent of asthma severity degree, which allows to think that the elderly patients tolerates Bbls more than is currently accepted.

However the results of this study should be confirmed by prospective studies.

Asthma during pregnancy and congenital malformations

Are asthma exacerbations during the first trimester of pregnancy associated with congenital malformations? This has been the object of a study involving a cohort of 4344 pregnant asthmatic patients (Lucie Blais et al : Asthma exacerbations during the first trimester of pregnancy and the risk of congenital malformations among asthmatic women, JACI 2008 Apr 12; [Epub ahead of print] ). Clinical episodes were recorded on the basis of corticosteroid prescriptions, visits to emergency departments and hospitalisations due to asthma, whereas the presence of malformations was assessed at birth and during the first year of life. Thus, within this cohort of asthmatic patients, 398 (9.2%) newborns had at least one malformation and the latter had a major feature in 261 of them. The prevalence of these congenital malformations was 12.8% and 8.9%, respectively in pregnant women that had had asthma exacerbations during the first trimester of their pregnancy or not, with an adjusted odds ratio (OR) for malformations of 1.48 (95% IC, 1.04-2.09) in favour of the former. If applied to major malformations, OR would be 1.32. These statistically significant results demonstrate, according to the authors of this study, the risk of fetal congenital malformations in case of asthma inadequately controlled in early pregnancy and suggest that increased surveillance of the respiratory status of asthmatic pregnant women should be increased during the first trimester.

(Cf Consequences of asthma on pregnancy)

 

Can all proteins become allergens ?

We know that allergens are most frequently proteins. The question is to know whether allergenic proteins have features that are different from those that are not allergenic and whether the sensitisation to the former depends upon their concentration, their source and/or exposure route (respiratory, cutaneous or digestive) . The usual classification between aero-allergens and food allergens had allowed the realisation that there were common features between some protein families (Profilins, Tropomyosin, Bet v1) .

In a recent study based on the fusion of european (Allergome) and international (Allfam) databases, a group of Austrian and Italian authors have put forward a new classification based on sequence, structure and functions of proteins.

Allergens are distributed into few protein families and possess a restricted number of biochemical functions C. Radaeur et al JACI 2008 124 847-52.

Thus it seems that out of 3012 known families of proteins, only 5% of them contain allergens and most can be grouped into some functional classes such as : hydrolytic enzymes, metal-, lipid- or polysaccharide-linked proteins, storage proteins and proteins of cytological skeleton. For instance, the Der p1 major allergen of house dust is a cystine protease which directly acts on immune system cells, particularly on dendritic cells, by cleaving surface proteins. Food allergens are characterised by their high content in dissulphide bridges which ensure their stability and allow them to resist to heat and digestive secretions.

Thus, structural and functional features that turn a restricted group of proteins into allergens, allow a better understanding of the molecular mechanisms of allergen sensitisation and open the way to novel therapeutic targets, at the onset of such allergic process.

 

These texts have been translated by L. Taborda, Covilha (Portugal).

Source: CEFCAP

 

You may send your comments to these short news to: cme.inallergy.online@wanadoo.fr

 

{tab=Mar 2008}

Claude MOLINA and Franz MARRACHE

  • Anaphylaxis to Monoclonal Antibody : Cetuximab
  • Eosinophil markers and corticosteroid tapering in Asthmatic patients
  • Classical Alternaria Alternata-specific immunotherapy: Randomised study
  • Mepolizumab and Hypereosinophilic Syndrome
  • Geohelminthiasis and anti-IgE treatments : potential risks

Anaphylaxis to a Monoclonal Antibody : Cetuximab

 

Monoclonal antibodies are the therapeutic innovations of the beginning of the 21st century, successfully used in Allergy (Omalizumab) and in Oncology.

Cetuximab (Erbitux® or Mabthera® ) is a chimeric mouse-human IgG1 Monoclonal antibody_ against the Epidermal Growth Factor Receptor or EGFR. It is approved for the treatment of - colo-rectal cancers and squamous tumors of the head and neck . In some areas of the US hypersensitivity reactions have been reported with a high frequency (prevalence of 22% of cases in Tennessee and North Carolina but of 1% in the Northeast, and - an average 3%, as mentioned by drug company leaflets).

That is - why the group of Prof. Platts-Mills analyzed serum samples for anti-Cetuximab IgE antibody, particularly in individuals who had had severe allergic reactions anaphylaxis-type at the beginning of Monoclonal antibody perfusions (Cetuximab-induced anaphylaxis and IgE specific for Galactose-á-1,3-Galactose : C.H. Chung et al NEJM 2008 158 1109-1117).Then they extended their study to 76 individuals who had been on Cetuximab treatment (in Tennessee, Arkansas and North Carolina) and 72 controls in Tennessee, 49 individuals with head and neck cancers in California and 341 female control individuals in Boston. Among 76 treated individuals, 25 had hypersensitivity reactions to drug and 17 of these had Cetuximab-specific IgE antibodies, before treatment. In contrast, there was only one individual with Cetuximab-specific IgE among the remaining 51 individuals . Within the the 2nd group (control), 15 out of 72 had IgE antibodies against Cetuximab (20.8%). In the 3rd group, there were 3 Cetuximab-specific IgE+ individuals out of 49 (6.1%). Within the 4th group, there were 2 Cetuximab-specific IgE+ individuals out of 341 (0.6%). These IgE antibodies were shown to be specific for an oligosaccharide which is present on the F(ab’)2 region of Cetuximab heavy chain : Galactose-á-1,3-Galactose. They are not anti-murine protein antibodies (there is no connection with the other monoclonal antibodies such as Rituximab or Infliximab); in contrast, there is a clear correlation with antibodies against non-primate mammalian proteins : cat, dog and cow, but not against mites or pollens. The authors cannot explain the regional differences observed, but they draw attention to the need for detection of anti-Cetuximab IgE prior to treatment with this monoclonal antibody since in most subjects who had ractions to the drug, IgE antibodies were present before therapy. One may also ask whether this notion also applies to other monoclonal antibodies.

Eosinophil markers and tapering of corticosteroids in Asthmatic patients

It is known that the association of Long acting beta-agonists (LABA) to corticosteroids is more efficient than isolated drugs, and allows corticosteroid tapering. A group of Danish authors has tried to evaluate the risk associated with corticosteroid tapering, based on eosinophil markers (EM) which are regarded as signs of bronchial inflammation. 61 patients recruited in 5 Danish hospitals, and efficiently treated with doses between 750 and 1000mcg/day of Corticosteroids were randomised into 2 groups : one of the groups received the minimal dose of 500mcg Fluticasone® + 50mcg Salmeterol ®, and the other group were given 500mcg Fluticasone alone. Once Asthma was well controlled, corticosteroid doses were reduced every 6 weeks, as clinical parameters and EM were monitored, until asthma symptoms eventually reappeared or patients kept on placebo (Asthmatics able to step down from inhaled corticosteroid treatment without loss of asthma control have low serum eotaxin/CCL11 : H. J. Hoffmann et al, Clinical Respiratory Journal 2008; DOI:10.1111/j.1752-699X.2008.00054.x.)

9 patients could be kept on placebo for 6 weeks, 36 patients developed mild Asthma symptoms , 16 had severe symptoms . EM were monitored in 39 cases (blood eosinophils, EPO, ECP, and chemokines : eotaxin/CCL11, eotaxin 2/CCL24, eotaxin 3/CCL26) and Th2 cytokines : IL1-â, IL-4, IL-5, TNF-á, INF-ã. Among the EM, eotaxin/CCL 11 seemed to be the most discriminating variable : patients who were able to be kept on placebo without developing severe symptoms had noticeably lower eotaxin levels than those who developed moderate or severe Asthma.

Thus, eosinophilic chemokines are, according to the authors, a useful guide for the tapering of corticosteroids in Asthmatic patients.

Alternaria Alternata-specific classical immunotherapy : Randomised study

Fungi are, after house dust mites and pollens, the 3rd most important cause of respiratory allergies. Among allergy-inducing fungi, besides Aspergillus and Penicillium,Cladosporium is the most frequent one in the North of Europe whereas Alternaria seems to predominate in Mediterranean regions. In any case, desensitisation to fungi does not have a great reputation of efficacy or tolerance induction. Spanish authors carried out a treatment with a metabolic extract -previously standardised and controlled, (by skin prick testing and immuno-enzymology) in a randomised, double blind, placebo-controlled study, involving 28 patients between 7 and 29 years of age (of which 14 were controls) who had Rhinitis with or without associated Asthma and were monosensitised to Alternaria . (Double-blind, placebo-controlled study of Alternaria alternataAna I. Tabar et al Pediatric Allergy and Immunology, February 2008 Volume 19 Issue 1 Page 76-81). immunotherapy: Clinical efficacy and safety

The protocol followed was a classical one, performed in accordance with the criteria of the EAACI. : one injection per week of a progressively higher dose of allergen extract until a maintenance dose was achieved (or the maximal tolerated dose), then once monthly for 6 to 12 months ( 1670 BE Units, corresponding to 0.167mg of lyophilised extract containing 0.1µg Alt a 1 ).

23 patients were able to complete the treatment with only 2 developing minimal side effects such as cutaneous pruritus.
It took 6 months to observe a significant improvement in all respiratory symptoms (measured clinically and with daily clinical scores) in the treated group. FEV1 was also significantly increased, but not in the placebo group. Asthma severity was decreased only in the treated group, but the symptoms of rhinitis or rhino-conjunctivitis were decreased in both after one year of treatment .

Thus, in this randomised study involving a limited number of patients and including a regular count of Alternaria spores in the environment of both randomised groups of patients, desensitisation, which was well tolerated, was efficacious at decreasing respiratory symptoms and function, but its effects were less clear upon rhino-conjunctivitis .

It is nevertheless a kind of rehabilitation of specific immunotherapy at a time where its efficacy is doubtful, even among allergists.

Mepolizumab and hypereosinophilic Syndrome

 

Hypereosinophilic syndrome (HES) includes a group of illnesses that are associated with blood eosinophilia > 1000 eosinophils/ml and eosinophil tissue influx into affected organs. Manifestations may be variable and may include respiratory, cardiac, gastro-intestinal, muscle and skeletal, cutaneous and neurological symptoms. Efficacy of corticosteroids in most HES cases is acknowledged, but is associated with side effects that may involve an important morbidity.

Taking into consideration the involvement of interleukin-5 (IL-5) in the development of eosinophils from their bone marrow precursors, as well as its role in the maturation, differentiation, mobilisation, activation and survival of this cell type, it was thus logical to ask whether using a humanised anti-IL-5 monoclonal antibody might be associated with corticosteroid-sparing effects in HES.

An international, multicentre, double blind study was performed between March 2004 and March 2006 by the Mepolizumab Group. NEJM published the results in a recent article (M.E. Rothenberg et al , Treatment of Patients with theEosinophilic Syndrome with Mepolizumab. NEJM march 20, 2008 vol. 358 no. 12)

Out of 107 recruited patients who were negative for the FIP1L1–PDGFRA fusion gene (which allows exclusion of cases of myeloproliferative HES, which usually require treatment by Imatinib) 87 individuals were selected and randomised into 2 goups : Mepolizumab group (MG) and placebo group (PG). All selected patients were clinically stabilised on a daily dose of 20 to 60 mg prednisone or prednisone equivalent, and their blood eosinophilia was < 1000/ml. Mepolizumab at a dose of 750mg or placebo were given as intravenous perfusion every 4 weeks for the duration of the study (36 weeks). The main objective of the study was to decrease prednisone or prednisone- equivalent to 10mg/day or even less for 8 consecutive weeks or even longer.

Within the MG group, 36/43 participants (84%) were able to achieve the protocol until its conclusion whereas in the PG only 36% of patients were able to do so. The clearly more frequent patient dropouts within the PG group were particularly linked to the re-occurrence of symptoms due to the decrease in corticosteroid dose.

The objective was attained in 84% of patients of the MG group versus 43% within the PG group. A reduction in corticosteroid doses to < 10 mg/day without destabilisation of the clinical status or an increase in eosinophilia was possible for a period of 8 weeks in almost all MG patients whereas it was only possible in 41% of PG patients.

Severe reactions, not associated with the drug, were observed with a similar frequency in both groups (5 to 7 patients). Drug-related side-effects were varied, not severe and were not more frequent in any of the groups.

In conclusion, Mepolizumab, which targets eosinophils, seems to allow a steroid-sparing effect in HES patients that are negative for the FIP1L1–PDGFRA fusion gene.

Geohelminthiases and Omalizumab : potential risks

 

If the role of IgE antibodies in anti-parasite defense is not denied, their place deserves to be clarified as mentioned byP.J. Cooper et al, (Geohelminth infections: a review of the role of IgE and assessment of potential risks of anti-IgE treatment, Allergy 2008: 63: 409–417).

In order to try and assess the potential role of IgE responses against helminths in humans and the possible risk associated with treatment by Omalizumab, the authors cite the study carried out by Cruz AA et al (Safety of antiimmunoglobulin E therapy with omalizumab in allergic patients at risk of geohelminth infection. Clin Exp Allergy2007;37:197–20).

In this study, 137 Brazilian patients, with a high risk of parasitic infection, aged between 12 and 30 years, with asthma or perennial allergic rhinitis were selected. Before the beginning of the study, an adequate anti-helminthic treatment was given to the patients in order to free them from any parasitic infection. In this double blind, placebo-controlled, 52 week-long study, participants included in the active group were given one sub-cutaneous injection of Omalizumab every 2 to 4 weeks.

At the end of the study, the rate of parasitic infections was practically identical in both groups. There was a slightly higher, but not significant, morbidity within the actively treated group, with a more relevant propensity of these individuals for re-infection.

Overall, risks that allergic patients on Omalizumab treatment face depend upon the type of population, the degree of exposure and the nature of the parasitic infection :

- negligible risk for populations who live in the European Union or the US, in case of minimal exposure, and very low risk in case of short exposure, as when on holidays, for instance;

- low risk for prolonged stays such as those involving volunteers that work in missions abroad (risk that depends upon the nature of the parasite);

- low to moderate risk for migrants originating from endemic areas;

- in contrast, increased vigilance is necessary for individuals having had previous infection with Strongyloides, given the ubiquitous feature of this parasite.

 

Source: CEFCAP

 

You may send your replies or comments to these notes to: cme.inallergy.online@wanadoo.fr

 

 

A must-attend event for CME Professionals, Providers and Supporters interested in International CME.

1357Mara Xatzipsalti

Second Dpt of Pediatrics“P & A Kyriakou”
Children’s Hospital
23-27 Makrigianni str.
11742, Athens

Tel: +306974456750
marax5873@hotmail.co.uk

 

 

 

I studied Medicine in Athens at National & Kapodistrian Medical University. After my graduation I started my PhD studies, which I have successfully completed in 2005. My thesis dealt with the immunological response to rhinovirus, its survival and the relationship with the asthma exacerbation. This project was conducted in the Allergy Research Laboratories of the Second Dpt of Pediatrics of the University of Athens, under the supervision of Dr N G Papadopoulos. During this period I have been also working as a S.H.O in General Paediatrics of General Hospital  of Asclipio Voula in Athens.

Then I worked as a Research Fellow at Brooke Laboratories, Allergy and Inflammation Research, at the University of Southampton (Prof S. Holgate), where I investigated the deficient immune response of Differentiated Asthmatic Bronchial epithelial cells to Rhinovirus. During my post-doc time I was also working as Clinical Attachment in the outpatient Paediatric Allergy clinic of General Hospital of Southampton.

Since October 2006 I am completing my specialisation in General Paediatrics at the First Dpt of “performing research work in clinical center.

My main research interest focus on interaction between virus infections and asthma with particular emphasis on rhinovirus infections.

JMA Working Group Meeting Minutes

Hannover, 28th of September, 2006

 

Present: Ulrike Raap (UR), JMA Chairperson

Marcin Kurowski (MK), JMA Representative in Immunology Section

Luis Miguel Borrego (MB), JMA Representative in Pediatric Section

Elena Borzova (EB), JMA Representative in Dermatology Section

Chrysanthi Skevaki (CS), JMA Webmaster

Peter Hellings (PH), JMA Representative in ENT Section

 

Apologies from David Groneberg (DG) JMA Representative in Asthma Section

 

  1. Welcome and a report from the task force meeting on the European Exam.

UR welcomed JMA WG in Hannover and congratulated with the beginning of Hannover Allergy School. She also informed about the progress with preparation of the European Exam in Allergy and Clinical Allergology and plans for launching the exam at EAACI Congress in Barcelona, 2008. UR welcomed the suggestions for multiple-choice questions to be sent to her.

 

  1. Reports of JMA Representatives of their section activities.

LMB reported on junior involvement in Anaphylaxis Symposium prepared by Pediatric Section in Lisbon, Portugal. He informed about telephone conference of pediatric Section scheduled for 10th of October.

 

MK informed about the involvement of juniors in EAACI-GA2LEN Davos Meeting, 2007 prepared by Immunology Section.

 

CS presented a report about Allergy School in Chalkidiki and announced the successful start of Case-report series on EAACI website

 

EB presented an annual survey of junior membership of EAACI Dermatology Sections, informed that hand-out materials from Contact Dermatitis Workshop held in Vienna will be e-mailed to Section members. EB reported on JMA involvement in preparation of PG course organized by Derm Section for EAACI Congress in Göteborg.

 

PH reported on participation in preparing of position paper on Chronic Synusitis and Nasal Polyps by ENT Section.

 

UR reported that JMAs are free of charge to join the PG courses which was announced at the latest ExCom meeting. Our group was welcomed to suggest and organize PG courses like the sections.

 

  1. Applications (letters of intention and CVs) for two new open JMA WG positions of JMA Representatives in ENT Section and Pediatric Section were reviewed. There were 3 potential candidates for each section. One application was not accepted because the applicant would reach the age limit at the time of assuming the position in JMA WG. It was agreed to change in JMA WG election procedure that JMA candidates should be 34 years old or under in the year of becoming JMA WG member. The e-mail election voting of new JMA WG members is planned for December 2006 to end of January 2007 and will be announced on EAACI website (UR).

 

  1. It was decided to prepare a leaflet and slides in order to increase of JMA participation and involvement in EAACI activities. MK prepared the content for slides.

 

  1. JMA activities for Göteborg were discussed:

§ JMA Poster Session will be chaired by UR and LMB.

§ JMA Clinical Educational Workshops/PG course is planned by the ENT section, PH is involved as a speaker. EB prepared a JMA PG course on a dermatological topic.

§ JMA Forum “Rocketing airway inflammation” will be chaired by LMB and MK. The speakers at the forum: Chrysanthi Skevaki (Greece), Johanna Makowska (Poland), Gernot Rohde (Germany), Tibor Verres (Germany). UR welcomed chairs to approach speakers and announce their titles as soon as possible.

§ JMA postgraduate course on Biostatistics will be planned. George Konstantinou is suggested as a speaker. The second speaker will be announced.

§ Educational session: “Design and ethics: important tools for the success of your study” will be chaired by EB and PH.

Programme:

i. How to design an experiment (Martin Church, UK)

ii. Ethics in research and clinical studies (Kristof Nekam, NL)

§ was proposed to prepare a survey of the results of EAACI Fellowships (the number of papers published, etc). Arrangements were made to obtain the list of winners from ExCom.

 

  1. Allergy Schools:

§ Hannover Allergy School: CS will prepare the report on HAJ for EAACI website

§  Meeting in Lisbon in October, 2006: LMB is included in the organizing committee

§  Winter School: MK is invited to participate.

 

  1. AAAAI Meeting in San Diego, 2007: MK and EB expressed interest in going.

 

  1. JMA WG decided to prepare a report on JMA perspective reflecting current activities, achievements and perspectives of JMAs in the EAACI together with the last historian Ignacio Ansotegui for publication in Allergy journal.

 

The next JMA WG business meeting is planned for Göteborg, June, 2007.

 

Elena Borzova

EAACI JMA Representative of Dermatology Section

 

Ulrike Raap

EAACI JMA Chairperson

115Ioana Agache
Romania
Faculty of Medicine, Brasov

ibrumaru@unitbv.ro

Education
M.D. 1994, University Carol Davilla Bucarest
Specialist in Allergology and Clinical Immunology 1999

Lecturer at the Faculty of Medicine in Brasov in Clinical Immunology since 1996

Scientific area
Immunopathology of acute coronary syndromes and miocardium diseases, immunology of chamydial infection in atherosclerotic lesions, incidence and clinical profile of the antiphospholipid syndrome, clinical application of immunohistochemistry in an interdisciplinary approach, the value of immunofixation in defining monoclonal gammopathies

627Allergy Research Laboratories
Second Dpt of Pediatrics
“P & A Kyriakou” Children’s Hospital
University of Athens
41 Fidipidou str
11527 Athens
Greece
Tel: +30-210-7776964 (ext14)
Fax: +30-210-7774383
E-mail: cskevaki@allergy.gr

I studied medicine at the Semmelweis University of Medicine, Budapest, Hungary. For the last three years, I have been working as a scientific collaborator in the Infectious Diseases Unit (Prof D A Kafetzis) of the Second Department of Pediatrics of the University of Athens. During this time, I gained interest in pulmonary medicine and more specifically in the field of interactions between infections and asthma. Therefore, during the last year I have started a PhD project, which deals with the influence of rhinovirus infection upon the expression and production of molecules associated with apoptosis, in the context of airway remodeling in asthma. This project is conducted in the Allergy Research Laboratories of the Second Department of Pediatrics of the University of Athens, under the supervision of Dr N G Papadopoulos.

621I studied medicine at the Medical University of Luebeck and Hannover in Germany. My medical thesis about the programmed cell death of peripheral blood eosinophils (summa cum laude) was awarded with the Clemens of Pirquet award in 1999 by the German Society of Allergology and Clinical Immunology (DGAI).

During my post-doc time at the Department of Clinical Chemistry and Molecular Diagnostics (Prof Dr Harald Renz) at Marburg University I investigated the functional role of neuropeptides and neurotrophins in murine models of allergic inflammation. The work was awarded with the Pharmacia Allergy Research Foundation Award in Berlin 2001 and funded by an investigators grant of the Kempke-Foundation in Marburg. Back at Hannover Medical University I am working as a full specialist for dermatology and allergology at the Department of Dermatology and Allergology (Prof Dr Alexander Kapp). Besides the daily business with the outpatients I am involved in several studies on immunotherapy. My fields of interest are neuroimmune interactions in chronic inflammatory diseases such as allergic rhinitis and atopic dermatitis, which is funded by a young investigators grant for science of the Hannover Medical University since 2002.

Elections to the Board 2007-2009
EAACI Section on Pediatrics

 

Candidates for 4 open positions:

  • Maarten Hoeckstra,
    Sponsors: Tony Dubois, Hans de Groot
    link to CV
  • Susanne Lau
    Sponsors: Magnus Wickman, Andrea von Berg
    link to CV

EAACI

SECTION ON PEDIATRICS

We hereby cordially invite all members of the Section on Pediatrics to join the:

Annual Business Meeting in Göteborg
Sunday June 10th, 2007, 17:15 – 18:15
Venue: Göteborg EAACI 2007, Congress Center
Room J1
Agenda

§ 1. Opening by the Chairman (Philippe Eigenmann)
§ 2. Registration of members present by name and address
§ 3. Further topics proposed by members to be discussed
under § 11.
§ 4. Election of new board members (Philippe Eigenmann, Election Committee)
§ 5. Financial report for the Section (Antonella Muraro )
§ 6. Education in Europe (Arne Høst, José Lopes dos Santos)
§ 7. “EAACI-Clemens Von Pirquet Foundation” (Philippe Eigenmann)
§ 8. Financial report for the Foundation (Bodo Niggemann)
§ 9. Future meetings, other activities and new projects (Philippe Eigenmann, Antonella Muraro)
§ 10. Further points to be discussed according to § 3.
§ 11. Next Annual Business Meeting in Barcelona, Spain,
June 7 – 11, 2008
§ 12. Closing of the Business Meeting.

Padua, May 2007

 

Philippe Eigenmann Antonella Muraro
Chairman Secretary

XXVIII EAACI Congress
Monday, 8 June 2009
13.30 – 15.00

Severe Asthma: An unmet need?
Chairpersons: Paul Van Cauwenberge, Belgium, Gunilla Hedlin, Sweden

■ The epidemiology of severe asthma in Europe
Peter Burney, United Kingdom
■ Experiences from a British network of severe asthma in adults
Chris Brightling, United Kingdom
■ Severe problematic asthma, not one entity, but several
phenotypes throughout childhood
Kai-Håkon Carlsen, Norway
■ Towards a global definition of severe asthma
Jean Bousquet, France

The EAACI Section on Pediatrics invites you to the Annual Business Meeting during the XXIII EAACI Congress in Amsterdam, June 2004.

 

 

Three projects have been planned and partly initiated under the EuroBAT collaboration:

1. C. Mayorga has initiated a multicenter drug allergy trial for beta-lactam antibiotics, in which one confirmed drug allergic, one confirmed non-allergic and one allergic patient will be compared. One reference protocol is compared to individual protocols.

2. H.J. Hoffmann and G Sturm have initiated a round robin of basophil activation tests in which maximal response and sensitivity will be determined for one reference protocol and individual protocols. Data sharing will confirm to the MiFlowCyt standard.

3. C Brits and D Ebo plan to compare gating strategies for identifying basophils.

These projects will be discussed at the EuroBAT meeting after the in Warsawa and at the next EuroBAT meeting in the autumn of 2009.

1719The 9th Allergopharma Award, 2009 in the value of Euro 10,000

The Award was first established in 2000 on the initiative of Allergopharma Joachim Ganzer KG and in collaboration with the European Academy of Allergy and Clinical Immunology. It is intended that the Award should recognize scientific achievement on the part of younger members of the EAACI in the field of allergy and encourage their engagement in further research. Applications for the Award are therefore restricted to members or affiliates of the EAACI, under the age of 40 years, who have conducted their research in a European centre.

An application for consideration for the award shall take the form of a full research paper published in an international peer reviewed journal in 2006/2008, together with a covering letter and curriculum vitae including a list of publications. The applications will be considered by an ad hoc Commission nominated by the EAACI Executive Committee and Allergopharma. The 9th Award will be presented during the European Academy of Allergy and Clinical Immunology Congress, Warsaw 2009.

Applications should be submitted before 31 December 2008 electronically to both the EAACI Executive Office (executive.office@eaaci.org) and Allergopharma (oliver.cromwell@allergopharma.de).

The research paper, curriculum vitae and a covering letter should be included as three separate attachments. If this is not possible, then postal applications can be sent to:
EAACI Executive Office
Karlavägen 108, P O Box 24140
115 24 Stockholm, Sweden
Tel.: +46-8-4596623

Allergopharma Joachim Ganzer KG is committed to furthering excellence in allergy diagnosis and specific immunotherapy through investment in scientific research.

Further information can be obtained from: Allergopharma Joachim Ganzer KG, 21462 Reinbek, Germany, Phone +49 40 72765-185, Fax +49 40 72765-318, website www.allergopharma.com, e-mail: oliver.cromwell@allergopharma.de.

EAACI and the Local Organising Committee offer 100 travel grants for the XXVII EAACI Congress in Warsaw, 06 -10 June 2009 to EAACI Junior Members and Affiliate Junior Members, with an accepted abstract.

The travel grant application should be made in connection with the electronical abstract submission. The application deadline is 14 January, 2009.

Please note that to apply properly you need to fill in the following, otherwise your Travel Grant application will not be considered:

  • That you wish to apply for the Travel Grant (tick the box)
  • Date of birth (Only juniors up to 35 years can apply)
  • EAACI membership number (You must be a Junior Members or Affiliate Junior Member to apply)
  • If you have received the Travel Grant before
  • Name and e-mail of your supervisor

You must also upload your personal CV.
Those who are awarded a travel grant will receive free registration to the Congress, shared accommodation in a twin-bedded room (up to 4 nights) and travel costs refunded up to 500 EUR.

Two hotels for Juniors will be arranged to facilitate social contacts and the use of common transports. More information about the JMA hotel will be published later.
Travel grant recipients who do not wish to stay at JMA hotel will receive free registration and up to 500 EUR for travel expenses.

Those JMAs who do not receive a travel grant but are anyway interested in reserving this hotel at their own expense can contact Congrex and they will get accommodation on a first come first served basis.

Travel costs will be refunded on site at the Congress, upon presentation of your original tickets and travel receipts.

If the abstract is accepted but your grant application is not approved, you must register and pay the registration fee before 31 March 2009. Otherwise your abstract will be cancelled from the programme and the abstract book.

For abstract submission, click here.

For questions about Travel Grants, please contact the Congress secretariat at eaaci2009abstract@congrex.com
* Virtually Informed: The Internet as (New) Health Information Source
Vienna Interdisciplinary Research Unit for the Study of (Techno)Science and Society VIRUSSS
Date: 25-26 January 2008
Place: Vienna, Austria
For more information email at sec.wissenschaftsforschung (at) univie.ac.atImpressum or go to http://www.univie.ac.at/virusss/rubrik/1002///.

* Joint symposium of the Academy of Pharmaceutical Sciences and the Royal Pharmaceutical Society of Great Britain
Date: 30 January 2008
Place: Royal Pharmaceutical Society of Great Britain, London
More information: http://www.rpsgb.org/worldofpharmacy/events/
Click here to download the brochure.

* Egyptian Society of Pediatric Allergy and Immunology (ESPAI)
6th International Congress
Date: 21-22 February 2008
Place: Cairo, Egypt

* 64th AAAAI Annual Meeting
Date:14-18 March 2008
Place: Philadelphia, PA, USA

* DGAKI Allergy Workshop
Date: 07 - 08 March 2008
Place: Mainz, Germany
More information: http://www.dgaki.de/

* World Immune Regulation Meeting 2008 - WIRM 2
Date: 17 - 20 March 2008
Place: Davos, Switzerland
Focus on Regulatory Cells and Th17 cells
Abstract submission prolonged until 8 December 2007
More information: http://www.wirm.ch/WTM/Overview.html

* Basic and Clinical Allergy
Date: 31 March - 03 April 2008
Place: London, UK
The programme covers current and emerging concepts as well as an overview of basic principles. To view the announcement for the meeting click here.
More information:http://www.imperial.ac.uk/medicine/nhli/events

* GA²LEN Annual Conference, 10-12 April 2008, Paris, France
GA²LEN plenary session: 11 April 2008
GA²LEN Public Day - francophone: 12 April 2008
More information: www.ga2len.net - GA²LEN Office office@ga2len.net

* 2nd AllergoOncology Symposium
Date: 11-12 April 2008

Place: Lecture Halls of the Medical University Vienna

Level 7, Waehringer Guertel 18-20 1090 Vienna, Austria
Tel: +43 (0)1 40 400 – 5120
Click here to view the program!

For more info click here !!

* 3rd International Symposium on Molecular Allergology
The event is supported by the EAACI and promoted by the Interest Group on Allergy Diagnosis
Date: 18-20 April 2008
Place: Salzburg, Austria
For more information, pleaso go to http://www.isma2008.eu/ .

 

* Drug Allergy for Clinicians
Date: 1 May 2008
Place: Governors Hall, St. Thomas' Hospital, London, UK
For more information, pleaso go to http://www.allergycourses.org or tel. +44 208 906 7778

* 11th EFA Conference Equality in Health for People with Allergy, Asthma COPD in Europe
Main theme: From prevention and self-management to better quality of life
Date: 30 May- 2 June 2008
Place: Sofia, Bulgaria
For more information go to EFA website, http://www.efanet.org/

* GA²LEN Symposium at the EAACI 2008 Congress
Date: 9 June 2008, 10:30 - 12:00, Barcelona, Spain

* 22nd Congress of the European Rhinology Society
27th International Symposium of Infection & Allergy of the Nose
Date: 15-19 June 2008
Place: Crete, Greece
For more information email at ers2008isian@frei.gr
or click on the website http://www.ers2008isian.com/

* ROYAN International Twin Congress
9th Congress of Reproductive Biomedicine - 4th Congress on Stem Cell Biology & Technology
Date: 27-29 August 2008
Place: Tehran, Iran
For more information please go to the website www.royaninstitute.org .

* 12th International Paul - Ehrlich Seminar
Regulatory Control and Standardization of Allergenic Extracts
Date: 24 - 27 September 2008
Place: Bad Homburg, Germany
For more information please go to the website www.pei.de/ipes2008 or download the seminar brochure.

* 2nd Gaslini Advanced Course in Basic and Applied Immunology
Date: 20-25 September 2008
Place: Villa Quartara, Badia della Castagna, Genoa, Italy
Registration deadline: 25 August 2008. Click here to download the Registration Form. Click here to download the Programme of the course.

* ERS Congress
Date: 04-08 October 2008
Place: Berlin, Germany
For more information email at info@ersnet.org or visit the website http://dev.ersnet.org.

* 2nd Congress of the European Academy of Paediatrics
Date : 24-28 October 2008
Place: Nice
Congress Venue: Nice - Acropolis
Country Congress: France
Tel: +41 22 908 0488
Fax: +41 22 732 2850
For more info please visit the congress website http://www.kenes.com/paediatrics or contact the secretariat at paediatrics@kenes.com

* XIX World Congress of Asthma
Date: 05-09 November 2008
Place: Monte-Carlo, Monaco
For more information email at wca2008@publicreations.com
or click on the website www.aim-internationalgroup.com/2008/wca

* ERS-GA2LEN Research Seminar: Post Genome Respiratory Epidemiology II:
An interdisciplinary challenge
Date: 06-08 November 2008
Place: Cernay, France
For more information please visit www.ga2len.net

* 7th Symposium on Experimental Rhinology and Immunology of the Nose (SERIN)
Organised by the EAACI ENT Section.
Date: 13-15 November 2008
Place: Dubrovnik, Croatia
For more information please visit the official website www.hdorl.net/serin2008.

* EAACI-GA2LEN Allergy School
Theme: Epidemiology of Allergy and Respiratory diseases
Date: 25-28 November 2008
Place: London, United Kingdom
For more information click here.

* The 16th International Rhinology Update Course
Faculty of Medicine Siriraj Hospital and in cooperation with The Free University of Brussels, Belgium
Date: 24-28 November 2008
Place: Bangkok, Thailand
For more information email at sispi@mahidol.ac.th .

* 3rd International Consensus Meeting on Urticaria
Date: 04-05 December 2008
Place: Berlin, Germany
For more information please go to http://www.allergie-centrum-charite.de/index.php?id=1146.

* International Congress on Cytokines in Immune Regulation and Disease
Date: 04-06 December 2008
Place: Palazzo dei Congressi, Auditorium, Florence, Italy
To download the programme click here. For more information click on the website www.cytokines2008.com

The 8th Allergopharma Award was instituted in association with the European Academy of Allergology and Clinical Immunology, in order to recognise excellent research conducted by younger members of the Academy in the field of mechanisms of allergic inflammation and allergen specific immunotherapy.The eight Award was presented by the President of the European Academy, Professor Roy Gerth van Wijk, to Dr. Georgina Xanthou during the XXVII Congress of the Academy in Barcelona, Spain.

Dr. Xanthou is a graduate of the University of Athens. The work for her PhD was conducted in the Department of Pathophysiology at the University of Athens Medical School and concerned the role of chemokines produced by antigen presenting cells in the autoimmune disease Sjogren’s syndrome. Chemokines were a continuing theme in her post-doctoral studies with Professor Tim Williams at Imperial College London. Here, she investigated the functional cross-talk between chemokine receptors and the influence on different lymphocyte subsets during immune responses. She returned to Athens to take-up a faculty position at the Biomedical Research Foundation where she is now an Assistant Professor.

Her current work focuses on the role of cytokines, and in particular Osteopontin and Activin-A, in the induction and regulation of T-helper lymphocyte immunity, and the dysregulated immunity associated with allergy and autoimmunity. Dr. Xanthou was chosen to receive the Allergopharma Award on the basis of a publication in Nature Medicine which presents evidence that Osteopontin exhibits dual and opposing effects on T-helper lymphocyte reactivity in allergic disease through regulation of dendritic cell sub-sets.

 

The winner, Georgina Xanthou with (from left) Prof. Wahn, EAACI past president, Lars Ingemann, Allergopharma, and EAACI president Prof. Gerth van Wijk.



 

EAACI offers a number of Educational Grants each year to help members in financial difficulty to cover the cost of their yearly membership. The educational grant includes a subscription to the journals ''Allergy'' and "Pediatric Allergy and Immunology''. All Individual and Affiliate Members in EAACI who can motivate their application are welcome to apply for this grant.

2008 Educational Grant Winners:

Rosa Torres-Blanch
Ahmed Mahrous
Mohammad Fereidouni
Peyman Amini
Sophia Tsabouri
Mona Al-Ahmad
1681Göteborg 2007, Sweden

XXVI EAACI Congress
9-13 June, 2007
CME Accredited.

XXV EAACI Congress in Vienna 2006

10 - 14 June 2006
Vienna, Austria

CME Accredited

The XXV Congress of the European Academy of Allergology and Clinical Immunology is taking place in Vienna, Austria from 10-14 June, 2006. The meeting’s main theme is “Basic Science in Allergology and Clinical Immunology: a Prerequisite for Improving Patient Care” and it is combined with the celebration of “100 Years of ALLERGY as defined by Clemens von Pirquet”. The EAACI 2006 is hosted by the Austrian Society of Allergology and Clinical Immunology at Austria Center Vienna, “located between the towers of the "Donau City" and the United Nations headquarters in the most modern part of Vienna” (R Valenta).

710

Source: ''Wien Tourismus''

Vienna, a capital of the “Holy Roman Empire” and the Habsburgian Monarchy is a true melting pot for many European cultures. Additionally, it holds a strong record in the scientific allergy community as it is where the Austrian pediatrician Clemens von Pirquet coined the term ALLERGY for the first time, in 1906, just 100 years ago. It is therefore allergy’s centennial birthday !!!

 

Scientific Programme

The rich scientific programme in Vienna 2006 follows a tradition of the highest standards set in all previous EAACI Congresses. Integrated plenary sessions, symposia, workshops, postgraduate courses, pro- and con- sessions on controversial and topical issues are all included in the scientific agenda, set out “to meet the educational and scientific needs of all clinicians and scientists involved in understanding and managing allergic disorders” (A J Frew). Poster Sessions, one of the most powerful and popular activities of the Congress, will be the meeting point for all attendees, covering topics on basic and clinical allergy, asthma and immunology.

 

The full scientific programme is now available on-line.

 

EAACI General Assembly:12th June 2006, 12.15-13.30 pm.

 

Social Programme
A day at the EAACI Congress never ends on the closure of the sessions. The social programme for Vienna 2006 is planned with daily tours in the historic city center of Vienna,visits to famed and distinguished museums, operas, and short excursions to small wineries and vineyeards.

 

55A special event is included for the first time in the Social Programme. The 1st EAACI Allergy 10km Run took place on Saturday, 10 June 2006, at 10.00 am (20 EUR).

 

Registration

On-line registration to the Congress is available from Congress website www.congrex.com/eaaci2006/.

For travel grants and more information, please visit www.congrex.com/eaaci2006.

 

See the Photo Album!

 

The XXV EAACI Congress will be CME Accredited

 

For more information click on the Congress Website: www.congrex.com/eaaci2006/

Report from XXVI EAACI Congress in Göteborg 2007

The XXVI Congress of the European Academy of Allergology and Clinical Immunology, which took place from 9-13 June, 2007 in Göteborg, Sweden proved to be a highly successful meeting with more than 5,200 participants from 95 countries world wide. The Congress was very well covered by press, TV, and radio both internationally and in Sweden. The main theme was “Prevention and Treatment of Allergy and Asthma”, focusing on the exploration of asthma as an allergic disease along with the basic mechanisms, clinical care and consequences on health economics and the overall quality of life. However, all aspects of allergic disease, such as Urticaria, Rhinitis, Dermatological-, Food-, and Drug- allergy, as well as topics on inflammatory cells and mediators, functional genomics and proteomics and many more were covered by a great range of symposia, oral abstract sessions, postgraduate courses, poster discussion and “meet the experts” sessions.

The Congress started off with an exciting Opening Ceremony, taking place at the Goteborg Convention Center where all delegates had a taste of a pure Swedish evening including an amazing Abba Show and traditional food. The social program also involved a series of events, such as the Linnaeus expedition and the Archipelago evening, all together making everyone’s stay an enjoyable and unforgettable experience. Goteborg, situated on the verge of the North Sea, provided the ideal setting for a very fruitful scientific experience as well as for an exciting interaction among clinicians and basic researchers from all over the world.

All photos taken during the Congress are now available via the Congress Web Site www.congrex.com/eaaci2007 for you to download and print, free of charge for personal use.
1004Date: 7-11 June, 2008
Place: Barcelona, Spain

The European Academy of Allergology and Clinical Immunology has the honor to announce the invitation to the XXVII EAACI Congress which will take place in Barcelona, Spain, 7-11 June 2008, under the main theme: Clinical Features of Allergy: From Pediatric to Geriatric. A specific Pediatric track will also be available during the whole Congress. 

All EAACI members are kindly invited to contribute to the scientific programme,by submiting proposals for suggested topics, symposia, speakers, etc. Any kind of contributions to make this Congress an outstanding event in terms of good science, collegiality andculture are also welcome.

Abstract submission deadline: now closed.

Registration
Deadline for late registration: now closed, 2008

For more information on the Congress please go to the official Congress website here.

422Allergy has been increasing all over the world. The "Western" world in particular has not only one of the heaviest burdens, but also the most demanding patients, frequently expecting to be completely cured with a 'magic' pill.

Contemporary medicine cannot, unfortunately, offer this. Resisting our fervent research efforts the cure for most allergic diseases remains unreachable. This is probably the main reason why a considerable number of patients seek relief in 'alternative' or complimentary treatments.

The fundamentally different approach to health and disease most such systems take, makes it difficult to objectively assess their effectiveness. In some occasions it may not even be about effectiveness at all !

Our responsibility as allergists is to ensure optimal treatment for our patients. If any approach works, or seems it could work we should certainly evaluate it and even endorse it! However, according to a recent poll, only a few of our members are convinced that there's any benefit in alternative medicine (table 1).

Actually, supporters were half of those considering these systems of little value or even a fraud! Still, the most popular vote was for the scientific approach: more studies are needed to verify or reject. In my view, this reflects the ethos of our Academy: it is a privilege of science to view novelty, even in radical form, without prejudice.

Nikos Papadopoulos

EAACI Website Editor

EAACI offers a number of Educational Grants each year to help members in financial difficulty to cover the cost of their yearly membership. The educational grant includes a subscription to the journals ''Allergy'' and "Pediatric Allergy and Immunology''. All Individual and Affiliate Members in EAACI who can motivate their application are welcome to apply for this grant.

2007 Educational Grant
Download the application form and send it
by post:
EAACI Executive Office
P O Box 24140
104 51 STOCKHOLM, Sweden
Visiting address: Karlavägen 108, elevator V, 8th floor.

by email: executive.office@eaaci.org

by fax:    +46 8 663 38 15
telephone +46 8 459 66 23

2007 Educational Grant Winners

Jan Gutermuth                          Germany
Jose Laerte Boechat                  Brazil
Alfredo Arias Cruz                      Mexico
Kateryna Gashynova                  Ukraine
Emilija Vlaski                             Rep. of Macedonia
Simona Eva Zitnik                      Slovenia
Jordan Minov                            Rep. of Macedonia
Loreta Bagdonaite                     Lithuania
Roksolyana Holovyn                   Ukraine
Nanneth Tiu                             Philippines
Valentina Cvejoska-Colakovska    Rep. of Macedonia|Ilija Kirovski                                   Rep. of Macedonia
Zhiyi Guo                                China
Nektaria Spanoudaki                 Greece
Paraya Assanasen                    Thailand
Jahja Zacharia                         Indonesia
Hartono Gunardi                       Indonesia
Zijadin Hasani                          Kosovo
Tiia Voor                                 Estonia

881MSc Allergy
The School of Medicine, University of Southampton

The School of Medicine at The University of Southampton has places available for students on the following MSc Allergy courses which are held at Southampton GeneralHospital.

2006 - Nasal Disease and Its Management
(Dr Peter Howarth)

Monday 9th & Tuesday 10th October 2006

a.m. Examination - Wednesday 11th October 2006

 

2006 - Introduction to Respiratory Disease
(Dr Peter Howarth)

p.m. Wednesday 11th & Thursday 12th October 2006

Friday 13th October 2006 & p.m. Examination

 

2007 - Mechanisms and Management (I) of Allergic Disease

Tuesday 16 January 2007

Wednesday 17 January 2007

Tuesday 27 February 2007

Wednesday 28 February 2007

Examination : Wednesday 28 March 2007

 

2007 - Dietetic Management of Allergic Disease

Tuesday 13 March 2007

Wednesday 14 March 2007

Case Presentations:

Tuesday 26 June 2007 & Wednesday 27 June 2007

 

2007 - Skin Disease and Its Management
(Prof Peter Friedmann)

12 & 13 June 2007

Exam : Monday 16 July 2007

 

2007 - Nasal Disease and Its Management
(Dr Peter Howarth)

Monday 8th & Tuesday 9th October 2007

a.m. Examination - Wednesday 10th October 2007

 

2007 - Introduction to Respiratory Disease
(Dr Peter Howarth)

p.m. Wednesday 10th & Thursday 11th October 2007

Friday 12th October 2007 & p.m. Examination

 

This programme aims to develop your interest in and knowledge and understanding of the mechanisms and management of allergic disease including the immunological basis, diagnostic testing, pharmaceutical preparations, management programmes and research techniques. The course is open to the wide range of people who require a basic understanding of allergic disease and who come into frequent contact with potential allergy sufferers e.g. doctors, nurses, midwives, health visitors, and school nurses. It is also suitable for specialist registrars and scientists who require a basic training in order to carry out research in allergy.

 

All modules can be taken alone or in combination with others as part of the MSc Allergy programme. A candidate for the MSc may also be a candidate for the subsidiary award of a Postgraduate Diploma (120 credits) or a Postgraduate Certificate (60 credits).

For further information and an application form please contact:

Dr. Jill A Warner Tel: 44 (0)2380 796941
email jaw4@soton.ac.uk
Mrs. Brenda Colwell Tel: 44 (0)2380 796379
Email b.colwell@soton.ac.uk

Website:

http://www.soton.ac.uk/PostgraduateTaught/MedicineHealthandLifeSciences/Allergy/

 

http://www.som.soton.ac.uk/prospectus/postgrad/msc_allergy/default.asp

 

EAACI Accreditation Council
May 31st 2002

EAACI Accreditation Council Coordinating Secretariat has been operating for 12 months, since the first Accreditation of the Berlin European Congress, May 9th, 2001. Since that event a lot of effort has gone into effect, trying to develop a working strategy for CME and its diffusion among the affiliated Societies.

CME is an ever growing reality in Europe, and it's not by mere chance that we have begun alongside the very institution for CME, EACCME. EACCME is the UEMS` Accreditation Council, designed specifically to implement upon international recognition of educational events. In an imperfect society, represented by the various countries of the European Union, UEMS has designated EACCME as a clearing-house for those events that strive for international recognition and exchange of CME Credits in a reciprocity status. National Authorities, represented by the medical associations, are the governing national bodies that bestow and authorize Credits for educational events to the physicians attending them.

The need for transfer and acquisition of Credits by Doctors that take part in events around Europe, as well as in the USA, has bolstered the strengthening of EACCME in developing more Credit validation. In fact EACCME has started its operation in the year 2000, with only 15 events accredited. In 2001, we had already 102 events, and the current trend is expanding ever more, judging by the information received and by our own activity.

Even in our medical field we represent one of the higher entries, ranging around 10 % of the total, along with Oncology and Cardiology events. European Societies such as ours are playing an important and essential role in this growth, acting as an "umbrella" system that helps developing CME in various countries and national medical societies.
This fact is enhanced in those instances where we don't have a national Operating CME system, such as in Spain, Portugal, France, Greece, and until recently, in Italy.
In these case the European societies, among which stand out FECS (Cancer), EBAC (Cardiology), EBAP (Neurology), and naturally EAACI, act as authorities to accredit international events that couldn't otherwise distribute Credits to attending Physicians.

The system is working and spreading, forming a strong bond among national societies and a rich educational texture that works smoothly along the same guidelines and ethical pathways. We consider this mission inevitable and fulfilling the noblest purpose that stands at the base of the very
essence of the medical profession, represented by the quest for excellence and good practice in the interest of the patient.

A lot remains to be done, working on our strong points, and following suit with the weakest areas. This past year alone we have had the first accreditations ever, not only the Allergology and Clinical Immunology field, but in any event ever, in countries such as Hungary, Spain, Poland and Portugal.

Our friends and colleagues in those countries are grateful for the effort of developing CME there, promoting rapidly new opportunities for medical education, and its merging into the other systems. A lot is happening in Europe and in the rest of the world in this field, and the more advanced systems,
such as in the USA, U.K, and others, are leading the way for improved development.

Distance Learning, Continuing Professional Development, creation of Providers delegated to independently implement UEMS-EACCME operations in Europe, are all quests and goals that will be soon achieved, spreading worldwide.
The ever-growing need for a global focus on the reality of the medical profession is the engaging force behind this operation, and EAACI is surely playing a major role in it.

Dr. Alfonso Negri, CME Consultant,
EAACI Accreditation Council,
Coordinating Secretariat
Milan, May 31st, 2002
Continuing Medical Education, CME, as a moral and ethical tool, is the reason why every doctor has to adapt his knowledge and working experience to the ever-changing world of medical practice and the relationship with professional roles. A revolution in health care is occurring as a result of changes in the practice of medicine and the nature of modern society.These include changing demographics and the pattern of disease, with new technologies and innovations in health care delivery.

A new increase in consumerism, patient empowerment and authonomy, puts an emphasis on effectiveness and efficiency in changing medical awareness.
CME has proven itself a valuable tool to grasp and profit in the technological innovations provided by scientific research, applied to medical practice, translating into optimal care and
service for the patient. CME and medical economics represent a necessary bonding, with a natural tendency
to represent the basis for professional fees, career advancement and professional recertification.

Some countries in Europe have adopted a compulsory system, such as in Holland, UK and Italy, following the
U.S. example where you can have fiscal benefits thanks to your CME activity. Scientific Societies are called
to act as quality controllers of scientific contents in educational procedures. One way is to supply its own
members with a rich international events programme, controlled by UEMS. Another role is, in accordance
with EACCME, to function as an accreditating body for events held in countries that have not developed a
full system of CME.

EAACI will undoutedly have a major role in its Allergology and Clinical Immunology field, as in other proven experiences, such as Cancer, Cardiology, Respiratory, Nephrology, Neurology, etc.

The CME system has progressed from a prestigious factor to a moral necessity and an economic advantage, due to the possibility of financing the very same Societies through the accreditation of their events. After an initial investment in secretarial structures, the accreditation, certification and publishing fees of their events, can result in a very profitable result.

We have to bear in mind that, besides the classic residential
events, such as congresses, workshops, courses, etc.,UEMS is considering shortly the accreditation of distance learning events for CME credits (on-line, self-assessment publishing etc.) This will be needed to fulfill the needs of an ever growing demand for medical education, certified and controlled in its quality output.

Alfonso Negri March 18, 2002

In June 2000, following the AMA-UEMS 1998 letter of intent, the AMA Council on Medical Education has developed a Pilot Project for the recognition of CME credits authorized by EACCME ( European Accreditation Council for Continuing
Medical Education), for live events, based on a system of shared international standards.

UEMS is a Brussels-based organization composed of 17 National Associations from the European Union, with 37 specialist organizations, to act as clearing house in helping medical specialists in the Common Market develop uniform standards in medical education. The goal of the pilot Project has been to establish a system of International Credit, encouraging physicians from the US and Europe to collaborate and participate in international congresses. EACCME does not provide accreditation of CME activities directly, thus not superseding national Authorities on accreditation of CME, rather validating the event on the agreed quality criteria.

The AMA is notified of each internationally relevant event, and US State and Professional bodies have an agreement
with AMA to convert EACCME credits into AMA credits as well. On 14 June 2002, a joint AMA-UEMS council approved unanimously to extend the reciprocal recognition till 2006, with an interim report in 2004.

There is, also a firm commitment between UEMS/EAACME, the ACCME and AMA not only on the exchange of credits,
but also on the matter of quality policy. There is an ACCME-Canadian document, by and large consistent with UEMS policy, that allows for common ground in a reciprocal credit system. This could very well be the base for moving towards a system of universal recognition of " International Credits", issued by qualifying accreditation bodies worldwide. A quality assessment statement could be based on a scientific program with educational input, peer review, outcome measurements, quality requirements.

A further step proposed by the Joint AMA-UEMS Council, will be the organizing of a joint meeting of accrediting organizations in Europe, USA, Canada, Latin America, Australia, New Zealand, South-East Asia, in order to explore joint interest and possibilities for " International Credits". This meeting could possibly take place at the end of 2003. EAACI has been accrediting with EACCME about 18 events this year alone, in 8 different countries in Europe.

Physicians attending these events received UEMS/EACCME Credit Certificates, that can be tranferred to any other European System in CME, and American Physicians can receive immediate validation from AMA/ACCME, through AAAAI. This opens invaluable avenues both for American Doctors attending European events, as well as for European ones in the U.S., thanks to the automatic system started this year. This will continue in a very widespread fashion, as more events and countries will develop accreditation policies
through EAACI Accreditation Council, and could very well benefit Anerican Physicians, inviting them to attend European events.
Perhaps a more active advertising of this new system could benefit both sides, through exchange of programs and published calendars on respective websites.
*Open Forum on the Future of Networks of Excellence - Will the investment be lost?
Place:Royal Institute of Natural Science, rue Vautier 29, B-1000 Brussels, Belgium
Date:20 November 2007
Link:www.supportresearchnoes.eu

For more information click here!!

* The First North African Course on Clinical Immunology and Allergy
Place:Hammamet,Tynisia meeting
Date: 25-28 October 2007
Tel: +216 71 843 317
Fax: +216 71 791 833
For more information click here!!

* IX International Symposium on Respiratory Viral Infections  Sponsor: The Macrae Group
Date: 3 - 6 March 2007
Place: Mandarin Oriental, Excelsior Hotel,Causeway Bay, Hong Kong
Tel: (+1) 212.988.7732
E-mail: TheMacraeGroup@comcast.net
Link: www.TheMacraeGroup.com

* 2e Congress Francophone d' Allergologie - CFA 2007
Date: 11-13 April, 2007
Place: Palais des Congress - Porte Maillot, Paris - France
For more information please click on www.cfa2007.com

* 2007 World Immune Regulation Meeting
Main Theme: Special Focus on Regulatory Cells
Date: 11-15 April 2007
Place: Davos, Switzerland
For more information click on the website http://www.siaf.unizh.ch/WTM/Overview.html

*Ist International Allergooncology Symposium in Vienna,2007
Date: April 16  2007,
Place: Vienna, Austria
For more information click here!!

*Basic and Clinical Allergy Course 2007
Date: 16-19 April 2007
Place:London, UK
E-mail: k.dixon@imperial.ac.uk
Tel: +44 (0)20 7351 8172 
For more information click here!!

*GA²LEN Annual Conference 2007
Date: 20 April 2007
Place: Imperial College London, UK
For more info click here!!

* V European Asthma Congress
Date: 21-24 April, 2007
Place: Moscow, Russia

* World Asthma Meeting
Date: 22-25 June 2007
Place: Istanbul, Turkey
For more information go to www.toraks.org.tr or email at edagli@superonline.com

* 2007 Joint Technical Symposium
Date: 28-30 June
Place: Toronto, Canada
For further details either visit:  www.jts2007.org
For information send mail to : info@jts2007.org
Tel: 323-463-1500

* The British Society for Allergy and Clinical Immunology 2007 Meeting
Date: Monday 2nd - 4th July 2007
Place: Burleigh Court International Conference Centre, Loughborough, Leicestershire, UK
For further details either visit: www.bsaci.org or email: info@bsaci.org
Tel: +44 (0)207 404 0278

*Gaslini Advanced Course in Basic and Applied Immunology
Date: 9-13 July 2007
Place: Villa Quartara, Genoa (Italy)
For further details please visit www.sispge.com/immunology
Tel:+39 010 5636554 - 5636805  
Fax +39 010 3776590

* 25th International Congress of Pediatrics
Date: 25-30 August 2007
Place: Athens Congress Hall, Athens, Greece
For more information click on the website http://www.icp2007.gr/

* 17th ERS Annual Congress
Date: 15-19 September, 2007
Place: Stockholm, Sweden
For more information please visit www.ersnet.org

* 9th Baltic Summer School (BSS) course / workshop Inflammation :­ A Key to Common Complex Disease
Dates & place:
Theoretical course, 2nd - 13th September, 2007, Lund, Sweden &
Practical course, 17th - 21st September, 2007, Lund, Kiel and Copenhagen.
Additional information is available on the website: http://www.balticsummerschool.net

* 1st International Congress on Exacerbations of Airway Disease (ICEAD)
Sponsor: The Macrae Group
Date:  4-7 October 2007 
Place: Ritz-Carlton Hotel, San Juan, Puerto Rico
Tel: (+1) 212.988.7732
E-mail: TheMacraeGroup@comcast.net
Link:  <http://www.TheMacraeGroup.com> www.TheMacraeGroup.com

* Jordanian Society of Allergy & Immunology Annual Meeting
Date: 10 October 2007 
Place: Amman, Jordania
E-mail: ababnehhani@yahoo.com

* Turkish National Society of Allergy & Clinical Immunology Annual Meeting
Date: 16-20 October 2007 
Place: Antalya, Turkey
Contact: www.aid.org.tr
E-mail: okalayci@hacettepe.edu.tr

* Israel Association of Allergy & Clinical Immunology Annual Meeting
Date: 18-20 October 2007 
Place: Afule, Israel
Contact: drwerner@012.net.il

* Portuguese Society of Allergology & Clinical Immunology October Meeting
Date: 18-20 October 2007 
Place: Estoril, Lisabon, Portugal
For more information: www.spaic.pt

* Congress of Slovak and Czech Allergists and Clinical Immunologists
Date: 24-27 October 2007 
Place: Trnava, Slovakia
For more information: www.csaki.cz

* Meeting of the Spanish Society of Allergy and Clinical Immunology
Date: 25-27 October 2007 
Place: Santander, Spain
For more information: www.seaic.es

* EAACI-IUIS-STI Course
Main Theme: 1st North African Course on Clinical Immunology and Allergy
Date: October 25th-28th, 2007
Place: Yasmine-Hammamet,  Tunis

*Cytokines in Health & Disease
Fifteenth Annual Conference of The International Cytokine Society
Date: October 26-30, 2007
Place: San FRancisco, California
For more information go to www.cytokines2007.org
Email: info@cytokines2007.org
Fax: 706-228-4685

* Meeting of the Finnish Society of Allergology & Immunology
Date: 14 November  2007
For more information: http://www.terveysportti.fi/kotisivut/sivut.koti?p_sivusto=435

* Meeting of the Norweigan Society of Allergology & Immunopathology
Date: 14 November  2007
Place: Oslo, Norway
For more information: www.legeforeningen.no

* Meeting of the Dutch Society of Allergology
Date: 17 November  2007
Place: Utrecht, Netherlands
For more information: www.nvva-allergologie.nl

* Ukrainian Society for Clinical Immunology and Allergology
Date: 19-21 November  2007
Place: Poltava, Ukraine
For more information: www.immunology-ua.org/ua

* Meeting of the Swedish Society for Allergy
Date: 29 November  2007
Place: Stockholm, Sweden
For more information: www.sffa.nu

* World Allergy Congress 2007
Date: 2-6 December 2007
Place: Bangkok, Thailand
For more information click on the website http://www.congrex.com/wac2007/

* Meeting of the Hungarian Society of Allergology and Clinical Immunology
Date: 3-6 December 2007
Place: Budapest, Hungary
For more information: www.makit.hu

* 12th Congress of the International Rhinologic Society
Date: 5-8 December 2007
Place: Venice, Italy
For more information click on the link www.irspinocchio2007.org
Contact Details:  MCA Events srl - via G. Pellizza da Volpedo 4, 20149 Milano, Italy,
Tel. +39 02 3493440
Fax +39 02 34934397
info@mcaevents.org

* Annual Meeting of the Austrian Society for Allergology and Immunology
Date: 13-15 December 2007
Place: Alpback in Tirol, Austria
For more information: www.oegai.org

* Virtually Informed: The Internet as (New) Health Information Source
Vienna Interdisciplinary Research Unit for the Study of (Techno)Science and Society VIRUSSS
Date: 25-26 January 2008
Place: Vienna, Austria
For more information email at sec.wissenschaftsforschung (at) univie.ac.atImpressum or go to http://www.univie.ac.at/virusss/rubrik/1002///.

* Joint symposium of the Academy of Pharmaceutical Sciences and the Royal Pharmaceutical Society of Great Britain
Date: 30 January 2008
Place: Royal Pharmaceutical Society of Great Britain, London
More information: http://www.rpsgb.org/worldofpharmacy/events/
Click here to download the brochure.

* Egyptian Society of Pediatric Allergy and Immunology (ESPAI)
6th International Congress
Date: 21-22 February 2008
Place: Cairo, Egypt

* 64th AAAAI Annual Meeting
Date:14-18 March 2008
Place: Philadelphia, PA, USA

* DGAKI Allergy Workshop
Date: 07 - 08 March 2008
Place: Mainz, Germany
More information: http://www.dgaki.de/

* World Immune Regulation Meeting 2008 - WIRM 2
Date: 17 - 20 March 2008
Place: Davos, Switzerland
Focus on Regulatory Cells and Th17 cells
Abstract submission prolonged until 8 December 2007
More information: http://www.wirm.ch/WTM/Overview.html

* Basic and Clinical Allergy
Date: 31 March - 03 April 2008
Place: London, UK
The programme covers current and emerging concepts as well as an overview of basic principles. To view the announcement for the meeting click here.
More information:http://www.imperial.ac.uk/medicine/nhli/events

* GA²LEN Annual Conference, 10-12 April 2008, Paris, France
GA²LEN plenary session: 11 April 2008
GA²LEN Public Day - francophone: 12 April 2008
More information: www.ga2len.net - GA²LEN Office office@ga2len.net

* 2nd AllergoOncology Symposium
Date: 11-12 April 2008

Place: Lecture Halls of the Medical University Vienna

Level 7, Waehringer Guertel 18-20 1090 Vienna, Austria
Tel: +43 (0)1 40 400 – 5120
Click here to view the program!

For more info click here !!

* 3rd International Symposium on Molecular Allergology
The event is supported by the EAACI and promoted by the Interest Group on Allergy Diagnosis
Date: 18-20 April 2008
Place: Salzburg, Austria
For more information, pleaso go to http://www.isma2008.eu/ .

 

* Drug Allergy for Clinicians
Date: 1 May 2008
Place: Governors Hall, St. Thomas' Hospital, London, UK
For more information, pleaso go to http://www.allergycourses.org or tel. +44 208 906 7778

* 11th EFA Conference Equality in Health for People with Allergy, Asthma COPD in Europe
Main theme: From prevention and self-management to better quality of life
Date: 30 May- 2 June 2008
Place: Sofia, Bulgaria
For more information go to EFA website, http://www.efanet.org/

* GA²LEN Symposium at the EAACI 2008 Congress
Date: 9 June 2008, 10:30 - 12:00, Barcelona, Spain

* 22nd Congress of the European Rhinology Society
27th International Symposium of Infection & Allergy of the Nose
Date: 15-19 June 2008
Place: Crete, Greece
For more information email at ers2008isian@frei.gr
or click on the website http://www.ers2008isian.com/

* ROYAN International Twin Congress
9th Congress of Reproductive Biomedicine - 4th Congress on Stem Cell Biology & Technology
Date: 27-29 August 2008
Place: Tehran, Iran
For more information please go to the website www.royaninstitute.org .

* 12th International Paul - Ehrlich Seminar
Regulatory Control and Standardization of Allergenic Extracts
Date: 24 - 27 September 2008
Place: Bad Homburg, Germany
For more information please go to the website www.pei.de/ipes2008 or download the seminar brochure.

* 2nd Gaslini Advanced Course in Basic and Applied Immunology
Date: 20-25 September 2008
Place: Villa Quartara, Badia della Castagna, Genoa, Italy
Registration deadline: 25 August 2008. Click here to download the Registration Form. Click here to download the Programme of the course.

* ERS Congress
Date: 04-08 October 2008
Place: Berlin, Germany
For more information email at info@ersnet.org or visit the website http://dev.ersnet.org.

* 2nd Congress of the European Academy of Paediatrics
Date : 24-28 October 2008
Place: Nice
Congress Venue: Nice - Acropolis
Country Congress: France
Tel: +41 22 908 0488
Fax: +41 22 732 2850
For more info please visit the congress website http://www.kenes.com/paediatrics or contact the secretariat at paediatrics@kenes.com

* XIX World Congress of Asthma
Date: 05-09 November 2008
Place: Monte-Carlo, Monaco
For more information email at wca2008@publicreations.com
or click on the website www.aim-internationalgroup.com/2008/wca

* ERS-GA2LEN Research Seminar: Post Genome Respiratory Epidemiology II:
An interdisciplinary challenge
Date: 06-08 November 2008
Place: Cernay, France
For more information please visit www.ga2len.net

* 7th Symposium on Experimental Rhinology and Immunology of the Nose (SERIN)
Organised by the EAACI ENT Section.
Date: 13-15 November 2008
Place: Dubrovnik, Croatia
For more information please visit the official website www.hdorl.net/serin2008.

* EAACI-GA2LEN Allergy School
Theme: Epidemiology of Allergy and Respiratory diseases
Date: 25-28 November 2008
Place: London, United Kingdom
For more information click here.

* The 16th International Rhinology Update Course
Faculty of Medicine Siriraj Hospital and in cooperation with The Free University of Brussels, Belgium
Date: 24-28 November 2008
Place: Bangkok, Thailand
For more information email at sispi@mahidol.ac.th .

* 3rd International Consensus Meeting on Urticaria
Date: 04-05 December 2008
Place: Berlin, Germany
For more information please go to http://www.allergie-centrum-charite.de/index.php?id=1146.

* International Congress on Cytokines in Immune Regulation and Disease
Date: 04-06 December 2008
Place: Palazzo dei Congressi, Auditorium, Florence, Italy
To download the programme click here. For more information click on the website www.cytokines2008.com

1545Date: 18-20 April, 2008

Place: Salzburg, Austria


The 3rd International Symposium on Molecular Allergology (ISMA), will take place in Salzburg, Austria, from 18 to 20 April, 2008, under the theme “Allergens: From Identification to Therapy". The meeting is co-sponsored by The European Academy of Allergology and Clinical Immunology (EAACI) and ALLERGOME and promoted by the Interest Group on Allergy Diagnosis.

The scientific agenda will focus on structural biology of allergens, special allergen sources and measurements, allergy diagnosis: shifting from extracts to molecules in the daily practice, decision making and immuno-monitoring of allergen-specific immunotherapy, animal models in allergic diseases and food allergy. Moreover, an interactive workshop along with poster workshops will also be available.

 

To get the full scientific programme, please visit http://www.isma2008.eu/programme.htm.

 

Registration and abstract submission are now open.

 

For more information, please go to the website http://www.isma2008.eu/.

1542May 8-11, 2008 in Aspenäs, Sweden

Functional genomics and proteomics (FGP) are getting increasingly important in clinical research. In order to promote their application to allergy research, EAACI Interest Group on Functional Genomics & Proteomics organises a workshop in May 8-11, 2008 in Aspenäs, Sweden. The aim of the workshop is to provide young students with sufficient theoretical and practical knowledge to include Functional Genomics & Proteomics in their research. Leading researchers in allergology, genomics, proteomics, systems biology, bioinformatics and computer science have been invited for this purpose. In order to get an informal and interactive workshop, it has been restricted to 45 participants, of whom 10 are lecturers.

The workshop also, includes oral abstract presentations and group discussions. Abstract submission is not mandatory, though. A program and a registration form can be found at www.congrex.com/fgpar.

The conference fee for the workshop is 100 euro. The workshop is co-sponsored by the EAACI.

For more information please go to the official website http://www.congrex.com/fgpar/.

768The QuizzTM Series are back, offering the chance to EAACI Juniors to win a travel grant to Barcelona 2008!

The JMA QuizzTM Series, initially launched in 2006, consist of a new quiz, posted each month in order to test the scientific knowledge along with other, EAACI-related, information. Each quiz has 5 single-choice questions, the answers of which can be traced in the EAACI website, or in any one of the Academy’s publications, ie ALLERGY, PAI and the Newsletter, all accessible through the EAACI website.

The winners will awarded with a 500E travel grant for the XXVII Congress, in Barcelona, 7-11 June 2008. Take your chance and test your knowledge, now!

April Quiz 3

Deadline for participation to March Quiz is April 14th. Stay tuned as more QuizzTM Series are about to come shortly!

* January Quiz Winner: Ana-Maria Muresan from Romania.
* February Quiz Winner: Paraskevi Magina from Greece.
* March Quiz Winner: Christiana Alonzi from Italy.

All travel grant recipients should go to Registration Area / Travel Grants Office at the time of the Congress for a full refund of their grant.

Participation rules

1. Quizz™ Series is available to EAACI Junior members and affiliates only, by using their username and password.

2. Each JMA will be permitted to participate 3 times per month.

3. Winners will be selected randomly among the ones who have answered correctly to all 5 questions of a given month’s Quizz™.

4. If the winner has been awarded another prize, award or travel grant for the same venue of the EAACI, the Quizz™ Series prize is automatically annuled and a second winner is randomly selected.

Aims:
To spread Allergy and Clinical Immunology in Europe
Promote fellowships in allergy and clinical immunology in order to support highly skilled specialists on this field in Europe

Target: Member in training for allergy and clinical immunology.

The Clinical Fellowships will be prioritized to clinicians early in their career, and are not intended for well-established specialists.

Conditions for application:

1. Member of EAACI, in training or recently specialized in allergy and clinical immunology.
2. Letter of recommendation.
3. Motivation letter, specifying the centre for application.
4. Commitment letter assuming that the candidate will not apply to any other national/european grant for the fellowship.

Fellowship’s duration: 3 months.

Time for application: Fellows should send their application form till the end of February, each year.

Winner’s announcement: The formal announcement of the winners will take place after the JMA poster session on the EAACI annual meeting. Nevertheless, all applicants will receive a formal answer by e-mail regarding their application till the end of May.

Fellowship’s schedule: all fellows will have one year after the formal announcement to complete their fellowship, depending on the centres/fellow availability.

Number of fellowships: Every year there will be 5 fellowships available for application.

Grants: The winners of the clinical fellowships will have a grant of 3000 Euros provided by EAACI in order to pay expenses for accommodation and travels, for which they must present receipts. Salary would be provided by the hospital of origin. The sum of 3000 Euros will cover 450Euros for travel and 850Euros/month for accommodation.

Final Reports: At the end of the fellowship the candidate has to make a report emphasising the activities made, as well as critics/suggestions. A brief report of the candidate would also be made by the centre.

Application deadline: now closed.

55On the occasion of 2008 World Asthma Day, May 6, Pr Nikos Papadopoulos, EAACI Vice President on Communication, says there are no added risks for the athletes suffering from asthma in the Bejing Olympics 2008.

By Karolos Grohmann - Athletes suffering from asthma face no greater health risk at this summer's Beijing Olympics than other athletes, despite the city's pollution problem, a European anti-asthma organisation said on Tuesday, May 6, World Asthma Day.

Beijing has been under increasing pressure to improve air quality ahead of the Aug. 8-24 Games after the International Olympic Committee (IOC) said there was some risk to athletes competing in endurance events lasting more than an hour. Beijing is one of the most polluted cities in the world and despite a 120 billion yuan ($17.12 billion) clean-up over the last decade, air quality remains a big concern. "I don't see any greater danger to the athletes suffering from asthma who will be competing in the Beijing Olympics than the other athletes," said Nikos Papadopoulos, vice president of the European Academy of Allergology and Clinical Immunology (EAACI).

"We want to stress that having good diagnosis and treatment means that any athlete suffering from asthma can reach his or her full potential." Beijing's pollution has already claimed its first high-profile victim, with twice Olympic champion Haile Gebrselassie, who suffers from asthma, withdrawing from the men's marathon fearing pollution could damage his health.

Top-class marathon runners compete outdoors for just over two hours. The IOC said it would consider rescheduling events that require physical activity of more than an hour if the air quality on the day was not satisfactory. Pr Papadopoulos said it was not necessarily only endurance events that could affect athletes suffering from asthma or trigger exercise-induced bronchoconstriction. "The sprint events can also affect an athlete," he said, adding the intake of air at these events was several hundred times more than normal quantity, increasing the health risk.

Other factors include humidity and whether the event was held indoors or outdoors.
He said the EAACI was taking part in an ongoing European study, monitoring athletes from 10 countries prior, during and after the Beijing Olympics. Past studies have shown about 20 percent of summer sports athletes have asthma, with cyclists, runners and swimmers reporting a high number of cases.

"But we believe diagnosis and the right treatment can lead to gold," Pr Papadopoulos added.

Source: ATHENS (Reuters)

1560Main theme: Regulatory Control and Standardization of Allergenic Extracts

The 12th International Paul-Ehrlich-Seminar - supported by the European Academy of Allergy and Clinical Immunology - took place in Bad Homburg, Germany, from September 24 to 27, 2008. Once again, this exceptional seminar achieved to arrange a successful get-together of international regulators, industry and academia discussing recent developments and improvements of control methods and standardization procedures as well as current regulatory aspects of present and novel allergen products. The meeting was arranged by the local organizing committee under the guidance of the chairman Stefan Vieths from the Paul-Ehrlich-Institut, Langen, Germany. Speakers were chosen by the scientific committee composed of leading experts in the field.

One specific aim of the triennial International Paul-Ehrlich-Seminars is always to provide extra time for extended discussion of hot topics. This might be one reason for the active and interested participation of all attendees up to the last session of the meeting. Altogether, the over-booked seminar was visited by 275 participants from 25 countries. Government and international regulators were represented by Johanna Strobel (German Ministry of Health), Jay Slater & Ronald Rabin (US Food and Drug Administration), Karl-Heinz Buchheit (EDQM Council of Europe) and Pascal Venneugues (European Medicines Agency) as well as 24 representatives of medicine agencies from Brazil, Denmark, France, Germany, Italy, Japan, Spain, Sweden, Switzerland and The Netherlands. Moreover, the meeting was attended by 168 international representatives of industry and 78 academics of medical and research institutions from all over Europe, Argentina, Australia, China, New Zealand and the USA. The organizers enjoyed to welcome both Roy Gerth van Wijk and Anthony Frew, the present and past president of the European Academy of Allergy and Clinical Immunology. The German Society for Allergology and Clinical Immunology and the German Society of Allergists were represented by Joachim Saloga and Hans Merk, respectively.

Subject-matters of the seminar covered up-to-date solutions and problems regarding (i) the standardization and characterization of allergen products
(ii) the state-of-the-art of clinical trials with therapeutic allergens
(iii) novel diagnostic approaches in allergy
(iv) the approval and marketing authorisation of allergen products
(v) present and novel approaches of specific immunotherapy

As expected, hot topics of the meeting and reasons for egnaged discussion were the drafted version of the CHMP/BWP guideline on "Allergen Products: Production and Quality Issues", the novel CHMP/EWP guideline on the "Clinical Development of Products for Specific Immunotherapy for the Treatment of Allergic Diseases" and the revision of the "Monograph on Allergen Products" of the European Pharmacopoeia, which were introduced by Carlo Pini of the Istituto Superiore di Sanità, Rome, Italy. Besides regulatory aspects, further hot topics concerned
(i) proteomics and the standardization/characterization of native and hypoallergenic allergen products (introduced e.g. by Thierry Batard from Stallergènes, France, and Martin Himly, University of Salzburg, Austria)
(ii) the potential and problems of new "in the pipeline" products, such as formulations consisting of recombinant allergens (reported e.g. by Oliver Cromwell from Allergopharma Joachim Ganzer KG, Germany, and Gabrielle Pauli, Strasbourg, France).
Finally, the meeting dealt with future therapeutic approaches such as the current state and future perspectives of prophylactic allergen vaccination (introduced by Patrick Holt, Telethon Institue for Child Health Research, Australia) or allergen vaccines targeting multipotential dentritic cells (introduced by Andrew Saxon, UCLA School of Medicine, CA, USA).

A special highlight of the 12th International Paul-Ehrlich-Seminar was certainly the social event at the Senckenberg Museum Frankfurt, which could be summarized with the motto "Dining with Dinosaurs". There, the background music of the jazz band of Jörg Kleine-Tebbe (Berlin, Germany) was the icing of the cake. The next meeting in 2011 will presumably be organized by the US Food and Drug Administration and would then take place in Rockville, MD, USA.

1774

Figure 1: The scientific committee of the 12th International Paul-Ehrlich-Seminar together with EAACI Presindent, Roy Gerth van Wijk (from left to right: Jay Slater, Rockville, MD, USA; Wolf-Meinhard Becker, Borstel, Germany; Oliver Cromwell, Reinbek, Germany; Martin Chapman, Charlottesville, VA, USA; Fatima Ferreira, Salzburg, Austria; Ronald van Ree, Amsterdam, The Netherlands; Roy Gerth van Wijk, Rotterdam, The Netherlands; Stefan Vieths; Langen, Germany; Jörg Kleine-Tebbe, Berlin, Germany; Henrik Jacobi, Hørsholm, Denmark; Marcel Hoefnagel, BA Bilthoven, The Netherlands; Carlo Pini, Rome, Italy; and Anthony Frew, Brighton, United Kingdom; not shown are Philippe Moingeon, Antony Cedex, France; Jean-Hugues Trouvin, Saint Denis Cedex, France; and Rudolf Valenta, Vienna, Austria).

* See the full Web Photo Album!

Special thanks to Prof Stefan Vieths for providing eaaci.net with the report and the photos.

Allergopharma Joachim Ganzer KG is committed to furthering excellence through research in

ALLERGY DIAGNOSIS • ALLERGY THERAPY • ALLERGY PREVENTION

980

The presentation of the 7th Award will be made in recognition of scientific achievement in the field of Allergology during the European Academy of Allergy and Clinical Immunology (EAACI) Congress, Gothenburg 2007.

A submission for the award shall take the form of one full research paper published in an international peer reviewed journal in 2004/2006, together with a curriculum vitae.

Applicants must be members or affiliates of the EAACI, under the age of 40 years, and the research that is the subject of the application must have been conducted in a European centre. Special consideration will be given to research concerning the mechanisms of allergic inflammation and allergen specific immunotherapy.

Submissions should be made before 31 December 2006
and addressed to:

EAACI Executive Office
Allergopharma Award
c/o Ms Ostrom
Karlavägen 108, elevator V, 8th floor
104 51 STOCKHOLM, Sweden

Further information can be obtained from:
Allergopharma Joachim Ganzer KG
21465 Reinbek, Germany
Phone: + 49 40 727 65 185
Fax: +49 727 65 318
Website: www.allergopharma.com
E-mail: oliver.cromwell@allergopharma.de

115Ioana Agache
Romania
Faculty of Medicine, Brasov
ibrumaru@unitbv.ro

Education
M.D. 1994, University Carol Davilla Bucarest
Specialist in Allergology and Clinical Immunology 1999

Lecturer at the Faculty of Medicine in Brasov in Clinical Immunology since 1996

Scientific area
Immunopathology of acute coronary syndromes and miocardium diseases, immunology of chamydial infection in atherosclerotic lesions, incidence and clinical profile of the antiphospholipid syndrome, clinical application of immunohistochemistry in an interdisciplinary approach, the value of immunofixation in defining monoclonal gammopathies
by Peter W. Hellings, JMA Representative ENT Section

In the beginning of April, the Advanced Sinus Surgery Course took place in the Academic Medical Center (AMC), Amsterdam, The Netherlands, organized by Prof. Wytske Fokkens, present head of the Department of Otorhinolaryngology at the AMC and chairman of the ENT Section of the EAACI.

This two-day course aimed at extending both the theoretical knowledge as well as practical skills of ENT surgeons beyond the boundaries of the sinonasal cavity. This first course was attended by 55 participants from 10 different countries. The teacher of honour was Professor Valerie Lund, London, U.K., authority in the field of sinus surgery and well-known for her contribution to sinonasal tumor surgery. The lectures by the board of teachers covered a wide range of topics, from image-guided surgical navigation and powered instrumentation, to mucocoeles, hypophysectomy, frontal sinus surgery, endonasal dacryocystorhinostomy, orbital decompression, sinonasal tumor surgery and handling of complications after sinus surgery.

During the course, participants were allowed to actively train their operative skills in endoscopic sinus surgery on cadaver heads. The facilities made available for each of the participants were high-standard, including whole skulls, CT scans of the skulls, own monitors and powered instruments (cfr. pictures). The dissection manual was especially designed for the course and guided the participants step-by-step through the different sinus surgery techniques with emphasis on helpful tips and highlighting pitfalls of sinus surgery.
As an ENT surgeon, I recommend this course to ENT surgeons with special interest in sinus surgery as most participants rated the quality of the course from very good to excellent. The next course will be held in April 2005.

347 346

Pic 1: Overview of training facility in the dissection room.
Pic 2: Professor Wytske Fokkens in discussion during the sinus surgery training session.

2006-2007 Board Members

President
Prof. Anthony J. Frew
Secretary General
Prof. Jan Lötvall
Past President
Prof. Ulrich Wahn
1:st Vice President
Prof. Roy Gerth van Wijk
Vienna President
Prof. Rudolf Valenta
Göteborg President
Prof. Jan Lötvall
Barcelona President
Prof. Ignacio J. Asotegui
Warsaw President
Prof. Marek L. Kowalski
SPC Coordinator
Prof. Cezmi Akdis
JMA Working Group Chair
Ulrike Raap
Asthma Secretary
Dr. Ioana Agache
ENT Secretary
Dr. Glenis Scadding
Paediatrics Secretary
Dr. Antonella Muraro
Immunology Secretary
Dr. Barbara Bohle
Dermatology Secretary
Prof. Torsten Zuberbier

2003-2005 Board Members

President
Prof. Ulrich Wahn
Secretary General
Prof. Anthony J Frew
Treasurer
Prof. Marek L. Kowalski
Past President
Prof. Paul van Cauwenberge
1:st Vice President
Prof. Jean Bousquet
Amsterdam President
Prof. Roy Gerth van Wijk
Munich President
Prof. Johannes Ring
Vienna President
Prof. Rudolf Valenta
Gothenburg President
Prof. Jan Lötvall
CME Co-ordinator
Dr. Sergio Romagnani
Asthma Secretary
Dr. Antonio M. Vignola +
ENT Secretary
Dr. Joaquim Mullol
Paediatrics Secretary
Dr. Maria A. Muraro
Immunology Secretary
Dr. Thilo Jakob
Dermatology Secretary
Dr. Thomas Bieber

* Pediatrics Meeting: The management of pediatric allergy: in whose hands? From bench to bedside
Date: 20th-21st January 2006
Place: Hotel Executive, Milan, Italy
In cooperation with ACAAI and EAACI.
For more information click on http://www.mcaevents.org or email at info@mcaevents.org. To download the programme click here.

* EAACI ENT Section Meeting
Date: 9-11 February, 2006
Place: Barcelona, Spain
For more information email at serin2006@pacifico-meetings.com or click on the website http://pacifico-meetings.com/serin2006.

* 4th EAACI-GA2LEN DAVOS  Meeting
Basic Immunology Research in Allergy and Clinical Immunology
Date:16-19 February 2006
Place: Eibsee-Hotel, Grainau, Garmisch-Partenkirchen, Germany

* 1st International Symposium on Molecular Allergology Allergen Molecules: Basic and Clinical Aspects
Date: March 31 – April 1, 2006
Place: Rome, Italy
For more information click on www.allergome.org/meetings/rome.html

* GA2LEN Annual Conference
Date: March 29- April 1st, 2006
Place: Berlin, Germany
For more information click on the website www.ga2len.net

* Training Course in Food Allergy
Date: April 8-11, 2006
Place: Middelfart, Denmark

* 2nd International Drug Hypersensitivity Meeting
Clinical Management, Basic Mechanisms, Genetics and latest research on Drug Hypersensitivity.
Date: 18-21 April, 2006
Place: Liverpool, England
For more information click on the website
http://pcwww.liv.ac.uk/drughypersensitivity/index.htm

* IV European Asthma Congress
Date: 22-25 April, 2006
Place: Tenerife, Canary Islands
For more information click on www.immunopathology.org

* 2006 EFA Conference
Date: 10-13 May, 2006
Place: Prague, Czech Republic
For more information click on the EFA website http://www.efanet.org

* IX International Congress of Polish Society of Allergology
Date: 10-13 May, 2006
Place: Wisla, Poland
For more information click on the website www.kongrespta.pl

* HB 2006  Buildings
Creating a healthy indoor environment for people
Date: 4-8 June 2006
Place: Lisboa, Portugal
For more information email at hb2006@fe.up.pt or click on the website www.hb2006.org

* ERS & ISIAN 2006
21st Congress of the European Rhinologic Society
25th International Symposium of Infection and Allergy of the Nose
Date: 11-15 June, 2006
Place: Tampere, Finland
For more information click on www.ers2006isian.com

* 2006 BSACI Annual Meeting
Date: 10-12 July, 2006
Place: Burleigh Court International Conference Centre, Loughborough, UK
For more information click on http://www.bsaci.org/annualmeeting.html

* XVIII World Congress of Asthma
Novel Concepts in Pathogenesis and therapy
Date: 15 -18 July, 2006
Place: Beaulieu, Lausanne, Switzerland
For more information click on www.worldasthma2006.ch

* 14th Latin American Society of Allergy, Asthma and Immunology
Date: 19-22 August, 2006
Place: Buenos Aires, Argentina
For more information email at latamcong@alergia.org.ar

* 16th ERS Annual Congress
Date: 2-6 September 2006
Place: Munich, Germany
For more information click visit www.ersnet.org.

*Symposium on Aging Research in Immunology: the Impact of Genomics (ARIG)
Date: September 4-5, 2006
Place: Coeur Defense Conference Center, Paris, France.
Student travel grants are available! For more infromation please visit www.arig.ac.at .

* ACAAI - HSACI Joint Allergy Symposium
Allergy update in Greece
Date: 6-9 September 2006
Place: Athens, Greece
For more information click on www.joint-allergy2006.gr

* 17th Annual Scientific Meeting 2006
Australian Society of Clinical Immunology & Allergy Inc.
Date: 7-10 September 006
Place: Manly Pacific Hotel, Manly Beach, Sydney, Australia
More information at education@allergy.org.au or at the website www.allergy.org.au (available in late 2005).

* III International Congress "Modern Methods of Diagnostics and Treatment of Allergy, Asthma and Immunodeficiency"
Date:24-27 September 2006
Place: Sheraton Metekhi Palace Hotel, Tbilisi, Georgia
More information at info@wipocis.org and iaaci@mail.ru.

* 5th Meeting of the European Mucosal Immunology Group
Main topics:Mucosal innate immunity, microbiota and probiotics, inflammation, regulation of immune responses, mucosal vaccines
Date: 5-7 October 2006
Place: Prague, Czech Republic
For more information click on the website www.congressprague.cz/emig2006.

* EASL Monothematic Conference
Main theme: Clinical Immunology in Viral Hepatitis
Date: 7-8 October 2006
Place: University Collegr London, London, UK
For more information click here. Download the Registration Form here.

* XVIII World Congress of Asthma Interasma
International Association of Asthmology
Date: 14-17 October 2006
Place: Hilton Hotel, Guadalajara, Mexico
More information at the website http://www.worldcongressofasthma2006.com/

Allergopharma Joachim Ganzer KG is committed to furthering excellence through research in

ALLERGY DIAGNOSIS • ALLERGY THERAPY • ALLERGY PREVENTION

680

The presentation of the sixth Award will be made in recognition of scientific achievement in the field of Allergology during the European Academy of Allergy and Clinical Immunology (EAACI) Congress, Vienna 2006.

A submission for the award shall take the form of one full research paper published in an international peer reviewed journal in past years, together with a curriculum vitae. Applicants must be members or affiliates of the EAACI, under the age of 40 years, and the research that is the subject of the application must have been conducted in a European centre. Special consideration will be given to research concerning the mechanisms of allergic inflammation and allergen specific immunotherapy.

 

Further information can be obtained from:
Allergopharma Joachim Ganzer KG
21465 Reinbek, Germany
Phone: + 49 40 727 65 185
Fax: +49 727 65 318
Website: www.allergopharma.com
E-mail: oliver.cromwell@allergopharma.de

Section on Pediatrics, EAACI

2006 – 2007 Annual Report

Members of the board

 

Luis Miguel Borrego, Junior Member Affiliate (JMA)

Philippe Eigenmann, Chairman of the Section

Frank Friedrichs, Member

Susanne Halken, Member

Gideon Lack, Member

Antonella Muraro, Secretary of the Section

Antonio Nieto, Member

Fabienne Rancé, Member

 

The Section on Pediatrics-EAACI has currently 867 members with voting rights.

 

During the last year, we continued to focus on our main activities, which are the following:

 

Post graduated education - continuous education in pediatric allergy for trained pediatric allergists as well as continuous education for primary care physicians - patient education - promotion of research - elaboration of guidelines for better care of children with allergies.

 

The Education and Training Committee in Pediatric Allergy (ETC-PA), has continued evaluation of pediatric allergists fulfilling the requirement outlined in the Training Syllabus for European Pediatric Allergists. In the last year, 96 colleagues from Spain received their diploma of Pediatric Allergists. In addition, 12 pediatric allergists from Switzerland have also fulfilled the requirements and were provided with their diploma. Currently, the curricula of colleagues from France, Portugal and Italy are evaluated. We strongly encourage pediatric allergists from other European countries to apply for their diploma. Application should be made through their national delegates. The list can be obtained from Jose Lopes Dos Santos, the Secretary of ETC-PA. In the near future, main training centers in various European countries will be evaluated and accredited.

 

In 2006, we had a very successful congress in Vienna, with several sessions devoted to Pediatric Allergy. In Goteborg, sessions of interest to pediatric allergist will be specifically labeled. At the 2008 EAACI Annual Congress in Barcelona, a complete pediatric track will be devoted to pediatric allergy, allowing pediatricians to have a large exposure to post-graduated courses and state-of-the-art sessions devoted to their specialty.

 

In 2006 and 2007, there were two PAPRICA sessions for primary care physicians. The first one took place in Macedonia and Albania and benefited from a great interest from specialists as well as primary care physicians from these countries. In April 2007, two sessions took place in the Netherlands, in Utrecht and in Groningen. There, the attendance was exclusively by primary care physicians who were most interested to have a direct exposure to pediatric allergy during their continuous educational program. An additional session is schedule in the autumn 2007, in Lithuania.

 

This autumn will also see a 2nd edition of the Food Allergy Training Course that we initially organized together with the Section on Dermatology and the Food Allergy Interest Group in 2006, in Denmark. This session will take place in Cork (Ireland). As there were many more applicants in 2006 than places available, we strongly encourage early application for the Cork training course.

 

Our Bi-Annual Common Meeting with the ERS Pediatric Chapter will take place in Estoril (Portugal), 20-23 October 2007. This will be a unique opportunity for pediatric allergist and pediatric pulmonologists to be exposed to the latest news in their specialty. It is most important for us to gather on a regular basis, and we strongly encourage the members of the Section to attend this meeting.

 

It took approximately two years to establish the new Pediatric Allergy Foundation, which is called “EAACI-Clemens von Pirquet Foundation”. This Foundation was established with the remaining assets from the former ESPACI. The Foundation is devoted to support Education and Research in Pediatric Allergy and Immunology. As a first activity, the Foundation together with the Section and the American Academy of Allergy, Asthma and Immunology (AAAAI) is organizing a Pediatric Allergy Immunology Research Brainstorming in order to define future directions for research in pediatric allergy and immunology. This meeting will take place prior to the Estoril meeting and proceedings should be published in Pediatric Allergy and Immunology.

 

The Section has recently closed the work on the task force “Anaphylaxis in Children”. Their recommendations will be published in the June issue of Allergy and will be of great help to all practicing allergists. The Section plans to implement these guidelines as widely as possible. The Section has also launched a new task force “The Allergic Child in the School".

 

At the business meeting in Goteborg, new elections to the board will take place. I take this occasion to thank all current members for the friendly and nice atmosphere that allowed many projects to be fulfilled and to wish to the new board all the best for their work in supporting our specialty.

 

It has been a pleasure to work with you in the last 4 years, and thank you to all for your commitment.

 

 

 

 

Philippe Eigenmann

Chairman

Section on Pediatrics, EAACI

May 2007
EAACI Section on Pediatrics

Members of the board


Luis Miguel Borrego, Junior Member Affiliate (JMA)

Philippe Eigenmann, Chairman of the Section

Frank Friedrichs, Member

Susanne Halken, Member

Gideon Lack, Member

Antonella Muraro, Secretary of the Section

Antonio Nieto, Member

Fabienne Rancé, Member

 

The Section on Pediatrics-EAACI has 818 members with voting rights.

 

During the last year, we continued to focus on our main activities which are the following:

 

Post graduated education - continuous education in pediatric allergy for trained pediatric allergists as well as continuous education for primary care physicians - patient education - promotion of research - elaboration of guidelines for better care of children with allergies.

 

The section closely collaborates with the education and training committee in pediatric allergy (ETC-PA). ETC-PA is currently chaired by Arne Høst (Denmark) and coordinated by José Lopes Dos Santos (Portugal). ETC-PA started in 2004 to establish lists of individuals qualified to obtain the Certificate of European Pediatric Allergist. In 2005, ETC-PA has accredited Finish pediatric allergists, and the registration process of our Lithuanian colleagues will be finished by the time you read this report. Further countries, Portugal, Spain, Italy, Switzerland among others will start the review process soon. It's most important that as many pediatric allergists as possible will have the title of European pediatric allergist in the future. If your country has not started the registration process, I would encourage you to get in touch with your national representatives or your national pediatric allergy society as soon as possible.

 

2005 and early 2006 has seen four major events for continuous education in pediatric allergy. The annual EAACI 2005 Congress has been hold together with the World Allergy Congress in Munich in June. Several sessions have been devoted to pediatric allergy. Most of them have been visited by a large number of delegates. We expect this year’s meeting to be as successful.

In 2004, the section has launched the PAPRICA Program for continuous education of primary care physicians. The session of 2005 took place in Ukraine, and close to 150 participants enjoyed a full day program with state-of-the-art lectures. Delegates from the whole country enjoyed this unique opportunity to have in their country an international meeting in pediatric allergy. For the speakers it was a very enjoyable experience and it generated many interesting questions and personal contacts.

Last fall, the section had together with ERS-Pediatric Assembly a meeting in Prague. Besides top science, it was an important possibility for us to meet between pediatrician with a common interest in chest diseases and in allergy. It was decided that we should hold this meeting every other year. The next meeting will probably take place in Portugal Please bookmark this meeting in your agendas. in fall 2007.

In April 2006, the section on pediatrics together with the section on dermatology, and the food allergy interest group organized a food allergy training course in Denmark.Close to 100 delegates had the possibility to attend state-of-the art presentations as well as practical hands-on courses and interesting case presentations. Unfortunately, half of the applicants could not to be accepted to this course. We will definitely have to repeat it in a close future.

 

On "behalf" of the former ESPACI, the section launched a new foundation for promotion of education and research in pediatric allergy. After a written consultation of the section members, it was decided that the most suitable name for the Foundation would be "Clemens von Pirquet Foundation". The Foundation will start its activities with assets of over 200'000 Euros. The Foundation will work together in close collaboration with EAACI, and in particular the section on pediatric.

 

Finally, the section was also instrumental in two task forces. The Atopy Patch Test task force was initiated together with the Section on Dermatology. Its final report will be published this summer in Allergy. The task force on Anaphylaxis in Children is also close to the final conclusions and will publish it's recommendations this year. Please visit the sessions devoted to this topic during this year's annual meeting

 

 

Again, it would not have been possible to fulfill all achievements of this past year without the continuous work of the board member, the people involved in ETC-PA, as well as many other members and friends of the section. Thank you for your commitment.

 

With your continuous help, I look forward for a fruitful 2007.

 

 

 

Philippe Eigenmann

Chairman Section on Pediatrics, EAACI

May 2006

We hereby cordially invite all members of the Section on Pediatrics to join the:

Annual Business Meeting in Amsterdam
Monday June 14, 2004, 17:45 - 18:45
RAI Congress Centre Room P

The annual business meeting is a unique opportunity to have a yearly contact between the board and the members of the section. We warmly encourage you to come in order to actively contribute to future activities.

 

Padua, May 2004

Philippe Eigenmann
Chairman

Antonella Muraro
Secretary

We hereby cordially invite all members of the Section on Pediatrics to join the:

Section on Pediatrics Business Meeting
Education and Training in Pediatric Allergy
Monday, June 14 th, 16.00 - 17.30
Room P. RAI Congress Centre

 

 

Padua, June 2004

Philippe Eigenmann
Chairman

Antonella Muraro
Secretary

Minutes from the Section on Pediatrics Business Meeting
Amsterdam, Monday June 14, 2004, 17:45 - 19:00

 

1. Present:
Joanna Rijntjes, Andrea von Berg, Cristina Pascual, Bodo Niggemann, Fabienne Rancé, Magnus Wickman, Arne Host, Bulent Sekerel, Marzia Duse, Alessandro Fiocchi, Ed Van Leer, Zsolt Szepfalusi, Wolfan Rebien, Isidor Huttegger, Frank Friedrichs, Susanne Lau, Yolanda Meijer, Paola Miglioranzi, Tine K Hansen, Irina Sidorenko, Angela Gaspar, Luis Garcia-Marcos, Roger Rolland, Daniel Caillot, Roger Launer, Photini Sayonij-Papageorgor, Nikos Papadopoulos, Christian Moller, Marisdna Kuhar, Vesna Plevnik-Vodusek, Armando Di Fazio, Michele Rana, Liliane De Swert, José Lopes Do Santos, Philippe Eigenmann, Antonella Muraro.

Apologies:
Osmar Yusuf, Johanes Forster, Ernst Rietschel, Frans Timmerrmans, Stephan Strobel.

 

2. Commemoration of Herman Neijens

3. Report from the Chairman Philippe Eigenmann
Promotion of Education:
The education and training Committee on Pediatric Allergy ETC-PA chaired by Arne Host (Secretary José Lope Dos Santos) met on June 14, 2004 in Amsterdam. José Lope Do Santos, Section’s liaison officer in CESP, reported on the opportunity that the Section on Pediatrics has to start a provisional accreditation of the existing pediatric Allergists. This programme will begin on January 2005. Detailed instructions will be provided on the website soon. Accordingly, an accreditation of the Pediatric Allergy Centers in the European countries can commence including a visitation programme. Eastern pediatric allergists are encouraged to join the ETR-PA.

Within the Educational activity of the Section two other initiatives were activated. The first of these is PAPRICA symposia (acronymous for Pediatric Allergy for Primary Care Physicians) in collaboration with EAACI and Ga2LEN: the first symposia is scheduled for Ireland on Fall 2004. The next country involved in this activity will be Ukraine in Fall 2005. The second of these initiatives is the collaboration with WHO regarding the implementation of pediatric allergy in underdeveloped countries.

Early Diagnosis Campaign:
The Campaign started in June 2003 in Paris. At present 8 European countries are involved. The Business Office of EAACI coordinates the Campaign while the Section contributes to the Scientific part. Pharmacia will act as sponsor.

Some issues still need to be clarified. In Italy, the general pediatricians left out the pediatric allergists community in the project they had drawn for the Campaign. In Austria it appears that members of the Section were not chosen as EAACI representatives for the Campaign by the sponsor. A similar situation seems to have occurred in Belgium since EFA people started the Campaign with the patients without involving pediatric allergists and in particular Section members. It was decided to compose a list of the EAACI Section on Pediatrics representatives for each country to be sent to the EAACI Office in Brussels. This list should be distributed to Pharmacia and to EFA. The EAACI Section on Pediatrics representatives in each country will be the national representatives present in the ETC-PA Committee endorsed by their national allergy or pediatric allergy societies. Arne Host will provide an update of this list to Antonella Muraro.

Next meetings:
A meeting with the Section on Immunology is scheduled for February 3-6, 2005 in Davos. The meeting is devoted to young Scientists and members are encouraged to send fellows and residents.

A joint meeting with ERS Pediatric Assembly is scheduled from November 12-15, 2005. Information about the scientific programme and the deadline for the abstracts will soon be available on the website.


4. The cash report (Bodo Niggemann):
The Section on Pediatrics had some funds from the previous ESPACI. At present the budget has a positive balance and has been unanimously approved by the assembly.


5. Situation of ''Pediatr Allergy Immunol'' (Philippe Eigenmann)
The Board of the Section needs some feedback from the members regarding PAI. The attendants agreed that a pediatric allergy journal should continue to be published and that they prefer to receive PAI in hard copy in addition to the one available on-line. It was discussed whether or not other EAACI members should receive PAI in hard copy and it was proposed to use some of the Section’s funds to support this initiative. However this matter will be discussed with Blackwell as far as the costs are concerned.

6. Future activities (Philippe Eigenmann)
A collaboration with WHO was started. The aim is to provide guidelines for better diagnosis in pediatric allergy in underdeveloped countries.
A task force on Anaphylaxis in children, chaired by Antonella Muraro, will be constituted jointly with the Food Allergy Interest Group.


7. Next Business Meeting
The next Business meeting will be held at the EAACI Congress in Munich, June 26 – July 1, 2005.

 

 

Padua, June 2004


Philippe Eigenmann Antonella Muraro
Chairman Secretary

218A total of 24 presentations were offered over the two-days course, varying from dietary and environmental prevention to new therapeutic approaches and diagnoses of specific conditions. Whilst a detailed examination of each topic discussed would be impossible to relate in this forum, it was decided to highlight a number of the take home messages from the abstracts as a reminder to all of us of the specialized topics that comprise the multi-faceted and intervolving nature of Pediatric Allergy.

 

The sessions held on Friday 14 November produced insights ranging from allergy prevention at the prenatal stage to the problems involved in properly diagnosing food allergy. Opening with a discussion of the importance of the maternal environment and its impact on the immunological development of the child (C. Thornton), the morning sessions encompassed dietary and environmental prevention methods.

The dietary recommendations should be based on prospective randomised studies when possible (A. Høst). Based on an analysis of extant material some recommendations can be extrapolated for all infants: no special diet during pregnancy or for the lactating mother and exclusively breastfeeding for at least 4 months. Further recommendations can be suggested for high-risk infants: a documented hypoallergenic formula is recommended if supplement is needed during the first 4 months. As regards breastfeeding, randomisation is impossible and unethical, and for that reason recommendations on breastfeeding are based on prospective controlled non-randomised studies of high quality. Its role in prevention of allergic disease was confirmed in a recent metaanalysis published in Allergy.

As far as environmental recommendations are concerned, indications were provided against parental smoking and in favour of the avoidance of furry animals in families where in some members already have reactions (M. Wickman). It was pointed out that it is necessary to give practical advice to patients on allergen avoidance and to provide a rationale for such to increase adherence (A. Boner).

 

Moving into the realm of accurate diagnoses and testing, a presentation (P. Eigenmann) underscored the fact that a good knowledge of the mechanism of allergy is prerequisite for using allergy tests in clinical practice. Mosty IgE-related tests are extensivelly scientifically validated. Others might be used with care, by taking into account their sensitivity and specificity when defined. Notwithstanding all sophisticated diagnostic tests, clinical observation (e.g. by allergen challenge tests if necessary) remains the basis of allergy diagnosis.

Early allergic diagnosis (U. Wahn) is the essential prerequisite for correct measures of secondary prevention. Diagnostic tests combined with clinical history can only indicate possible clinical allergy and only elimination in combination with challenge tests can prove clinically significant allergy (S. Dreborg). In effect some clinically allergic children have non IgE to the causative allergen. At least some of these children have a cell-mediated allergic reaction. Allergy testing is furthermore most important before specific immunotherapy is prescribed (G. Hedlin).

A discussion of the mechanisms of food allergy asserted that food allergy is a malfunction of the gastrointestinal immune system to dietary antigens (K. Beyer). The majority of food allergic reactions are IgE-mediated. However even in non-IgE mediated food protein induced gastrointestinal disorders the duodenal presence of IgE-bearing cells has been shown suggesting a localized IgE mediated response. Though food-specific IgE is often present without clinical reactivity, the concentration of specific IgE correlates positiviely with the risk of reactions.

On the topic of clinical management of cross-reactivity (C. Pascual) it was indicated that this is a laboratory concept imported to the clinic and the meaning of cross reactivity varies for every group of allergens.

Regarding the pitfalls in food allergy diagnoses, sensitization is not the same as clinical allergy and elimination diets may only be provided on the basis of the individual proof of clinical relevance (B. Niggemann). The mainstay of food allergy management today remains the education of patients and their caregivers in appropriate food allergen avoidance techniques, early recognition of allergic symptoms, and early self-treatment of food allergic events (H. Sampson).

 

Atopic eczema/dermatitis syndrome (AEDS) was the main topic of one of the sessions held on Saturday 15 November. It was imparted that in the “allergic” form of AEDS, patient symptoms may be exacerbated by a variety of food and airborne allergens (H. Sampson) and that food allergies play a role in one third of children with AEDS while diagnoses of this should be based on double-blind, placebo controlled food challenges (F. Rancé). The role of topical immunomodulators in AEDS was evaluated (T. Hoeger). In order to avoid serious side effects, use of TCS in children with AD should be restricted to class I and II (mild and moderate) steroids. Topical calcineurin antagonists (TCA) have been shown to be effective in children with AD. Pimecrolimus and tacrolimus have been licensed for use in children >2 years of age; recent studies have also demonstrated their efficacy in infants. Unlike TCS, TCA do not induce skin atrophy and might therefore be suitable for long-term therapy. Given their potent suppression of cytokine synthesis, there are a number of unresolved issues regarding their use in children. Until long term studies (extended to 5-10 years) are available, TCA should be regarded as useful and effective antiinflammatory agents supplementing, but not completely replacing topical steroid therapy. As a precautionary measure, regular use of sunscreens on UV-exposed areas treated with TCA should be strictly recommended.

In the session devoted to the role of allergy in the lung and the nose it was recognized that the exposure to allergens is an important factor in initiating and maintaining allergic airway inflammation in atopic asthmatics (SH. Arshad). Generation of pro-inflammatory cytokines causes amplification and persistence of the inflammatory process by cell recruitment and activation. Repeated exposure to low levels of allergen may result in persistent chronic inflammation. In addition there may be interaction between allergic and virus induced responses (RSV) that contribute to the development and/or persistence of inflammation.

Longitudinal studies have allowed the clearer definition of distinct wheezing phenotypes (G. Lack), as well as risk factors for the development thereof, it is hoped that the correct and early recognition of the asthmatic will allow for early environmental and therapeutic intervention.

The interplay between hay-fever and asthma was discussed (S. Halken), pointing out that allergic rhinitis and asthma often coexists. Effective treatment of allergic rhinitis may also improve coexistent asthma. SIT has the potential for preventing the development of asthma in children with hay-fever though, further studies will be necessary to determine whether early pharmaceutical treatment may prevent the progression from hay-fever to asthma.

 

Drug allergies are iatrogenic diseases and need a careful evaluation of the severity during the acute stage to advise the patient correctly. Distinct T cell functions can be associated with distinct clinical symptoms; cytoxic reaction are always involved in delayed reaction (W. Pichler). It is crucial to assess immediate reactions within a few months (A. Romano). The patient’s history continues to be crucial. In choosing diagnostic tests, it is important to distinguish between immediate and non-immediate reactions and to consider whether the clinical phase is acute or late (i.e., 3 to 4 weeks after recovery). Patch testing is useful, together with delayed-reading intradermal testing, in assessing non-immediate reactions, particularly maculopapular eruptions such as those occurring during anticonvulsant therapy. With regard to in vitro tests, determination of serum specific IgE levels (radioallergosorbent test or RAST and immunoenzymatic assay or ELISA) is the most common in vitro method for evaluating immediate reactions. In selected cases with negative allergologic tests, provocation tests could be useful. They are very sensitive, but should be performed in specialist centers with intensive care facilities, in the remission phase. Provocation tests can reduce the number of children falsely labelled as “drug allergic”.

The number of infections, the type and localisation of the infections and factors such as e.g. failure to thrive should be carefully considered in evaluating a child with recurrent infections (R. Lauener). For the differential diagnosis, consider primary immunodeficienceis, but also other diseases, such as e.g. secondary, acquired immune deficiency, allergies, cystic fibrosis, ciliary dysfunctions.

The specific allergy treatments were discussed in the final session.

A review on specific immunotherapy was done by E.A. Cuesta.

Advise was given on how to manage an elimination diet with particular attention to nutritional adequacy (A. Muraro). Tips in instruction of patients and family were provided with regards to the “hidden ingredients”, food contamination as well as the evaluation of compliance.

The complexity and diversity of the allergic response can explain individual differences in the response to the treatments (A. Nieto). Strategies (agonistic or antagonistic) addressing specific factors of the allergic response are now available, or under advanced investigation. The identification of key factors in each patient, and the selective approach to them would suppose a safer and more effective control of allergic diseases.

a) Assignment of EAACI Congresses

The organisation of EAACI Congresses is assigned by the EAACI Executive Committee (ExCom) to a National Member Society of EAACI.

National Societies wishing to organise a Congress must apply in writing to the EAACI Secretary General not less than five years in advance. This letter should indicate the names of the President of the Congress and (if possible) some of the members of the Local Organising Committee (LOC).

Applicants will then be invited to make a formal oral presentation to the ExCom of their bid. This presentation should include a detailed and realistic description of the proposed Congress (venue, date, congress facilities, accommodation, transfers, financial plan, scientific programme overview etc.). In the event that a large number of bids are received, the board of officers may make an initial selection of candidates based on the feasibility of the bids.

The assignment of any EAACI Congress is regulated by a contract between EAACI and the LOC. The contract must be agreed and signed according to a timetable which is laid out by the Administrative Programme Committee (APC) and discussed at the time of the bidding process.

The LOC of the event proposes the place and date of the congress but these are subject to approval by the ExCom. The responsibilities of the LOC are laid out in Article 1(f). The LOC is aided and advised in its work by the EAACI Programme Committee (EPC).

b) Denomination, Venue, Languages

The denomination of the congress must be worded as follows: “European Congress of Allergology and Clinical Immunology”, followed by the relevant roman numeral.

On the letter-head paper, circulars and programmes, the official emblem of EAACI must be used with the exclusion of all others.

The host city should be easily accessible and have adequate hotel and transportation facilities.

The congress facilities should have a total minimum capacity of 5,000 participants. The main hall should accommodate at least 70% of the participants. In special cases this may be extended by internal video transmission, Two additional halls should accommodate at least 500 persons each.  In addition, 8 - 12 medium-sized to small-medium-sized rooms should be available for scientific sessions. Small rooms for committee meetings, secretariat and hospitality suites should be conveniently located.

An area for a commercial exhibition, allowing a minimum of 1,200m2 rentable space, should be available close to the congress facilities.

The official language of EAACI congresses will be English.

c)  EAACI Programme Committee

The EPC has the ultimate responsibility for the overall programme and consists of two parts: the Scientific Programme Committee (SPC) and the Administrative Programme Committee (APC). The SPC consists of the SPC Co-ordinator, President, Secretary General, 1st Vice President, Past President, the secretaries of the EAACI sections, and one representative (the Congress President or anyone named by him/her) of each of four consecutive EAACI congresses (the current year’s congress and the following three congresses). The Executive Manager is an adjunct member of the SPC. The SPC is chaired by the Secretary-General or their designated deputy. The work of the SPC is organised and coordinated by the SPC Co-ordinator, who is appointed by the Executive Committee. The SPC Co-ordinator is appointed for a term of two years, which may be preceded by a year acting as Assistant Co-ordinator, in order to learn the duties of the SPC Co-ordinator role.

The APC consists of the EAACI Treasurer, one ExCom representative, and the EAACI Executive Manager.

d) Professional Congress Organiser

The EAACI may appoint a Professional Congress Organiser (PCO) to organise EAACI Congresses.  Relationships between EAACI and PCOs are regulated by a contract approved by the ExCom. The PCO interacts with the APC and the LOC. The PCO provides the ExCom with six-monthly reports on the current status of the congress.

e) removed

f)  Local Organising Committee

The LOC is proposed by the National Member Society hosting an EAACI Congress. The LOC works in close collaboration with the SPC and PCO to help EAACI to organise its events and ensure the highest scientific and logistical standards.  The LOC accepts responsibility for all EAACI obligations in relation to organisation of the event deriving from the Constitution and By-laws, or from existing contracts and agreements (between EAACI and sponsors, publishing companies, etc.). The LOC is responsible for the preparation and realisation of:

1. Scientific aspects of the Congress

  • A scientific programme, proposed by the LOC to be
    approved by the SPC.
  • The receipt, selection and organisation of the 
    abstracts of posters and free communication
  • The editing and printing of an Abstract Book.

2. Social activities

  • The preparation of a social programme for delegates and accompanying persons, intended to stimulate personal contacts between the participants of the meeting. It should include one main social event open to all participants.
  • The organisation and financing of a Presidents’ Dinner.

3.Programmes and Publicity

  • The LOC is responsible for making the publicity necessary for the success of the Congress (information to various medical journals, national institutions, etc.) All major items of publicity material should be shown to the EAACI President and Secretary-General prior to printing (especially 1st & 2nd announcements).
  • An Invitation Programme (the Second Announcement) including Registration and Abstract forms, should be sent to all members of EAACI and to all members of EAACI National Member Societies, Affiliate Societies and co-operative Societies nine months before the congress.  The Invitation Programme should also include the main subjects to be discussed and, if possible, the names of the invited speakers as well as the main social activities.
  • The Final Programme is prepared by the LOC after approval by the EPC.  All programmes must be published in English.

4.  Other general aspects of the event

  • Covering the costs for travel, Business Class or equivalent, accommodation and registration of all elected and adjunct members of the ExCom, allowing them to participate in all business, scientific and social activities of the meeting.  In addition, registration and accommodation of ExCom accompanying persons should be covered.
  • Covering the costs for travel APEX or equivalent, accommodation and registration for all EAACI past-Presidents.
  • Providing, without any charge, adequate space and facilities including telecommunication facilities for the Secretariat of EAACI during the event.
  • Granting facilities free of charge for meetings of the ExCom, General Assembly, other committees and scientific bodies of EAACI, in so far as these have been requested beforehand, including an ExCom meeting on the day before the start of the congress.
  • Providing, without any charge, a hospitality suite or room for the EAACI President.
  • Offering at least 10 free registrations to persons nominated by the EAACI President.
  • Covering all costs (travel, Business Class or equivalent, accommodation, etc.) for the APC and for two representatives of the SPC at two planning meetings,  as well as the costs for participation of the EPC in the congress.
  • Consulting the EAACI President on all decisions which may influence the image of EAACI and the satisfaction of members attending the congress.

 

g) Finances

The financial relationship between the LOC and EAACI is defined by a special agreement.

The LOC receives from the EAACI Treasurer an initial support to be able to start the preparation of the event. Additional financial support should be raised by the LOC in the name of EAACI for the specific congress.

The overall budget and the registration fees are established by the LOC, but should be approved by the ExCom. Members and affiliates of EAACI (names will be provided by the Executive Office) should be entitled to a reduction of the registration fee (currently 20%). A percentage of all paid registration fees (currently 15%) should be transferred by the LOC to EAACI no later than three months after the congress.  This percentage is established by the ExCom prior to the signing of the contract for the congress.

* Workshop on Animal Models of Asthma
Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM)
Date: 28-29 January, 2005
Place: Hannover, Germany
For more information contact Dr Armin Braun (braun@item.fraunhofer.de) or click on www.item.fraunhofer.de

*3rd EAACI Davos Meeting in Basic Immunology in Allergy and Clinical Immunology
Date: 3-6 February 2005
Place: Davos, Switzerland
For more information contact siaf@siaf.unizh.ch or click on www.siaf.unizh.ch/EAACI_meeting/EAACI_2004.html

* III World Congress on Immunopathology & Respiratory Allergy
Date: 5 - 8 February, 2005
Place: Pattaya, Thailand
Main themes: Allergy & Asthma, Autoimmune Diseases, Immunodeficiency and Basic Immunology, the Immune System Physiology
For more information click on www.isir.ru/thailand/general.html

* 3rd Annual Meeting of the Egyptian Society of Pediatric Allergy and Immunology (ESPAI)
Date: February 24-25, 2005
Place: Cairo Conrad Hotel, Cairo, Egypt
More information on the email congress@espai-eg.org or click on www.espai-eg.org/scientific.htm.

*  First International Congress on Immunodeficiency Disorders
Date: 28 February-2 March 2005
Place: Tehran, Iran
Main theme: Immunodeficiencies, Immunogenetics, Immunodiagnosis and Infections
For more information click on www.iaari.hbi.ir/icid.htm

* VII International Symposium on Respiratory Viral Infections
Date:  March 3 – 6, 2005
Place: Curacao Marriott Beach Resort, Curacao, The Dutch Antilles
Keydates:  December 15, 2004 – Early registration fee
January 5, 2005 – Young Investigator Award abstracts due
January 5, 2005 – All abstracts due
For the program, registration and more information click on www.themacraegroup.com

* Frontiers in Neonatal & Infant Immunity
Date: March 18-20, 2005
Place: Westin Palace, Madrid Spain
Keydates:  January 10, 2005 – Early registration fee
January 10, 2005 – Young Investigator Award abstracts due
January 10, 2005 – All abstracts due
February 10, 2005 – Hotel reservation deadline for group rate
The event is CME Accredited.
For the program, registration and more information click on www.themacraegroup.com.

* 61st Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI)
Date: March 18-23, 2005
Place: San Antonio, Texas, USA
More information on: www.aaaai.org

* GA2LEN Annual Conference
Date: 18-19 April, 2005
Place: Ghent, Belgium
More information at the website: www.ga2len.net

* 1st Baltic Allergy Congress
Lithuanian Society of Allergollogy & Clinical Immunology
Date: 24-25 May, 2005
Place: Vilnius, Lihtuania
Main Theme: "Allergy: From the Past to the Future"
More information on www.balticconference.com/bac2005

* 10th EFA Conference
Allergy, asthma and COPD - Breaking through barriers.
Device: start with possibilities instead of limitations
Date: 2-4 June, 2005
Venue: Mitland Hotel, Utrecht, the Netherlands
More information at www.efanet.org.

*  ERS/ATS joint course on Basics in asthma
Date: June 8-10, 2005 
Place: Oslo, Norway
For more information click on www.ersnet.org

*The 10th Annual Meeting of the Global Alliance for Medical Education
Date:June 19-21, 2005
Place: The Westin New York at Times Square
New York, NY
For Registration information contact Meghan Arnott
at marnott@medicallectures.com or click on the GAME website www.game-cme.org

* XVIII IFOS World Congress
International Federation of Oto-Rhino-Laryngological Societies
Date: 25 - 30 June, 2005
Place: Rome, Italy
For more information email to ifos2005@gruppotriumph.it

* XIX World Allergy Congress
Organised by World Allergy Organisation (WAO) and the European Academy of Allergology and Clinical Immunology (EAACI)
Date: 26 June - 1st July, 2005
Place: Munich, Germany
Main Theme: Allergy in a Changing World
For more information click on www.congrex.com/wac2005 or contact wac2005@congrex.se .

* RSV 2005 Symposium
Date: September 15 – 18, 2005
Place: Keble College, Oxford, UK
Keydates:  May 9, 2005 – Early registration fee
May 9, 2005 – Young Investigator Award abstracts
May 9, 2005 – All abstracts due
July 25, 2005 – Late Breaker abstract deadline
September 5, 2005 – Final registration deadline
For the program, registration and more information click on  www.themacraegroup.com

* 4th Balkan Congress of Allergology and Clinical Immunology
Date: September 22-25, 2005
Place: Patriarchy Palace, Bucharest, Romania
For more information click on http://www.sraic.ro/congress/congress_en.html

* 2nd Croatian-Italian Symposium on Psoriasis
Date: 23-24 September 2005
Place: Naftalan, Ivanic Grad, Croatia
For more information email at naftalan@zg.htnet.hr or click on www.naftalan.nr

* VVM 2005, Viral Vaccine Meeting
Date: October 27 – 30, 2005
Place: Westin Palace, Madrid, Spain
For more information click on www.TheMacraeGroup.com

* International Cytokine Society Conference 2005
Cytokines, Immunity, Immunotherapy and Vaccine
Date: 27-31 October, 2005
Place: Lotte Hotel Jmasin, Seoul, Korea
More information at www.ics2005.org

* Joint Meeting of the Pediatric Assembly of the European Respiratory Society (ERS) and the EAACI Section on Pediatrics
Date: November 12-15, 2005
Place: Prague, Chech Republic
More information on www.ers-eaaci2005.ch

*  Iranian Asthma Meeting - Biennial Seminar of Iranian Society of Asthma & Allergy (ISAA)
Date: 14-16 November 2005
Place: Tehran, Iran

* Superantigens in Airway Diseases Symposium
Immunology and clinics of superantigen-driven inflammation
Date: November 25-26, 2005
Place: Hotel Novotel, Ghent, Belgium
More information on www.semico.be/superantigens2005/

* European Patient Conferece on Stem Cell Research: The Patient's Perpsective
Date: 15-16 December 2005
Place: The Charlemagne Building, Brussels, Belgium
More information on the website www.erastepps2005.eu.com/index.htm

* EAACI Immunology Section and SIAF Symposium
Place: Davos, Switzerland
Date: 9th January 2004
Main Theme: Immune Mechanisms of Allergy

* Allergy and Eczema
A CME Accreditation Event in cooperation with ACAAI in Milan, 23rd - 24th January, 2004.
Main theme: Adverse reactions to food proteins, the changing patterns, the mechanisms and the teatment.
For further Information click on the website
www.mcaevents.org

* 4th World Asthma Meeting
Place: Bangkok, Thailand
Date: 16th -19th February 2004
Main theme: Asthma: A World-Wide Approach to Understanding, Treatment and Prevention
For more information click on the website www.WAM2004.com

* International Primary Care Respiratory Group - 2nd World Conference
Place: Melbourne, Australia
Date: 19th - 22nd February 2004
For more information click on the website
www.theipcrg.org

* 6th International Congress of Pediatric Pulmonology
Place: Lisbon Congress Centre, Portugal
Date: February 28th - March 2nd 2004
For more information on the Congress and the programme click on the website: www.cipp-meeting.com/CIPP6/

* 9th International Symposium on Immunological, Chemical and Clinical Problems of Food Allergy
Place: Budapest, Hungary
Date: 18th - 21st April 2004
Details of preliminary programme, abstract submission, exhibition, registration procedures and accommodations available at the website: www.foodallergy.makit.hu

* Basic and Clinical Allergy
18th course in the series
Place: London
Date: 19th - 22nd April, 2004
For further information click on the website: www.med.ic.ac.uk/divisions/49a/mtgs.htm

* 1st Drug Hypersensitivity Meeting
Place: Bellevue Palace, Bern, Switzerland
Date:  5th - 8th May, 2004
For more information click on the website
www.drughypersensitivity.ch

*  9th EFA Conference
Place: Oslo, Norway
Date: 24-26 June, 2004
Main Theme: Asthma and COPD:The Patient's Perspective
For more information click on www.efanet.org or contact hk.be@lhl.no

* Krakow Conference
Place: Krakow, Polland
Date: July 31st - August 3rd, 2004
Theme: Present and Future Developments on Allergy & Immunology
For more information click on the website www.pta.med.pl/krakow2004/index.php

* ERS Annual Congres
Place: Glasgow, U.K
Date: 4-8 September 2004
For more information click on www.ersnet.org or contact info@ersnet.org.

* Allergy Congress 2004
Place: Aachen, Germany
Date: 15th-19 September, 2004
For more information click on www.allergie-kongress-2004.de/.

* 2nd International Consesus on Urticaria
Place: Berlin, Germany
Date:1-2 October 2004
Main theme: Pathophysiology, Epidemiology, Quality of Life, Diagnosis and Treatment
For more information click on www.ecarf.org.

* XII. Turkish National Congress of Allergy and Clinical Immunology
Place: Antalya, Turkey
Date:  6th - 10th October, 2004
For more information click on the website:
www.allerji.kongresi.info

* Annual Conference of the Romanian Society of Allergology and Clinical Immunology
Place: Brasov, Romania
Date:  7th - 9th October, 2004
For more information click on the website:
www.rsaci.3x.ro

* 3rd Slovenian Congress of Pneumology and Allergology
2nd Slovenian Immunology Congress-Immunology and Clinics IV:1st Slovenian Congress of Respiratory Nursing
Place: PORTORO, SLOVENIA, Grand hotel Emona
Date:  20th - 22nd October, 2004
For more information click on the website:
www.klinika-golnik.si

*American College of Allergy, Asthma & Immunology
Annual Meeting
Date: 12-17 November 2004
Place: Boston, USA
For more information contact diannekubis@acaai.org or click on the website www.acaai.org/annual.html.

* Interasma - EAACI Asthma Section Joint Meeting
Date: 27 - 30 November 2004
Place: Bilbao, Spain
Main Theme: Asthma and Rhinitis: from guidelines to patient´s care
For more information click on www.interasma.org/bilbao2004

*Recent Advances in Asthma
Turkish Thoracic Society
Date: 2 - 4 December 2004
Place: Istanbul, Turkey
For more information click on www.toraks.org.tr

* XVII World Asthma Congress
Place: St. Petersburg, Russia
Date: July 5-8,2003
Main theme
Asthma: From Genes to Clinical Management

* World Allergy Organisation Congress-IXVIII ICACI
Place: Vancouver, Canada
Date: 7-12 September, 2003
For more information click on the website www.worldallergy.org

*III Balcan Congress of Allergy and Clinical Immunology
XI.Turkish Congress of National Society of Allergy and Clinical Immunology
Place: Istanbul
Date: 11-14 October 2003
For more information click on the website www.tnsaci.org

* EAACI Section on Pediatrics Symposium
Main theme: ''Advances in Pediatric Allergy''
Date: 14-15 November 2003
Place: Gevena Switzerland
For more information click on the website
www.sp-eaaci2003.ch

* EAACI and Section ENT Meeting
An event of Allergy Week in Ghent 2003
Place: Ghent, Belgium
Date: 15-18 November 2003
For more information click on the website www.semico.org
* Open Forum on the Future of Networks of Excellence - Will the investment be lost?
Place:Royal Institute of Natural Science, rue Vautier 29, B-1000 Brussels, Belgium
Date:20 November 2007
Link:www.supportresearchnoes.eu

For more information click here!!

The First North African Course on Clinical Immunology and Allergy
Place:Hammamet,Tynisia meeting
Date: 25-28 October 2007
Tel: +216 71 843 317
Fax: +216 71 791 833
For more information click here!!

* IX International Symposium on Respiratory Viral Infections  Sponsor: The Macrae Group
Date: 3 - 6 March 2007
Place: Mandarin Oriental, Excelsior Hotel,Causeway Bay, Hong Kong
Tel: (+1) 212.988.7732
E-mail: TheMacraeGroup@comcast.net
Link: www.TheMacraeGroup.com

* 2e Congress Francophone d' Allergologie - CFA 2007
Date: 11-13 April, 2007
Place: Palais des Congress - Porte Maillot, Paris - France
For more information please click on www.cfa2007.com

* 2007 World Immune Regulation Meeting
Main Theme: Special Focus on Regulatory Cells
Date: 11-15 April 2007
Place: Davos, Switzerland
For more information click on the website http://www.siaf.unizh.ch/WTM/Overview.html

* Ist International Allergooncology Symposium in Vienna, 2007
Date: April 16  2007,
Place: Vienna, Austria
For more information click here!!

* Basic and Clinical Allergy Course 2007
Date: 16-19 April 2007
Place:London, UK
E-mail: k.dixon@imperial.ac.uk
Tel: +44 (0)20 7351 8172 
For more information click here!!

* GA²LEN Annual Conference 2007
Date: 20 April 2007
Place: Imperial College London, UK
For more info click here!!

* V European Asthma Congress
Date: 21-24 April, 2007
Place: Moscow, Russia

* World Asthma Meeting
Date: 22-25 June 2007
Place: Istanbul, Turkey
For more information go to www.toraks.org.tr or email at edagli@superonline.com

* 2007 Joint Technical Symposium
Date: 28-30 June
Place: Toronto, Canada
For further details either visit:  www.jts2007.org
For information send mail to : info@jts2007.org
Tel: 323-463-1500

* The British Society for Allergy and Clinical Immunology 2007 Meeting
Date: Monday 2nd - 4th July 2007
Place: Burleigh Court International Conference Centre, Loughborough, Leicestershire, UK
For further details either visit: www.bsaci.org or email: info@bsaci.org
Tel: +44 (0)207 404 0278

* Gaslini Advanced Course in Basic and Applied Immunology
Date: 9-13 July 2007
Place: Villa Quartara, Genoa (Italy)
For further details please visit www.sispge.com/immunology
Tel:+39 010 5636554 - 5636805  
Fax +39 010 3776590

* 25th International Congress of Pediatrics
Date: 25-30 August 2007
Place: Athens Congress Hall, Athens, Greece
For more information click on the website http://www.icp2007.gr/

* 17th ERS Annual Congress
Date: 15-19 September, 2007
Place: Stockholm, Sweden
For more information please visit www.ersnet.org

* 9th Baltic Summer School (BSS) course / workshop Inflammation :­ A Key to Common Complex Disease
Dates & place:
Theoretical course, 2nd - 13th September, 2007, Lund, Sweden &
Practical course, 17th - 21st September, 2007, Lund, Kiel and Copenhagen.
Additional information is available on the website: http://www.balticsummerschool.net

* 1st International Congress on Exacerbations of Airway Disease (ICEAD)
Sponsor: The Macrae Group
Date:  4-7 October 2007 
Place: Ritz-Carlton Hotel, San Juan, Puerto Rico
Tel: (+1) 212.988.7732
E-mail: TheMacraeGroup@comcast.net
Link:  <http://www.TheMacraeGroup.com> www.TheMacraeGroup.com

* Jordanian Society of Allergy & Immunology Annual Meeting
Date: 10 October 2007 
Place: Amman, Jordania
E-mail: ababnehhani@yahoo.com

* Turkish National Society of Allergy & Clinical Immunology Annual Meeting
Date: 16-20 October 2007 
Place: Antalya, Turkey
Contact: www.aid.org.tr
E-mail: okalayci@hacettepe.edu.tr

* Israel Association of Allergy & Clinical Immunology Annual Meeting
Date: 18-20 October 2007 
Place: Afule, Israel
Contact: drwerner@012.net.il

* Portuguese Society of Allergology & Clinical Immunology October Meeting
Date: 18-20 October 2007 
Place: Estoril, Lisabon, Portugal
For more information: www.spaic.pt

Congress of Slovak and Czech Allergists and Clinical Immunologists
Date: 24-27 October 2007 
Place: Trnava, Slovakia
For more information: www.csaki.cz

Meeting of the Spanish Society of Allergy and Clinical Immunology
Date: 25-27 October 2007 
Place: Santander, Spain
For more information: www.seaic.es

* EAACI-IUIS-STI Course
Main Theme: 1st North African Course on Clinical Immunology and Allergy
Date: October 25th-28th, 2007
Place: Yasmine-Hammamet,  Tunis

* Cytokines in Health & Disease
Fifteenth Annual Conference of The International Cytokine Society
Date: October 26-30, 2007
Place: San FRancisco, California
For more information go to www.cytokines2007.org
Email: info@cytokines2007.org
Fax: 706-228-4685

* Meeting of the Finnish Society of Allergology & Immunology
Date: 14 November  2007
For more information: http://www.terveysportti.fi/kotisivut/sivut.koti?p_sivusto=435

* Meeting of the Norweigan Society of Allergology & Immunopathology
Date: 14 November  2007
Place: Oslo, Norway
For more information: www.legeforeningen.no

* Meeting of the Dutch Society of Allergology
Date: 17 November  2007
Place: Utrecht, Netherlands
For more information: www.nvva-allergologie.nl

* Ukrainian Society for Clinical Immunology and Allergology
Date: 19-21 November  2007
Place: Poltava, Ukraine
For more information: www.immunology-ua.org/ua

* Meeting of the Swedish Society for Allergy
Date: 29 November  2007
Place: Stockholm, Sweden
For more information: www.sffa.nu

* World Allergy Congress 2007
Date: 2-6 December 2007
Place: Bangkok, Thailand
For more information click on the website http://www.congrex.com/wac2007/

* Meeting of the Hungarian Society of Allergology and Clinical Immunology
Date: 3-6 December 2007
Place: Budapest, Hungary
For more information: www.makit.hu

* 12th Congress of the International Rhinologic Society
Date: 5-8 December 2007
Place: Venice, Italy
For more information click on the link www.irspinocchio2007.org
Contact Details:  MCA Events srl - via G. Pellizza da Volpedo 4, 20149 Milano, Italy,
Tel. +39 02 3493440
Fax +39 02 34934397
info@mcaevents.org

Annual Meeting of the Austrian Society for Allergology and Immunology
Date: 13-15 December 2007
Place: Alpback in Tirol, Austria
For more information: www.oegai.org

JMA chair (Ex Com)
Dr U Raap, Germany (mail@ulrike-raap.de)
JMA past chair (SPC)
Dr Ph Gevaert, Belgium (Philippe.Gevaert@UGent.be)
ENT
Dr P Hellings, Belgium (peter.hellings@med.kuleuven.ac.be)
Dermatology
Dr E Borzova, Russia (eborzova@online.ru)
Immunology
Dr M Kurowski, Poland (marcin.kurowski@gazeta.pl)
Asthma
Dr D Groneberg, Germany (david.groneberg@charite.de)
Pediatrics
Dr L Borrego, Portugal (miguel.borrego@sapo.pt)
Webmaster
Dr C Skevaki, Greece (cskevaki@allergy.gr)
1007Date: 20-23 October 2007
Place:Estoril-Lisbon, Portugal

First Announcement

2007 EAACI - ERS Pediatrics Joint Meeting will take place between 20-23 October in Estoril Convention Centre, Lisbon, Portugal. The main theme will be "New Challenges from Childhood to Adolescence" aiming at the respiratory diseases and allergy as chronic conditions in young children and stressing the need for improvement of knowledge, as well as clinical and research collaboration.

Dates to Remember
January 2007: Second Announcement and Call for Abstracts��
April 2007: Deadline for Abstract Submission �
June 2007: Deadline for Early Registration��

Click here to download the relevant brochure .

1005

1113

World Asthma Day is an annual event organized by the Global Initiative for Asthma (GINA) to improve asthma awareness and care around the world. World Asthma Day 2007, organized around the theme "You Can Control Your Asthma," will be held on Tuesday, May 1.

The emphasis on asthma control is illustrated on the variety of the ideas concerning previous WAD:

  • In Serbia and Montenegro, the Yugoslav Association of Asthma and COPD (JUDAH) planned diverse activities to spread the message that it is possible to have a normal childhood with asthma. The organizers identified 66 children with persistent asthma from Serbia 's five poorest regions; these children were brought to Belgrade for comprehensive medical examinations and received 6 months of free treatment.

 

  • In Puerto Rico, physicians at San Jorge Children's Hospital collaborated with other medical groups to offer seminars about asthma to health care providers. Topics were Asthma in Puerto Rico in the Twenty-First Century and Management and Diagnosis of Asthma.

 

  • In China, Nanhai Asthma Net (NAN) is organizing an event in which patients in the countryside can meet and exchange their experiences of asthma treatment. The group also plans to offer educational lessons for healthcare workers who treat patients with asthma. This will involve education about asthma prevention and treatment, including the GINA guidelines.

 

For more information on WAD 2007 please click here!!

943First Announcement
Date: April, 11th-13th 2007 Palais des Congr¦Ès - Porte Maillot, Paris - France

 


Chairmen of the convention

Pr Pierre SCHEINMANN (Chairman of the SFAIC)

Dr Jean-Pol DUMUR (Chairman of the ANAFORCAL)

 

The CFA 2007 is a french-speaking convention on allergology organised under the auspice of the SFAIC (French Society of Allergology and clinical Immunology) and the ANAFORCAL (National Association for the Continuing Medical Education on allergology).

 

This second edition will gather doctors and opinion leaders around allergology and all its medical disciplines and will make an exhaustive overview of the medical actualities around allergology: from scientific research to the daily medical practice.

 

For more information click on the website and registrations:

www.cfa2007.com (Only for Doctors and Medical Staff).

 

Organisation Agency

Margaux Orange

20, Rue du Mail

75002 Paris - France

T¦Él. : 0033(0) 1 42 21 15 25

Fax : 0033(0) 1 42 21 15 55

Contact : cfa2007@margauxorange.com
Open calls for JMA Working Group

Dear JMA,

We are happy to announce great news for you all: We offer two new open positions within our group, the JMA WG, so this may represent your chance to get involved in the JMA activities !

If you are willing to overtake this challenging job, we would very much appreciate your letter of intention and CV sent in before September 10th 2006.

In the last years the JMA working group has actively participated in EAACI activities and has achieved considerable benefits for the JMA, including free registration, travel grants, poster prizes, Junior sessions etc. The JMA working group consists of the Chairperson, 5 section representatives and the webmaster, and is elected every 2 years following the periodicity of the Executive Committee.

The present JMA working group was elected in Munich (2005) and following the JMA procedures the current JMA chairperson (Ulrike Raap) will forward her position to Miguel Borrego in Gotheborg 2007 who had been elected as the following chairperson in Vienna 2006. Furthermore, Peter Hellings will leave the JMA working group after Göteborg 2007 since he is at the age limit of 35 years by then.

The responsibilities of JMA representatives
To provide information to JMAs regarding activities and to liaise with the relevant section board, the JMA group and all the JMAs in the section, in order to promote participation in EAACI activities. The main forum for meeting and discussing among JMAs is the yearly JMA Business Meeting held at the occasion of the EAACI Congress, where the JMA Working group should give a full report of activities. The JMA group organises a Poster session, an Educational Session, a Forum and Workshops during the EAACI yearly Congress. The JMA Working group is also responsible for developing contacts with similar groups in other organisations, such as the Fellows in Training (FITs) in the AAAAI.

Voting procedures

• The Working Group is elected every 2 years, following the periodicity of the Executive Committee.

• Available JMA representative posts are open for re-election for any JMA given that the person is graduated MD or BSc and under 35 years at the time of election, is an inhabitant of a European country, is a member of the section to which he/she is applying and is prepared and able to come to the EAACI Annual Congress and other JMA meetings. The same JMA representative post can be held for a maximum of 2 periods (4 years).

• The JMA Chairperson must have held one of the other positions in the Working group for at least one period before being elected by the JMA Working group. The JMA Chairperson that leaves the position to the newly elected JMA chairperson will stay in contact with the group as a consultant.

• Interested candidates should send a CV and a short description of their work intentions (±500 words) to the group to the EAACI Executive Office before the given deadline. The working group will select up to 3 candidates/post based on keeping a well balanced group (gender, nationality etc.) The list will be presented, together with the candidates’ CV and summary, on the JMA Website and voting will be made by e-mail. The voting is open to all JMAs of the EAACI. The new JMA Working group starts after the results of the election have been presented at the JMA Business Meeting.

Interested?

Please send your e-mail, with a CV and a short description of yourself and your interest for EAACI activities (<500 words), to the EAACI Executive Office at executive.office@eaaci.org .

Please indicate whether your interest is for the Pediatric or the ENT JMA representative position. The deadline for submission is September 10th 2006.

We are looking forward to receiving your responses and will contact the nominated JMA by e-mail.

Good luck and kind regards,

The current JMA working group:

- JMA chairperson: Ulrike Raap
- Asthma section representative: David Groneberg
- ENT section representative: Peter Hellings
- Dermatology section representative: Elena Borzova
- Immunology section representative:Marcin Kurowski
- Paediatric section representative: Miguel Borrego
- Webmaster: Chrysanthi Skevaki

726EAACI and the Local Organising Committee offer 100 travel grants for the XXV EAACI Congress in Vienna, 10-14 June 2006. Junior Members and Affiliate Junior Members can apply with an accepted abstract.

Those who are awarded a travel grant will receive free registration to the Congress, shared accommodation in a twin-bedded room (up to 4 nights) and travel costs refunded up to EUR 500.

 

Travel costs will be refunded on site at the Congress, upon presentation of your original ticket and travel receipts. The travel grant application should be made in connection with the electronical abstract submission. Please note that to apply properly you need to fill in the following, otherwise your Travel Grant application will not be considered:

 

- That you wish to apply for the Travel Grant (tick the box)

- Date of birth (Only juniors up to 35 years can apply)

- EAACI membership number (You must be a Junior Members or Affiliate Junior Member to apply)

 

 

 

For more information, please visit the Congress website www.congrex.com/eaaci2006/index.html

The winners of the 2006 EAACI Educational Grant were announced during the XXV EAACI Congress in Vienna, 2006.

 

Recipient

Country

Wong, Edmund

Philippines

Gulbahar, Okan

Turkey

Sporcic, Zorica

Serbia & Montenegro

Glück, Joanna

Poland

Kouhkan, Azam

Iran

Noleva, Katya

Bulgaria

Vlaski, Emilija

FYROM

Raukas-Kivioja, Aet

Estonia

Pumputiene, Ingrida

Lithuania

Jakovska-Maretti, Tatjana

FYROM

Minov, Jordan

FYROM

Schober, Wolfgang

Germany

Novakova, Sylvia

Bulgaria

Hansen, Anker

Denmark

Stavric, Katarina

FYROM

Bakalova, Rossitza

Bulgaria

Gerstmayr, Marianne

Austria

Keskin Göksel, Ozlem

Turkey

Nanou, Anna

Greece

Voor, Tiia

Estonia

Zvoristeanu, Anca

Romania

Holovyn, Roksolyana

Ukraine

Huss-Marp, Johannes

Germany

Kirovski, Ilija

FYROM

Kamchaisatian, Wasu

Thailand

Uguz, Aysen

Turkey

Arias Cruz, Alfredo

Mexico

Sonomjamts, Munhbayarlah

Mongolia

Sun, Baoqin

China

2001
Professor Cezmi A. AKDIS, MD, SIAF, Davos, Switzerland.
A molecular basis for T cell suppression by IL-10: CD28- associated IL-10 receptor inhibits CD28 tyrosine phosphorylation and phosphatidylinositol 3-kinase binding. FASEB J. 2000; 14:1666-1668.

2002
Dr. Susanne VRTALA, AKH, University of Vienna, Vienna, Austria.
Genetic engineering of a hypoallergenic trimer of the major birch pollen allergen.
Bet v 1. FASEB J. 2001, 15:2045-2047.

2003
Dr. Peter W. HELLINGS, University Hospital Gasthuisberg, Leuven, Belgium.
Blockade of CTLA-4 enhances allergic sensitization and eosinophilic airway inflammation in genetically predisposed mice. Eur. J. Immunol 2002, 32:585-594.

2004
Professor Eckard H. HAMELMANN, MD, Humboldt-University Berlin, Berlin, Germany. Exposure to endotoxin and allergen in early life and its effect on allergen sensitization in mice. J. Allergy Clin. Immunol. 2003;112:389-396. and

Dr. Eleanor LING, Imperial College Faculty of Medicine, London, UK.
CD4+CD25+ regulatory T cell suppression of allergen-driven T cell activation is related to atopic status and expression of allergic disease. The Lancet 2004, 363/9409:608-615.

2005
Univ.Doz. Dr. Barbara BOHLE, AKH, University of Vienna, Vienna, Austria.
A novel approach in specific allergy treatment: The recombinant fusion protein of a bacterial cell surface (S-Layer) protein and the major birch pollen allergen Bet v 1 (rSbsC-Bet v 1) combines reduced allergenicity with immunomodulating capacity.The Journal of Immunology 2004;172:6642-48. and

Dr. Hamida HAMMAD, Erasmus Medical Centre, Rotterdam, The Netherlands.
Essential role of lung plasmacytoid dendritic cells in preventing asthmatic reactions to harmless inhaled antigen. J. Exp. Med. 2004; 200: 89-98.

Anne Casset from France with her project “Characterization of new mite allergens”. Her host is Prof. Rudolf Valenta, Center of Physiology and Pathophysiology, Medical University of Vienna, Austria

 

Monica Vilhelmsson from Sweden with her project “The role of cross-reactivity between Mala s 11 and human MnSOD in the pathogenesis of atopic eczema”. Her host is Prof. Reto Crameri, Swiss Institute of Allergy and Asthma Research., Davos, Switzerland.

 

Q. Thai Dinh from Germany for his project “Allergy and environmental changes: Associate between ozone exposure and neuronal mechanisms in a mouse model of asthma.“. His host is Prof. K. Fan Chung, Thoracic Medicine Dept. Imperial College, London, United Kingdom


Natalija Polovic from Serbia for her project “Design of a new chimeric protein for application in specific immunotherapy of allergy to cat.”  Her host is Prof. Marianne van Hage, Karolinska Institute, Stockholm, Sweden


Iliara Puxeddu from Italy for her project “The role of ADAM33 in the origin and Progression of Asthma.” Her host is Prof. Stephen Townley Holgate, University of Southampton, School of Medicine, Southampton, United Kingdom.

 

 

Short Term winners

 

Beata Berent-Maoz from Israel for her project “The role of TRAIL in the mast cell differentiation and apoptosis.” Her host is Prof. Hans-Uwe Simon, University of Bern, Bern, Switzerland

 

Rebeca Rodriguez Pena from Spain for her project “CD4+CD25+ regulatory T cells, immune tolerance and allergic responses to betalactams.” Her host is Prof. Sergio Romagnani, Dipartamento di Medicina Interna. Univesita di Firenze, Florence, Italy

303Hannover Medical School Germany
MD/PHD-Program ''Molecular Medicine''
Member of the International PHD-Program (DAAD/DFG)

Hannover Medical School (MHH) (Germany) invites applications for new PhD studentships to commence in October 2005. 20 positions are available, funded by the MHH and its departments. The program is member of the International Postgraduate Program (IPP; DAAD/DFG). Projects are from areas such as: Immunology, Infection and Immunity, Oncology, Differentiation, Signal transduction, Stem Cells etc.

 

Positions are available for MDs as well as PhD students (Biology, Biochemistry etc.). Successful candidates are expected to finish with a PhD, alternatively Dr. rer. nat., within three years. The curriculum is in English. Over 60% of the students come from non-German countries.

 

The deadline for receipt of completed application is: April 1st, 2005.

 

Application forms, further information about the international MD/PhD-Program and the research projects at: www.mh-hannover.de/studium/phd

 

Further information: Dr. Susanne Kruse

Phone: +49-511-532-6011

E-mail: daniel.marlies@mh-hannover.de)

NEW GINA Workshop Report 2002
A Global Strategy for Asthma Management and Prevention.

1252005 World Asthma Day

Date: 3rd May 2005
This year’s World Asthma Day will be celebrated on May, 3rd, 2005 with the theme "The Unmet Needs of Asthma’’. GINA, (Global Initiative for Asthma) addresses this theme to scientists, doctors and patients in order to stress the need for better asthma treatment and control. The theme is built on last year’s World Asthma Day theme, “The Burden of Asthma” and the Global Report that followed it, claiming that by recognizing and meeting the unmet needs of asthma, it is possible to make the first steps to reduce the burden of this important disease.

World Asthma Day takes place yearly on the first Tuesday in May. Each year GINA chooses a theme based on the needs and problematic aspects of asthma and organizes preparation and distribution of World Asthma Day materials and resources in each country.

GINA works with health care professionals and public health officials around the world for the reduction of asthma prevalence, morbidity, and mortality. Through resources and publications, such as evidence-based guidelines for asthma management, and events such as the annual celebration of World Asthma Day, GINA is working for the improvement of the lives of people with asthma in every corner of the globe.


1252006 World Asthma Day took place on May 2. The theme of this year's event was "The Unmet Needs of Asthma, "chosen to call the attention of health care workers, governments, and patients alike to the need for better asthma treatment and control.

 

Asthma is one of the most common chronic diseases in the world, affecting more than 300 million people worldwide1. According to the experts, the unmet needs lead gradually to poorer asthma control. “Although asthma cannot be cured, it can be effectively treated,” says Paul O’Byrne, MD, Chair of the Global Initiative for Asthma (GINA) Executive Committee. He continues: “That so many people around the world find their daily lives limited by asthma symptoms shows that we need to do more to address the unmet needs of asthma.”

 

WAD is organized by the Global Initiative for Asthma (GINA) in order to improve asthma awareness and care around the world. GINA publishes a Backgrounder on the unmet needs of asthma, along with other relevant documents, all available through the website www.ginasthma.com. GINA was launched in 1993 and it collaborates with health care professionals and public health officials around the world for the reduction of asthma prevalence, morbidity and mortality. Through resources and publications, such as evidence-based guidelines for asthma management, and events, such as the annual celebration of World Asthma Day, GINA is working on the improvement of the lives of people with asthma in every corner of the globe.

 

Each year GINA chooses a theme based on the needs and difficult aspects of asthma and organizes preparation and distribution of World Asthma Day materials and resources in each country.

 

 

 

1. Global Burden of Asthma Report, 2004.
Minutes Meeting of the ENT Section of the EAACI Held at the Hotel Fira Palace Barcelona 9th February 2006 Present: Joaquim Mullol (Chairman) Glenis K Scadding (Secretary) Kees van Drunen Livije Kalogjera Wytske Fokkens Peter Hellings 1) The 100+ posters submitted for the EAACI meeting has been reviewed, graded and an oral session proposed for the meeting. 2) Glenis Scadding is to attend the Scientific Programme Committee meeting of EAACI in Vienna on the 24/25th February. 3) Schering Plough have submitted a proposed congestion screen for rhinitis patients. This is to be circulated to all members of the committee who will then send in their thoughts. 4) The EP3OS document – Wytske Fokkens is to provide a pocket guide which will be presented at a new meeting towards the end of 2006. 5) The 7th SERIN meeting will be held in November 2009 in Croatia probably in Dubrovnik, organised by Livije Kalogjera. One day may be jointly held with the asthma section of EAACI. 6) Committee members were asked to present the awards for the best presentations at SERIN at the ceremony on the 10th February 2006. 7) The role of our Section in the European Academy of Otorhinolaryngology was discussed. Livije Kalogjera had attended a meeting in Rome. It was felt that it is important for us to take part in order to have a say in guideline courses etc. Joaquim Mullol is to circulate relevant documents for our consideration. 8) Joaquim Mullol proposed a Task Force on the tools/ methods used in the investigation of rhinitis and rhinosinusitis. He will circulate a proposal. 9) Glenis Scadding proposed a vote of thanks to Joaquim Mullol for his excellent organisation of the 6th SERIN meeting. The meeting was then closed.

* Pediatrics Meeting: The management of pediatric allergy: in whose hands? From bench to bedside
Date: 20th-21st January 2006
Place: Hotel Executive, Milan, Italy
In cooperation with ACAAI and EAACI.
For more information click on http://www.mcaevents.org or email at info@mcaevents.org. To download the programme click here.

* EAACI ENT Section Meeting
Date: 9-11 February, 2006
Place: Barcelona, Spain
For more information email at serin2006@pacifico-meetings.com or click on the website http://pacifico-meetings.com/serin2006.

* 4th EAACI-GA2LEN DAVOS  Meeting
Basic Immunology Research in Allergy and Clinical Immunology
Date:16-19 February 2006
Place: Eibsee-Hotel, Grainau, Garmisch-Partenkirchen, Germany

* 1st International Symposium on Molecular Allergology Allergen Molecules: Basic and Clinical Aspects
Date: March 31 – April 1, 2006
Place: Rome, Italy
For more information click on www.allergome.org/meetings/rome.html

* GA2LEN Annual Conference
Date: March 29- April 1st, 2006
Place: Berlin, Germany
For more information click on the website www.ga2len.net

* Training Course in Food Allergy
Date: April 8-11, 2006
Place: Middelfart, Denmark

* 2nd International Drug Hypersensitivity Meeting
Clinical Management, Basic Mechanisms, Genetics and latest research on Drug Hypersensitivity.
Date: 18-21 April, 2006
Place: Liverpool, England
For more information click on the website
http://pcwww.liv.ac.uk/drughypersensitivity/index.htm

* IV European Asthma Congress
Date: 22-25 April, 2006
Place: Tenerife, Canary Islands
For more information click on www.immunopathology.org

* 2006 EFA Conference
Date: 10-13 May, 2006
Place: Prague, Czech Republic
For more information click on the EFA website http://www.efanet.org

* IX International Congress of Polish Society of Allergology
Date: 10-13 May, 2006
Place: Wisla, Poland
For more information click on the website www.kongrespta.pl

* HB 2006  Buildings
Creating a healthy indoor environment for people
Date: 4-8 June 2006
Place: Lisboa, Portugal
For more information email at hb2006@fe.up.pt or click on the website www.hb2006.org

* ERS & ISIAN 2006
21st Congress of the European Rhinologic Society
25th International Symposium of Infection and Allergy of the Nose
Date: 11-15 June, 2006
Place: Tampere, Finland
For more information click on www.ers2006isian.com

* 2006 BSACI Annual Meeting
Date: 10-12 July, 2006
Place: Burleigh Court International Conference Centre, Loughborough, UK
For more information click on http://www.bsaci.org/annualmeeting.html

* XVIII World Congress of Asthma
Novel Concepts in Pathogenesis and therapy
Date: 15 -18 July, 2006
Place: Beaulieu, Lausanne, Switzerland
For more information click on www.worldasthma2006.ch

* 14th Latin American Society of Allergy, Asthma and Immunology
Date: 19-22 August, 2006
Place: Buenos Aires, Argentina
For more information email at latamcong@alergia.org.ar

* 16th ERS Annual Congress
Date: 2-6 September 2006
Place: Munich, Germany
For more information click visit www.ersnet.org.

* Symposium on Aging Research in Immunology: the Impact of Genomics (ARIG)
Date: September 4-5, 2006
Place: Coeur Defense Conference Center, Paris, France.
Student travel grants are available! For more infromation please visit www.arig.ac.at .

* ACAAI - HSACI Joint Allergy Symposium
Allergy update in Greece
Date: 6-9 September 2006
Place: Athens, Greece
For more information click on www.joint-allergy2006.gr

* 17th Annual Scientific Meeting 2006
Australian Society of Clinical Immunology & Allergy Inc.
Date: 7-10 September 006
Place: Manly Pacific Hotel, Manly Beach, Sydney, Australia
More information at education@allergy.org.au or at the website www.allergy.org.au (available in late 2005).

* III International Congress "Modern Methods of Diagnostics and Treatment of Allergy, Asthma and Immunodeficiency"
Date:24-27 September 2006
Place: Sheraton Metekhi Palace Hotel, Tbilisi, Georgia
More information at info@wipocis.org and iaaci@mail.ru.

* 5th Meeting of the European Mucosal Immunology Group
Main topics:Mucosal innate immunity, microbiota and probiotics, inflammation, regulation of immune responses, mucosal vaccines
Date: 5-7 October 2006
Place: Prague, Czech Republic
For more information click on the website www.congressprague.cz/emig2006.

* EASL Monothematic Conference
Main theme: Clinical Immunology in Viral Hepatitis
Date: 7-8 October 2006
Place: University Collegr London, London, UK
For more information click here. Download the Registration Form here.

* XVIII World Congress of Asthma Interasma
International Association of Asthmology
Date: 14-17 October 2006
Place: Hilton Hotel, Guadalajara, Mexico
More information at the website http://www.worldcongressofasthma2006.com/

865
Johan Winte

In a celebrating atmosphere and a crowed hall, full of colors and music, took place on June 10th, the Opening Ceremony for the XXV EAACI Congress in Vienna 2006. The ceremony started with Viennese classical music by the Mastaire’s Vienna Ladies Orchestra and the 1st violinist, Gabriele Fussganger, who opened the event with “Also Sprach Zaratustra” by R. Strauss.

863
Johan Winte

The EAACI President, Pr Anthony Frew, welcomed all participants to the XXV Congress, which has broken all records of registrations, and wished everyone an exciting and unforgettable scientific experience. A visual introduction to Austria and the city of Vienna followed under the sounds of “Wiener Blut” by Johann Strauss II. The President of the Local Organising Committee, Pr. Rudolf Valenta, then welcomed all delegates to Vienna, a city of unique history and beauty, and promised to make the Congress in Vienna a most memorable scientific, social and cultural event.

864 866
Johan Winte

The Ballet that followed, gave a thrilling performance as they danced harmoniously under the sounds of “The Blue Danube” and the Ceremony closed with polka music, the Tritsch Tratsch Polka by Johann Strauss II.

 

Vienna, June 11, 2006


726EAACI and the Local Organising Committee offer 100 travel grants for the XXV EAACI Congress in Vienna, 10-14 June 2006. Junior Members and Affiliate Junior Members can apply with an accepted abstract.

Those who are awarded a travel grant will receive free registration to the Congress, shared accommodation in a twin-bedded room (up to 4 nights) and travel costs refunded up to EUR 500.

 

Travel costs will be refunded on site at the Congress, upon presentation of your original ticket and travel receipts. The travel grant application should be made in connection with the electronical abstract submission. Please note that to apply properly you need to fill in the following, otherwise your Travel Grant application will not be considered:

 

- That you wish to apply for the Travel Grant (tick the box)

- Date of birth (Only juniors up to 35 years can apply)

- EAACI membership number (You must be a Junior Members or Affiliate Junior Member to apply)

 

The application deadline is 25 January 2006.

 

For more information, please visit the Congress website www.congrex.com/eaaci2006/index.html

749Date: 26-30 March, 2006

Place: Antalya, Turkey

 

Dear allergy and asthma scientists,

 

It is our pleasure to invite you, on behalf of the Organizing Committee, to the first EAACI & GA2LEN joint 2006 summer school-scientific research seminar hosted by Turkish National Society of Allergy and Clinical Immunology with the title:

 

 

 

‘’Mouse Models of Allergy and Asthma’’

 

to be held in Antalya, Turkey between 26-30 March, 2006.

 

The aim of this meeting is to gather scientists working on allergy and asthma research in the mouse, to discuss the most recent data, the latest methodology, and to increase the understanding how the mouse models are relevant for human disease.

 

The meeting will be highly interactive, with a few high class lectures each morning and afternoon, and plenty of room for interaction, poster viewing and thorough discussion.

 

The meeting is STRONGLY SUBSIDISED and even FREE OF CHARGE for many participants. All registrations are “all inclusive”, thus covering all costs for hotel (four nights) as well as meeting costs, meals and social events.

 

SCIENTIFIC PROGRAMME

Click here to download the scientific programme of the summer course.

 

ABSTRACT SUBMISSION

We kindly invite you to send us your abstract to this e-mail

mouse2006@lungall.gu.se.

 

Deadline for abstract submission is February 1st, 2006.

 

PLEASE NOTE that ABSTRACTS will not be published or made available in the public domain in any way, and you are allowed to bring interesting abstracts that you have presented at other scientific congresses or meetings. All abstracts will be presented as posters, and will be discussed at special discussion sessions according to categories.

 

Attendees up to the age of 35 with an accepted abstract will have the chance to receive a travel grant which will include accommodation, meal and limited flight cost.

 

SPECIAL EVENT AND SOCIAL PROGRAMME

 

750

 

There is a special event in Antalya around lunchtime on the 29th, about which you can read on this web address:

 

http://sunearth.gsfc.nasa.gov/eclipse/SEmono/TSE2006/TSE2006.html

 

There will also be several social events in the late afternoon and evenings.

 

751

 

We are looking forward to meet you in Antalya both to enjoy the scientific interaction and to salute the total solar eclipse on the 29th of March! Do not forget to bring your No 14 welders glass, since looking at a solar eclipse may damage your eyes permanently, or even cause blindness (see:

http://sunearth.gsfc.nasa.gov/eclipse/SEhelp/safety.html)

 

REGISTRATION


We have the following categories for registration:

 

Juniors

A junior (up to 35 years of age) with an accepted abstract will have free registration. This will cover all local expenses including hotel and all meals.  Juniors can also receive a travel grant to cover part of the costs of a return flight to the meeting. A registration fee of €150 will have to be paid as a deposit, but this sum can be returned at the meeting. The number of free registrations will be limited!

 

EAACI / GA2LEN members

Any member of EAACI or GA2LEN can attend the meeting at a strongly subsidized fee of €250 (all inclusive).

 

Non Members, University

Any university / hospital staff member may register at a subsidized fee of €400 (all inclusive).

 

Non-Members, Industry The registration fee for industry staff is €700 (all inclusive).

 

PLEASE NOTE that the number of registrations is limited at 100 including faculty.

 

TO REGISTER; please contact congress@topkon.com

 

We are very much looking forward to meeting you in Antalya in March.

 

Sincerely,

 

Isil B. Barlan                   Jan Lötvall

Member at large            EAACI Secretary-General

On December 12 of 2006, the Global Initiative for Asthma (GINA) announced the release of additional 2006 GINA documents--the “Pocket Guide for Asthma Management and Prevention” and the “Pocket Guide for Asthma Management and Prevention in Children”.

 

The new guidelines, which are already available at the GINA website (www.ginasthma.org), define a new approach of asthma symptom control different from the previously used levels of disease severity. According to GINA: ‘These patient-based guidelines will revolutionize asthma care around the world as they include information about asthma epidemiology, pathogenesis, prevention, and socioeconomics as well as asthma management plans that include recommendations for treatment and health education programs that can be adapted to various health care settings’.

731

Venue: Hindsgavl Slot, Hindsgavl Alle 7, 5500
Middelfart, Denmark
Date: April 8th-11th 2006

The EAACI/GA2LEN training course in Food Allergy will be held at Hindsgavl Castle, Middelfart, Denmark from April 8th-11th, 2006. Course responsible are the Sections of Dermatology and Pediatrics together with the EAACI Interest Group on Food Allergy. The number of participants is limited to 85.

The aim of this course is to update clinicians and other wishing to diagnose and treat children and adults with food allergy. The focus will be on the practical aspects of diagnosis and treatment. Theoretical lectures will be mixed with clinical cases and practical demonstrations on patients (videotaped). Participants are encouraged to bring their own clinical cases. These should be announced in advance on the Clinical Cases Submission Form. Priority will be given to clinicians working with food allergy and to those presenting clinical cases.

Donwload the full Scientific Programme here.

Hindsgavl
Hindsgavl Castle (www.hindsgavl.dk) is located in Middelfart at the island Funen in the middle of Denmark. The castle is beautifully situated on a peninsula overlooking the sea and has very nice facilities for the course and also excellent surroundings.

General Information
The nearest airport (Billund) is only 60 kilometres away, and Kastrup Airport can be reached by train within 90 minutes with hourly connections.

Currency and Exchange Rates
The official currency is the Danish Crown (DKK). The official exchange rate: 1 EUR = 7,50 DKK

Registration fee: 250 Euro

Register on-line for the course.

Deadline for registration: 1st of February 2006. The number of participants is limited to 85.

Accomodation
Accommodation in a shared double room with another course participant and full board are all included in the registration fee.

Grants
A number of travel grants will be provided. A motivation letter will be required for your application. Please send your motivation letter to allergicenter@ouh.fyns-amt.dk

735

Secretariat:
Ms Kirsten Larsen
Allergy Center
Odense University Hospital
29 Sdr Boulevard DK 5000
Odense Denmark
Tel +45 6541 3622
E-mail allergicenter@ouh.fyns-amt.dk

Payment details
Totalbanken Odense,
Denmark: Account no. 6880 4104260 SWIFT code: NRSBDK24.
IBAN no.: DK 7568800004104260

 

Co-sponsored by and


EAACI and GA2LEN gratefully acknowledge the generous support of the sponsor


Phadia AB

327News from the EU

A workshop held on 12 and 13 September heard that a European Union funded research project has standardised 20 birth cohorts so that their findings can be used to appraise the contribution of different known factors influencing allergy in childhood. Dr Susanne Lau, who leads the work programme on birth cohorts in the Global Allergy and Asthma European Network (GA²LEN), described the achievements of her study.

A unique Europe-wide database tracking 50 factors that may have an affect on allergy in children was presented on Tuesday, 12 September 2006. The announcement was made at a workshop on birth cohort and intervention studies in Berlin.

The significance of this scientific work by one of Europe’s largest network on allergies and asthma has been acknowledged internationally. A research team in Australia have asked permission to use the European model for a database on allergies for the Asian-Pacific region.

Two scientific papers about 18 of the 20 harmonised birth cohorts on children and asthma, allergic rhinitis (hay fever) or eczema have recently appeared in Allergy journal. (3)
The 30,000 children involved in these study groups, or birth cohorts, are spread through different countries in Europe, though most are living in urban areas. Many of the children continue to be involved in ongoing studies.

The development of standardised procedures for cohorts and intervention studies offers the potential of more effective and precise pooling of the data collected. This will ultimately allow subtle subgroup analyses that are necessary to allergy and asthma.

More...

549In June 2006, the European Parliament voted amendments recognizing allergic diseases as a first priority within health research in the 7th Framework Programme. However, this position was not reflected in the political agreement reached by the Council of the European Union (representing the 25 EU Members States) that does not take on board the amendments on “allergic diseases”.

Until the end of the year 2006, while the second reading of the FP7 is taking place, all those concerned about funding for allergy research are encouraged to take action to ensure allergic diseases remain a health priority in FP7.

 

* EAACI Position on the 7FP

* EFA Position on the 7FP

 

 

 

 

 

986 987 988

 

Some indicative reasons why the amendment is crucially important:

 

·         Allergy is a global disease that affects many organs and has many causes. Research funds are available for allergic disease linked to food but food allergies represents only 8% of the total. Research must be developed in a much broader way. Europe is in an excellent position to do this due to its diversity of heritage and culture and because it has a good scientific infrastructure.

·         The problem of allergies is growing. One child in three is allergic today and up to 50% of European may be affected by an allergic disease by 2015.

·         The cost to health care systems and society is increasing steadily. Allergic diseases are a major public health problem in Western countries and an increasing burden in the recent accession countries. These chronic and complex diseases create health care and treatment costs, cause-missed days of school and work, and impair the quality of life of patients.

·         Integrated and co-ordinated research is urgently needed to better understand allergic diseases and their increasing prevalence. It is important to determine causes, identify factors in our lifestyle and environment and finally to treat and control the diseases.

 

985

741The EAACI ENT Section Board and GA2LEN are organising the 6th Symposium on Experimental Rhinology and Immunology of the Nose (SERIN) from 9th to 11th February 2006, in Barcelona, Spain. The objective of the meeting is to gather together "people working in the rhinology field, from young researchers to experienced leaders, and to let them discuss the new findings and future scopes of the field in a free and open atmosphere" (J. Mullol). The main topics for discussion will range from basic research to diagnosis and treatment.

Deadline for abstract submission: now closed

For more information click at the website www.pacifico-meetings.com/serin2006/index.php

206.RES.AREAOn 15th May, the European Parliament Committee on Industry, Research and Energy voted in favour of the 2 compromise amendments including "allergic diseases" in the proposal for FP7 research programme (2007-2013). All members of the European Parliament should vote these amendments in plenary session mid-June.

 

The compromise amendments encourage research in major diseases, including “allergic diseases” in Health, first priority.

 

After the vote of the Parliament, as it is a co-decision procedure, the Council has to give an opinion on the new proposals.

 

For more information, kindly contact Anne Wilmes (wilmes.anne@skynet.be).


Read also:
- New Members of the European Parliament ITRE
“The EAACI is in good shape! “

 

 

Venue: XXV EAACI Congress in Vienna
June 12, Hall C

The EAACI 2006 General Assembly and Council of National Societies opened with the President’s Report: Pr. Anthony Frew, announced that over 6.400 delegates are currently attending the XXV EAACI Congress in Vienna, a record number for the Academy!

 

Furthermore, he reported on the Academy’s events that were greeted with success, such as the 2005 Summer Schools in Prague and Rotterdam, the 4th Winter School in Garmisch-Partenkirchen, a state-of-the-art immunology meeting that will continue taking place every year, and other meetings (Denmark, Antalya), all in co-operation with GA2LEN, with which there are continuing strong ties.

 

Moreover, the President announced the Academy’s significant contribution to the recognition of “allergic diseases” within EU’s 7th Framework Program for Research.

The Academy keeps working hard to reach an ever better agreement on the reduction of the membership fees in countries with difficult economical status. Finally, next year’s plans include the introduction of the EAACI Code of Ethics, and more summer and winter schools.

 

The “EAACI is, indeed, in good shape!” was the President’s concluding remark.

 

The General Assembly continued with the Secretary General’s Report. Pr Jan Lötvall, gave a more detailed view of the Academy’s activities last year, as well as of its future plans. Advances through work by EAACI’s Task Forces include reports on the effect of sports on allergic conditions, the side-effects of biologicals and the Allergy Exam, in co-operation with the UEMS.

 

The EAACI Summer and Winter Schools will continue with the new name “Allergy Schools”, emphasizing more their allergy-centered identity. The first such school took place in Antalya, Turkey in spring, the next, in Chalkidiki, Greece is well under way and the third Allergy School for 2006 will take place in Hannover in autumn. Apart from the Allergy Schools, the EAACI held PAPRICA Symposia in Belarus and Ukraine.

 

The Secretary General concluded with reporting on the continuously increasing membership of the Academy; currently close to 5.000 are the active members, an almost 500% increase since the Rhodes Congress 10 years ago!

 

The EAACI Treasurer, Pr Marek Kowalski, confirmed the President’s confidence on the robustness of the Academy’s finances, with a brief report on the good financial status of the Academy last year, as well as giving a picture of 2007.

 

Vienna, June 12, 2006

EAACI offers a number of Educational Grants each year to help members in financial difficulty to cover the cost of their yearly membership. The educational grant includes a subscription to the journals ''Allergy'' and "Pediatric Allergy and Immunology''. All Individual and Affiliate Members in EAACI who can motivate their application are welcome to apply for this grant.


2006 EAACI Educational Grants: The Winners!

Recipient

Country

Wong, Edmund

Philippines

Gulbahar, Okan

Turkey

Sporcic, Zorica

Serbia & Montenegro

Glück, Joanna

Poland

Kouhkan, Azam

Iran

Noleva, Katya

Bulgaria

Vlaski, Emilija

FYROM

Raukas-Kivioja, Aet

Estonia

Pumputiene, Ingrida

Lithuania

Jakovska-Maretti, Tatjana

FYROM

Minov, Jordan

FYROM

Schober, Wolfgang

Germany

Novakova, Sylvia

Bulgaria

Hansen, Anker

Denmark

Stavric, Katarina

FYROM

Bakalova, Rossitza

Bulgaria

Gerstmayr, Marianne

Austria

Keskin Göksel, Ozlem

Turkey

Nanou, Anna

Greece

Voor, Tiia

Estonia

Zvoristeanu, Anca

Romania

Holovyn, Roksolyana

Ukraine

Huss-Marp, Johannes

Germany

Kirovski, Ilija

FYROM

Kamchaisatian, Wasu

Thailand

Uguz, Aysen

Turkey

Arias Cruz, Alfredo

Mexico

Sonomjamts, Munhbayarlah

Mongolia

Sun, Baoqin

China

206.RES.AREAFrom the EUROPA website:

Europe has a long standing tradition of excellence in research and innovation, and European teams continue to lead progress in many fields of science and technology. However our centres of excellence are scattered across the continent and all too often their efforts fail to add up in the absence of adequate networking and cooperation. In the past, collaborative actions have been initiated at European and Community level, but now is the time to bring our endeavours together and to build a research and innovation equivalent of the "common market" for goods and services. That structure is called the European Research Area and is regrouping all Community supports for the better coordination of research activities and the convergence of research and innovation policies, at national and EU levels.

All important developments related to the ERA are followed in the EUROPA website, which is under the CORDIS server at <http://www.cordis.lu/era/> .

Dear JMA,

We are happy to announce great news for you all: We offer two new open positions within our group, the JMA WG, so this may represent your chance to get involved in the JMA activities !

If you are willing to overtake this challenging job, we would very much appreciate your letter of intention and CV sent in before September 10th 2006.

In the last years the JMA working group has actively participated in EAACI activities and has achieved considerable benefits for the JMA, including free registration, travel grants, poster prizes, Junior sessions etc. The JMA working group consists of the Chairperson, 5 section representatives and the webmaster, and is elected every 2 years following the periodicity of the Executive Committee.

The present JMA working group was elected in Munich (2005) and following the JMA procedures the current JMA chairperson (Ulrike Raap) will forward her position to Miguel Borrego in Gotheborg 2007 who had been elected as the following chairperson in Vienna 2006. Furthermore, Peter Hellings will leave the JMA working group after Göteborg 2007 since he is at the age limit of 35 years by then.

The responsibilities of JMA representatives
To provide information to JMAs regarding activities and to liaise with the relevant section board, the JMA group and all the JMAs in the section, in order to promote participation in EAACI activities. The main forum for meeting and discussing among JMAs is the yearly JMA Business Meeting held at the occasion of the EAACI Congress, where the JMA Working group should give a full report of activities. The JMA group organises a Poster session, an Educational Session, a Forum and Workshops during the EAACI yearly Congress. The JMA Working group is also responsible for developing contacts with similar groups in other organisations, such as the Fellows in Training (FITs) in the AAAAI.

Voting procedures

• The Working Group is elected every 2 years, following the periodicity of the Executive Committee.

• Available JMA representative posts are open for re-election for any JMA given that the person is graduated MD or BSc and under 35 years at the time of election, is an inhabitant of a European country, is a member of the section to which he/she is applying and is prepared and able to come to the EAACI Annual Congress and other JMA meetings. The same JMA representative post can be held for a maximum of 2 periods (4 years).

• The JMA Chairperson must have held one of the other positions in the Working group for at least one period before being elected by the JMA Working group. The JMA Chairperson that leaves the position to the newly elected JMA chairperson will stay in contact with the group as a consultant.

• Interested candidates should send a CV and a short description of their work intentions (±500 words) to the group to the EAACI Executive Office before the given deadline. The working group will select up to 3 candidates/post based on keeping a well balanced group (gender, nationality etc.) The list will be presented, together with the candidates’ CV and summary, on the JMA Website and voting will be made by e-mail. The voting is open to all JMAs of the EAACI. The new JMA Working group starts after the results of the election have been presented at the JMA Business Meeting.

Interested?

Please send your e-mail, with a CV and a short description of yourself and your interest for EAACI activities (<500 words), to the EAACI Executive Office at executive.office@eaaci.org .

Please indicate whether your interest is for the Pediatric or the ENT JMA representative position. The deadline for submission is September 10th 2006.

We are looking forward to receiving your responses and will contact the nominated JMA by e-mail.

Good luck and kind regards,

The current JMA working group:

- JMA chairperson: Ulrike Raap
- Asthma section representative: David Groneberg
- ENT section representative: Peter Hellings
- Dermatology section representative: Elena Borzova
- Immunology section representative:Marcin Kurowski
- Paediatric section representative: Miguel Borrego
- Webmaster: Chrysanthi Skevaki

1252006 World Asthma Day took place on May 2. The theme of this year's event was "The Unmet Needs of Asthma, "chosen to call the attention of health care workers, governments, and patients alike to the need for better asthma treatment and control.

 

Asthma is one of the most common chronic diseases in the world, affecting more than 300 million people worldwide1. According to the experts, the unmet needs lead gradually to poorer asthma control. “Although asthma cannot be cured, it can be effectively treated,” says Paul O’Byrne, MD, Chair of the Global Initiative for Asthma (GINA) Executive Committee. He continues: “That so many people around the world find their daily lives limited by asthma symptoms shows that we need to do more to address the unmet needs of asthma.”

 

WAD is organized by the Global Initiative for Asthma (GINA) in order to improve asthma awareness and care around the world. GINA publishes a Backgrounder on the unmet needs of asthma, along with other relevant documents, all available through the website www.ginasthma.com. GINA was launched in 1993 and it collaborates with health care professionals and public health officials around the world for the reduction of asthma prevalence, morbidity and mortality. Through resources and publications, such as evidence-based guidelines for asthma management, and events, such as the annual celebration of World Asthma Day, GINA is working on the improvement of the lives of people with asthma in every corner of the globe.

 

Each year GINA chooses a theme based on the needs and difficult aspects of asthma and organizes preparation and distribution of World Asthma Day materials and resources in each country.

 

 

1. Global Burden of Asthma Report, 2004.

1070On 30 November 2006, the European Parliament voted on the 7th Research Framework Programme (FP7) which specifies respiratory diseases and allergies an EU research priority for the next seven years, from 2007 to 2013, with a total budget of more than €54 billion euros. The vote took place in line with the Council’s position, so the Programme will come into force 1st January 2007.

This is a great time for allergy research!

The 7th Framework Programme is organised around four Specific Programmes:

• Co-operation: a programme to support cooperation between universities, industry, research centres and public authorities, and between the EU and third countries.

• Ideas: a programme to create an autonomous European Research Council to support investigator-driven “frontier research”.

• People: a programme to support training and career development of researchers.

• Capacities: a programme focusing on the coordination and development of research infrastructure, support for regional research clusters, SMEs, closer ties between science and society and international cooperation.


Moreover, the Members of the European Parliament are insisting on shifting some of the spending towards Parliament's own priorities, including research on renewable energy and energy efficiency as well as the possibility of funding research on children's health, respiratory diseases (including those induced by allergies), plus research into neglected diseases.

The overall budget planned for the 7th Framework Programme in the 2007-2013 Financial Perspective is €54 582 million in current prices. Of this, €50 521 million is for the European Community programme and €2751 million for the Euratom programme, which runs from 2007 to 2011.

To visit the European Parliament Press Release Site, click here!!

10 - 14 June 2006
Vienna, Austria

Second Announcement

 

The XXV Congress of the European Academy of Allergology and Clinical Immunology will take place in Vienna, Austria from 10-14 June, 2006. The meeting’s main theme is “Basic Science in Allergology and Clinical Immunology: a Prerequisite for Improving Patient Care” and it is combined with the celebration of “100 Years of ALLERGY as defined by Clemens von Pirquet”. The EAACI 2006 will be hosted by the Austrian Society of Allergology and Clinical Immunology at Austria Center Vienna, “located between the towers of the "Donau City" and the United Nations headquarters in the most modern part of Vienna” (R Valenta).

710

Source: ''Wien Tourismus''

Vienna, a capital of the “Holy Roman Empire” and the Hamburgian Monarchy is a true melting pot for many European cultures. Additionally, it holds a strong record in the scientific allergy community as it is where the Austrian pediatrician Clemens von Pirquet coined the term ALLERGY for the first time, in 1906, just 100 years ago. It is therefore allergy’s centennial birthday !!!

Scientific Programme

The rich scientific programme in Vienna 2006 follows a tradition of the highest standards set in all previous EAACI Congresses. Integrated plenary sessions, symposia, workshops, postgraduate courses, pro- and con- sessions on controversial and topical issues are all included in the scientific agenda, set out “to meet the educational and scientific needs of all clinicians and scientists involved in understanding and managing allergic disorders” (A J Frew). Poster Sessions, one of the most powerful and popular activities of the Congress, will be the meeting point for all attendees, covering topics on basic and clinical allergy, asthma and immunology.

The full scientific programme is now available on-line.

 

Social Programme

A day at the EAACI Congress never ends on the closure of the sessions. The social programme for Vienna 2006 is planned with daily tours in the historic city center of Vienna, visits to famed and distinguished museums, operas, and short excursions to small wineries and vineyeards.

 

55A special event is included for the first time in the Social Programme. The 1st EAACI Allergy Run will take place on Saturday, 10 June 2006, at 10.00 am (20 EUR). All EAACI participants are encouraged to take part in the 10 km run along with local runners under conditions of real electronic time.

 

 

 

 

 

 

Important Dates

Abstract submission is now open. Submit your abstract on-line.
Deadline for submission: 18 January 2006

 

For abstract submission guidelines and more information, please visit www.congrex.com/eaaci2006.

 

 

The XXV EAACI Congress will be CME Accredited

 

For more information click on the Congress Website: www.congrex.com/eaaci2006/

 

Responsible: SGO Johansson (sgoj@vialen.se)

A revised nomenclature for Allergy
An EAACI Position Statement from the EAACI Nomenclature Task Force.
SGO Johansson, J O’B Hourihane, J. Bousquet,C. Bruijnzeel-Koomen, S. Dreborg, T. Haahtela, M. L. Kowalski,
N. Mygind, J. Ring, P. van Cauwenberge, M. van Hage-Hamsten, B. Wuthrich
ALLERGY (2001):56: 813-824

The EAACI Allergy Definitions represent a Glossary for the most important terms from EAACI Nomenclature Position Statement and is now available in the following languages. You are welcome to print any of those and use in your profession. If your language is missing, please contact the Chairman of the Nomenclature Task Force.

Bulgarian, Chinese, Czech, Danish, Dutch, English, Estonian, Finnish, German, Greek, Hungarian, Italian, Japanese, Korean, Lituanian, Norwegian, Polish, Portuguese, Romanian, Slovenian, Spanish, Swedish and Turkish.

Responsible: Paolo Matricardi (matricardi.pm@mclink.it)

Microbial Products in Allergy Prevention & Therapy
P. M. Matricardi, B. Bjorksten, S. Bonini, J. Bousquet, R. Djukanovic, S. Dreborg, J. Gereda, H.-J. Malling, T. Popov, E. Raz, H. Renz, A. Wold for the EAACI Task Force
ALLERGY (2003): 58: 461–471

Task Force 15
Responsible: J Ring (Johannes.Ring@lrz.tu-muenchen.de)

More information will come shortly.

Mehmet Hoxha, Albania
Hector Ariel Badellino, Argentina
Veronika Kirchlechner, Austria
Darina Dimova, Bulgaria
Nadejda Takovska, Bulgaria
Rossitza Bakalova, Bulgaria
Igor Marinic, Croatia
Suzana Ljubojevic, Croatia
Louise Jensen, Denmark
Mona Hojgaard Pedersen, Denmark
Tiia Voor, Estonia
Constantinos Pitsios, Greece
J M Balo-Banga, Hungary
Lajos Attila Réthy, Hungary
Loreta Bagdonaite, Lithuania
Blagica Manceva, FYROM
Ivan Sokolovski, FYROM
Katarina Stavric, FYROM
Tatjana Jakovska-Maretti, FYROM
Eva Maria Rebelo Gomes, Portugal
Anca Zvoristeanu, Romania
Elena-Camelia Berghea, Romania
Liana Marzan, Romania
Elena Savchenko, Russia
Maya Slavkovic-Jovanovic, Serbia- Montenegro
Jenny Van Odijk, Sweden
Madeleine Rådinger, Sweden
Aysen Uguz, Turkey
Khrystyna Lishchuk-Yakymovych, Ukraine
Roksolyana Holovyn, Ukraine
Guzal Sharafutdinova, Uzbekistan

EAACI-GA2LEN Fellowship Programme for 2005:

 

1.      Medium term Fellowships will be funded at 10,000 € each. These fellowships are aimed to fund travel and living expenses for about six months in a foreign European laboratory.

2.     Short-term Fellowships of 5000 € each. The short-term fellowships are aimed to fund a 3 months research fellowship in a foreign European laboratory. Preference is give to specified acquirements of new techniques and establishment of collaborations.

General conditions:

 

1.     To be eligible to apply you must be under the age of 35 and be a member of the EAACI (EAACI-JMA). Please note EAACI junior membership is free to all those aged 35 and under.

2.     Applicants must contact an institution in a foreign European country, that is willing to host them for the whole duration of the fellowship, and define a supervisor. The host supervisor must be a member of EAACI or GA2LEN, or have applied for membership of EAACI at the time of the Fellowship application.

3.     Some of the funding is reserved for exchanges that involve institutions that form part of the GA2LEN network. This may be someone coming from a GA2LEN institution or someone going to a GA2LEN institution.  EAACI money is available for fellowships at non-GA2LEN host institutions and these will be considered on an equal basis.

4.     Your home institution must be willing to release you of all work, laboratory and clinical, during the whole duration of the fellowship and ensure that you will have the possibility to come back after the conclusion of the fellowship.

5.     Adequate fluency in a language that permits effective communication in the host institution is required.

6.      Fellowship recipients are not insured by EAACI or GA2LEN and are encouraged to make sure that both they and the institutions which receive them are fully covered by the necessary insurance’s. Host institutions are encouraged to assist and pay for this. Neither EAACI nor GA2LEN accept any liability.

7.     The Fellowship is a scholarship which in most European countries is tax free. However, the recipient is responsible for any tax that may be required in some countries.

8.      A person may submit only one application at a time.

9.    All documents must be submitted in English by e-mail (executive.office@eaaci.org), fax (+46-8 663 38 15) or by mail (EAACI Executive Office - PO Box 24140 - 104 51 Stockholm - SWEDEN) before the closing date of July 30, 2005. The signed original documents must be received at the EAACI Executive Office within 1 week after the deadline.

10.  Applications that do not include all required forms or forms that are not properly completed will not be considered for review.

11. The applications will be reviewed by an expert panel including representatives of GA2LEN and EAACI and will be handled in strict confidence.

12. The Fellowship period should be planned to start before the end of 2005.

13. Fellowship recipients will be asked to provide a detailed report on the results of the scientific project including a short financial report (no receipts).

 

Application (make 5 copies of each document) must contain:

 

1.      A completed and signed “Application Form

2.      A Curriculum Vitae (maximum 1 A4 page)

3.      List of publications (title, author list + journal issue page) (maximum of 1 key manuscript may be included in your application)

4.      A project description of maximum 4 pages must be prepared in advance together with the host- supervisor. It must be adjusted to the duration of the fellowship and will be the most important part of you application for the reviewers. You should state the relevance and what you expect to obtain with the project.

5.      A letter of invitation from the host institute.

6.      A completed “Host Acceptance Form” signed by the host supervisor.

7.      A completed “Home Institution Release Form” signed by the home supervisor.

Mehmet Hoxha, Albania

Rene Maximiliano Gomez,Argentina

Farzaneh Osati, Canada

Zoran Arsovski, FYROM

Emilija Vlaski, FYROM

Ivan Sokolovski, FYROM

Jordan Minov, FYROM

Katarina Stavric, FYROM

Jovanka Bislimovska Karadzinska, FYROM

Reinhold Kiehl, Germany

Zahra Pourpak, Iran

Ingrida Pumputiene, Lithuania

Edmund Wong, Philippines

Tomaasz Szczerbinski, Poland

Liana-Monica Marzan, Romania

Anca Zvoristeanu, Romania

Maja Slavkovic-Jovanovic, Serbia & Montenegro

Dragan Jovanovic, Serbia & Montenegro

Madeleine Rådinger, Sweden

Ilknur Harebal Can, Turkey

Alla Nakonechna, Ukraine

The aims of the EAACI Fellowship Awards are:

1. To support research and training of EAACI Junior members and Affiliates (JMAs) by offering the possibility to make short- (3 months) or long-term (1 year) fellowships in a foreign European country.
2. To increase the mobility of young researchers within Europe. Movement between EAACI members outside of Europe can also be considered.
3. Spread the implementation of new techniques between European laboratories.
4. Highlight the work of EAACI JMAs through increased publications and a special Fellowship Symposia at the EAACI annual Congresses.

EAACI Fellowship Programme for 2004:

1. 5 Long-term Fellowships of 20 000 € each. The long-term fellowships are aimed to fund travel and living expenses for a full-time 1-year research fellowship in a foreign European laboratory.
2. 5 Short-term Fellowships of 5000 € each. The short-term fellowships are aimed to fund a 3 months research fellowship in a foreign European laboratory. Preference is give to specified acquirements of new techniques and establishment of collaborations.

General conditions:

1. To be eligible to apply you must be under the age of 35 and be a member of the EAACI (EAACI-JMA).
2. You must yourself contact an institution in a foreign European country, who is willing to host you for the whole duration of the fellowship, and define a supervisor. The host supervisor must either be a member of the EAACI, or have applied for membership, at the time of the Fellowship application.
3. Your home institution must be willing to release you of all work, laboratory and clinical, during the whole duration of the fellowship, and ensure that you will have the possibility to come back after the conclusion of the fellowship.
4. Adequate fluency in a language that permits effective communication in the host institution is required.
5. Fellowship recipients are not insured by the EAACI and are encouraged to make sure that both they and the institutions which receive them are fully covered by the necessary insurance’s. Host institutions are encouraged to assist and pay for this. EAACI accepts no liability.
6. The Fellowship is a scholarship which in most European countries is tax free. However, the recipient is responsible for any tax that may be required in some countries.
7. A person may submit only one application at a time.
8. All documents must be submitted in English by e-mail (executive.office@eaaci.org), fax (+46-8 663 38 15) or by mail (EAACI Executive Office - PO Box 24140 - 104 51 Stockholm - SWEDEN) before the closing date of December 15, 2003. The signed original documents must be received at the EAACI Executive Office within 1 week after the deadline.
9. Applications that do not include all required forms or forms that are not properly completed will not be considered for review.
10. The applications will be reviewed by an expert panel and are handled in strict confidence.
11. The Fellowship period must start before the end of 2004.
12. Fellowship recipients will be asked to provide a detailed report on the results of the scientific project including a short financial report (no receipts).

Application (make 5 copies of each document) must contain:

1. A completed and signed "Application Form"
2. A Curriculum Vitae (maximum 1 A4 page)
3. List of publications (title, author list + journal issue page)(maximum of 1 key manuscript may be included in your application)
4. A project description of maximum 4 pages must be prepared in advance together with the host- supervisor. It must be adjusted to the duration of the fellowship and will be the most important part of you application for the reviewers. You should state the relevance and what you expect to obtain with the project.
5. A letter of invitation from the host institute.
6. A completed "Host Acceptance Form" signed by the host supervisor.
7. A completed "Home Institution Release Form" signed by the home supervisor.

We are now proud to announce the Major and Minor Winners of the EAACI Fellowship Award in 2004:

Major Winners

Apostolos Bossios from Greece with his project “Bone marrow activation in asthma and allergy”. His host is Prof. Jan Lötvall, Department of Pulmonary Medicine and Allergology, Sahlgrenska University Hospital in Gothenburg, Sweden.

Tanja Cirkovic Velickovic from Serbia with her project “Engineering of rFel d 1 with altered T-cell epitopes with the potential for application in novel forms of allergen specific immunotherapy”. Her host is Prof. Marianna van Hage-Hamsten, Clinical Immunology and Allergy Unit, Karolinska Institute in Stockholm, Sweden.

Wojciech Feleszko from Poland with his project “Effects of Probiotics on allergen-mediated sensitization and airway inflammation in a murine asthma model”. His host is Prof. Eckard Hamelmann, Department of Pediatric Pneumonology and Immunology, University Hospital Charite in Berlin, Germany.

Musa Khaitov from Russia with his project “The role of type 1 interferons in virus induced exacerbations of asthma”. His host is Prof. Sebastian Johnston, Department of Respiratory Medicine, National Heart and Lung Institute in London, UK.

Cansin Sackesen from Turkey with his project “The role of IFN-y-induced bronchial epithelial cell chemokines in the pathogenesis of asthma”. His host is Prof. Cezmi Akdis, Immunology department, Swiss Institute of Allergy and Asthma Research in Davos, Switzerland.

Minor awards

Asunción Martínez from Spain with his project “Effect of corticosteroids on infiltration of proinflammatory cells and cytokine expression pattern in nasal polyposis”. His host is Prof. Wytske Fokkens, ENT Department, Academic Medical Center, University of Amsterdam in Amsterdam, The Netherlands.

André Miguel Afonso de Sousa Moreira from Portugal with his project “Effect of the oral supplementation with Lactobacillus rahmnosus on the IgE mediated allergy on marathon runners”. His host is Prof. Tari Haahtela, Department of Clinical Allergology, Skin and Allergy Hospital, Helsinki University Central Hospital in Helsinki, Finland.

Cevdet Ozdemir from Turkey with his project ''Oral tolerance in a mouse model of food allergy''. His host is Prof. Harald Renz, Department of Clinical Chemistry & Molecular Diagnostics, Central Laboratory, Hospital of the University in Marburg, Germany

Eva Untersmayr, Austria with her project “Effects of digestion and digestion inhibition on the allergenicity of food antigens. A clinical and epidemiological study”. Her host is Prof. Lars K. Poulsen, Allergy clinic, National University Hospital in Copenhagen, Denmark.

Franziska Walter from Austria with her project “Establishment of an in vitro M-cell model to study uptake of oral vaccines against allergy”. Her host is David Brayden, University College Dublin, Faculty of Veterinary Medicine, Institute for Biomolecular and Biomedical Research, Dublin, Ireland.

EAACI received 31 applications for fellowships, and each application was judged by at least three reviewers. Overall, the quality of the applications were very high, and it was not easy to choose the successful awardees.

The EAACI fellowship is regarded as a very successful programme, which has greatly extended the mobility of researchers in the field of allergy and immunology in Europe. This increased mobility will be even further enhanced when the GA2LEN fellowship grants are advertised for the coming years.

Jan Lötvall

For EAACI EXCOM (historian)
Coordinator, EAACI fellowships

Contact Info:
Jan Lötvall
Professor Clinical Allergology
Department of Respiratory Medicine and Allergology
Göteborg University
Bruna Stråket 11
SE-413 45 GÖTEBORG
SWEDEN
Tel: + 46 31 342 2967
Tel: + 46 31 342 6151 (secretary)
Fax: + 46 31 415249

Allergopharma Joachim Ganzer KG is committed to furthering excellence through research in

ALLERGY DIAGNOSIS • ALLERGY THERAPY • ALLERGY PREVENTION

262

The presentation of the fifth Award will be made in recognition of scientific achievement in the field of Allergology during the World Allergy Congress, Munich 2005.

A submission for the award shall take the form of one full research paper published in an international peer reviewed journal in 2002/2004, together with a curriculum vitae. Applicants must be members or affiliates of the EAACI,
under the age of 40 years, and the research that is the subject of the application must have been conducted in a European centre. Special consideration will be
given to research concerning the mechanisms of allergic inflammation and allergen specific immunotherapy.

Submissions should be made before 31 December 2004
and addressed to:
The EAACI Executive Office,
Allergopharma Award,
c/o Ms. C. Öström
Karlavägen 108,
elevator V, 8th floor, 10451 Stockholm, Sweden

Further information can be obtained from:
Allergopharma Joachim Ganzer KG
21465 Reinbek, Germany
Phone: + 49 40 727 65 185
Fax: +49 727 65 318
Website: www.allergopharma.com
E-mail: oliver.cromwell@allergopharma.de
392.Winners1This year’s top prize for the Allergopharma Award on the best scientific research in allergy field, was shared between Dr. Eleanor Ling of Imperial College London and Pr. Eckard Hamelmann of the University Hospital Charité in Berlin. The President of the European Academy of Allergy and Clinical Immunology, Pr. Ulrich Wahn, and Herr Joachim Ganzer, managing partner of Allergopharma, congratulated the two winners on the Award Ceremony that took place on June 13th 2004, during the XXIII EAACI Congress in Amsterdam. Dr. Ling was awarded for her work on the relation of regulatory T cell suppression of allergen-driven T cell activation to atopic status and the expression of allergic disease. Her paper was published in the Lancet. The subject of Pr. Hamelmann’s application for the Award concerned the influence of endotoxin and allergen exposure in early life on allergen sensitisation.

The Allergopharma Award was instituted in 2001, in association with the European Academy of Allergology and Clinical Immunology, in order to recognise excellent research conducted by members of the Academy under the age of 40 years in the field of mechanisms of allergic inflammation and specific immunotherapy.

Vasil Dimitrov, Bulgaria

George Christoff, Bulgaria

David Usharauli, Georgia

Zahra Pourpak, Iran

Dejan Dokic, FYROM

Zoran Arsovski, FYROM

Kamelija Busljetic, FYROM

Emilija Vlaski, FYROM
Genciana Stevcevska, FYROM
Ivan Sokolovski, FYROM Jordan Minov, FYROM
Angelko Gjorcev, FYROM

Sonomjamts Munhbayarlah, Mongolia

Eva Maria Rebelo Gomes, Portugal

Elena-Camelia Berghea, Romania

Cristina Surdu, Romania

Elena Savchenko, Russian

Maja Slavkovic-Jovanovic, Serbia and Montenegro

Dragan Jovanovic, Serbia and Montenegro

Rajica Rajica Stokovic, Serbia and Montenegro

Madeleine Rådinger, Sweden

Gül Karakaya, Turkey

Emel Harmanci, Turkey

Sergei Minenko, Ukraine

Alla Nakonechna, Ukraine

Faris Alenzi, United Kingdom

Rosa Alberta Barroso Sanchez, Venezuela

Allergopharma Joachim Ganzer KG is a leading company involved in research and development in the field of allergy and clinical immunology.

The Company is committed to furthering excellence through research, and to this end an annual award is made in recognition of excellent research concerning the mechanisms of allergic inflammation and allergen specific immunotherapy.

The 3rd Allergopharma Award
in the value of 10.000 euro

The presentation of the third award will be made in recognition of scientific achievement in the field of Allergology during the European Academy of Allergology and Clinical Immunology Congress, Paris 2003.

The recipient should be a member or affiliate of the EAACI, under the age of 40 years, who has conducted research in a European centre. An application for consideration for the award shall take the form of a full research paper published in an international peer reviewed journal in 2000/2002, together with a curriculum vitae. Special consideration will be given to research concerning the mechanisms of allergic inflammation and allergen specific immunotherapy.

The Award will be decided by an ad hoc Commission nominated by the EAACI Executive Committee and Allergopharma. Candidates for the Award can apply directly or be nominated by a member of the Award Commission. A simultaneous application for a similar award cannot be submitted and only one application may be made by a research group.

Submissions should be made before 10 January, 2003 and addressed to:

EAACI Executive Office
Allergopharma Award
c/o Ms. C. Öström
PO Box 24 140
Karlavägen 108, 8th floor
SE-10451 Stockholm
Sweden

Further information can be obtained from Allergopharma Joachim Ganzer KG, 21465 Reinbek, Germany. Phone: + 49 40 727 65 185, Fax: +49 727 65 201, web site: www.allergopharma.de

Major Winners

 

Pavels Gordins from Latvia

His host was Dr. Frank Anderson, Infection, Inflammation & Repair, University of Southhampton, Southampton General Hospital, UK.

 

Aleksandar Petlichkovski from Macedonia.

His host was Dr. Todor Popov, Department of Allergology, Medical Academy in Sofia, Bulgaria.

 

Claudio D’Ambrosio from Italy

His host was Prof. Sergio Bonini, Institute of Neurobiology & Molecular Medicine, Italian National Research Council, Rome, Italy.

 

Katarzyna Solarwicz from Poland.

Her host was Prof. Kurt Blazer, Swiss Institute of Allergy & Asthma Research, Davos, Switzerland.

 

Peter Hellings from Belgium.

His host was Prof. J. L. Ceuppens, Laboratory of Experimental Immunology, O & N, Leuven, Belgium.

 

Susanne Gabrielsson from Sweden.

Her host was Prof. Rudolf Valenta, Molecular Immunopathology Group, Dept of Pathophysiology, Vienna General Hospital, Austria.

 

 

 

Minor awards

 

Annabella Procoli from Italy.

Her host was Dr. Ignacio Ansotegui, Santiago Apostol Hospital, Immunology Laboratory, Vitoria-Gasteiz, Spain.

 

Cinzia Maria Bellettato from Italy.

Her host was Prof. Sebastian Johnston, Dept. of Respiratory Medicine, National Heart & Lung Institute, Imperial College of Science, London, UK.

 

Anna Åsa Dorothea Kasche from Germany.

Her host was Prof. Per Venge, Department of Medical Sciences, University of Uppsala, Sweden.

After the success of the EAACI Naples Congress we are pleased to announce the Winners of the following competitions:

EAACI Exchange Research Fellowships 2002

Major Winners
Pavels Gordins - Latvia
Aleksandar Petlichkovski - FYROM
Claudio D'Ambrosio - USA
Katarzyna Solarwicz - Poland
Peter Hellings - Belgium
Susanne Gabrielsson - Sweden

Minor Winners
Annabella Procoli - Italy
Cinzia Maria Bellettato - Italy
Anna Åsa Dorethea Kasche - Germany
Paska Csilla - Hungary

ALLERGOPHARMA Award

Winner
Susanne Vrtala - Austria

EAACI Media Awards

Winners - TV category
1st Prize: Martine Allain-Regnault & Laurent Broomhead
(''Les allergies en question'')
2nd Prize: Marc Moras & Jo Frére (''Astma en allergie'')

Winners - Lay print category
1st Prize: Adrain Morris (The allergy guide)
2nd Prize: Hervé Masson & Philippe Auriol
(www.allergique.org and www.allergie.remede.org)

JMA Poster Prizes

Winners
E. Von Hoffen - 56
S. Guerra - 97
A. Riemer - 163
P.W. Hellings - 404
D. Bullens - 416
A. Gaspar - 571
E. Melén - 568
A. Ptasinska - 717
P. Verdino - 882
E. Volanaki - 965

Major Winners
Dietke Buck from Germany.
His host was Dr. Jean-Pierre de Villartay, INSERM, Hospital Necker, Paris, France.

Radoslaw Spiewak from Poland.
His host was Prof. Johannes Ring, Munich Technical University, Centre for Allergy & Enviroment, Munich, Germany.

Alessandra Micera from Italy.
Her host was Prof. Francesca Levi-Schaffer, Hebrew University of Jerusalem, Dept of Pharmacology, Jerusalem, Israel.

Philippe Gevaert from Belgium.
His host was Prof. Joachim Lundahl, Karolinska Hospital, Dept of Clinical Immunology, Stockholm, Sweden.

Marianna Bellafiori from Italy.
Her host was Dr. D.E. Davies, Brooke Laboratory, Division of Infection, Inflammation & Repair, Southampton General Hospital, UK.

 

Minor awards

 

Igor Kaidashev from Ukraine.

His host was Prof. Marek Kowalski, University School of Medicine of Lodz, Dept. of Clinical Immunology and Allergy, Lodz, Poland.

 

Ervin Mingomataj from Albania.

His host was Prof. Axel Fischer, Clinical Research Unit of Allergy, Dept. of Pediatrics, Charité, Berlin, Germany.

 

Alessandro Lambiase from Italy.

His host was Prof. Harald Renz, Dept of Clinical Chemistry & Molecular Diagnostics, Central Laboratory, Marburg, Germany.

 

Ilaria Puxeddu from Italy.

Her host was Prof. Francesca Levi-Schaffer, Hebrew University of Jerusalem, Dept of Pharmacology, Jerusalem, Israel.

 

Elona Gjebra from Albania.

Her host was Prof. Jean Emberlin, Pollen Research Unit, University College Worcester, UK.

Responsible: SGO Johansson (sgoj@vialen.se)

A revised nomenclature for Allergy
An EAACI Position Statement from the EAACI Nomenclature Task Force.
SGO Johansson, J O’B Hourihane, J. Bousquet,C. Bruijnzeel-Koomen, S. Dreborg, T. Haahtela, M. L. Kowalski,
N. Mygind, J. Ring, P. van Cauwenberge, M. van Hage-Hamsten, B. Wuthrich
ALLERGY (2001):56: 813-824

The EAACI Allergy Definitions represent a Glossary for the most important terms from EAACI Nomenclature Position Statement and is now available in the following languages. You are welcome to print any of those and use in your profession. If your language is missing, please contact the Chairman of the Nomenclature Task Force.

Bulgarian, Chinese, Czech, Danish, Dutch, English, Estonian, Finnish, German, Greek, Hungarian, Italian, Japanese, Korean, Lituanian, Norwegian, Polish, Portuguese, Romanian, Slovenian, Spanish, Swedish and Turkish.

Task Force 15
Responsible: J Ring (Johannes.Ring@lrz.tu-muenchen.de)

More information will come shortly.

Task Force 5
Responsible: Werner Pichler ( pichler@insel.ch )

For Immediate reactions:
Diagnosis of immediate allergic reactions to beta-lactam antibiotics
M.J. TORRES, M.BLANCA, J.FERNANDEZ, A.ROMANO, A.WECK, W. ABERER, K.BROCKOW, W.J.PICHLER, P.DEMOLY, for ENDA, the EAACI interest group on DRUG HYPERSENSITIVITY
ALLERGY (2003), 58,10:961-972

For Non immediate reactions:
Diagnosis of immediate allergic reactions to beta-lactam antibiotics
M.J. TORRES, M.BLANCA, J.FERNANDEZ, A.ROMANO, A.WECK, W. ABERER, K.BROCKOW, W.J.PICHLER, P.DEMOLY, for ENDA, the EAACI interest group on DRUG HYPERSENSITIVITY
ALLERGY (2003), 58,10:961-972

Task Force 12
Responsible: Sergio Bonini (sbonini@mclink.it)

Organisation of health care on Allergy and Clinical Immunology
European standards and minimal requirements for allergy and clinical immunology services (Allergy Services)

Background
Even in countries where Allergology and Clinical Immunology (ACI) is recognised as a specialty or subspecialty, ACI services are often not recognised by the National Health System and allergy diagnosis and treatment is covered by Departments of Internal Medicine or of other Specialties. Moreover, there are no recent position statements about specific tasks and minimal requirements for ACI services, in the past clearly defined by WHO-IUIS documents.

Aim of the TF
The Task Force should aim at:

- Producing position statements and reference European Guidelines for National Health Services

- Re-evaluating the professional skills acquired through         a specific education in ACI

- Highlighting the specific competence and importance for the various national health services of allergists and clinical immunologists

- Defining the features and tasks of different ACI Services, depending on their location and goals (for instance Excellence National Centres, Central Regional Services, Local Services).

Composition of the TF
The composition of the TF should answer some often conflicting needs:

- To get information on existing structures and needs of all national (and regional) environments. This would imply a high number of members

- To produce concrete results in a short time and at a low cost (usually an objective only achieved by small working groups).

On the basis of the above considerations, it is proposed to structure the TF as having three different components:

A drafting group made of 3 persons uncharged to collect the information and to write documents. The following names are suggested for this task: S. Bonini, K. Nekam.

A consultive board  of up to for ensuring transnational representation, specific areas of competence (paediatrics), links to other EAACI bodies.
For this board the following names are proposed, but others can be suggested by the Executive Committee: R. Dahl, G.S. Del Giacco, M. Kowalski, G. Lack, H. Mosbech, C. Pascual,
T. Popov, J. Rosado Pinto, C. Saxoni Photini. The consultive board should meet at least one a year, possibly at EAACI Congresses.

An assembly of Members at large representing all countries members of the EAACI, to be consulted by E-mail.

Task Force 14
Responsible: W Fokkens (W.J.Fokkens@amc.uva.nl)


EAACI Position Paper on Rhinosinusitis and Nasal Polyps

Executive Summary - Complete Paper
ALLERGY (2005): 60: 583–601


Background

Update November 2004
TF final report was sent for approval on November 3rd, 2004. The ExCom approved the paper but was sceptic about the potential cost of publishing as a whole supplement in ALLERGY. The Editor-in-Chief advised that it was possible to publish an Executive Summary of the paper in ALLERGY, while the Editors of Rhinology expressed their will for publication as a supplement, which was finally agreed.

Update May 2004
WF reported on 040507 that TF14 is almost finished. The PP has been assembled and will go to the whole group for final approval.

WF advises that this group is also trying to work with a parallel American task force led by Eli Melzer and Daniel Hamilos. This is a task force set up by 5 American societies, the AAAAI, AA Otolaryngic Allergy, AAOHNS, ACAAI, and ARS. Their title is ''Rhinosinusitis: establishing definitions for clinical research and patient care''. WF is working with Dan Hamilos to try to bring the two papers in line as much as possible, although quite some differences do still exist.

EAACI-ERS Joint Task Force 16
Responsible: L Delgado (jldelgado@mail.telepac.pt) & S del Giacco (delgiac@tiscali.it)

Members of the Task Force:
EAACI: Bonini S. (Italy), Canonica G.W. (Italy), Del Giacco St. (Italy), Delgado L. (Portugal), Galatas J. (Greece), Haahtela T. (Finland), Popov T. (Bulgaria), Van Cauwenberge P. (Belgium).

ERS:
Anderson S.D. (Australia), Bjermer L. (Sweden), Brusasco V. (Italy), Carlsen K.H. (Norway), Drobnic F. (Spain), Larsson K. (Sweden), Palange P. (Italy).

IOC: Cummiskey J, (Ireland)

Observer: Khaltev N, (WHO)

Background

Update November 2004
As part of their IG report, the IGAAS requested continuing funding for the TF on recognising and diagnosing exercise-related hypersensitivity in sports. The ExCom was sceptic towards such a prospective and requested for a formal report on the overall expenditure and the future activities.

Update May 2004
The TF met in Monaco on May 13-14, 2004 at the 3rd Sports & Science Forum (an organization of Sergio Bonini and Walter Canonica with members of the International Olympic Committee Medical Comission). During the meeting, they reviewed the written contributions from both EAACI & ERS members, aiming to join up several parts of the first contribution on: "Asthma and Sports: Diagnosis, Treatment and the relationship to Doping".

In addition to Asthma & Sports contribution, an evidence-based Position Paper covering practical aspects of the management of Asthma & Allergy in Sports, will also be produced, shortly.

Task Force 17
Responsible
: Jean Bousquet (jean.bousquet@wanadoo.fr)


Background

This initiative is under the overall supervision of Onno van Schayck. JB reported on 040507 that the IPAG project is almost finalized and the first draft of the report has been circulated among the members of ARIA, GINA and GOLD. It should be finalized before the WONCA Meeting in Orlando in October 2004.

Task Force 5
Responsible: Werner Pichler ( pichler@insel.ch )

For Immediate reactions:
Diagnosis of immediate allergic reactions to beta-lactam antibiotics
M.J. TORRES, M.BLANCA, J.FERNANDEZ, A.ROMANO, A.WECK, W. ABERER, K.BROCKOW, W.J.PICHLER, P.DEMOLY, for ENDA, the EAACI interest group on DRUG HYPERSENSITIVITY
ALLERGY (2003), 58,10:961-972


For Non immediate reactions:
Diagnosis of immediate allergic reactions to beta-lactam antibiotics
M.J. TORRES, M.BLANCA, J.FERNANDEZ, A.ROMANO, A.WECK, W. ABERER, K.BROCKOW, W.J.PICHLER, P.DEMOLY, for ENDA, the EAACI interest group on DRUG HYPERSENSITIVITY
ALLERGY (2003), 58,10:961-972

Responsible: Paolo Matricardi (matricardi.pm@mclink.it)

Microbial Products in Allergy Prevention & Therapy
P. M. Matricardi, B. Bjorksten, S. Bonini, J. Bousquet, R. Djukanovic, S. Dreborg, J. Gereda, H.-J. Malling, T. Popov, E. Raz, H. Renz, A. Wold for the EAACI Task Force
ALLERGY (2003): 58: 461–471

Task Force 12
Responsible: Sergio Bonini (sbonini@mclink.it)

Organisation of health care on Allergy and Clinical Immunology
European standards and minimal requirements for allergy and clinical immunology services (Allergy Services)

Background
Even in countries where Allergology and Clinical Immunology (ACI) is recognised as a specialty or subspecialty, ACI services are often not recognised by the National Health System and allergy diagnosis and treatment is covered by Departments of Internal Medicine or of other Specialties. Moreover, there are no recent position statements about specific tasks and minimal requirements for ACI services, in the past clearly defined by WHO-IUIS documents.

Aim of the TF
The Task Force should aim at:

- Producing position statements and reference European Guidelines for National Health Services

- Re-evaluating the professional skills acquired through         a specific education in ACI

- Highlighting the specific competence and importance for the various national health services of allergists and clinical immunologists

- Defining the features and tasks of different ACI Services, depending on their location and goals (for instance Excellence National Centres, Central Regional Services, Local Services).

Composition of the TF
The composition of the TF should answer some often conflicting needs:

- To get information on existing structures and needs of all national (and regional) environments. This would imply a high number of members

- To produce concrete results in a short time and at a low cost (usually an objective only achieved by small working groups).

On the basis of the above considerations, it is proposed to structure the TF as having three different components:

A drafting group made of 3 persons uncharged to collect the information and to write documents. The following names are suggested for this task: S. Bonini, K. Nekam.

A consultive board  of up to for ensuring transnational representation, specific areas of competence (paediatrics), links to other EAACI bodies.
For this board the following names are proposed, but others can be suggested by the Executive Committee: R. Dahl, G.S. Del Giacco, M. Kowalski, G. Lack, H. Mosbech, C. Pascual,
T. Popov, J. Rosado Pinto, C. Saxoni Photini. The consultive board should meet at least one a year, possibly at EAACI Congresses.

An assembly of Members at large representing all countries members of the EAACI, to be consulted by E-mail.

Task Force 14
Responsible: W Fokkens (W.J.Fokkens@amc.uva.nl)


EAACI Position Paper on Rhinosinusitis and Nasal Polyps
Executive Summary - Complete Paper
ALLERGY (2005): 60: 583–601

Background

Update November 2004
TF final report was sent for approval on November 3rd, 2004. The ExCom approved the paper but was sceptic about the potential cost of publishing as a whole supplement in ALLERGY. The Editor-in-Chief advised that it was possible to publish an Executive Summary of the paper in ALLERGY, while the Editors of Rhinology expressed their will for publication as a supplement, which was finally agreed.

Update May 2004
WF reported on 040507 that TF14 is almost finished. The PP has been assembled and will go to the whole group for final approval.

WF advises that this group is also trying to work with a parallel American task force led by Eli Melzer and Daniel Hamilos. This is a task force set up by 5 American societies, the AAAAI, AA Otolaryngic Allergy, AAOHNS, ACAAI, and ARS. Their title is ''Rhinosinusitis: establishing definitions for clinical research and patient care''. WF is working with Dan Hamilos to try to bring the two papers in line as much as possible, although quite some differences do still exist.

EAACI-ERS Joint Task Force 16
Responsible: L Delgado (jldelgado@mail.telepac.pt) & S del Giacco (delgiac@tiscali.it)

Members of the Task Force:
EAACI: Bonini S. (Italy), Canonica G.W. (Italy), Del Giacco St. (Italy), Delgado L. (Portugal), Galatas J. (Greece), Haahtela T. (Finland), Popov T. (Bulgaria), Van Cauwenberge P. (Belgium).

ERS:
Anderson S.D. (Australia), Bjermer L. (Sweden), Brusasco V. (Italy), Carlsen K.H. (Norway), Drobnic F. (Spain), Larsson K. (Sweden), Palange P. (Italy).

IOC: Cummiskey J, (Ireland)

Observer: Khaltev N, (WHO)

Background

Update November 2004
As part of their IG report, the IGAAS requested continuing funding for the TF on recognising and diagnosing exercise-related hypersensitivity in sports. The ExCom was sceptic towards such a prospective and requested for a formal report on the overall expenditure and the future activities.

Update May 2004
The TF met in Monaco on May 13-14, 2004 at the 3rd Sports & Science Forum (an organization of Sergio Bonini and Walter Canonica with members of the International Olympic Committee Medical Comission). During the meeting, they reviewed the written contributions from both EAACI & ERS members, aiming to join up several parts of the first contribution on: "Asthma and Sports: Diagnosis, Treatment and the relationship to Doping".

In addition to Asthma & Sports contribution, an evidence-based Position Paper covering practical aspects of the management of Asthma & Allergy in Sports, will also be produced, shortly.

Task Force 17
Responsible: Jean Bousquet (jean.bousquet@wanadoo.fr)

Background

This initiative is under the overall supervision of Onno van Schayck. JB reported on 040507 that the IPAG project is almost finalized and the first draft of the report has been circulated among the members of ARIA, GINA and GOLD. It should be finalized before the WONCA Meeting in Orlando in October 2004.

Responsible: Carsten Bindslev-Jensen

Standardization of Food Challenges in Patients with Immediate Reactions to Foods
C. Bindslev-Jensen, B. K. Ballmer-Weber, U. Bengtsson, C. Blanco, C. Ebner, J. Hourihane, A. C. Knulst, D. A. Moneret-Vautrin, K. Nekam, B. Niggemann, M. Osterballe, C. Ortolani,
J. Ring, C. Schnopp, T. Werfel
ALLERGY (2004), 59:690-697

Responsible: Werner Pichler ( pichler@insel.ch )

Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations
W.ABERER, A.BIRCHER, A. ROMANO, M. BLANCA, P. CAMPI, J.FERNANDEZ, K. BROCKOW, W. J. PICHLER, P. DEMOLY for ENDA, and the EAACI Interest group on DRUG HYPERSENSITIVITY
ALLERGY (2003),58:854
Standardization of Food Challenges in Patients with Immediate Reactions to Foods
C. Bindslev-Jensen, B. K. Ballmer-Weber, U. Bengtsson, C. Blanco, C. Ebner, J. Hourihane, A. C. Knulst, D. A. Moneret-Vautrin, K. Nekam, B. Niggemann, M. Osterballe, C. Ortolani,
J. Ring, C. Schnopp, T. Werfel
ALLERGY (2004), 59:690-697
Responsible: Werner Pichler ( pichler@insel.ch )
Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations
W.ABERER, A.BIRCHER, A. ROMANO, M. BLANCA, P. CAMPI, J.FERNANDEZ, K. BROCKOW, W. J. PICHLER, P. DEMOLY for ENDA, and the EAACI Interest group on DRUG HYPERSENSITIVITY
ALLERGY (2003),58:854
Task Force 8
Responsible: Lars Poulsen


TF-completed.
Task Force 8
Responsible: Lars Poulsen


TF-completed.

The Sahlgrenska Academy formally announces a post as:

Professor of Respiratory medicine
including A position as senior physician at
Sahlgrenska University hospital

The post is a professorial chair at the Institute of Internal Medicine.

Reference number: E 311 3796/04

This is a chair at the Department of Respiratory Medicine and Allergology, which is part of the Institute of Internal medicine. The Department is closely affiliated with the corresponding wards and departments at Sahlgrenska University Hospital. All these academic and medical units cooperate closely in the areas of specialization of respiratory medicine and allergology, in research and medical care, as well as teaching. The research carried out in these disciplines builds on collaboration in basic experimental research, patient-related clinical research and epidemiology.

Responsibilities: Conducting, directing and developing international, high-level, research in respiratory medicine. Supervising PhD students and mentoring researchers who have completed their PhDs. Teaching undergraduate medical students and other professionals.

Grounds for eligibility: Scientific and pedagogical skills, and competence in a relevant area of clinical specialization.

Grounds for assessment: Primarily scientific and secondarily pedagogical skills.

Administrative skills will also be taken into consideration in making the appointment, as well as the ability to co-operate.

For information:

* About this post

Department head, Professor Jan Lötvall,
+46 31 342 29 67
Department director, Professor Olle Isaksson
+46 31 342 38 39

* Trade union representatives:

OFR/S S (The Public Employees’ Negotiation Council)
Eva Sjögren +46 31 773 11 71 –
SACO (The Swedish Confederation of Professional
Associations)
Annika Badre +46 31 773 11 70 – SEKO (The Union of
Service and Communication Employees)
Lennart Olsson +46 31 773 11 73

Application: Please append to your application your curriculum vitae and the various other supporting documents about your qualifications required in accordance with the instructions, available in Swedish only as*: “Anvisningar för upprättande av meritportföljer”. Your application and all supporting documents are to be submitted in triplicate.

Application forms may be downloaded from: www.sahlgrenska.gu.se/akademin/dokument/meritport/index.jsp (for support in the process of application, please do not hesitate to contact Jan Lötvall (jan.lotvall@mednet.gu.se).

The 20 publications you select for submission are to be enclosed in triplicate with your application.

Your signed application form, including the above-mentioned reference number, must have reached the Sahlgrenska Academy office no later than 11 November 2004.

Mailing address: Sahlgrenska Academy at Göteborg University, The Registrar, Box 400, SE-405 30 Göte­borg SWEDEN

Street address: Medicinaregatan 3

  • The board met in Croatia in April and in December in Copenhagen, relevant minutes have been circulated.
  • Housekeeping rules have been created and must be approved at this occasion.
  • It was decided to include our JMA as member with voting rights – since the bylaws only allows for 6 members in the board, we so far decided to include our JMA as an Adjunct Member. This item should also be discussed.
  • Two Task forces are currently working: one on APT chaired by Kristiina Turjanmaa and a second one has just been approved by ExCom, namely on Late phase reactions in AD, chaired by Thomas Werfel. Discussion with Rudolf Valenta on presenting the APT position paper in Vienna is undergoing.
  • The Vienna program has adopted most of our decisions, including a session together with ESCD.

Future congresses:

  • Vienna
  • Gothenburg
  • Barcelona
  • Warsaw
  • London
  • Istanbul

The two latter may be switched.

Regarding the process of evaluating abstracts or the congresses, it has been agreed between Pediatric and Dermatology Sections, that we evaluate abstracts on dermatological topics together.

Activities 2004/2005

  • Urticaria Consensus Meeting October, Berlin
  • Newsletter June 2005
  • Planning and approval for Food Allergy Course april 2006, together with Ped Section
  • Practall – a Joint Initiative between EAACI and AAAAI on the topic AD. Two more are planned, Anaphylaxis and Pediatric Asthma.

  • For 2006, 2-3 summer schools EAACI/GA2LEN are scheduled. One is already accepted in Oslo, two more are currently being evaluated. Application for summer schools must be filed in during the next two months.

Dermatology section should propose a summer school for 2006 or 2007 (preferentially). Topic should be decided here.

Unsolved issues to be addressed in the next period:

  • The number of members with voting rights in our Section is stable at a low level (280). ENT is closing in on us and we need to find ways of increasing the number of our core members. This can only be done internally by taking members from other sections - an unwise solution: Instead we should attract members from outside EAACI and talks with EADV and ESCD has been initiated and will be substantiated in the near future.
  •  

  • Our JMA, Ulrike Raap has been nominated JMA Chair and will represent the JMA in ExCom. She has been replaced by Dr Elena Borzova, from Russia. A warm welcome to you. We must decide whether our JMA is an ordinary member or an adjunct member. The work in ExCom has been interesting and sometimes hard – there are a lot of things to be learnt especially since there are several political issues to be aware of at and between the meetings. But our impact is increasing and we should strengthen our efforts in seeking influence there. Therefore I am willing to serve another period as chairman of our Section.


Carsten Bindslev-Jensen

1 – Board
The board is elected according to the bylaws of the EAACI.
In addition, the JMA Dermatology representative is taken as an Adjunct Board Member with full responsibilities and voting rights. He/she will count as the 8th ordinary member of the board. The number of members present to make a formal decision is 4/8, single majority votes (e.g. 5/3) are required for decisions. Only members present at the meeting are allowed to be elected for their first period serving on the board.

2 – Section board meetings
Minimum twice per year: one at the EAACI congress, one at the Derm Section meeting. In years with no section meeting, the meeting should be held preferably at other congress, e.g. EADV. Extra meeting in case of urgent matters is possible if it is announced by the chairman one month in advance, unless all board members have unanimously accepted a prior meeting. Electronic communication, telephone conference may be used for intermediate decisions. Meetings are normally on invitation by the chairman, but any member of board can request on extra meetings or electronic/telephone conferences. In this case, a majority decision is required by e-mail in advance. Any extra meeting in person is subject to available funding.
Meetings are chaired by the chairman, in unexpected absence by the secretary.

3 – Daily routine
The daily routine is run by the Chairmen and Secretary, all communication should be preferably by e-mail and all board members will be copied in.

4 – Section activities

4.1 Meetings
At the EAACI Congress, the section should ensure a balanced programme regarding dermatological contents in allergy.

EAACI Derm section meetings should be held preferably annually, external additional funding should be looked for every 2-3 years, joint meetings with other sections are encouraged.

Joint sessions at international or national dermatology congresses, esp. EADV, are desirable.

4.2 Internet
The internet should provide information about meetings, protocols of board meetings, task forces, guidelines, activities (responsible: secretary).

4.3 Guidelines
Guidelines on relevant subjects should be prepared by the section, if possible of highest level. Guidelines prepared by other sections or the EAACI ExCom dealing with dermatological topics in allergy should be co-authored by the Derm Section.

4.4 Task forces
In topics of dermatology where special attention is needed, the Derm Section should be putting up EAACI Task Forces.

4.5 Other activities
All other activities which are in the interest of the aims of the EAACI and dermatology in allergy, e.g. contact with patient organisation, are encouraged, but usually not extra-funded.

5 – Collaboration with other institutions
Collaboration with other institutions, especially GA²LEN, is strongly encouraged.

6 – Financial affairs
Both, the Chairman and the Secretary, are responsible for the correct spending of the budget, all decisions on higher sums of spending, esp. for section meetings, need to be approved by the board.

All junior activities were marked with great success in Munich 2005. Starting with the Junior Poster Session, which was held on the Opening Evening of the congress, more than 180 junior members presented and discussed their work with junior colleagues as well as senior members of the Academy.
Moreover, ten poster prizes of 300 € were awarded for outstanding poster presentations through sponsorship of Pharmacia Diagnostics AB.  These are:

1) Asthma: P Bogaert (Belgium)
2) Rhinitis: A Vroling (Netherlands)
3) Dermatology: I Angelova (Bulgaria)
4) Paediatrics: M Schedel (Germany)
5) Food allergy: Y Lorenz (Germany)
6) Allergens: J Wallmann (Austria)
7) Immunotherapy: R Weiss (Austria)
8) Clinical Immunology: J Makowska (Poland)
9) Immunology: I C Nassenstein (Germany)
10) Immunology: II A Taylor (Switzerland)

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The Junior Social Event followed on the same evening in a former bathhouse, which proved to be a great opportunity for all junior members to meet and get to know each other in a friendly and relaxed environment.

Snapshots from Munich!

The Junior Member Symposium took place on Thursday. H Hammad (NL), Bel Elisabeth (NL), Vermaelen K (BE) and Raap Ulrike (DE) were the speakers of this session.

The Junior Member Educational Session included two parts; one focused on the best possible ways for presenting a scientific project (Anthony Frew), while the second was an introduction on understanding statistics in medical research (Thomas Keil).

Finally, during the Junior Member Business Meeting the New EAACI JMA Working Group was presented:

- JMA chair (Ex Com): Dr U Raap, Germany (mail@ulrike-raap.de
- JMA past chair (SPC): Dr Ph Gevaert, Belgium (Philippe.Gevaert@UGent.be)
- ENT: Dr P Hellings, Belgium (peter.hellings@med.kuleuven.ac.be)
- Dermatology: Dr E Borzova, Russia (eborzova@online.ru)
- Immunology: Dr M Kurowski, Poland (marcin.kurowski@gazeta.pl)
- Asthma: Dr D Groneberg, Germany (david.groneberg@charite.de)
- Paediatrics: Dr L Borrego, Portugal (miguel.borrego@sapo.pt)
- Webmaster: Dr C Skevaki, Greece (cskevaki@allergy.gr)

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by Peter W. Hellings, JMA Representative ENT Section

In the beginning of April, the Advanced Sinus Surgery Course took place in the Academic Medical Center (AMC), Amsterdam, The Netherlands, organized by Prof. Wytske Fokkens, present head of the Department of Otorhinolaryngology at the AMC and chairman of the ENT Section of the EAACI.

This two-day course aimed at extending both the theoretical knowledge as well as practical skills of ENT surgeons beyond the boundaries of the sinonasal cavity. This first course was attended by 55 participants from 10 different countries. The teacher of honour was Professor Valerie Lund, London, U.K., authority in the field of sinus surgery and well-known for her contribution to sinonasal tumor surgery. The lectures by the board of teachers covered a wide range of topics, from image-guided surgical navigation and powered instrumentation, to mucocoeles, hypophysectomy, frontal sinus surgery, endonasal dacryocystorhinostomy, orbital decompression, sinonasal tumor surgery and handling of complications after sinus surgery.

During the course, participants were allowed to actively train their operative skills in endoscopic sinus surgery on cadaver heads. The facilities made available for each of the participants were high-standard, including whole skulls, CT scans of the skulls, own monitors and powered instruments (cfr. pictures). The dissection manual was especially designed for the course and guided the participants step-by-step through the different sinus surgery techniques with emphasis on helpful tips and highlighting pitfalls of sinus surgery.
As an ENT surgeon, I recommend this course to ENT surgeons with special interest in sinus surgery as most participants rated the quality of the course from very good to excellent. The next course will be held in April 2005.

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Pic 1: Overview of training facility in the dissection room.
Pic 2: Professor Wytske Fokkens in discussion during the sinus surgery training session.

EAACI WEBMASTER
Nikos Papadopoulos ngp@allergy.gr
COMMUNICATIONS/BRUSSELS OFFICE
Anne Wilmes  wilmes.anne@skynet.be
NEWSLETTER EDITOR
Claus Bachert  claus.bachert@rug.ac.be
EAACI WEBMASTER ASSISTANT
Irene Andriopoulou irinia@allergy.gr

SECTION WEBMASTERS
Asthma
I Agache ibrumaru@unitbv.ro
ENT
C Nunes cn@imunoalergologia.com
Dermatology
C Bindslev-Jenssen 
Carsten.Bindslev-Jensen@ouh.fyns-amt.dk
Pediatrics
A Muraro muraro@pediatria.unipd.it
Immunology
T Jakob thilo.jakob@gsf.de

INTEREST GROUP WEBMASTERS
Aerobiology & Pollution
M Orta morta@imqnavarra.com
Allergy, Asthma & Sports
J Galatas doby@hol.gr
Immunotherapy
D Caillot dcaillot@wanadoo.fr
E Valovirta  erkka.valovirta@allergiakeskus.net
Infections & Allergy
N Papadopoulos ngp@allergy.gr
Drug Allergy
J Fernandez fernandez_jav@gva.es
Functional Genomics & proteomics
R. Pawliczak  rafal.pawliczak@csk.am.lodz.pl
Food Allergy
G Reese  reege@pei.de
Occupational Allergy
J Walusiak jolantaw@imp.lodz.pl
Diagnostic Tests
J Kleine-Tebbe kleine-tebbe@allergie-experten.de
Ocular Allergy
St Bonini sbonini@mclink.it
Insects Venom Hypesensitivity
J Fernandez fernandez_jav@gva.es
COMMITTEE WEBMASTERS 
JMA

I Agache ibrumaru@unitbv.ro
Ethics
K Nekam nekamkr.allergy@mail.datanet.hu
Specialty
J Gayraud j.gayraud@wanadoo.fr
CME
A Negri a.negri@cme-icap.it
Ex.Com.
N Papadopoulos ngp@allergy.gr
EAACI Ex. Office
D. Öwerström Deirdre.Owerstrom@eaaci.org
Technical Advisor (Steficon)
M Sarantinos msarantinos@steficon.com
Technical Advisor (Congrex)
B Pehrson bjorn@shocklogic.com
EAACI WebMaster Assistant
I Andriopoulou irinia@allergy.gr

* Workshop on Animal Models of Asthma
Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM)
Date: 28-29 January, 2005
Place: Hannover, Germany
For more information contact Dr Armin Braun (braun@item.fraunhofer.de) or click on www.item.fraunhofer.de

* 3rd EAACI Davos Meeting in Basic Immunology in Allergy and Clinical Immunology
Date: 3-6 February 2005
Place: Davos, Switzerland
For more information contact siaf@siaf.unizh.ch or click on www.siaf.unizh.ch/EAACI_meeting/EAACI_2004.html

* III World Congress on Immunopathology & Respiratory Allergy
Date: 5 - 8 February, 2005
Place: Pattaya, Thailand
Main themes: Allergy & Asthma, Autoimmune Diseases, Immunodeficiency and Basic Immunology, the Immune System Physiology
For more information click on www.isir.ru/thailand/general.html

* 3rd Annual Meeting of the Egyptian Society of Pediatric Allergy and Immunology (ESPAI)
Date: February 24-25, 2005
Place: Cairo Conrad Hotel, Cairo, Egypt
More information on the email congress@espai-eg.org or click on www.espai-eg.org/scientific.htm.

* First International Congress on Immunodeficiency Disorders
Date: 28 February-2 March 2005
Place: Tehran, Iran
Main theme: Immunodeficiencies, Immunogenetics, Immunodiagnosis and Infections
For more information click on www.iaari.hbi.ir/icid.htm

* VII International Symposium on Respiratory Viral Infections
Date:  March 3 – 6, 2005
Place: Curacao Marriott Beach Resort, Curacao, The Dutch Antilles
Keydates:  December 15, 2004 – Early registration fee
January 5, 2005 – Young Investigator Award abstracts due
January 5, 2005 – All abstracts due
For the program, registration and more information click on www.themacraegroup.com

* Frontiers in Neonatal & Infant Immunity
Date: March 18-20, 2005
Place: Westin Palace, Madrid Spain
Keydates:  January 10, 2005 – Early registration fee
January 10, 2005 – Young Investigator Award abstracts due
January 10, 2005 – All abstracts due
February 10, 2005 – Hotel reservation deadline for group rate
The event is CME Accredited.
For the program, registration and more information click on www.themacraegroup.com.

* 61st Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI)
Date: March 18-23, 2005
Place: San Antonio, Texas, USA
More information on: www.aaaai.org

* GA2LEN Annual Conference
Date: 18-19 April, 2005
Place: Ghent, Belgium
More information at the website: www.ga2len.net

* 1st Baltic Allergy Congress
Lithuanian Society of Allergollogy & Clinical Immunology
Date: 24-25 May, 2005
Place: Vilnius, Lihtuania
Main Theme: "Allergy: From the Past to the Future"
More information on www.balticconference.com/bac2005

* 10th EFA Conference
Allergy, asthma and COPD - Breaking through barriers.
Device: start with possibilities instead of limitations
Date: 2-4 June, 2005
Venue: Mitland Hotel, Utrecht, the Netherlands
More information at www.efanet.org.

* ERS/ATS joint course on Basics in asthma
Date: June 8-10, 2005 
Place: Oslo, Norway
For more information click on www.ersnet.org

* The 10th Annual Meeting of the Global Alliance for Medical Education
Date:June 19-21, 2005
Place: The Westin New York at Times Square
New York, NY
For Registration information contact Meghan Arnott
at marnott@medicallectures.com or click on the GAME website www.game-cme.org

* XVIII IFOS World Congress
International Federation of Oto-Rhino-Laryngological Societies
Date: 25 - 30 June, 2005
Place: Rome, Italy
For more information email to ifos2005@gruppotriumph.it

* XIX World Allergy Congress
Organised by World Allergy Organisation (WAO) and the European Academy of Allergology and Clinical Immunology (EAACI)
Date: 26 June - 1st July, 2005
Place: Munich, Germany
Main Theme: Allergy in a Changing World
For more information click on www.congrex.com/wac2005 or contact wac2005@congrex.se .

* RSV 2005 Symposium
Date: September 15 – 18, 2005
Place: Keble College, Oxford, UK
Keydates:  May 9, 2005 – Early registration fee
May 9, 2005 – Young Investigator Award abstracts
May 9, 2005 – All abstracts due
July 25, 2005 – Late Breaker abstract deadline
September 5, 2005 – Final registration deadline
For the program, registration and more information click on  www.themacraegroup.com

* 4th Balkan Congress of Allergology and Clinical Immunology
Date: September 22-25, 2005
Place: Patriarchy Palace, Bucharest, Romania
For more information click on http://www.sraic.ro/congress/congress_en.html

* 2nd Croatian-Italian Symposium on Psoriasis
Date: 23-24 September 2005
Place: Naftalan, Ivanic Grad, Croatia
For more information email at naftalan@zg.htnet.hr or click on www.naftalan.nr

* VVM 2005, Viral Vaccine Meeting
Date: October 27 – 30, 2005
Place: Westin Palace, Madrid, Spain
For more information click on www.TheMacraeGroup.com

* International Cytokine Society Conference 2005
Cytokines, Immunity, Immunotherapy and Vaccine
Date: 27-31 October, 2005
Place: Lotte Hotel Jmasin, Seoul, Korea
More information at www.ics2005.org

* Joint Meeting of the Pediatric Assembly of the European Respiratory Society (ERS) and the EAACI Section on Pediatrics
Date: November 12-15, 2005
Place: Prague, Chech Republic
More information on www.ers-eaaci2005.ch

* Iranian Asthma Meeting - Biennial Seminar of Iranian Society of Asthma & Allergy (ISAA)
Date: 14-16 November 2005
Place: Tehran, Iran

* Superantigens in Airway Diseases Symposium
Immunology and clinics of superantigen-driven inflammation
Date: November 25-26, 2005
Place: Hotel Novotel, Ghent, Belgium
More information on www.semico.be/superantigens2005/

* European Patient Conferece on Stem Cell Research: The Patient's Perpsective
Date: 15-16 December 2005
Place: The Charlemagne Building, Brussels, Belgium
More information on the website www.erastepps2005.eu.com/index.htm

Venue: World Allergy Congress, ICM, Munich
Date: June 26th-July 1st, 2005

614

For a whole week, Munich was the centre of the international allergy community. EAACI and WAO successfully joined forces towards a meeting that gathered experts and young scientists from all over the world. Read a general report on the World Allergy Congress. More...

The development of the Academy last year and the future prospects throughout the effective use of the main communication tools were discussed at the General Assembly on June 28th. More...

The EAACI new President, Pr. Anthony Frew, introduces the Academy's future plans and goals.

Meet also the new Secretary General, Pr. Jan Lotwall, on his first interview to the EAACI website!

Finally, EAACI web editor shares with us his personal view on the big Bavarian surprise, ‘L’Allerigica Comedia’.

327The Conference of the flagship European Network on Allergy and Asthma, GA²LEN, took place on Tuesday 19 April at 10.00 am at Holiday Inn, Ghent Expo, Belgium.

Allergy increases blamed on environmental changes

Research into why half of all Europeans will have developed allergies by 2020 is focussing on environmental factors, such as air pollution and food quality.

 

''The reasons for the rise in allergies and asthma remain unclear but epidemiological evidence indicates that this rise has been driven by changes in the social and physical environment,” according to Professor Paul van Cauwenberge, Coordinator of GA²LEN (Global Allergy and Asthma European Network), an EU-funded initiative aimed at mobilising the entire European research community to work together on this growing public health problem.

 

Speaking at GA²LEN’s first annual meeting (18-19 April 2005), he remindes the audience that the past 40 years have witnessed a dramatic increase in the prevalence of allergic diseases and asthma. “Over 50% of the population of Europe is likely to be allergic within the next 10-15 years,” he says. The increases will not only take place in Western Europe but also in poorer countries. “Environmental factors play an important role in altering host resistance to respiratory diseases in childhood. It is likely that the accession of a number of former Soviet Union countries to the European Union will be accompanied by changes in the patterns of disease among children in those countries.''

 

Professor van Cauwenberge believes that at the end of its first year the GA²LEN “network of excellence” is already on track to create a structure that will maximise Europe’s scientific contribution to controlling allergy and asthma. European Commissioner for Science and Research, Janez Potocnik is demostrating his interest in GA²LEN’s work through his participation in the meeting in Ghent. He explained that allergy and asthma are an important part of European Research on health-related research in his presentation entitled: “Allergy within the European Research Programme.”

 

Professor Peter Burney from King’s College London, one of the centres involved in GA²LEN, describes three areas of environmental research being undertaken by the network. One is the influence of indoor and outdoor air pollution on allergic and asthmatic patients. He says that this is “already an area of excellence in European research.” He believes that new findings will provide an important basis for developments in “evidence-based” policy.

 

A second important area of research to be highlighted is occupational hazards, including the exposure of office workers and health care personnel to cleaning agents. A review of the effects of cleaning products on the development of asthma has just been completed and will be published shortly.

 

A third subject of environmental research is the quality and safety of food. The quality of European food is recognised to be deteriorating. “This is a known contributor to asthma,” Professor Burney says. GA²LEN research is concentrating on which aspects of the changing diet is associated with the observed increases in allergies.

 

The joint research programme to be implemented throughout the network will address issues in relation to their effect in different life stages and steps in disease progression. One of the most promising research areas to be described at the meeting is the work on the exposure to infections in early life. Professor Erika von Mutius from the University Children’s Hospital Munich, Germany, describes how increased exposure to infections leads to protective effects on asthma and wheeze. Her paper reports that children growing up on dairy farms have a significantly lower prevalence of allergic diseases, with the exception of eczema and positive allergy tests. “Contact with stables and barns and the consumption of non-pasteurised milk was found to explain much of the relationship between farming and allergies.” The timing of farm exposure is crucial to the protective effect. Children need to be exposed in the first year of life, and mothers should ideally have exposure to farm animals during pregnancy and lactation.

 

Pooling excellence

Professor Paul van Cauwenberge believes that GA²LEN affords the best way to tackle the growing menace of allergies and asthma. He says: “Despite many collaborative projects, such as the European Community Respiratory Health Survey (ECRHS) and the International Study of Asthma and Allergy in Childhood (ISAAC), significant weaknesses continue to exist in the European research community. GA²LEN, which is built on the European Commission’s concept of a “Network of Excellence”, brings together 25 leading European research centres to jointly address these shortcomings.”

 

First, GA²LEN ensures that research teams can take advantage of epidemiological data from countries with different prevalence rates and different environmental conditions. “The variability of environmental exposure and the sharp contrast in prevalence make international cooperation vital and Europe an ideal community laboratory,” Professor van Cauwenberge says. He points out that the prevalence of asthma and allergies among teenage children varies from 32% in the UK to just 2.6% in Albania. GA²LEN’s first year of activity has provided partners with numerous opportunities to exchange during symposia and meetings, as well as via a regular newsletter and intranet communication within a new website, and during two summer schools.

 

A second way in which GA²LEN is helping to overcome the European research community’s limitations is through the recent establishment of a research platform that will help standardise methods for epidemiological surveys, common basic research and clinical trials. Once fully established, the results of studies in different European countries will become more fully comparable. All new and ongoing research projects also benefit from the support of specialist sections within the network dealing with gender, ethics and the role of intellectual property rights in patent and product development.

 

Non-research partners

Another important contributor to the likely future success of GA²LEN is the membership of two key organisations outside the research community. These two bodies can help GA²LEN hasten the process of translating research findings into clinical practice. One is the professional association of allergy experts, known as European Academy of Allergology and Clinical Immunology (EAACI). Its president, Ulrich Wahn is keenly involved in disseminating recent research findings to his several thousand members throughout Europe. He describes some promising approaches on how to help patients avoid provoking allergy symptoms.

 

Patients as well as medical experts should be provided with practical updates on research findings if rapid changes in clinical management are to be achieved. The network helps to ensure information is disseminated to patients via the membership of the European Federation of Allergy and Airways Diseases Patients Associations (EFA). EFA represents 35 patients’ associations in 20 countries and a total of 400,000 patients. Susanna Palkonen of the EFA Brussels office tells the meeting that GA²LEN fits perfectly into the EFA’s mission of “improving the health-related quality of life of patients with these diseases in Europe.”

 

The first 12 months of GA²LEN’s life has produced concrete developments, including a research platform, several opportunities for partners to meet, the launch of a website and intranet, and a summer school programme. Little wonder then that the first annual report concludes: “GA²LEN is on track to create a permanent and durable structure that will maximise Europe’s scientific contribution in the area of allergy and asthma.”

A GA²LEN brochure, a full list of research partners, contacts and other information is available on request to:

GA²LEN Communication Centre
Avenue Louise, 327 BP6
B-1050 Brussels
Tel: +32 2 640 77 80
Fax: +32 2 647 89 29

Mobile:0475 48 89 85
Anne.wilmes@ga2len.net

www.ga2len.net

617Venue: World Allergy Congress, ICM
Date: June 28th, 2005 Munich

 

The EAACI General Assembly took place on June 28th during the 2005 World Allergy Congress in Munich. A significant number of participants attended the event. The EAACI outgoing 2003-2005 President, Pr. Ulrich Wahn, thanked the Academy for the most rewarding and refreshing experience that he had, serving as EAACI’s President. He then reported the tremendous developments within the Academy, including the EU-funded network of excellence GA2LEN, bringing “allergy into a new era where everyone can be part of it”.

 

Communication Tools

The visibility of the Academy was also enforced by the annual meetings, the website and the Newsletter, the latter gaining more ground with the New Look, produced by Brussels Office. Still, there is always room for improvement, room for more use to promote internal and mostly external communication. The Journals also constitute an integral part of the Academy. New contracts have now been signed with the Publishers along with the strong support by the sponsors. What is more important, ‘Pediatric Allergy and Immunology’ is now included in the free benefits of the EAACI membership.

 

New Initiatives

The new initiatives of the Academy are heading towards the “Acknowledgement of the Best”, a new European Academy Award in order to raise public awareness for allergy. Moreover, a stronger interconnection with the AAAAI is planned. The main object is to raise one topic for discussion, on an annual basis, between the delegates of both Academic bodies and have a “consensus paper”, the results of which will be presented in the annual meetings.

 

Moreover, the EAACI outgoing Secretary General, Pr. Tony Frew, reported on the activities undertaken by the Academy during the last 2 years (2003-2005) and thanked all EAACI members for their dynamic response, resulting from 1100 members in Rhodes Congress in 1997 to 3043 in 2005 WAC in Munich.

 

Sources of income

The financial side of the Academy is of major importance demanding a careful approach. EAACI Treasurer, Pr. Marek Kowalski, reported briefly on the 3 main sources of income: a) the membership subscription b) funding from the founding sponsors and corporate societies and c) income from journals.

 

The General Assembly moved towards the election of the new Executive Committee and all newcomers were welcomed and further introduced to the public.

 

The next General Assembly will take place in XXV EAACI Congress in Vienna 2006.

July 2005

202Dear Colleagues,

Nominations are requested from EAACI members for candidates who might serve as Members at Large for the Executive Committee of EAACI from June 2005 to June 2007. Any individual member of EAACI may be nominated as a candidate. The nomination should take place on the accompanying form, copies of which can be obtained from the EAACI website or Executive Office. Electronic submissions are preferred and must be sent by Friday 11 February 2005 to the Secretary General (ajf@eaaci.org) preferably with copy to the Executive Office(executive.office@eaaci.org).

Members are reminded that the Executive Committee tries to maintain a balance of membership from different parts of Europe but there are no specific seats reserved on the Executive Committee for a representative from any particular country. Candidates may be nominated by National Societies or by individuals. In general, the elected candidates should have the support of the National Society but the National Society cannot veto any candidate.

Members at Large are expected to attend three Executive Committee Meetings per year including the Executive Committee Meeting held at the time of each EAACI Congress. ExCom members should also attend the EAACI General Assembly where the general membership can ask questions of the Committee as a whole or individual members of the ExCom. Modest travel expenses are covered by EAACI but there is no stipend for Members at Large. Any EAACI member wishing to discuss these positions should contact the Secretary General. Once again please note the closing date of 11 February, which has to be respected so that we can adhere to our constitutional requirement for nominations to be made at least three months before the General Assembly and at the same time to allow the Executive Committee a reasonable time to consider the nominations and develop a balanced slate of nominations.

Click here to download the Application for Nomination Form.

A J Frew
EAACI Secretary General

599The symposium on "Superantigens in Airway Disease", will be held in Ghent, Belgium on 25-26 November, 2005. The venue will take place at the Hotel Novotel Ghent, in the heart of the historical center of the city of Ghent.

The topic of this symposium is 'Immunology and clinics of superantigen-driven inflammation". Download the Scientific Programme.

Abstract Submission deadline: now closed.

For instructions on how to apply and further information on the symposium visit the website: www.semico.be/superantigens2005/

 

With the support of:

LOGOEAACI_sm 694 Logo-Galen-Standard_sm

352The impact of Allergic Rhinitis on the lives of sufferers across Europe was the main subject of the Patient Allergy Voice survey that was conducted in 11 European countries by the European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) this spring. The quantitative self-completion survey was addressed to patients from EFA member organisations. Results of the survey were reported in 2 waves on 23rd of May and 20th June 2005.

 

The main parameters of the survey were:

- the clinical characteristics of allergic rhinitis (e.g. seasonality; triggers; severity; intermittent vs persistent)

- the impact on sleep, daily activities (work, school) and emotional well-being

- the measures that need to be taken for a better quality of life

- perceived efficacy of medications

- the interaction of allergic rhinitis with other conditions (asthma, eczema, urticaria, food allergies).

 

Allergic Rhinitis (AR) is a long-term and, in many cases, lifelong condition. The main triggers identified for the emergence of AR were plants/flowers and dust with animals, tobacco, mould following. Over half of patients suffer from relevant symptoms for at least half the year whereas almost three quarters experience at least one symptom severely enough to interfere with daytime activities and/or sleep. Symptoms are more intense in spring and summer.

 

Moreover, the survey showed that a high proportion of AR sufferers receive medications, both to prevent and control symptoms, whereas three-quarters of patients also suffer from other allergic conditions, particularly asthma.

Older patients are more likely to suffer from concomitant conditions, particularly food allergies and asthma.

 

To find out more about the survey visit EFA website.

 

The Survey was supported from an unrestricted grant from UCB.

610Over 7000 participants from 105 countries joined the 2005 World Allergy Congress in Munich. For a whole week (June 26th-July 1st) Munich was the centre of the international allergy community. EAACI and WAO successfully joined forces towards a meeting that gathered experts and young scientists from all over the world.

 

The main theme of WAC was ''Allergy in a Changing World'' aiming at covering all important new aspects of experimental and clinical allergology and related fields. The latest advances in allergy, immunology and major allergic diseases were thoroughly explored through plenary sessions, symposia, workshops, courses, debates, free communications and meetings with experts. A new session entitled ''Sherlock Holmes in Allergy'' was launched during the Congress in which carefully-selected illustrative clinical cases were presented. Poster Sessions were also very popular with over 1600 posters participations!

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The social programme included daily tours around Munich to old and new attractions, such as BMW driver training, Dachau, Salzburg, the Royal Castle. The rather hot weather supported all outdoor activities.

615 614

Moreover, all participants had the chance to taste Bavarian and international cuisine at the Opening Ceremony and Welcome Reception, at the Congress Evening outside the three famous Pinakotheks and at the Bavarian Evening at Lowenbrau Kelller beer hall where the attendees were nicely surprised by a theatrical performance set up by the organizers themselves!

613 612

Junior Members and Affiliates, EAACI‘s special and most popular group, held a relaxing night in a former swimming pool where Juniors (and not only) had time for lengthy discussions in the bar, snacks on the terrace and lots of dance in the empty swimming pool!

View the Photo Album!

July 2005

624The new EAACI President, Pr. Anthony Frew, was handed officially the “Hammer of Power” by the Past President, Pr. Ulrich Wahn at the Presidential Dinner that took place on Tuesday, June 27th, at the 2005 World Allergy Congress in Munich. The new President has served as the Secretary General for 7 years and his contribution to the current development of the Academy has been unanimously appreciated.

 

At the EAACI General Assembly, the new President thanked everyone for their strong support within the Academy and outlined presented the EAACI’s future plans and goals. The Academy is a very strong organization, not only within the European borders but on a global scale as well. The Annual Congress is the major “engine” for both growth and income. It provides all its members new avenues towards the enrichment of their scientific knowledge with new findings. This is successfully coupled with a social program that helps the improvement of communication amongst members. Other educational activities, like the Summer and Winter Schools, attract also a considerable number of new scientists to EAACI.

 

However, there is always room for improvement. The intellectual competition from neighboring disciplines and the changing regulatory climate that affects both sponsors and doctors (CME included) are the main parameters that need to be examined carefully.

 

The review of the educational and scientific needs of the current and potential Congress attendees is another issue that should be approached. To succeed in that, EAACI needs to co-operate closer with the National Societies, to increase individual membership and to explore techniques for “capturing” new members. These can include members from less prosperous countries, non-congress attendees and the Junior members reaching the age of 35.

 

Another priority for EAACI is to increase the engagement of the Interest Groups and find new ways of expanding their activities.

 

The role of the Executive Committee is crucial to the Academy’s development within the next two years. The ExCom is going to look at ways they can use their “time and energy” towards the most effective results. In particular the ExCom will aim for improvement of the budget-setting process, increased engagement with clinical practice and using more effectively the main communication tools of the Academy: a) Journals (allergy, pediatric allergy b) Newsletter c) Website.

 

With the dynamic contribution of the EAACI Sections, Interest Groups and individual members, we can look forward to a bright future for European allergy and EAACI!

 

June 2005

125Date: 3rd May 2005

 

EAACI celebrates World Asthma Day on May 3rd, 2005 this year with the theme "The Unmet Needs of Asthma’’. GINA, (Global Initiative for Asthma) addresses this theme to scientists, doctors and patients in order to stress the need for better asthma treatment and control. The theme is built on last year’s World Asthma Day theme, “The Burden of Asthma” and the Global Report that followed it, claiming that by recognizing and meeting the unmet needs of asthma, it is possible to make the first steps to reduce the burden of this important disease.

 

World Asthma Day takes place yearly on the first Tuesday in May. Each year GINA chooses a theme based on the needs and problematic aspects of asthma and organizes preparation and distribution of World Asthma Day materials and resources in each country.

 

GINA works with health care professionals and public health officials around the world for the reduction of asthma prevalence, morbidity, and mortality. Through resources and publications, such as evidence-based guidelines for asthma management, and events such as the annual celebration of World Asthma Day, GINA is working for the improvement of the lives of people with asthma in every corner of the globe.

Venue: Patriarchy Palace, Bucharest, Romania

Date: September 22-25, 2005

 

First Announcement

The Romanian Society of Allergology and Clinical Immunology will host the 4th Balkan Congress of Allergology and Clinical Immunology in Bucharest, from 22nd to 25th, September 2005.

 

Main Topics

  • Genetics in Immune Diseases
  • Micro environmental interactions in allergic IgE mediated diseases
  • Asthma
  • Breast feeding and early Allergy prevention
  • Viruses and exacerbations of asthma and allergies
  • WHO, IAACI, EAACI, AAAIC, positions on allergic diseases – Actualities
  • Early allergy diagnosis
  • Atopic dermatitis
  • Anaphylaxis
  • Food allergies
  • Sensitization mechanisms
  • Risks for allergic diseases in infancy and childhood
  • Management of IgE mediated disease
  • Ethics in Allergy and Clinical Immunology

Important Dates

Abstract Submission Deadline 15.05.2005

Confirmation of Abstract Selection 15.06.2005

Deadline Registration

at Reduced Fee 15.05.2005

Deadline for Pre-Registration 01.09.2005

 

Exhibition

A large exhibition highlighting medical devices, pharmaceutical products and books will take place during the congress.

 

The Congress will be organised under the auspices of

 

LOGOEAACI_sm and    542

 

For more information contact Local Organising Secretariat

 

TRICOLOR 21 - PROFFESIONAL CONGRESS ORGANISERS

56, Intr. Tudor Stefan, sector 1, Bucharest, Romania

Phone: +4021 230.51.10 • Fax: +4021 230.50.42

Contact : Gabriela Ion
E-mail: gabi@rotravelplus.com

671The U.S. Immunodeficiency Network (USIDNET) seeks for Concept Proposals on Primary Immune Deficiency Diseases (PIDD) for fund peer reviewed research grants on the related area. The proposal is addressed to new and established investigators,

US and Non-US citizens. Organisations are also eligible for application.

 

The US Immunodeficiency Network is a research consortium established to advance scientific research in the primary immune deficiency diseases era.

 

All candidates will go under evaluation and approval by the review committee and after the completion of which, they may be invited to submit a Full Application.

 

Submission
Full Applications should not exceed 10 pages of text and follow the NIH format. Deadline date for Full Application review is: March 1; July 1; and November 1, 2005

 

Concept Papers can be submitted electronically throughout the year to RAMS proposal Central's website: https://v2.ramscompany.com/. Concept papers will be reviewed within two weeks of receipt.

 

Budget
Budget for funded projects will range from $50,000 to $150,000 year, up to two years including indirect cost.

 

For more details visit the US Immunodeficiency Network website at www.usidnet.org.

763Informall - Communicating about Food Alergies to allergic consumers, the agro-food industry, health professionals and regulators, the EU funded project from the EU Fifth Framework Programme for Research, has now come to an end (end 2005). The objective of the project was to promote the provision of visible, credible food allergy information sources to these target groups.

The main, free to download, Informall Project Tools are:

Ø The Database on allergenic foods. It contains information on food allergens targeted to the general public and technical information for specialists (clinical characteristics and biochemical data), in English. The information on plant foods is already available now, for animal origin foods it will be available by the end of 2006. More at http://foodallergens.ifr.ac.uk/

 

Ø The Food allergens information portal (FAIP). It contains easy-to-read information about food allergy for consumers, food processing and regulation information to the industry and also on diagnosis and management to health professionals, in English. In addition, it serves as a portal to worldwide and credible information in several languages, on food allergy for consumers, specialists and industry that has been assessed by experts. More at http://www.foodallergens.info/portal.html

 

Ø Food allergy communications recommendations are easy-to-print leaflets in English for different target groups; food industry, general public, health professionals, patients, food authorities, and caterers and food-service industry, on how to best communicate food allergy information to them. More at http://www.informall.eu.com/informationleaflets2005.htm

 

 

These resources will be followed up and developed in the context of the EuroPrevall – Prevalence, Cost and Basis of Food Allergy project.

687At least 1.5 million Europeans with severe asthma live with constant fear of an asthma attack, according to the report of the survey “Fighting for Breath - a European Patient's Perspective on Severe Asthma”, that was launched by the European Federation of Allergy and Airways Diseases Patients’ Associations (EFA). The aim of the survey was to investigate and highlight the impact of severe asthma on people from across Europe as well as to explore the future challenges from the scientist’s perspective.

The results of the survey were presented at the 15th Annual Congress of the European Respiratory Society (ERS) in Copenhagen, September 17-21, 2005. A quarter of patients have speech limiting attacks at least once a week. Severe asthma symptoms, such as chest tightness and breathlessness, affect around 6 million people in Europe with disturbing effects in their daily activities and the overall quality of life. Despite the fact that, in most cases, the symptoms are manageable, there is still long way until all asthma sufferers receive complete relief and treatment.

 

Get the full report from the EFA website.

122JMA Poster Session                                  


9th of May
19.30-21.30 in Hall 4/5
Chaired by S. Olsson, D. Metcalfe

 

Posters are exclusively presented by EAACI-JMAs in this session. Poster walks will be lead by a Junior and a senior chair-persons in an informal atmosphere. A light dinner buffet and wine are served.

Poster prizes will be awarded through the support of Pharmacia Allergy Research Foundation and furthermore the recipients of the EAACI Fellowship Awards will be announced.

All JMAs are especially welcome to this session to discuss your work and ideas!

Abstracts

JMA FORUM

Bridging the Gap Between
Basic Research and Clinical Practice

Thursday 10th of May
12.45-13.45 in Hall 4/5
Chaired by N.G. Papadopoulos, S. Olsson

  • S. Bonini
    MDs vs PhDs : a changing pattern within the EAACI
  • S. Del Giacco
    Clinical thinking and basic ideas: Can they coincide?
  • Current controversies
    M. Leckie
    Are eosinophils involved in asthma?
    S. Salvi
    Is IgE crucial to allergy?
  • Round table discussion

Critical thinking development: Can one become wise early? 
With the participation of speakers, audience and specially invited discussants: P. van Cauwenberge, A. Frew, S. Holgate, SGO Johansson

The 2nd JMA Forum was realized during the Berlin meeting, making this event another JMA activity with a specific scope and repeatability. In these Forums, we intend to explore different educational aspects of our specialty.

In this respect, the idea for 2001, as presented by Nikos Papadopoulos and Susanna Olson that were chairing the Forum, was to look into contrasts between clinical perspectives and basic research ideas.

Pr. Sergio Bonini, the President of the EAACI, opened the meeting with an introductory talk on the changing balance between MDs and PhDs in the Academy. Initially, he said, there were no basic scientists, PhDs, within the EAACI members, as this was a purely medical society. However, this is changing as more scientists are interested in Allergy and more medical doctors are interested in basic research.

Pr. Sergio Del Giacco continued in analyzing the possibility for a physician to be able to achieve a 'scientific' way of thinking. His conclusion was that this is possible, however, there are several difficulties that have to be overpassed.

In the second part of the Forum, two young investigators gave interesting talks on currently controversial subjects, that challenge mainstream ideas. Maggie Leckie showed data that relate the eosinophil with asthma and referred to her much cited study on a anti-IL5 monoclonal antibody trial in humans, where although eosinophilia was significantly diminished, there were no effects on clinical parameters. Sundeep Salvi, presented a long list of evidence that contradict the traditional dependence of atopy on IgE.

Unfortunately, having to squeeze the Forum between two other sessions, time was very short for discussion. Pr. Tony Frew and Pr. Paul Van Cauwenberge closed the meeting, concluding that caution and insight are needed when interpreting data. The Forum successfully demonstrated that science is changing continuously and nothing is to be taken for granted!
Allergy in the European Union 6th
Framework Programme
Tuesday June 4, 11.00-12.30, Room Italia

Chairpersons:
Paul van Cauwenberge (BE), EAACI President
Susanna Olsson (SE), JMA Chairperson

  • Paul van Cauwenberge
    EAACI and EU Institutions
  • Barend Verachtert (BE)
    European Commission - Research Directorate-General: The European Research Programmes beyond 2002
  • Ted Popov (BG)
    Braveheart 2: EU grant application
  • Questions & Discussion

Click here to see the Photo Album from JMA Social Dinner.

Allergy in Different Organs - Eosinophils:
Hallmark or Epiphenomenon?
Monday June 3, 13.45-15.30

Chairpersons:
Ulrike RAAP (GE)) and Philippe GEVAERT (BE)

Place: Congress Centre Mediterraneo
Time: Saturday June 1 at 17.30-19.00

Hotel Ibis Porte de Clichy was specially reserved for JMAs. This is a nice middle class hotel with swimming pool located in Porte de Clichy and easily reached from the Congress by Metro. This common lodging will allow JMAs to meet more easily and to arrange social activities as well as facilitating common transports.
At the EAACI stand all JMAs were welcomed to meet up and use the computer with internet reserved for us.
Sunday June 8, 17.30-18.30, room 342B
Sunday June 8, 15.30-17.30, room 342B
Chairs: Katarina Bluemchen (GE) and Ulrike Raap (GE)
  • How to write a scientific paper
    Claus Bachert (BE)
  • How to write a grant application
    Sergio Bonini (IT)
  • Marie Curie Grant Programme
    Representative from the European Union
JMA Symposium (Main Symposium 3)
Molecular Control Mechanisms in Allergic Disease
Sunday June 8, 8.30-10.15, the Grand Amphithéâtre
Chair : Ioanna Agache and Bart N Lambrecht

Winners of Pharmacia Diagnostics Poster Prizes at the JMA Poster Session in Paris June 7, 2003

  • Dr. E. Untersmayr, University of Vienna , Austria
  • Dr. O. Palomares, University Complutense de Madrid , Spain
  • Dr. T. Saarne, Karolinska Institute and Hospital, Stockholm , Sweden
  • Dr. T. Cirkovic Velickovic, Fac. of Chemistry and Biochemistry, Belgrade , Serbia-Montenegro
  • Dr. S.M. Reinartz, AMC, Amsterdam , The Netherlands
  • Dr. L.E. Chialda, University of Erlangen , Germany
  • Dr. B.N. Pereira, St Mary's Hospital, Newport , Isle of Wight , UK
  • Dr. C. Gore, Wythenshawe Hospital , Manchester , UK
  • Dr. E.U. Borzova, Russain Medical Academy of Postgraduate Education, Moscow , Russia
  • Dr. V. Mariani, Div. Of Environment and Allergy, Munich , Germany

Winners of the JMA best poster prize, ENT-EAACI meeting Ghent 2003

  • Dr. K. Gunhan, Celal Bayar University , Turkey
  • Dr. M. Gavrovic-Jankulovic, University of Belgrade , Serbia & Montenegro

Winners of the JMA best free paper prize, ENT-EAACI meeting Ghent 2003

  • Dr. J. Smit, Utrecht University , The Netherlands
  • Dr. M. Kupczyk, Medical University of Lodz , Poland
Saturday June 7, 18.30-20.30,
Salle Passy at level 1 in Palais des Congres


Chairs: Susanna Olsson (S) and Philippe Gevaert (BE)

The JMA Poster Session is now becoming a tradition and will be held on the first night of the congress in parallel with the Opening cocktail. This session is aimed to promote the work of the EAACI-JMAs in an informal atmosphere where contacts with senior experts as well as fellow JMAs are supported. Posters are exclusively presented by JMAs and poster prices sponsored by Pharmacia Diagnostics will be awarded for out standing abstracts and poster presentations.

*Allergens Section
JMA Chaiperson Susanna Olsson
*Asthma Section
JMA Chaiperson Bart Lambrecht
*Dermatology Section
JMA Chaiperson Ulrike Raap
*Immunotherapy and Allergy Diagnosis Section
JMA Chaiperson Stefano Del Giacco
*Food Allergy Section
JMA Chaiperson Ioana Agache-Brumaru
*Inflammation of Upper Airways Section
JMA Chaiperson Philippe Gevaert
*Mechanisms of Inflammation Section
JMA Chairperson Peter Hellings
*Paediatric Allergy Section
JMA Chairperson Katarina Bluemchen

* EAACI Immunology Section and SIAF Symposium
Place: Davos, Switzerland
Date: 9th January 2004
Main Theme: Immune Mechanisms of Allergy

* Allergy and Eczema
A CME Accreditation Event in cooperation with ACAAI in Milan, 23rd - 24th January, 2004.
Main theme: Adverse reactions to food proteins, the changing patterns, the mechanisms and the teatment.
For further Information click on the website
www.mcaevents.org

* 4th World Asthma Meeting
Place: Bangkok, Thailand
Date: 16th -19th February 2004
Main theme: Asthma: A World-Wide Approach to Understanding, Treatment and Prevention
For more information click on the website www.WAM2004.com

* International Primary Care Respiratory Group - 2nd World Conference
Place: Melbourne, Australia
Date: 19th - 22nd February 2004
For more information click on the website
www.theipcrg.org

* 6th International Congress of Pediatric Pulmonology
Place: Lisbon Congress Centre, Portugal
Date: February 28th - March 2nd 2004
For more information on the Congress and the programme click on the website: www.cipp-meeting.com/CIPP6/

* 9th International Symposium on Immunological, Chemical and Clinical Problems of Food Allergy
Place: Budapest, Hungary
Date: 18th - 21st April 2004
Details of preliminary programme, abstract submission, exhibition, registration procedures and accommodations available at the website: www.foodallergy.makit.hu

* Basic and Clinical Allergy
18th course in the series
Place: London
Date: 19th - 22nd April, 2004
For further information click on the website: www.med.ic.ac.uk/divisions/49a/mtgs.htm

* 1st Drug Hypersensitivity Meeting
Place: Bellevue Palace, Bern, Switzerland
Date:  5th - 8th May, 2004
For more information click on the website
www.drughypersensitivity.ch

* 9th EFA Conference
Place: Oslo, Norway
Date: 24-26 June, 2004
Main Theme: Asthma and COPD:The Patient's Perspective
For more information click on www.efanet.org or contact hk.be@lhl.no

* Krakow Conference
Place: Krakow, Polland
Date: July 31st - August 3rd, 2004
Theme: Present and Future Developments on Allergy & Immunology
For more information click on the website www.pta.med.pl/krakow2004/index.php

* ERS Annual Congres
Place: Glasgow, U.K
Date: 4-8 September 2004
For more information click on www.ersnet.org or contact info@ersnet.org.

* Allergy Congress 2004
Place: Aachen, Germany
Date: 15th-19 September, 2004
For more information click on www.allergie-kongress-2004.de/.

* 2nd International Consesus on Urticaria
Place: Berlin, Germany
Date:1-2 October 2004
Main theme: Pathophysiology, Epidemiology, Quality of Life, Diagnosis and Treatment
For more information click on www.ecarf.org.

* XII. Turkish National Congress of Allergy and Clinical Immunology
Place: Antalya, Turkey
Date:  6th - 10th October, 2004
For more information click on the website:
www.allerji.kongresi.info

* Annual Conference of the Romanian Society of Allergology and Clinical Immunology
Place: Brasov, Romania
Date:  7th - 9th October, 2004
For more information click on the website:
www.rsaci.3x.ro

* 3rd Slovenian Congress of Pneumology and Allergology
2nd Slovenian Immunology Congress-Immunology and Clinics IV:1st Slovenian Congress of Respiratory Nursing
Place: PORTORO, SLOVENIA, Grand hotel Emona
Date:  20th - 22nd October, 2004
For more information click on the website:
www.klinika-golnik.si

* American College of Allergy, Asthma & Immunology
Annual Meeting
Date: 12-17 November 2004
Place: Boston, USA
For more information contact diannekubis@acaai.org or click on the website www.acaai.org/annual.html.

* Interasma - EAACI Asthma Section Joint Meeting
Date: 27 - 30 November 2004
Place: Bilbao, Spain
Main Theme: Asthma and Rhinitis: from guidelines to patient´s care
For more information click on www.interasma.org/bilbao2004

* Recent Advances in Asthma
Turkish Thoracic Society
Date: 2 - 4 December 2004
Place: Istanbul, Turkey
For more information click on www.toraks.org.tr

507For the EAACI website, 2004 was a year of several noteworthy landmarks: among these, just before the end of the year, the site’s statistical program recorded 1,000,000 hits!



These represented information traffic of over 23 Gigabytes! And the trend continues to rise on a steady basis. What could be a better present for eaaci.net this Christmas?

In a short period of time, and with the collaboration of the webteam and many EAACI members, www.eaaci.net obtained high visibility, by promoting a not only informational but mostly educational character, reaching a large number of users, members and non-members of the Academy.

In more detail, over 3000 weekly visits are currently recorded on average, a number almost double that of one year ago. Peak visit time is from 12.00 to 15.00 GMT during which the average hourly traffic is over 4MB. Visits span from 1 to 30 minutes. Almost half of the visitors come from Europe, but there is also interest from Asia, North America, South America, Africa, and occasionally the Caribbean! It is interesting to highlight that in December 2004 the numbers increased substantially to an average of 4000 visits per week. The peak was reported on December 13-19th with 4.303 visits, possibly due to the launch of the new e-learning application, the Web Casts, that took place at the same period.

It goes without saying that the overall traffic at www.eaaci.net closely reflects the activities of the Academy; during periods of intensive activity, such as around the annual Congress or close to Summer Schools, a dramatic increase in traffic is noted.

402 401 393

More than 5500 participants attended the XXIII EAACI Congress in Amsterdam, The Netherlands! The Academy's yearly reunion in one of the most beautiful cities in Europe was a great success, setting new standards in the field of allergy and clinical immunology. With the main theme ''Young Investigators at the Frontiers of Allergy'', a great amount of new, unpublished data from basic and clinical science were presented during numerous main symposia and 18 Allergy Forums. Along with the plenary sessions and symposia, this year the Postgraduate Courses were not limited as a pre-congress event but were integrated in the main scientific programme covering various and innovative aspects of allergy. ''Year in Review'' was, also a new element in the main programme of the Congress, giving an overview of the highlights in clinical and pre-clinical allergy and immunology

 

Well positioned just over the main entrance, over 1200 posters were presented during the Congress, with poster sessions taking place during lunch time; tasty sandwiches supported well an effective scientific communication!

 

The newly introduced GA2LEN, Network of Excellence funded by the European Union, was presented on a separate main symposium of the Congress, giving an overview of its functions and covering aspects of integration of research efforts on allergy and asthma in Europe.

 

319 410 400

 

Apart from the rich scientific programme, the social activities of the Congress were quite popular, attracting the interest of participants and offering them the chance to meet medieval Amsterdam with its unique artistic history as well as get to know each other in a relaxed and friendly atmosphere. Van Gogh, Rembrandt Museums and Anna Frank¡¦s House were among the most popular sites that we ''spotted'' EAACI people, enjoying the city's exclusive cultural heritage.

61EuroPrevall is a multidisciplinary integrated project (IP) involving 15 European member-states, Bulgaria (a candidate country), Switzerland and Iceland, and Ghana. Of the 53 partners, there are 17 clinical organisations and 11 small-medium sized enterprises (SMEs). Its aim is to deliver improved quality of life for food allergic people. EuroPREVALL will start in June 2005 if current negotiations, between the consortium and the European Commission’s Research Directorate General, are successful.

Improved quality of life, including reduced risk, will be delivered by integrating information and developing tools for use by European food allergy scientists, health professionals, food and biotech industries, and consumers – those who are food allergic and those who are not. Much of these benefits will be realised through exploitation of research results by SME industries. More specifically, EuroPREVALL will:

  • Characterise the patterns and prevalence of food allergies across Europe in infants [birth cohort in 5 centres], children and adults [cross-sectional surveys in 10 centres]. These wider-population studies will be complemented by more detailed studies based on referrals to allergy clinics at 12 centres.
  • Use samples and information from the surveys to identify risk factors (e.g. environmental, microbial or genetic) and novel predictive markers (e.g. biochemical and genetic) for food allergy, which would allow implementation of preventive measures (e.g. during pregnancy)
  • Develop serological methods based on purified food allergens (“component resolved diagnosis”), including conventional and novel formats – using post-genomics technologies – to improve the quality of food allergy diagnosis, reducing the need for food challenge tests
  • Investigate how the food matrix affects allergenicity of foods, including food processing procedures, and develop new reference materials for food challenges, which are truly blind and based on real foods (e.g. confectionary).
  • Create and apply instruments to determine the impact of food allergies on the quality of life and its economic cost for food allergic people and their families, workplace and employers, and healthcare

For further information, please contact the Project Coordinator: Dr Clare Mills (ifr.europrevall@bbsrc.ac.uk) or the Communications Manager for EuroPREVALL, Dr Siân Astley (sian.astley@bbsrc.ac.uk) European Communications Manager at EuroPREVALL, Institute of Food Research, Norwich Research Park, Colney, Norwich NR4 7UA (UK); tel. + 44 (0)1603 255219; fax. + 44 (0)1603 255168

312People affected by pollen allergy should be particularly alert to the danger of being outdoors during a thunderstorm in the pollen season.

Six adults and a girl of 11, experienced severe asthma attacks - nearly fatal in one case – during a thunderstorm in Naples, Italy on June 4, 2004. All patients received treatment in emergency departments, where it was registered that four of them had a history of asthma and the other two a history of rhinitis. None of them were taking antiallergic and/or antiasthma drugs on a regular basis at the time when the thunderstorm struck.

It is interesting to note that all patients were outdoors at the time of the thunderstorm and, according to the findings of Pr.G. D’Amato, EAACI Aerobioloy & Pollution IG Chairman, and his research team at the "Cardarelli” Hospital in Naples, the allergic respiratory symptoms of all seven patients were due to exposure to Parietaria pollen, an Urticarea widely spread in the Naples area. According to the pollen diary, the concentration of airborne Parietaria pollen grains was particularly high - a peak of 144 grains/m3 being recorded on June 3. However, air pollution levels were not particularly high on June 3rd and 4th.

Full article is published at BMJ Q & A Archive.

404 406 405

The new EAACI website was launched during the Paris meeting last year; this year in Amsterdam we celebrated its 1st birthday. Any pediatrician would ascertain that infancy is one of the most important periods in life. Many events that would influence future development take place during that time. Not to mention that if one survives infancy, one has very high chances for further survival… EAACI.net not only survived, but thrived. With a continuous increase in content and visits it reached over 500,000 hits in less than a year, many more than anticipated. New experiences, such as the Slide kit Resource and the Job Center resulted from a mix of planning and inspiration. Hundreds of pages and new ideas were the result of a productive team of webmasters.

However, this is only the beginning. This year’s plans include the addition of new e-learning resources, starting with Webcasts from the Amsterdam meeting that will appear in early autumn. A new set of pages with annotated case reports will also be offered for CME purposes. With so many new things, don’t forget to turn off the computer and keep some time for vacation. Enjoy the summer !!!

Two stars have passed away within a month: one confirmed star, Professor Romain Pauwels and one rising star, Professor Maurizio Vignola. Maurizio turned 40 in September 2004 and died peacefully less than 6 months later after a desperate fight against a devastating disease.


Up until June 2003, Maurizio was an extremely active young man with remarkable skills not only in medicine but also in every other field he was involved in. He was an excellent tennis player and a friend to all of us, but, even more, he was a good man. He was present at all respiratory and allergy meetings and we were desperately saddened to learn of his passing. It is a tragic loss as he was someone irreplaceable who was at the height of his career. Everyone in the respiratory community will sadly miss him. He was one of our greatest hopes for the future of respiratory medicine and allergy.

 

Maurizio was born in Sicily where his father was a primary care doctor, and received his medical degree in Palermo, Italy. He trained in respiratory medicine with Professor Giovanni Bonsignore and then spent just over 3 years in Montpellier where he graduated as a PhD. His links with our staff remained very strong and we are still collaborating actively with the Italian National Research Council (CNR) laboratory in Palermo. He was the leader of the Section of Lung Immunopathology, Respiratory, Clinical and Experimental Pharmacology at the Institute of Biomedicine and Molecular Immunology of the CNR in Palermo. Maurizio had just been promoted to Professor of Respiratory Medicine.

 

Maurizio was initially attracted to medicine and research because of the opportunity to identify causes of disease and a desire to help find the cures for such diseases. His main research interest was in the area of asthma, COPD and rhinitis attempting to understand the molecular and cellular mechanisms associated with chronic inflammation and remodeling. He always tried to correlate biologic outcomes with clinical parameters and he made the concept from bench to bedside a reality. Despite his young age, Maurizio had already published 113 articles listed in Medline and over 40 book articles. He was a remarkable speaker and had been invited to many congresses including the American Thoracic Society, the European Respiratory Society and the European Academy of Allergology and Clinical Immunology. He was a member of the executive committee of ARIA and was coordinating the GINA Mediterranean activities. He was also one of the work package leaders of GA2LEN (Global Allergy and Asthma European Network) and an Associate Editor of the European Respiratory Journal.

 

Maurizio’s family was very close to his heart. His wife Tiziana played a major role in his career and also in his fight against the terrible disease. His wife, his mother and his wife’s parents and brother were all by his side during his final 18 months. It was truly remarkable to see the glow of solidarity around the world following the discovery of his disease. Walter, Giovanni, Leo, Sergio, Pascal, Peter, Sven-Eric, Klaus and many others did all they could to help, in particular when Maurizio was in Genoa. He was a true leader and every member in his laboratory has shown deep sadness.

 

I present my sincere condolences to his wife Tiziana, to his children Andrea and Christina and to all the members of his family.

 

Jean Bousquet
292.smIn March poll on reasons for choosing one scientific meeting over another, financial support was admitted to be the defining factor for over 27% of EAACI members who responded. Strong scientific program (22.5%), nice location (17.5%) and the opportunity to present one’s own data (15%) were the next most popular reasons.

In contrast, the social program and opportunity to meet with peers scored low. This information, which can be useful to future meeting organizers, reflects both the continuous demand of allergists for scientific excellence, as well as the relative lack of financial resources. This however, may soon improve as allergy is increasingly recognized as a major medical and social problem, attracting more Community and industry funds.

414Well, the countdown is on! Finally Olympic games are back in their Birthplace. ''Athens 2004'' Games are approaching in this very special year in which the God of Sport wanted to present to Greece also the Victory in the Euro 2004 football Championship in Portugal.

Thousands of Athletes from every corner of the World will meet in Greece from 13 to 29 August to fight till their last effort to get a medal or, as Baron De Coubertin said, only to participate and leave their name in the Olympus of the lucky men or women that tried to get their country on the podium. But, since 15-20% of people are allergic in the industrialized country, may we hypothesize that also allergy will participate to Olympic Games? The answer is yes.

 

In fact, allergy is able not only to influence performance in sports (asthma, rhinitis for example) but also some of the allergic syndromes are induced theirselves by sport activity. So, Olympic athletes, trainers, managers and, why not, people attending to the Games, should be aware about the dangers of Allergy during Olympic time.

 

Exercise-induced asthma (EIA), exercise-induced anaphylaxis (EIAn) and exercise-induced urticaria (EIU) are the three principal disorders that can be induced by exercise and the practice of sport; minor aspects of allergic disorders during sporting activity are related to contact dermatitis caused by different substances or situations (contact with sport tapes, swimming goggles, substances contained in wet suits and so on). Pollen levels can obviously influence patients affected by asthma, rhinitis and conjunctivitis, and these people should check pollen levels informations to avoid symptoms and to perform the correct prevention.

In the area of Athens, Goosefoot and Ragweed are expected to be present in moderate levels, while Cupressaceae, Oleaceae, Gramineae and Urticaceae in Low levels. High levels of Alternaria and moderate levels of Cladosporium are also expected; more informations can be reached in a dedicated website from the University of Thessaloniki (www.aeroallergen.gr/en).

 

Many world-class athletes have asthma; the prevalence of this disease range from 3.7 to 22.8% according to the systematic review of Helenius and Haahtela. They are living proof that you can achieve what you set your mind to as long as you perform a correct treatment of your disease, and you can compete at the same level of all the other athletes.

Tom Dolan, Kurt Grote, Nancy Hogshead and Amy Van Dyken are three asthmatic Olympic medallists in the swimming disciplines, Jackie Joyner-Kersee in track and field, Greg Louganis in diving; the prevalence of asthma and bronchial hyperreactivity has been reported to be higher in athletes than in the general population. This can be also related to reported asthma in order to obtain permitted use of Beta-2 agonists with the idea of a better performance after the assumption of these drugs. This is one of the reasons for which the use of these drugs is strictly regulated by the anti-doping regulations. The list of prohibited drugs is constantly updated by the World Anti-Doping Agency (WADA) and available in this website or with the link www.wada-ama.org; in many countries since a few years it is indicated in each drug box a clear sign of potential doping or non-doping drug.

 

In the last years, criteria and regulations for the diagnosis of asthma in Olympic athletes became very strict; metacholine or other bronchial challenges have to be performed by athletes to prove their asthma, but apart from the very low thresholds for the diagnosis of mild asthma, the risk of underdiagnosis of asthma is increased because, apparently, tests recommended by IOC regulations are not sensitive enough to document subclinical bronchial obstruction in rhinitic athletes (WHO-ARIA guidelines provided a large evidence that rhinitic subjects have subclinical bronchial obstruction); furthermore, the risk of an inadequate management of asthma: topical steroids inhibit responses to bronchial challenges, and the risk that athletes discontinue their treatment to prove their asthma is real. The EAACI Interest Group on Allergy, Asthma and Sports (IGAAS), is driving the joint Task Force with ERS (European Respiratory Society) “Recognising and diagnosing exercise-related hypersensitivity in Sports” and in the next months an evidence-based position paper on ''Recognising and diagnosing exercise related asthma'' will soon, be ready.

Well, the Olympic torch is approaching to Athens, and it is very important to underline that there is no doubt that the allergic athletes can compete at the same level of the others if their doctor will be able to give them the right advices on prevention, diagnosis, therapy and treatment of their diseases: maybe some of us will be able one day to share a little piece of medal with their...patient!

 

Useful references:

 

  1. SR Del Giacco, PE Manconi, GS Del Giacco. “Allergy and Sports” (review). Allergy 2001, 56:215-223
  2. S Bonini, V Brusasco, K-H Carlsen, L Delgado, S.R. Del Giacco, T. Haahtela, G. Rasi, P.B Van Cauwenberge. “Diagnosis of asthma and permitted use of inhaled Beta-2 agonists in athletes”. Allergy 2004, 59:33-36
  3. Helenius I, Haahtela T. “Allergy and asthma in elite summer Athletes”. J Allergy Clin Immunol 2000, 106:444-452
  4. Weiler JM, Layton T, Hunt M. “Asthma in United States Olympic athletes who participated in 1996 Summer Games”. J Allergy Clin Immunol 1998, 102:722-726
  5. Katelaris CH, Carrozzi FM, Burke TV, Byth K. “A springtime Olympic demands special consideration for allergic athletes”. J Allergy Clin Immunol 2000, 106:260-266

 

Stefano Del Giacco (delgiac@tiscali.it)
Chairman of Allergy, Asthma & Sports IG

Useful Links

Athens 2004 Olympic Games
http://www.athens2004.com/athens2004/
International Olympic Committee:

http://www.olympic.org/uk/index_uk.asp
World anti-doping Agency (WADA):
http://www.wada-ama.org
World Health Organisation:
http://www.who.int/en/
GINA (Global Initiative on asthma):
http://www.ginasthma.com/
ARIA (Allergic Rhinitis and its impact on Asthma):

http://www.whiar.com/

29This is the title of a new, monthly column that will soon appear in ''Allergy''. Ignacio J. Ansotegui and Ronald van Ree will be coordinating this effort that will cover all possible fields in which the European Union (EU) is involved in allergy and asthma.

As stated by J Bousquet et al in a recent editorial in ''Allergy'' (Jan 2004;59:1), study protocols of EU-funded programs are usually not published and therefore are not available on Medline. The authors describe an interesting list of 29 programmes funded by EU 5th Framework Programme (FP5) and give an overview of the priorities of the 6th Framework Programme (FP6).


Such information will help the readers of ''Allergy'' to follow major developments in European policy in this area and can be invaluable tools for everybody working in the field of allergology.

36Regulatory T cells have been implicated in the suppression of Th2 responses to allergens. A number of T cell populations with regulatory properties have been described (Th3, Tr1, CD4+CD25+ ).

In a recent article by Ling et al 1, inhibition of allergic responses by CD4+CD25+ regulatory T cells was studied in 3 groups of people: non atopic, sensitized but asymptomatic and patients with allergic rhinitis during and outside the grass pollen season. In normal individuals CD4+CD25+ T cells could suppress proliferation and IL-5 production of allergen-stimulated CD4+CD25- cells. However, this effect was significantly reduced in atopic individuals and even more diminished in allergic rhinitis patients during the pollen season. In the latter, the out-of season suppression remained less compared to non-atopics.

Although it is not yet clear whether decreased suppression is a cause or a bystander effect of the allergic diathesis, the work by Ling et al, provides an important clue in the understanding of the pathophysiology of allergic diseases and suggests a putative target for therapeutic intervention.

Reference

1) Ling EM, Smith T, Nguyen XD, Pridgeon C, Dallman M, Arbery J, Carr VA, Robinson DS. Lancet. 2004 Feb 21;363(9409):608-15.

Note: For more infomation go to www.thelancet.org.

352 LOGOEAACI_sm

Consultation on draft proposal by the European Commission

EFA European Federation of Allergy and Airways Disease Patients’ Associations and EAACI European Academy of Allergology and Clinical Immunology welcome the draft Regulation of the European Parliament and of the European Council on medicinal products for pediatric use.

Medicinal products, which are not at all studied in children, are currently used in clinical work for children. The use of new medications in children starts often before they are tested for the age group, and the majority are never tested in children or results of such trials never published. The effect of medication and possible side-effects when using adult medication in children are not known. There are serious uncertainties, because of children’s special vulnerabilities: children are in a stage of growth and development; their metabolism and liver functions may not be developed as compared to adults; absorption of medication may differ and whether the medication penetrates the blood-brain barrier.

Allergy and asthma are the most common chronic illnesses in childhood in EU countries. In some countries one child in four is affected. The regular use of the medication is the key in controlling of the disease. Early diagnosis and active treatment in even very young children may even prevent the disease developing severe. Allergy and asthma are increasing, especially in childhood, and increasingly younger children need for example anti-histamines, of which only very small minority are tested on children.

In addition for possibly not being safe and based on the clinicians experience and relying on individual expertise only, the use of medication not indicated for children undermines and weakens the doctor-patient relationship and compliance. The parents are concerned about the use of medication in treatment of their children in general, and in particular when they are not tested for use in children. The practical implication is that parents hesitate to follow the instructions of their doctor, when the patient leaflet in the medication package states that it is not be used/not indicated for use in children. Even when convinced by the doctor, the Pharmacist – rightfully so - may alert on this.

As a consequence, compliance may be poor and medical treatment not optimal. In this respect, when considering pediatric medicines, educational aspects of health professionals: doctors, nurses and pharmacists should be taken into consideration. Also the role of patient education and proper information cannot be underestimated for best possible compliance and cost effectiveness.

There are major concerns in the use of adult medication in children in terms of children’s safety, health and development, medicinal safety, long term effects, education and parental concerns. The evaluation of the efficacy and safety of medicinal products used in children is therefore not only of utmost importance, but also urgent. It can also be argued, that current practice of using adult medication in children is not ethical. On the other hand ethical concerns in conducting trials for children should though be carefully considered. The Commission proposal, made by the EFA President, Pr. Svein-Erik Myrseth, (efaoffice@skynet.be) and the EAACI Section on Pediatrics Chairman, Pr. Philippe Eigenmann (philippe.eigenmann@hcuge.ch) intends to strike a good balance between the two.

* XVII World Asthma Congress
Place: St. Petersburg, Russia
Date: July 5-8,2003
Main theme
Asthma: From Genes to Clinical Management

* World Allergy Organisation Congress-IXVIII ICACI
Place: Vancouver, Canada
Date: 7-12 September, 2003
For more information click on the website www.worldallergy.org

* III Balcan Congress of Allergy and Clinical Immunology
XI.Turkish Congress of National Society of Allergy and Clinical Immunology
Place: Istanbul
Date: 11-14 October 2003
For more information click on the website www.tnsaci.org

* EAACI Section on Pediatrics Symposium
Main theme: ''Advances in Pediatric Allergy''
Date: 14-15 November 2003
Place: Gevena Switzerland
For more information click on the website
www.sp-eaaci2003.ch

* EAACI and Section ENT Meeting
An event of Allergy Week in Ghent 2003
Place: Ghent, Belgium
Date: 15-18 November 2003
For more information click on the website www.semico.org

201.-Ostrom-by-O.-TsinkalovskBeing the head of the administrative part of EAACI in Sweden, Catharina Öström deals with the day-to-day running of a large Society with more than 3,800 active members during the last 5 years. She also leads the information centre for the Congress Organisers, the National Societies, the Summer Schools and other events within the EAACI fields.


EA: EAACI Executive Office is known as the Official Secretariat of the Academy. How would you characterize your work as the Executive Manager and have you faced any difficulties?


CO: I realized what a challenge it would be to undertake the organization of building up the Executive Office – the official gateway – for the Academy when I accepted the position of Executive Manager. I can look back now with pride and see how the number of members of our Academy has grown from 1100 to 3800 in only 5 years. I have organized many activities and met so many brilliant people who have made my work so enjoyable! I have only positive memories.

 

EA: The motto of the XXII Paris Congress is ‘Allergy as a Global Problem’. Do you think that people are well informed of the problem?

 

CO: Obviously, the flow of information, not only to the patients but to all people involved, varies from one country to another. This needs to be improved, but yet I think that the new EAACI website will certainly facilitate people, apart from the physicians, in their efforts to know more about allergies.


EA: JMA Poster Sessions are known to be quite successful, as well. Actually, this year in Paris, there are over a hundred posters, which is very interesting in terms of the educational purposes of the Congress.

 

CO: The JMA Poster Session was an initiative of the JMA Working Group a few years ago. Each year it gets better and better and attracts a lot of interest. It really is a great credit to the JMA Working Group. It is a very nice social occasion that works also as a sort of interaction between young scientists.


EA: The next EAACI Congress will take place in Amsterdam, 2004. What are the plans for then?


CO: The XXIII EAACI Congress will take place in Amsterdam, from the 12th to the 16th of June 2004. The main theme will be ‘Young Investigators at the frontiers of allergy’ and it will be focused on young scientists. Amsterdam itself reflects the youth culture. I am really enthusiastic about the programme; in addition to a general comprehensive programme, there will be unopposed poster sessions during lunch and allergy forums with oral communications at prime times.

EA: What about the social program that will follow the scientific one? Is it going to be equally interesting and impressive as the one here in Paris?

 

CO: Absolutely! We have a full speckled programme. The Congress Event is very important and has become a tradition at the EAACI Congresses. It was established many years ago with the aim of offering a memorable social programme at the congress; it also gives the delegates the possibility to get to know one another better.

EA: So, what do you think of the EAACI’s initiative to produce a new website?

 

CO: Actually, I had taken up the idea with the EAACI bodies to modernise the technique we have on the website quite some time ago as I realised that it is a very valuable tool for such a large society. Initially, we started working with it as a benefit to our secretariat and governing bodies but also to our members. Since EAACI is developing and expanding its activities to more areas of interest, we wanted to follow the developments and give to the Academy, through the website, a more public face. The important thing remains, nevertheless, to be able to get the information that is of interest to our members. We have encountered difficulties in the past from various bodies, as some of them responded regularly and some of them not. Hopefully, things will change now with the fresh new face of the website. Usually, when one part starts being very active, then the other groups don’t like falling behind; they realize that they will have to catch up with it, which in terms of content will be a very positive thing! It is only a matter of time.

EA: Paris Congress is heading towards its end. What are your plans for now on?


CO: Now the focus is on 2004. So, as soon as the XXII Congress is over, we will move straight on to the next scheduled one, which, as you already know, is in Amsterdam. Of course, the majority of the work has been done a long time ago, as is the case with all EAACI Congresses. For example, at this Congress it was decided to hold the 2008 Congress in Göthenburg by the Executive Committee.

In the meantime, we will be working on the Summer Schools and all the other activities within the Academy.

EA: Good luck in your busy program and thank you for your time!


Special thanks to EAACI Newsletter for providing the photographs.

Eirenie Andriopoulou

Interleukin-5 (IL-5) is a cytokine with a major role in eosinophil homeostasis. Anti-IL-5 (mepolizumab) is a humanized monoclonal antibody against IL-5. Early clinical trials in asthmatic patients have demonstrated its safety and effectiveness at lowering blood and sputum eosinophil levels but did not produce desirable effects on asthma outcome measures. However a recent report from Flood-Page et al (1) demonstrated that anti-IL-5 treatment reduces deposition of extracellular matrix proteins in the bronchial subepithelial basement membrane of mild atopic patients.

This month Garrett et al (2) published the results of an open-label trial of anti-IL-5 in which 3 intravenous doses were administered at 4-week intervals to 4 patients with the hypereosinophilic syndrom(HES). The drug was well tolerated in all patients and was able to lower peripheral blood eosinophil counts for at least 12 weeks after the last dose. Additionally, it improved clinical and quality of life measures. In one patient with striking tissue eosinophilia (eosinophilic esophagitis) it resulted in a 10-fold reduction of tissue eosinophil levels.

Although the number of patients was small, this study has important implications in the therapy of HES and other diseases with tissue eosinophilia such as eosinophilic esophagitis. Another interesting report has recently showed considerable benefit with anti IL-5 in 3 patients with hypereosinophilic syndrome with eosinophilic dermatitis (3).
These observations together with the encouraging results regarding asthma remodeling (1), may revive interest for the role of anti-IL-5 in allergy therapeutics.

References

1)  Flood-Page P, Menzies-Gow A, Phipps S, Ying S, Wangoo A, Ludwig MS, Barnes N,Robinson D, Kay AB. J Clin Invest.  2003 Oct;112(7):1029-36.
2) Garrett JK, Jameson SC, Thomson B, Collins MH, Wagoner LE, Freese DK, Beck LA,Boyce JA, Filipovich AH, Villanueva JM, Sutton SA, Assa'ad AH, Rothenberg ME. J Allergy Clin Immunol.  2004 Jan;113(1):115-9.

3) Plosz SG, Simon HU, Darsow U, Simon D, Vassina E, Yousefi S, Hein R, Smith T, Behrendt H, Ring J. New Eng J Med 2003; 349:2334-9

Information for Consumers, Regulators and Industry (InformAll,QLRT-2001-02284).
www.informall.eu.com/default.htm

452

Overview
This project aims to develop communication strategies in the food allergy area, which will promote the provision of visible, credible sources of information appropriate to different stakeholders including consumers, industry and regulators. It is being undertaken by a multidisciplinary consortium of 42 partners including social scientists, clinicians, food chemists, immunologists and regulators, with representatives of the allergic patient groups, food, Ag-Biotech and retail industries. It draws on the outputs of current food allergy research in Europe funded at a national level and through clustering of the RTD projects on food allergy funded through FPV, the project co-ordinators all being members of the project partnership.

Activities include

• Defining the communication issues relevant to the food allergy area, and developing a set of recommendations and strategies for communication of food allergy information.

• Developing a credible electronic database of information on allergenic food materials of plant and animal origin. Based on a database developed through a previous project, Protall, the database aims to link information regarding the clinical reactivity of foods in allergic disease with information on the properties and nature of the components (allergens) which trigger the sensitivities.

• A web-based “Food Allergy Information Platform (FAIP)” incorporating contextual information on food allergies for consumers, the food industry and health professionals, and a jumpstation of credible food allergy web-sites. It will ultimately host the new InformAll database and currently houses the protall database. It will be made available across Europe through a series of web gateways in various European languages being developed in collaboration with EFA. This can be found at http://www.foodallergens.info/.

• It draws on the expertise of a cluster of EU projects on food allergy and related topics funded through the 5th Framework programme. More information on the projects (and links to project websites) in the cluster can be found at http://www.informall.eu.com/WP5.htm

The project is co-ordinated by Dr Clare Mills at the Institute of Food Research (Clare.Mills@bbsrc.ac.uk).

Other members of the management team include:

Prof Dr Lynn J Frewer, Marketing and Consumer Behaviour Group, Wageningen University in The Netherlands (http://www.sls.wageningen-ur.nl/menc/), Dr Charlotte Madsen from the Danish Institute for Food and Veterinary Research in Denmark(http://www.foedevaredirektoratet.dk/Forside.htm)
Dr Erkka Valovirta representing EFA, Prof Henryk Kostyra and Dr Barbara Wroblewska from the Polish Academy of Sciences, Poland and Dr Ronald van Ree Co-ordinator from Sanquin & University of Amsterdam, The Netherlands

206.RES.AREAThe Food Quality Unit of DG Research published recently a catalogue titled "Allergy and Asthma EU research projects". The aim of this publication is to give an overview of the projects in the area of Allergy and Asthma financed under the Fifth Research Framework Programme. It presents abstracts, progress reports and Co-ordinator data of each project.

More information on the research projects on:
Europa: http://europa.eu.int/comm/research/quality-of-life.html
Cordis: http://www.cordis.lu/life/home.html

Claude MOLINA* & Jacques GAYRAUD**

1. Atopic dermatitis (AD) : inflammatory disease of the epithelial barrier
2. The role of immunosuppressive agents in AD treatment
3. Chronic Rhinosinusitis (CRS) in the elderly
4. Crenotherapy and Chronic Rhinosinusitis in children
5. Football and Exercise-Induced Bronchoconstriction/Asthma (EIB)


1.    Atopic dermatitis (AD) : inflammatory disease of the epithelial barrier

Theme: physiopathology, eczema
Key words: atopic dermatitis, epithelial barrier, atopic pathway, filaggrin

The French Academie Nationale de Medecine has just allotted a session to this theme under the guidance of J.Bazex and M.Bagot, and two reports were presented : Alain Taieb (Bordeaux) on AD physiopathology and Y. de Prost (Paris-Necker) on  immunosuppressive treatments.
We know that AD is very common in industrialised countries and affects approximately 15 to 30% of children and 2 to 10% of adults. The immunologic vision considers it as the 1st stage of the atopic pathway followed by asthma, rhinitis and food allergy. And yet, the discovery of mutations in the Filaggrin gene (FLG), a major protein in the maturation of the stratum corneum, has refocused attention on skin and, as A.Taieb underlines, has produced a Copernician revolution in the understanding of the affection which appears to be a model of inflammatory disease of the epithelial barrier (ANM Bulletin 2012, in press).

Irvine and Mac Lean’s experimental works have indeed shown that FLG-lacking mice have a thin, dry and porous skin, and that the gene mutations and lack of FLG in children are associated with a severe form of eczema. Moreover, although FLG has no expression in the lungs, it was observed with surprise that some of its mutations were strongly associated with asthma and others with peanut allergy. Simultaneously, the Holgate team from Southampton underlines the frailty of the bronchial epithelium in asthmatic patient whose mucous membrane is poor at self-repair after aggression. Such epithelial deficiency also affects nasal mucosa (hence the risk of rhinitis) and intestinal mucosa, (hence  food allergy).

But dermatologists go even further, for skin appears no longer to be a simple mechanical barrier but an agent of immunity, as keratocytes secrete cytokines which play a part in the atopic path. The search is therefore on-going for molecules capable of stimulating the production of FLG, while avoiding or by-passing mutations: such is the case of  gentamicin or growth factors like the Keratocyte Growth Factor, which is present in skin and intestinal mucosa and which reduces inflammation and epithelium leakiness of the airways in rats.


2.    The role of immunosuppressive agents in AD treatment

Theme: eczema, treatment
Key words: eczema, atopic dermatitis, immunosuppressive agents, tacrolimus, pimecrolimus, cyclosporine, biotherapies

Y. de Prost, whose great experience must not be overlooked, believes that the severe AD, in the form of impetigo and intense pruritus alter the quality of life ; they constitute 13 to 20% of cases in children and 15% in adults (an extreme form was observed in a 91-year old female patient). He gives a reminder of the treatment basics, i.e. dermocorticoids, limiting of infection and xerosis (emollients) and hygiene advice.

The most frequently used immunosuppressives (IS), when classic treatment fails and even for local medium or moderately intense affections, are Tacrolimus T (Protopic®) 0.1% and 0.03% ointment for children and Pimecrolimus P (Elidel), not  yet on sale in France, equally effective and acting as calcineurin inhibitors.

T, particularly recommended in the zones where corticoids should be avoided, such as the face, eyelids, buttocks and deep folds in adolescents, is extremely effective and well-tolerated apart from some local irritation in the 3 days following its application; 6 weeks of treatment is advised. The only counter-indications are herpes and exposure to the sun. The risks of Carcinogenesis (Lymphomas), which were evoked when T was administered in case of organ grafts, are not confirmed for local short-term treatment.

P offers the same indications and results as T.

As for per os IS, these are mainly represented in France by cyclosporine (4 to 5 mg/day), clearly effective but requiring careful monitoring of kidney function and blood pressure, and gradual reduction in dosage before the end of treatment to avoid rebound occurrences.

Methotrexate has also been suggested when cyclosporine is ineffective.

Finally, biotherapies : Omalizumab or Retuximab have shown interesting therapeutic test results, but a larger number of patients is necessary to confirm their possible efficiency and justify their high costs.


3.    Chronic Rhinosinusitis (CRS) in the elderly

Theme: ENT allergy, immunologic markers
Key words: rhino-sinusitis, elderly patients, nasal polyps

The physiopathology of CRS, little studied in elderly subjects, is the theme of the following article (S.H.Cho et al  JACI 2012 129  3 858-860 e2). The US-Korean authors distinguish two types : 1°) CRS with nasal polyps (CRSwNP), polarised toward a Th1-type immunologic reaction, and 2°) CRS without NPs, with eosinophilia and tendency to Th2 skewing, and point to the increasing evidence that these are linked to impairment of the barrier function of the airway mucosal epithelium 

The aim of the study was to evaluate the age-related differences in the clinical characteristics and to assess the respective immunologic markers.

A 1st retrospective study of 252 patients led to identification of a lot of demographic and clinical characteristics, by subdividing the group into adults (230 aged 16-49) and the elderly (22 aged 60-77). In the latter, asthma and associated NPs tended to be more frequent, but with no statistical significance; only the sinus opacification score, assessed by tomography and CRS severity marker, was statistically higher.

In a 2nd stage, in different subject groups (58 with NPs, 51 without NPs, and 50 control, with the same age range), they went further and studied nasal lavages and immunologic markers. Among them, ECP (Eosinophil Cationic Protein) blood counts were higher, above all in adults with NPs than in elderly subjects, a sign that the eosinophilic inflammation was lower in the latter. However, the neutrophilic inflammation detected by HNE (Human Neutrophil Elastase) was not discriminated by age or by CRS type.

As for markers of the epidermal differentiation complex, S100 A7 (psoriasin) and S100 8/9 (calprotectin), levels of which are generally reduced in CRS, were significantly lower in elderly subjects, above all for calprotectin in CRSwNP.

On the whole, and despite the skew toward severity and more frequent association with NPs, CRS eosinophilic inflammation subsides with age, whereas simultaneously the epithelial barrier dysfunction, as revealed by the lower levels of corresponding markers and above all of S100 A8/9, plays an important role in the pathogenesis of lesions and therefore indicates a need to develop modified treatment strategies for elderly patients with CRS.


4.    Crenotherapy and Chronic Rhinosinusitis in children

Theme: ORL allergy, nasal  thermal aerosol
Key words: crenotherapy, rhino-sinusitis, child, inflammation markers

Thermalism for treating allergic or non-allergic rhinosinusitis, which had its golden age in France in the past century, has been more or less dropped over the past years. But a recent article by Italian authors published in English (A.Passariello et al :American Journal of Rhinology &Allergy  January-February 2012  26  1 15e-19e), based on precise clinical, biological and statistical studies, now rehabilitates this treatment by the inhalation of sulphate-sodium chloride water from a thermal site in the island of Ischia.

65 children of an average 3.3 years of age received thermal aerosol inhalations for 15 days and 15 minutes per day. A complete preliminary ENT check up with sino-nasal severity score and sampling of nasal mucus by lavage, was performed with quantitative determination of inflammation markers such as TNFα, and immune-regulator anti-microbial peptides such as calprotectin and Hβ2 defensin. 60 other healthy children from a paediatrics ward were used as controls. All these parameters were compared in a thorough statistical study.

At the end of the treatment a marked improvement in symptoms (essentially nasal obstruction, and impairment of the sense of smell) and in the sino-nasal score was observed with significant values, whereas levels of calprotectin TNFα and Hβd-2 were also reduced in statistically significant proportions.

Crenotherapy is thus now taking on a new dimension, for it has already long been recognised as harmless, well accepted and perfectly tolerated, as well as an alternative to drug-based treatment. From now on it also appears as an inhibitor of cytokines and nasal inflammatory mediators.

Admittedly, one can be surprised, just as the authors were, to note a difference between the observations made in adults with CRSwNP for whom, as already said above, calprotectin and Hβd-2 levels are lower than controls. But in this study carried out with children, CRS is not associated with polyps or with eosinophilia, but rather with a mixed inflammatory cell population composed of lymphocytes, macrophages and neutrophils, which could account for a difference in the occurrence mechanism of lesions.

In any case and despite the absence in this study of an accurate allergist check-up (one single note pointing out the regression of allergic symptoms), the thermal treatment of chronic rhinitis in children, which was very fashionable a few decades ago, deserves to be  taken once again into consideration


5.    Football and Exercise-Induced Bronchoconstriction/Asthma (EIB)

Theme: asthma
Key words: exercise-induced asthma, football, bronchial provocation, bronchial dilatation, doping

The diagnosis of asthma or Exercise-Induced Broncho-constriction (EIB), which is well-known in sportspeople, relies heavily on athletes’ statements and is treated by bronchodilators or even corticosteroids, which are then authorised in high level sports competitions. Football, the most popular sport around the world, exposes its players to many factors of aggression: prolonged hyperpnoea causing loss of water, exposure to multiple and irritating aero-allergens during training or competition (10 to 13km run during each match, on grass or in cold weather).

Now, following a series of doping incidents with elite athletes in 2009, a change in the regulations of international competitions such as the Olympics Games for instance, allows the use of sympathomimetic or anti-asthma drugs, on condition that this is justified by a confirmed diagnosis after accurate pulmonary function testing.

A group of British authors from Newcastle, Liverpool and London (Ansley et al Allergy 2012 March  67 3 390-395) thus interviewed and examined 65 elite professional soccer players (English Premier League) thought to be suffering from EIB, in order to check the accuracy of the diagnosis.

They recorded by questionnaire the symptoms and the drugs used and conducted a bronchial provocation test with dry air (6 minutes of eucapnic voluntary hyperpnoea) in 42 players, and a mannitol challenge in 18 players. Five players with abnormal resting spirometry underwent a bronchodilator test. The results were surprising : in fact, of the 65 players assessed, 57 (88%) indicated regular use of asthma medication and 57 (88%) indicated EIB symptoms during a match. And yet only 33 (51%) had a positive bronchodilator or bronchial provocation test. Moreover neither symptoms nor the use of inhaled corticosteroids were predictive of the outcome of pulmonary function tests.

Thus, a high proportion of English elite professional soccer players are wrongly medicated for asthma, some of them using as reliever therapy only, while they present neither bronchial obstruction nor hyper-responsiveness to possible environmental stimuli.

This is an important piece of information which should be brought to the attention of sports authorities and all Olympic sports teams. It once more underlines the fair play of the British medical and sporting community.


-----
Comments and questions welcome :

Pr. Claude Molina    and/or    Dr Jacques Gayraud
*claude.nelly.molina@orange.fr
**j.gayraud@orange.fr


Centre for Immune Regulation (CIR) is a research centre established as a Centre of Excellence by the Research Council of Norway at the University of Oslo and the Oslo University Hospital. CIR is also a FOCIS (Federation of Clinical Immunology Societies) Center of Excellence. Our scientific goal is to identify and investigate mechanisms of immune dysregulation that contribute to allergic and autoimmune disease in order to advance the development of therapeutics. CIR consists of five research groups and approximately 100 people. The research environment is very dynamic and there is extensive interaction between the groups. CIR has an educational program which includes seminar series and invited internationally renowned guest professors. For more information, see http://www.med.uio.no/cir/english/.

Claude MOLINA* & Jacques GAYRAUD**

1. Allergic reactions of medical personnel to allergen extracts
2. Cold Urticaria (CU) : immuno-genetic and molecular data
3. Allergic consequences of climate changes
4. Risks of childhood allergy and asthma under phthalate exposure
5. Sputum eosinophilia and asthma (A)


1.  Allergic reactions of medical personnel to allergen extracts

Theme: allergens
Key words: medical staff – allergen extracts – beta blocking agent – timothy grass – pollens – pets

A rare case of occupational anaphylaxis, is reported by two US authors in a 32-year-old female compounding technician  while preparing an immunotherapy vial of timothy grass allergen extracts, who accidentally stuck herself on the hand with a needle (M.L Bandino et M.S.Tankersley JACI  2012 129 1 250-251). Within minutes, a local wheal-and -flare response appeared at the needle-stick site followed by rhino-conjunctivitis, diffuse urticaria, then a facial peri-orbital and tongue angio-oedema, requiring several adrenaline injections before stabilising. Admittedly, this woman was atopic, suffering from allergic rhinitis, which included sensitization to timothy grass, but usually treated by Loratadine®, and also from a regular hypertension by a β-blocking agent (Atenolol®), regarded as risk- factor of resistance to treatment.

Commenting on this observation, the Danish author S.Dreborg (JACI 2012 129 in press) reminds us that this type of risk can concern all medical staff. He quotes the case of a nurse, assigned to work on allergenic provocative tests in a Paediatrics hospital unit, with no allergy history, who started coughing the following winter, then as soon as she resumed work and undertook a 1st provocative test, had an asthma attack followed, despite having stopped working,  by a  rhino-conjunctivitis,.

In 1970 in Sweden, 18 out of 20 paediatric allergy nurses showed signs of sensitization, despite installation of an air extraction system. A nurses’ Union sent a web- questionnaire to 570 participants on the subject of allergic risks at work, and received 418 (71%) answers. Conducting skin tests (prick-tests, scarification or ID) was judged as responsible, but fingers were also pointed at immunotherapy and inhaled provocative tests. Allergens most frequently implicated were pollens and pets.

The authors set forth a series of recommendations on the training and careful handling of allergenic extracts, which they intend to submit to ad hoc Committees. A similar initiative in France and French-speaking countries, in the form of a Forum aimed at gathering similar observations would be welcome.


2.  Cold Urticaria (CU) : immuno-genetic and molecular data

Theme: skin allergy
Key words: cold urticaria – Ig deficiency – repeated infections – auto immunity – gene PLCG2 – phospholipase

CU is a diagnosis that allergists may be confronted by, atopy being not excluded from its pathogenesis. It is also due to mast cell degranulation by cold temperatures, and can culminate in anaphylaxis.

In an article dedicated to an inherited CU associated with antibody deficiency and auto-immunity (M.J.Ombrello et al NEJM 2012 January 12 330-338) a group of US researchers undertook a large number of immunologic and genetic investigations with 27 subjects belonging to three families  of European ancestry.

From a clinical point of view, every subject’s CU began in childhood and continued throughout their life. But it is not the contact with cold that triggers CU (ice-cube tests were negative as well as cold water immersion) but essentially cold air or wind. 15 subjects out of 26 also showed allergic manifestations.

26 out of 27 suffered from immunologic disorders: in 75% of cases a deficiency in immunoglobulins, associated  in 56% with susceptibility to sinus and lung infections. Signs of auto-immunity were also observed (auto-antibodies or associated auto-immune disease : granulomatous rash, vitiligo, inflammatory arthritis, thyroiditis, granulomatous lesion of larynx and soft palate).

Common lab tests showed reduced IgA and IgM serum levels, circulating natural killer cells and B lymphocytes, but higher IgE levels. In 13 of 21 treated subjects (62%) antinuclear antibodies were found.

From the genetic point of view, DNA sequencing, particularly through the Sanger enzymatic technique and identification of single nucleotide polymorphisms (SNP) showed some deletions in gene PLCG2 encoding phospholipase-active proteins, particularly PLCγ2 , signaling molecule expressed in many cells such as mast cells, B lymphocytes and natural killer.

This genetic research highlights the importance of molecular mechanisms contributing to the defence of the organism and immune tolerance.

The possible treatment of CU clinical manifestations by phospholipase inhibitors is a current subject of research and a possible example of targeted molecular pharmacology. The administration of immunoglobulins IV may be useful in some cases, but prescribing them in France is currently regulated.


3.  Allergic consequences of climate changes

Theme: allergy and environment
Key words: global warming – CO2 – tree pollens – grass – Ambrosia - Alternaria

A series of publications on the health impact of climate changes and global warming in the years to come ( L.Ziska et al: Proc.Natl.Acad.Sci.USA and JACI 2012  1 29 27-32) reveals that atmospheric gas accumulation, particularly CO2, influences photosynthesis and plant growth. This slogan sums up the consequences: “More sneezing in a warmer world”. Three types of plants are concerned: trees in spring, grass in summer and Ambrosias (ragweed) in autumn.

Tree flowering is now 2 to 4 weeks earlier, whether it be oaks or birches in the USA but also in Europe (Swiss and Denmark), and 1-3 weeks earlier for olive trees in Spain.

The same can be said of grass, whose pollen counts have increased as well as their allergenic protein contents, particularly for the US Artemisia and the European species Pellitory (Parietaria Officinalis). However, there is not always a direct relationship between atmospheric concentrations of CO2 and increased allergenic effect of these pollens.

However for Ambrosia (ragweed) there is a clinical and experimental impact of CO2 and T° on pollen allergenicity, proved by the authors,. They also remind us of importance of latitude, after having observed a 27-day lengthening in the pollen season over 15 years in some parts of northern USA, ending on a humoristic note when they recommend that Canadians should stock up on handkerchiefs for the years to come.

Finally, even molds are concerned by these climate changes. Such is the case of Alternaria whose sporulation has increased.

Thus, climate changes induce a higher exposition to allergens, in theory more so in the countryside than in towns. However, the role of gas (NO2 and Ozone) and particle pollutants (PM2,5) on respiratory mucous as well as pollen biology is, in large cities of the Western world, an exacerbation factor to allergy symptoms. Finally, let us recall that this anthropogenic accumulation of atmospheric gases also account for extreme climate events such as heavy rainfalls and thunderstorms; the latter were the cause of acute and spectacular episodes of rhinitis and asthma in Europe.
These notions should be kept in mind, if only for setting up the sequencing of preventive treatments (immunotherapy) of our allergic patients.


4.  Risks of childhood allergy and asthma under phthalate exposure

Theme: asthma - allergens
Key words: asthma – phtalates – benzyl-butyl-phtalate

Phtalates (Pht) are indoor pollutants emitted by everyday consumer goods, such as food packaging, plastic components, medical equipment (tubes and perfusion bags), toys, and cosmetics. They are often considered as endocrine disruptors impacting reproductive functions, and carcinogenic. A group of Chinese authors from Taiwan, having assumed the allergenic effect of these Pht, the degree of exposure to which can be measured by their metabolites in blood and urine, conducted a case control study of 101 pre-school children (2-6 years of age) selected between 2007 and 2009 in a population of several thousand.

A considerable amount of data was collected from parental questionnaires, daily monitoring of clinical symptoms, specific and total IgE levels, concentration of various indoor pollutants in patients’ homes, including 5 Phts in dust samples, and concomitant analysis of urine metabolites as well as creatinine concentration. The data were then subjected to statistical analysis.

Apart from the higher percentage of boys in the test group than in the control one, demographic, family, and environmental characteristics were almost identical in both groups, albeit with a higher percentage of atopic subjects in the 1st group.

Essentially, it appeared that high levels of benzyl-butyl-phtalate (BBzP) in home dust are significantly associated with cases of allergic manifestations (rhino-conjunctivitis, asthma or dermatitis) whereas its urine metabolite, mono-benzyl-phtalate (MBzP), was higher in asthmatics than in controls.
Overall, high levels of DBP (dibutyl-phtalate) and its metabolites MBP (mono-n-butyl-phtalate) and MEHP (mono-2-ethylhexyl-phtalate) may be regarded as risk factors for clinical manifestations concerning lung, skin or eyes.
Admittedly Phts, whose concentrations in urine were lower than in dust, are not the only culprits for poor quality indoor air (an important role is also played by exposure to fungus) but their contribution remains notable and for the first time quantitatively assessed, and particularly for BBzP


5.  Sputum eosinophilia and asthma (A)

Theme: asthma
Key words: sputum eosinophilia – asthma – blood eosinophilia - FENO

Having observed that a subgroup of asthmatics did not have airway eosinophilia, which it is regarded as asthma-typical, the NIH Californian authors ( K.W.Mc Grath  AJRCCM 2012 20 January  in press) wanted to determine the size and characteristics of this group, through repeatedly analysing the cytology data from these patients’ sputum.

995 asthmatics, aged 12-70, suffering from mild-to-moderate asthma and belonging to 9 different national cohorts, underwent repeated sputum induction, with the usual technique (2 to 4 times) followed by cytology examination in search of eosinophils (EO). The positivity threshold was fixed at 2% or more of the number of cells.

Three groups of subjects were discriminated : Asthmatics (A) with persistent EO, those with intermittent EO (at least once) and those who were consistently negative. Comparing cytological tests to blood eosinophilia or to FENO did not show any reliable sensitivity or specificity.

645 A. followed standard inhaled corticosteroids (ICS), 350 did not. The first statistical analyses reveal that 83% ICS have no sputum EO and 36% of the non ICs. Which constitutes a large group of non-eosinophilic asthmatics. This absence of EO was observed even in A whose disease was well-controlled.

From a therapeutic point of view, eosinophilic A. reacted favourably to 2 weeks of anti-inflammatory treatment (IC + anti-leukotriene Zafirlukast) with an improvement in airflow obstruction. This was not the case for non-eosinophilic A in whom only albuterol (β2 agonist) induced bronchodilation.

On the whole, more than half the patients with mild-to-moderate asthma showed a persistent absence of sputum eosinophils.

Among the different clinical forms of A., this group definitely represents a particular phenotype which responds only poorly to anti-inflammatory therapy.
Practically, this research should incite us to look more frequently for EO in our asthmatic patients’ sputum.

NB : As part of a general bibliography, our readers are encouraged to look at the special issue of Nature (Outlook 24 Nov 2011 479 7374) which presents a 27 page exclusive paper on Allergies.

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Comments and questions welcome:

Pr. Claude Molina    and/or    Dr Jacques Gayraud
*claude.nelly.molina@orange.fr **j.gayraud@orange.fr
For a term of two years, the duties of coordinator include:

• Responsible for the organisation and chairing of 3-4 SPC meetings and also telephone conferences.
• Oversee the compilation of the Congress Preliminary Programme, the final Congress Programme book and abstract handling.
• Chair the abstract selection procedure, and keeping scientific, topical and geographical balance in the congress scientific programme.
BIBLIOGRAPHY UPDATES IN ALLERGOLOGY


To our readers
Dear Colleagues,
At the dawn of this new year, we would like both to receive your opinions and to inform you of our motivations and thoughts as to our goals relating to ongoing professional training in Allergy and Clinical Immunology.

As you know, what we have in mind, so as to keep in line with the spirit which has guided the CEFCAP (Comite Europeen de Formation Continue pour Allergologues Praticiens) founders, and particularly our dear friend and late colleague Franz Marrache, is to give priority, in our scientific paper abstracts, to those with the most practical conclusions and the highest quality of methodology. Indeed, in this time of globalisation, the number of publications is growing exponentially.

But at the same time, scientists in many emerging or developing countries are accessing to new technologies and providing us with very high quality papers. Just to quote a few among the latest, documents from Morocco, China (Taiwan), Slovenia have joined the many Anglo-American and European publications which form our basic resources. And, of course, nearly all of them are in English, even those coming from France : it is the condition for worldwide identification.

Our aim is also to make them easier to understand for our French and French-speaking colleagues. Reading the abstracts alone, could lead to errors and misunderstandings; the full-text must be read to assess the quality of the research undertaken, its limits and weak points. That is why our BUAs (Bibliographic Updates in Allergy) which the EAACI publishes regularly each month, are not a simple transfer of the original abstracts but include all the comments and details added by us. Each month we glance at around thirty reviews, specialized in Allergy (Respiratory, Skin, ENT,…) and  Clinical Immunology concerning Adults and Children and also covering Internal Medicine. Each month we pick out the 4 or 5 most striking and most original articles, across all various themes.

In 2012, we would like to reward your efforts by crediting your regular reading of these ABA/BUA with some CME points. For this, each ABA/BUA will be accompanied each month by an multiple choice questionnaire in order to evaluate the knowledge acquired through reading.

If this experiment passes the test of method assessment by a sample of our readers, it will then be submitted to EBAACI (European Board of Accreditation in Allergy & Clinical Immunology) for validation. We will keep you informed of each step of this project.

To conclude, we would like to thank you retrospectively for your loyalty and in advance for your comments, and we also would like to thank all those who, in France and in Europe at large, participate in our initiatives : the Syndicat des Allergologues (Allergist Union) and Dr Madeleine Epstein who has for many years been in charge of publishing our texts, the Library teams of the Academie Nationale de Medecine and the Paris-Descartes Inter-University Library who are so helpful in our research, as well as Dr Taborda ,then Bernard and Sue Prefol who translate our French ABAs into English BUAs, and Dr Chrysanthi Skevaki who has opened the doors of the EAACI web site to us. Thank you all, and our very best wishes for 2012.

Claude Molina


Jacques Gayraud






1.    Preventive Inhaled Corticotherapy (IC) with pre-school children at high risk for asthma
2.    Monitoring honeybee venom immunotherapy with the Basophil Activation Test (BAT)
3.    Type-1 diabetes (T1D) and atopy.
4.    Adrenaline auto-injection by children and teenagers
5.    Particularities of severe asthma (SA)



1.    Preventive Inhaled Corticotherapy (IC) with pre-school children at high risk for asthma

Theme:
paediatric allergy, asthma
Key words: preventive Inhaled Corticotherapy (IC) – Low-dose daily IC – High-dose intermittent IC – Frequency of exacerbations – Oral corticotherapy

A US paediatrician multicentre study led by the California Allergy Department (R.S Zeiger NEJM 2011 365 1990-2001) was conducted among pre-school children considered at high-risk for asthma, in relation to a predictive index based on the frequency of wheezing and/or hospitalisations in the past year. The official recommendation in these cases was the use of IC, at varied doses but daily and for a long period. The major drawback observed was retarded growth and parents’ reluctance concerning continuous treatment. As a result the authors undertook a new randomised study comparing the benefits of a daily low-dose regimen to an intermittent high-dose.

Thus, 278 children aged 12 months to 5 years, enrolled in 7 different US centres, following an ethically validated protocol, received for 1 year either a nightly dose of 0.5mg IC (Pulmicort® in an inhalation suspension) or a 1mg twice-daily dose, from the onset of respiratory symptoms and for periods of an average 7 days. (Note : the protocol also included the on-demand addition of a bronchodilator, Albuterol, similar to Salbutamol® for 48hrs). The primary objective was the decreased frequency of exacerbations requiring oral glucocorticoid therapy.

At the end of the study, there appears no statistically significant difference between the two regimens, both equally efficient in the prevention of exacerbations and other symptoms (side effects or others). However, there is a notable reduction in the exposure to glucocorticoids (104mg over 1 year) in the intermittent as compared to the daily regimen, which is not negligible for young children in full growth.

As a conclusion, the authors recommend the intermittent rather than the daily regimen, something that clinical common sense could predict, but which from now on is supported by a precise statistical study and a clear protocol.


2.    Monitoring honeybee venom immunotherapy with the Basophil Activation Test (BAT)

Theme: allergy to insect venom
Key words: immunotherapy – honeybee venom – rush treatment – specific IgEs – IgG4

31 Slovenian children with a history of honeybee venom-induced anaphylaxis were submitted to a specific, rush- immunotherapy , in a single-blind prospective study, monitored  through the new Basophil Activation Test (S.E.K Zitnik et al Pediatr.Allergy&Immunol 2011, early view). This test is based on the biology of basophil cells whose degranulation is quantified by the expression of the CD63 marker and gauged by flow cytometry followed by fluorescent staining. Indeed, in non-active basophils, CD63 is strictly localised inside the granules, then, at the time of exocytosis and fusion with the cell membrane, transferred to the cell surface and measured through venom concentration.
BAT results are considered positive when CD63 gives a positive reaction in at least 15% of basophils, for 1µg/ml of venom. Moreover there exists a correlation between CD63 positivity and histamine liberation. The test was applied before starting the treatment, 5 days later and after 6 months or even 2-4 years in some subjects.

Before treatment, the BAT helped identify the culprit insect in 74% of the cases, while specific IgE reactivity was only observed in 52% of the children. Five days later, i.e. at the end of the rush-treatment, there is no statistically notable BAT modification.

However, after 6 months of regular immunotherapy (100µg every 4 weeks) specific IgEs remain at comparable levels (22.8kU/l on average, with a maximum of 100kU/l) whereas IgG4 levels are significantly higher. As for the BAT, it revealed in 85% of the children a marked CD63 decrease in the presence of 0.1µg/ml allergen (limit of cellular sensitivity) four times lower than at the start of treatment. The same observation is made after 2-4 years, whereas specific IgEs levels are also now significantly reduced.

In addition the authors observed that, during rush-treatment, BAT positivity was associated with the appearance of side effects.

In conclusion, the Slovenian authors recommend the BAT as a reliable monitoring method of hymenopterous insect immunotherapy. Senior French-speaking allergists will certainly rejoice in the rehabilitation and renovation of the basophil degranulation test, much favoured by our late colleague J.Benvesiste : it was known as the TDBH (Test de Degranulation des Basophiles Humains)


3.    Type-1 diabetes (T1D) and atopy.

Theme: atopy
Key words: Type 1 diabetes – Atopy – atopic dermatitis – Allergic rhino-conjunctivitis – Th1/Th2 balance

On a schematic point of view, T1D is controlled by the Th1-type immune response whereas atopy is considered as dependent on Th2-type immunity. Early studies had suggested an inverse association between T1D and allergic diseases. The Danish authors (S.F.Thomsen et al. Allergy 2011 66 645-647) therefore undertook a retrospective study of the association in a population of twins. They sent a questionnaire to 54,530 Danes, mono or dizygous, aged 3-71, having suffered from asthma, hay fever or atopic dermatitis, and who had been treated or hospitalised for T1D between 1931 and 2000.
After statistical crossing and adjusting for age, sex, and zygosity (96% confirmed), it appears that in the 3-20 year groups there exists an inverse association between T1D and the 3 symptoms of atopy (asthma, rhinitis, dermatitis) but only statistically significant for atopic dermatitis (AD). This AD risk is indeed 4 times lower in type-1 diabetics when compared to non-diabetics. Finally, with the dizygous T1D subjects (except for 91 pairs of twins) there is always a statistically lower risk than with their non-diabetic twin.
As to the genetic factors responsible for susceptibility to T1D or AD, they are also negatively correlated. For the authors, these findings substantiate the T1D/AD antagonism and the Th1/Th2 dichotomy.

This article was contested by an Italian group (Tosca et al. Allergy 2011 1612-14) who, in a prospective study of 112 children, aged 11 on average and suffering from T1D, on the other hand observed a positive correlation between this affection and allergic rhino-conjunctivitis. Besides, within the framework of the ISAAC epidemiologic study – which compares the incidence of T1D in the preceding 12 months in a group of 12-14 children from 31 countries, and the prevalence of atopic diseases – the authors (P.Fsadni et al Clin Resp.J 2012 6 18-25) also observe a positive T1D/AD correlation but no correlation at all with rhino-conjunctivitis.

It is clear that these conflicting findings can be explained by differences in methods of research, and also by the probable role of environmental factors. Whatever the case, these reports do not particularly affect diabetes or allergy therapies, but fuel the classical Th1/Th2 paradigm .


4.    Adrenaline auto-injection by children and teenagers

Theme: anti-allergy treatment
Key words: auto-injectable adrenaline – anaphylaxis – food allergy

Although adrenaline is unanimously recommended for first-aid treatment of anaphylaxis, its use in autoinjectors continues to be a subject of discussion as to its indications and practical implementation.

That is why a group of English allergists (L.Noimark et al Clin.&Exp. Allergy  2011 early view  1-9) undertook a multicentre prospective study involving 14 paediatric hospitals spread throughout the United Kingdom.
In this study 969 patients, aged 4-18 (average age 8), for whom an adrenaline autoinjector had been prescribed for a previous anaphylactic episode or food allergy the year before  answered a validated questionnaire.
503 of them had no new reaction and did not use adrenaline. 466 had an another allergic reaction, 221 a serious but non-anaphylactic episode, and 245 an anaphylactic shock (A) defined in the protocol as : loss of conscience, dysphagia, feeling of imminent fainting, wheezing, dyspnea, hoarseness. Among them, 97 even suffered 2, 3 or 4 episodes in the year. Most of the time and by order of frequency, the responsible allergens were peanuts and nuts, egg, milk, shellfish. As for the most frequent symptoms of these allergic reactions, they were : urticaria, skin redness, oedema, and wheezing.

Statistically speaking, in a united or multi-varied model, apart from the symptoms mentioned, oedema, throat prickling and stomach ache are associated with A. while A. risk factors are : a previous episode by non-identified allergen, milk cow allergy, ethnicity (non-whites) and associated asthma.
Most allergic reactions were treated by oral anti-histamines (83.3% for A, 86.4% for others, P=0.3). Finally, out of the 245 As., only 41 did receive adrenaline (16.7%, 95% CI :11.7-21.3), either by their parents or by a health professional and 2.4% by the patient himself. 13 patients who used their autoinjector needed another dose of adrenaline. The reason for not using autoinjectors were : 54.4% because it was not considered necessary and 19.1% probably not useful.
Thus, in the British community, adrenaline is only used by a minority of patients suffering from anaphylaxis. It is probable that a similar survey in Western Continental Europe would give the same results. This goes to show the need to explain more thoroughly the benefits of this process to families and young patients.


5.    Particularities of severe asthma (SA)

Theme: asthma
Key words: severe asthma – corticosteroids – smoking habit – obesity – gastro-oesophageal reflux – bio markers – Vitamin D – Pet-scan – FeNO – Super Dismutase Oxide– Anti-cholinergic bronchodilators - Macrolides

A large research programme on SA carried out in the USA is providing a better understanding of its definition, aspects and treatment (Nizar et al : AJRCCM 2011  November  17 in press). To define SA the authors propose two major criteria for treatment : use of high doses of oral or inhaled corticosteroids (IC), and 7 minor criteria based on : symptoms, frequency and severity of exacerbations, with or without hospitalisation possibly in Intensive Care Unit, troubles of respiratory function tests, extra medications, insensitivity to C. One major criterion and at least two minor criteria were considered as meeting the study conditions.

Lessons drawn from these researches confirm a large number of (sometimes classic) notions :

1)    Risk factors : active and passive smoking, obesity, gastro-oesophageal reflux, ethnicity (black skin), post-puberty females.

2)    Anatomical and functional aspects : incomplete bronchodilation and bronchial thickening, detected by tomography and MRI - a better technique for children than bronchial biopsy -, major alteration of small airways with alveolar inflation (trapping), and predominantly neutrophilic inflammation which can be detected by molecular imaging (Pet-Scan).

3)    Severity biomarkers : high FeNO due to respiratory obstruction and hyperinflation, but also lesser activity of the Super-Oxide Dismutase (SOD) associated to a severe drop in FEV1, increased expression of pro-inflammatory cytokines in relation to the molecular asthma phenotype (for instance, with predominant Th2 or Th1), as well as lack of vitamin D in children (A.Gupta et al AJRCCM 201101034 1342-1349).

4)    Therapeutically, it is often insufficiently regular treatment which is one of the causes of severity , together with either the brutal weaning from C or, on the contrary, the use of too high doses of β² agonists. Also worth noting (P.Barnes et al JACI 2012 1 129 48-59) is the benefit from long term anticholinergic bronchodilators of the Tiotropiun type, without forgetting the macrolide-type antibiotics in cases of neutrophilic predominance, and anti-inflammatory and blocking medications for incriminated mechanisms or mediators (anti-IgEs, or anti-IL13, IL, IL9, PGD2) as well as the products likely to invert the corticosteroid-resistance such as “old” theophylline and nortryptiline. Thus, research is more and more oriented towards biomarkers of different subtypes of SA in order to respond by appropriate and more and more specific therapies.

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Claude MOLINA  -  claude.nelly.molina@orange.fr

Jacques GAYRAUD  -  j.gayraud@orange.fr


Claude MOLINA* & Jacques GAYRAUD**

1. ATOPY HEREDITY : PATERNAL OR MATERNAL?
2. PEANUT ALLERGY : CAN SEVERE REACTIONS BE PREDICTED?
3. THE PSYCHOLOGICAL IMPACT OF DIAGNOSTIC FOOD CHALLENGES TO CONFIRM THE RESOLUTION OF PEANUT ALLERGY
4. NASAL POLYPOSIS (NP) AND ANTI-IL5 MONOCLONAL ANTIBODIES (MA)
5. RHINOVIRUS AND RISKS OF ASTHMA EXACERBATION


1.    ATOPY HEREDITY : PATERNAL OR MATERNAL?
Theme: atopy, asthma
Key words: heredity, asthma, cytokines, atopy

A Danish university team involved in research on child asthma and hereditary transmission of atopy hypothesized different parental imprinting on the cytokines and chemokines in the upper airway mucosa lining fluid of neonates (NN), a set of chemical mediators considered as markers of natural and adaptive immunity.

This team developed an original, clever and non-invasive technique (N.V.Folsgaard et al AJRCCM  November 2011 ahead of print) of sampling by absorption on a filter (of the blotting paper type) of the nasal mucosal lining fluid, applied for 2 minutes, thus avoiding the dilution coming from lavage, for mediator concentrations just above the detection threshold. This technique proved safe for neonates and later for children.

It was applied on 309, 1 to 31-day-old NNs of a Danish cohort, and 18 cytokines and chemokines were quantified. At the same time, atopy was diagnosed among 173 mothers and 142 fathers (47%). In all, 241 NNs had either an atopic father or mother, without showing different characteristics from non-atopic parents’ NNs. These data were statistically treated (principal component analysis).

The results showed that atopic mother NNs presented a significant decrease in cytokine levels (IL10, IL12p, IL2, IL4, TNFα, Eotaxin 3, MCP-1, CP-4 and TARC) as compared to NNs with atopic fathers and non-atopic mothers.

Generally speaking, maternal (but not paternal) atopy shows a strong down-regulation in all these mediators, suggesting some delay in NN’s immunity maturation and therefore a notable influence of the maternal milieu on his immunity programming, either in utero (depending on nutritional factors or pregnancy microbiome) or perinatal life by placental transfer of IgEs.

…And the answer is… the Mother !


2.    PEANUT ALLERGY : CAN SEVERE REACTIONS BE PREDICTED?
Theme: food allergy, allergens
Key words: peanut, food challenge, specific IgE, eliciting dose, age, atopic dermatitis

Dutch paediatric allergists (Groningen et Amsterdam :T.Van der Zee et al JACI2011 128 1031-6), noting that severe reactions can occur after accidental ingestion of peanuts, have attempted to look for risk factors in children. They based their research on the eliciting dose in double-blind, placebo controlled food challenges (DBPCFC) as a marker for clinical responsiveness.

This was a retrospective study of a 2001-2009 data base of 126 peanut-positive DBPCFC
in subjects aged 3-17, two-thirds male, a majority with family atopic history, and having suffered themselves from a severe reaction to peanuts 4-36 months before the test. Specific IgEs were high (18.6 kU/L on average, with a dispersion of 3.8 to 76.6 kU/L). Some subjects were also suffering from atopic dermatitis (79 cases), asthma (79) or rhinitis (53).

The symptoms observed after the challenges (the eliciting dose varying from 200 to 820mg, with an average of 310mg) were either: Objective (angioedema, urticaria, dermatitis, rhino-conjunctivitis, coughing, wheezing, vomiting, diarrhoea) or Subjective (itching, nausea, dyspnoea). A score was given on the basis of these data and then statistically analysed (Cox regression model).

Results reveal that the eliciting dose (ED) is statistically correlated with 3 main risk factors:
1)    Subject’s age : those over 10 years of age have the lowest ED and therefore the severest clinical response, a somewhat surprising result in view of the usual belief that peanut allergy is becoming milder as time goes by.
2)    Specific IgE levels : over 5.6kU/L, which is understandable.
3)    Absence of associated atopic dermatitis, which is unexpected.

As to other factors, incriminated in other research or in clinical experience, such as gender, association with asthma or rhinitis, or previous severe reactions, no significant correlation was shown.

The authors however, knowing that  a risk of accidental ingestion is still possible recommend a strict eviction diet and a self-injectable epinephrin kit in case of accidental ingestion of peanuts.


3.    THE PSYCHOLOGICAL IMPACT OF DIAGNOSTIC FOOD CHALLENGES TO CONFIRM THE RESOLUTION OF PEANUT ALLERGY
Theme: food allergy, allergens
Key words: resolution diagnosis, peanut, food challenge, skin test, specific IgEs, anxiety, quality of life

Publications on the psychological factors of allergy are often   of limited interest in current practice. The originality of this work by a British team from Southampton- (R.C.Knibb et al Clin. Exper Allergy 2011 November ahead of print) is that it is based on precise scientific criteria (case-control study).

The authors point out that peanut allergy resolves itself in 20% of children and walnut and hazelnut allergy in 10%. Such resolution, clinically established by absence of reaction over several years and negative skin tests and specific IgEs, has to be confirmed by a per os food challenge ; it was interesting to evaluate anxiety, stress and quality of life of children and their mothers, on the day of the test and during the following 3-6 months.

103 families took part in this research and completed the corresponding questionnaires, which were validated in Great Britain. 40 children, aged 6-16, underwent the challenge and answered the questions on their social, school and emotional life. 63 children, with persistent allergy in the opinion of the allergist, were used for comparison and answered the same questions (the mother rather than the father being interviewed).

Results : 17 tests (43%) were positive, indicating the persistence of the allergy ; 50% of the children had a negative test. From a psychological point of view:
1)    Mothers reported raised anxiety on the day of the challenge (P=0.007) whereas children were less anxious than usual.
2)    Children (P=0.01) and mothers (P=0.01) had improved quality of life with regards to the role of peanut in their diets, but not concerning food allergy in general.
3)    Children reported lower anxiety levels in the 3-6 months following the negative test (P=0.02) but mothers’ anxiety remained unchanged.
4)    Finally, the improvements in children’s and maternal anxiety and quality of life were independent of the test results.

So, as could be expected, and unlike their children, mothers were more anxious on the challenge day, thus reflecting differences in risk perception. But what is curious is that children’s and mothers’ quality of life was improved even in the case of a positive food challenge. The authors believe this reveals a real appreciation of the challenge, considered as both a diagnostic and therapeutic tool by the parents  and  even is disappointing, as a clarification  of information that influences management and imparts psychological benefits.  


4.    NASAL POLYPOSIS (NP) AND ANTI-IL5 MONOCLONAL ANTIBODIES (MA)
Theme: ORL allergy, immuno-physiopathology
Key words: nasal polyposis, anti-IL5 monoclonal antibodies, Mepolizumab, essinophils, cytokines

The Belgian university hospital ENT team (Gand et Liege P.Gevaert et al JACI 2011 128 989-95) famous for its expertise in NP, assisted by a group of English specialists, has in a recent paper rehabilitated the anti-IL5 MA Mepolizumab (M) which, presumably due to inaccurate indication, had been considered as inefficient in the treatment of asthma.

It should be remembered that, contrary to Chinese patients, in white Europeans 85% to 90% of nasal polyps are infiltrated by eosinophils, for which IL5 is the key driver of cell differentiation and survival. The authors sought to investigate the efficacy and safety of two intravenous injections (28 days apart) of M in severe NPs with chronic rhino-sinusitis, after a period of 11 months.

30 patients refractory to corticosteroids, some having relapsed after surgery and nearly half suffering from concomitant asthma, were randomised and treated (20 active and 10 placebo) ; the first objective was a reduction in NP size, to be seen via endoscopy and scanner, while at the same time monitoring the symptoms which usually accompany NPs (rhinorrhea, loss of smell, nasal peak expiratory flow, obstruction) and the biological signature  of activity (blood and tissue eosinophils, IL5, IL6, ECP and IgE dosage on nasal secretions),  are on the whole, subjected to statistical analysis.

At week 8, 12 patients of 20 in the active-group had a significantly improved NP size (compared to 1 of 10 placebo), calculated at 60% as opposed to 10% in the placebo group. The first objective was then achieved and confirms the authors’ first trial with a single M injection. As to the other symptoms, improvement was noted, except for rhinorrhea, but not statistically significant....

Finally, on a biological level, the treatment shows a significant reduction in blood eosinophilia, whereas the eosinophilia rebound observed with Reslizumab (another anti-IL5 mentioned in our September BUAs) was not observed, albeit frequently reported with these two anti-IL5 AMs. At the same time, blood and nose cytokines levels were also reduced.

Indeed, these improvements persisted until the 36th week and with no notable side effects, but the authors remain reserved on the long term use of M.


5.    RHINOVIRUS AND RISKS OF ASTHMA EXACERBATION
Theme: infection and allergy, asthma
Key words: rhinovirus, asthma exacerbation, neutrophilic inflammation

We have already reported (cf. November BUAs) the frequent appearance, even if not decisive, of rhinovirus in atopic children, as shown in the work of the Madison university team (Wisconsin, USA). The same authors, whose expertise in this field is prominent, now study the question with adults to assess its role in asthma exacerbations (L.C.Denlinger et al AJRCCM 2011 184 1007-14).

In other words, can an asthmatic’s routine seasonal cold be followed, in all cases, by greater viral multiplication and an infection of lower airways with neutrophilic inflammation ?

For this survey, during 9 consecutive winter seasons, they enrolled 52 asthmatics and 10 control, all volunteers, who were monitored daily at the first sign of a cold for the next 10 weeks, and with whom they went to specify, over and above the symptoms, the use of drugs, and the peak expiratory flow, performing periodical nasal lavage and sputum sampling for viral (including molecular) identification, and respiratory functional exploration, all this until all symptoms have disappeared.

25 participants developed an asthma exacerbation, preceded 5 days earlier by detection of human rhinovirus HRV. But among all the viral infections (3/4 being due to the rhinovirus), it is subgroup A’s rhinovirus which was statistically 4.4 times more likely to cause exacerbation.

However, it should be noted that neutrophils, and even virus, were present in sputum, in the non-atopic control lower airways and in the asthmatic group, which shows that these virus can behave no longer like pathogens but as ‘guests’ of these airways.

Nevertheless, asthma exacerbations were marked, and significantly so, by greater neutrophil counts.

On the whole, among adult asthmatic patients likely to catch a routine seasonal cold due to a rhinovirus, those who, over  ...upper airway infection, experience asthma exacerbation, have a high neutrophil count and a greater viral proliferation in sputum than i nasal samples. But the authors cannot specify by which mechanism ...allergic inflammation influences the antiviral response, or on the contrary sensitizes lower airways to viral injury.


-----
Comments and questions welcome :

Pr. Claude Molina    and/or    Dr Jacques Gayraud
*claude.nelly.molina@orange.fr **j.gayraud@orange.fr
Claude MOLINA* & Jacques GAYRAUD**

1.
ALLERGY OR RHINOVIRUS AS THE CAUSE OF CHILDHOOD ASTHMA
2. CROSS SENSITIZATION OF FOOD AND ENVIRONMENTAL ALLERGENS
3. PRACTICAL ASPECTS OF THE HUMAN GENOME STUDY IN ASTHMA
4. THE PROTECTIVE EFFECT OF FARM MILK CONSUMPTION ON CHILDHOOD ASTHMA AND ATOPY
5. TREATMENT OF PERENNIAL RHINITIS BY NASAL INSUFFLATION OF CO2

1. ALLERGY OR RHINOVIRUS AS THE CAUSE OF CHILDHOOD ASTHMA
Theme: asthma
Key words: aeroallergen sensitization, rhinovirus, respiratory syncitial virus (RSV), serum IgEs, asthma

The chicken or the egg paradox

For many years now, allergists and pneumologists have been wondering which of aeroallergen sensitization (AS) or rhinovirus (virus-induced wheezing) was the initial cause of childhood asthma. As suggested by some animal models and clinical studies on severe RSV bronchiolitis, it is the virus which induces AS. But,if AS precedes and predisposes to viral wheeze, it is allergy prevention which must be the strategy in fighting asthma. In order to answer this question, D.J.Jackson et al (AJRCCM 29 Sept 2011 ahead of print) of Madison University (Wisconsin) selected within a cohort of USA children, 285 subjects at high-risk for asthma, given their family histories, and followed them from birth to age six.
The chronology of events during these 6 years was studied in great detail with : precise virus identification, obtained in 90% of the cases (HRV or Human Rhinovirus, RSV or Respiratory Syncitial Virus, Adenovirus, Influenza virus, Coronavirus…), and corresponding clinical manifestations in the form of asthma-like wheezing, clinically diagnosed and requiring appropriate treatment (anti-infection and bronchodilator). At the same time serum IgEs to common aeroallergens were assessed each year. These data were treated using a multi-states Markov statistical model in continuous time. Results are significant :
1) children who were sensitized to aeroallergens have a greater risk of developing viral wheezing than non-sensitized children and, if this absolute risk is greatest at 1 year of age, the relative risk is consistently increased at every age assessed ;
2) AS leads to an increased risk of HRV- but not RSV- viral episodes ;
3) By contrast a viral wheezing episode does not induce a greater risk of AS.
Thus, for the authors, these results are indisputable:  AS precedes HRV viral wheezing and the converse is not true. So the prevention of allergy can indeed limit the development of viral wheezing, and consequently of childhood asthma.

2. CROSS SENSITIZATION OF FOOD AND ENVIRONMENTAL ALLERGENS
Theme: food allergy
Key words: tropomyosin, shell food allergy, dust mites, D.Farinae, cockroach, Blatella Germanica

It is known that food allergens such as shrimp, dust mite or cockroach, own a common protein : tropomyosin, which could account for the cross sensitization (CS) in subjects exposed to one or the other allergen, and who present high rates of specific IgEs, without clinical manifestations.
Based on data from USA national cohorts, which indicated that food allergy was particularly frequent – with an increased prevalence of high IgE shrimp allergy – in a population of inner-city black children, Julie Wang et al (JACI 128 4 834_837) wanted to check the possible correlation between IgE-mediated sensitization to shrimp and allergen exposure to dust mite and cockroach.
For this purpose, they studied the serum of 500 subjects in a cohort of 1528 children aged 4-9 and living in New-York, St Louis and Baltimore inner-cities, while their homes were checked for concentrations of Dermatophagoides Farinae and Blattela Germanica.
They first observed a strong correlation between shrimp, cockroach and dust mite specific IgE levels. Furthermore, high exposure to cockroach in the home, particularly in the bedroom and television room, was significantly correlated with higher shrimp and cockroach IgE levels. In contrast, high exposure to dust mite in the home was highly correlated with IgE levels to D.Farinae but not with shrimp IgE levels. Besides, exposure and presence of cockroach IgEs are predictive of high shrimp IgE levels.
Thus, in children with evidence of joint IgE-mediated sensitization to cockroach and shrimp, having high exposure to cockroach in their inner-cities’ home can contribute to higher shrimp IgE levels, which might not correlate with clinical allergic reactivity.
This notion should be taken into consideration for the interpretation of a shrimp sensitization in such subjects, and before any attempt of provocative tests usually recommended for confirmation of the corresponding food allergy.

3. PRACTICAL ASPECTS OF THE HUMAN GENOME STUDY IN ASTHMA
Theme: genetics, asthma
Key words: asthma, Single Nucleotide Polymorphism, inhaled corticosteroids, genome, gene GLCC11, allele rs37972, allele rs37973

The explosion in genetic research, the speed and accuracy of new generation techniques, call for acquaintance with interpretation of results and their present and future relevance for allergic diseases. A recent review does this with reference to respiratory diseases (J.Todd et al AJRCCM 2011 184 873-880). Up to February 2011 a total of 22 studies had been published, 13 of which on the genetic basis of asthma. The validity of results depends on an accurate classification of the disease, a great rigor in the genetic study, a platform large enough to cover the whole genome, quality controls, a study of the many genotypic nucleotides (SNP : single nucleotide polymorphism), a bio-informatic and statistical analysis and a confirmation in other patient groups (replication populations). The difficulty with asthma comes from the heterogeneity of clinical phenotypes, and the probable role of associated environmental factors in the development of the disease. Hence, the limited practical relevance of this research at present.
In contrast, by addressing a well-targeted category of asthmatics, i.e. subjects where inhaled corticosteroid therapy is ineffective (1 in 3 on average), the genome study (Genome-Wide Association) has led to identifying a genetic variant associated to the pharmacological treatment response (K.G.Tantisira et al NEJM 2011 365 1173-83).
The authors followed 1041 asthmatic children aged 5-12, enrolled in a large cohort (Childhood Asthma Management Program : CAMP) clinically and functionally monitored and random-treated either by Budesonide(®, Nedocromil® or Placebo, for an average of 4.6 years. 422 subjects were selected and genotyped (DNA) as well as their parents ; out of this group 118 trios (child + both parents) were isolated. From these examples, the researchers identified, based on family statistics, 13 possible SNP candidates among the 534290 tested ones. These SNPs were replicated in 4 different patient groups, which made it possible to isolate within gene GLCC11 (gluco-corticoid transcript) an allelic variant, rs37972, associated with a lower FEV1 in response to inhaled corticoids (ICs).
To confirm this observation, the authors made use of cell lineages isolated in vitro and managed to isolate re37973 which is in total correlation (linkage disequilibrium) with rs37972, both associated with decrements in gene GLCC11 expression, i.e. the absence of response to ICs.
This substantial pharmacological effect, prefiguring personalised treatment (according to J.M.Drazen in an Editorial on this research)  , is not however outstanding : if, in the IC-treated CAMP patients with rs37973 the FEV1 decrease is statistically 3 times lower than in those who do not own this allele, the values are low and only concern a small number of asthmatic patients.

4. THE PROTECTIVE EFFECT OF FARM MILK CONSUMPTION ON CHILDHOOD ASTHMA AND ATOPY
Theme: prevention, atopy
Key words: asthma, farm milk, raw milk, boiled milk, whey

This is the new factor identified by the German and Swiss epidemiologists of the E. Von Mutius group, among those which have been suspected to account for the protective effect of the rural life against asthma and atopy. The authors again used their data base (GABRIEL), sent a questionnaire to the parents of 8334 school children and obtained serum samples from 7606 of these children for the detection of specific IgEs. Moreover, on 800 samples of milk from the parents’ farm, they conducted bacteria counts and measured fat content and whey protein levels; this data was confronted to asthma, atopy and pollinosis, and statistically analysed by multiple regression (G.Loss et al JACI 2011 128 766-773).
It appears that raw milk consumption is inversely associated with asthma, atopy and hay fever, independent of other farm exposures. Boiled farm milk did not show this protective effect, nor bacterial counts or total fat content of milk.
In contrast, the whey proteins account for the protective effect against asthma, but not against atopy. It is the case for the bovine serum-albumin, α-lactalbumin, and β-lactoglobulin, all proteins pertaining to the residual liquid from milk skimming and contributing to the production of cheese and buttermilk.
On the whole, the protective effect of raw milk consumption on asthma could be attributed to the whey protein fraction of milk.
But, in cauda venenum, the authors admit that, even if this research is interesting from an epidemiological point of view, the consumption of raw milk for protection on asthma or atopy cannot be recommended in practice because it could contain a number of pathogenic elements !

5. TREATMENT OF PERENNIAL RHINITIS BY NASAL INSUFFLATION OF CO2
Theme: ORL, allergy
Key words: allergic rhinitis, nasal CO2 insufflation

The authors, who in 2008 had already pointed out the effect of CO2 administered by nasal insufflations, without inhalation (Casale et al JACI 2008 121 105-109), have extended their research by a multicenter random study with a view to confirming the efficacy and safety of this treatment, a symptomatic but non-pharmacological treatment which can be useful in certain persistent forms of rhinitis affecting quality of life of patients (Casale et al : Allergy,Asthma,Immunol 2011 107 364-370).
The technique consists in administering CO2 out of a standard gas high-capacity cylinders, fitted with a regulator and valves to control the flow rate (5 to 10 ml/s in the random trial), connected to a tube ending with an adaptable and disposable nasal piece. The insufflation is performed under medical supervision, for duration of a few seconds in each nostril (10 to 30 depending on the group) while the patient is asked not to inhale the gas, but invited to breath by mouth if necessary. At the same time, symptom scores are assessed from 1 to 6 according to the severity of nasal symptoms (congestion, rhinorrea, sneezes, itching) and non-nasal symptoms (eye and ear itches, pharyngeal lacrimation, red eyes).
Thus, 6 groups (including the Placebo ones) are formed, totalling 348 subjects suffering from rhinitis for over 2 years and presenting signs of allergy to common aeroallergens (except pollens).
It is group B (70 subjects), treated for 10 seconds at 10 ml/s in each nostril, which showed the most statistically significant results, with regression of all symptoms (nasal and non-nasal) in less than 30 minutes and for several hours (4 to 6) ; in the previous trial conducted by the authors the improvement could last up to 24 hours.
The other groups (5ml/s for 30 seconds, or 5 and 30 or 10 and 30) are more efficacious than the 2 Placebo groups, but not significantly enough. As to adverse effects, these were limited to some headaches and temporary nasal discomfort.
As a conclusion, we have evidence here of the treatment of symptoms, almost immediate but short in duration, which could be useful in young or elderly subjects, intolerant to drug treatments. But the effects of insufflation of CO2 several times a day, as well as the still unknown action mechanism of this treatment, call for further researches.

-----

Comments and questions welcome:

Pr. Claude Molina and/or Dr Jacques Gayraud
Claude MOLINA* & Jacques GAYRAUD**

1.
Sublingual immunotherapy (SLIT) to grass pollen (GP) : recent data
2. Chronic urticaria (CU) treated by single-dose Omalizumab (O) : a randomised study
3. Obesity (O) surgery in asthmatics (A)
4. Psoriasis (P) vs atopic eczema (AE) : clinical coexistence and biological antagonism
5. Treating atopic dermatitis (AD) with narrow-band UVB phototherapy (NB-UVB)

1. Sublingual immunotherapy (SLIT) to grass pollen (GP) : recent data

Theme:
specific immunotherapy
Key words: sublingual immunotherapy – grass pollen – Oralair – pollen calendar – symptom score

SLIT efficiency in treating GP allergic rhino-conjunctivitis is well known and recent data mainly concerns its administration modes and length of efficacy. This was the purpose of the survey conducted by the Euro-Canadian group led by A.Didier (Toulouse) in a multicenter randomised study whose carefully elaborated protocol made use of Oralair tablets (5-grass 300-IR Stallergens)® for 2- or 4-month periods before co-seasonal treatment (A.Didier et al : JACI 2011 128 3 September  559-566).
633 adults, aged 18 to 50, were then taken in charge from 2007 to 2009, firstly by watching the region-specific pollen calendar (23 countries took part in the survey), secondly by adjusting the individual symptom score according to the intensity of observed signs and the more or less urgent need for rescue medication, i.e. inhaled or per os antihistaminic drugs or corticosteroids.
Three consecutive seasons were monitored with three groups: 1 Placebo (P, 216 subjects) and 2 patient groups respectively treated for 2 months (147) and 4 months (149) before the beginning of the co-seasonal treatment, a treatment undertaken when the atmospheric pollen concentration was over 30 grains/m3 for three consecutive days.

The first goal was to statistically calculate an mean score adjusted for the study’s various parameters, at the end of the 3rd season, by comparing it to group P’s. The second was to compare the overall and individual symptomatology (including the rescue medication score) and the treated patients’ quality of life to those of group P. and, finally, to appreciate the general tolerance of the drug.

Results showed a significant reduction in the mean adjusted symptom score, respectively by 36% and 34.5% in the 2- and 4-month pre-seasonally treated groups (P ?.0001), for the mono- as well as the poly-sensitised subjects, whereas the questionnaire on quality of life showed marked improvement in both active groups. Finally, most adverse effects (essentially local) decreased in number and intensity over the 3 seasons, thus making it possible to compute 97% treatment compliance. Moreover, this favourable evolution was sustained without treatment for the 2 following seasons.

In conclusion, this long-term, very carefully conducted 5-year survey offers two interesting lessons :
1) It is not necessary to start the treatment long before the pollen season (2 months are generally sufficient), on the condition that it is followed by the co-seasonal treatment
2) It is not necessary to continue the treatment longer than the usual 3 years, since SLIT remains efficient for at least 2 more years

Overall, this is an accurate and convincing argument in favour of an economical treatment which will surely be appreciated by doctors and patients.

2. Chronic urticaria (CU) treated by single-dose Omalizumab (O) : a randomised study

Theme:
urticaria / treatment
Key words: chronic urticaria – auto anti-IgE antibodies, auto anti-Fc€R antibodies– urticaria activity score

It is a fact that the treatment of CU is particularly difficult and several isolated observations in recent publications have mentioned a variety of drug trials.

This is the case of beneficial effect recently observed with O, which, according to the authors, can be explained by the presence in some patients of IgG auto-antibodies, anti-IgE or anti-Fc€, its high affinity receptor, which cause degranulation of mast cells and skin basophils and release of histamine. We have here the first randomised, multicenter, US-German, phase II study, with a substantial number of patients (90), which brings in convincing results on the efficacy of single-dose Omalizumab (Xolair ®) in CUs resistant to usual antihistaminic treatment (S.Saini et al : JACI 2011 128 3 567-73).

The US patients were aged 12-75 and the Germans 18-75, all suffering from idiopathic CU, i.e. with daily or almost daily occurrence, in the form of pruriginous papules and erythema, sometimes of angio-oedema, an eruption lasting for more than 6 weeks without a known cause and needing the permanent use of antihistamines (AH) which can usually be recommended in quadruple dose in case of insufficient efficacy.
These subjects, AH-resistant and presenting an urticaria activity score (UAS) of 7-12 days (prurit, papules) and severity-graded from 0 to 6, were divided into 4 groups : a Placebo group (21 patients), and the 3 others respectively treated by a single O injection of 75mg  (23 patients), 300mg  (25), or 600mg (20).

The first objective was to evaluate the UAS improvement after 4 weeks. Only the 300mg and 600mg groups showed significant improvement vs the Placebo group, by 13 points for the first (-19 vs -6.9 i.e. P?.001) and 7 points for the second (-14.6 vs -6.9 i.e. P?.047). This improvement was confirmed during the 12 following weeks both for pruritus and eruptions. Only among the O-75mg group was no meaningful difference observed to that of the placebo.

However what is remarkable is that the onset of improvement occurred as early as week 2 (when 1 to 2 months are generally needed to appreciate O efficacy on asthma). As to tolerance, this did not differ from the placebo group : no notable side effects were observed.

Admittedly the study must continue on a larger number of patients, and in all cases this was a symptomatic treatment whose mechanism has not yet been elucidated. Besides it cannot be specified whether further injections will be necessary in the longer term.
However, and in conclusion, a 300mg (or 600mg) single-injection of O is capable of efficiently and rapidly treating chronic urticaria resistant to antihistamines ; which represents a valuable option in a disease such as CU the evolution of which often  causes despair.

3. Obesity (O) surgery in asthmatics (A)

Theme:
asthma
Key words: obesity – asthmatic – inflammation marker – bariatric surgery – serum IgEs – adipokine – lymphocytic markers

Asthma is difficult to treat in an obese patient. By assuming a pathogenic interaction between the asthmatic  airway inflammation and obesity, the US authors of Burlington-Vermont (A.Dixon et al: JACI 2011 2128 508-15) wished to check whether :
1) inflammation markers were higher with O than with non-O ;
2) corrective O surgery (also known as “bariatric surgery” BS) did improve treatment of A and decrease these markers.
With this view, they enrolled 41 OAs and 35 control and eventually followed 23 OAs and 21 non- OAs. over 3, 6, 9 and 12 months. All subjects underwent BS.

Beside the BMI (Body Mass Index in Kg/m2), the study focused on respiratory functions (particularly airway hyperresponsiveness (AHR) to methacholine) and markers (among which lymphocytes in the bronchoalveolar lavage fluid) as well as levels of serum IgEs and adipokine.
At the end of the surveillance period, and whatever the BS type, (laparoscopy with derivation: by-pass or stomach ringing or strapping) the patients observed a significant improvement in their A score and quality of life (P? .0001 for both groups).
AHR was also improved (P? .03), particularly in older, non atopic subjects, with normal IgE levels suffering from late onset asthma, but without relation to airway inflammation

Paradoxically, these subjects presented increased rates of lymphocytic markers and bronchoalveolar lymphocytes after BS.
On the other hand, the younger atopic obese subjects, with high IgE levels, suffering from early onset asthma, also experience an improvement, albeit with no changes in their AHR.

Thus, post-O-surgery dissociation seems to occur between asthmatic symptomatology, airway hyperresponsiveness and airway inflammation, whether the subject is atopic or not. And this suggests that O lead to a distinct and unique A phenotype, possibly suitable for surgery.

4. Psoriasis (P) vs atopic eczema (AE) : clinical coexistence and biological antagonism

Theme:
eczema / skin allergy
Key words: psoriasis – atopic eczema – interferon ? - lymphocyte Th1 - lymphocyte Th17 – lymphocyte Th2 – lymphocyte Th22 - HLA alleles - Filaggrine – IL 4 interleukin – staphylococcus aureus

These two common diseases, of an epithelial or immune origin, involving hereditary factors and environment, often associated to other body disorders (joints for P, airway for AE), have a distinct physiopathology: the former (P) is characterised by involvement of Th1 lymphocytes with release of interferon ??and Th17 with their cytokines IL17A, 17F and IL22; the latter (AE) is dominated by the Th2 with higher levels of IgEs, total or specific to one or more allergens. Such an antagonism could account for the rarity of their clinical association in the same patient. Therefore the file presented by the Munich (Germany) group of dermatologists and allergists (S.Eyerich et al NEJM 2011 365 231-238) only involves 3 patients, but these are particularly well studied, and complemented by 5 others suffering from P associated with Nickel-contact dermatitis (CD).

In addition to their history and clinical observations, including a severity score for P and the SCORAD index for AE, the study includes classical biological investigations, a series of allergic tests (Nickel and Dermatophagoides pteronyssinus patch-tests) and a skin biopsy for each type of lesion, divided in two parts : one is histological, the other is for studying cell lineages and their cytokine profile ; at the same time, a genomewide study of the leukocyte DNA was performed for HLA alleles and for Filaggrine gene mutations.

The results are shown in the numerous tables and graphs illustrating this article, from which a lesion-specific histological aspect appears: acanthosis, chequer plaques, neutrophilic micro-abscess and spongiosis for P, and mixed infiltrate with eosinophils, T cells and granulocytes for AE.
The cytological study confirms that P presents a number of Th1 and Th17, with secretion of interferon ? and IL17, and AE a large number of Th2 and Th22 with secretion of IL4 in vitro. IL22 (coming from Th17 and 22) is liberated in equal quantities in both lesions. As for the CD lesions resulting from Nickel allergy , they are dominated, like those of P, by Th1 and Th17, but few T cells of P react to Nickel.

Moreover, atopic lesions (and not those of P) frequently harbour microbiological colonies (Staphylococcus aureus), which proves that the immunity due to Th1 and Th17 is partially inhibited by the Th2, whereas the histochemical expression of Filaggrine is higher in P, also suggesting its inhibition by the Th2.
Therefore, the pathogenesis of these 2 diseases does not seem to be based on an intrinsic epithelial anomaly, but more likely on a migration of different T sub-populations, in response to a triggering factor, either known in AE or unknown in P, and leading to skin inflammation.
The treatment of these 2 affections confirm their antagonism: anti-TNFα molecules (Infliximab) are very efficient in P, but exacerbate AE lesions. IL4, which opposes INF ? and IL17 effects on keratocytes, could be an interesting therapy for P but would be inefficient or even contra-indicated for AE.

In fact, non-specific treatments such as the antibody Ustekinumab which targets Th1 and Th17, just like Ciclosporine which inhibits the 2 sub-populations, were efficient on P and AE conjunctive lesions in the subjects studied.

5. Treating atopic dermatitis (AD) with narrow-band UVB phototherapy (NB-UVB)

Theme:
eczema / skin allergy
Key words: atopic dermatitis -  UVB phototherapy, narrow band (NB-UVB) – lymphocytes TH1 – lymphocytes Th2 – cytokine IL22 –Th2/T22 axis

Among the many treatments of AD, the NB-UVB has the advantage of being usable with young subjects and for relatively long periods of time, with no major side effects and relatively low cost.

The multicenter US-Italian-Israeli study of this issue aimed to establish the reversibility of lesions, bio-markers of therapeutic response, and to specify the immuno-modulator effects of the treatment (S.Tintle et al JACI 2011 128 3 583-593).
12 patients aged 24 to 54, 9 male and 3 female, were treated 3 times a week for 12 weeks with the same protocol. Skin biopsies before and after treatment were carried out and evaluated by using gene expression and immunohistochemistry studies.
Results are as follows :
All patients benefited from a clinical improvement with a 50% reduction in their SCORAD score.
The lesion reversibility, in close correlation with the clinical symptomatology, was accompanied by a genomic reversal of the epidermal hyperplasia and above all of the inflammatory markers: the authors observed a decrease in the expression of 372 genes and an increase for 192 others, in whose list T-cells (CD2), activated T-cells (CD69), Th2 (CCL13, CCL26, CCL18 and mostly IL10), TNF α and IL12 could be found.
It is then a strong suppression of the Th2/T22 pathogenic axis and of associated cytokines that can be found in these lesions, with elimination of inflammatory leukocytes, including T-cells and dendritic cells.
As to the reduction of epidermal proliferation (decrease in thickening and in keratocyte proliferation), it is correlated with a reduced expression of the IL22 cytokine, responsible for this hyperplasia.
Finally, a normalised expression of epidermal barrier proteins completes the therapy.

The authors believe that the reversibility of chronic AD lesions results both from a correction of epidermal alterations and a reversal of immune activation. This runs against the fixed genetic phenotype theory and underlines the usefulness of checking the impressive list of Th2/T22 axis bio-markers drawn up by the authors, in the treatment of chronic AD.

Such treatment is widely targeting the immune factor: in addition to local (corticosteroids and calcineurine inhibitors such as tacrolimus) or general treatments (such as cyclosporine, UVA with psoralens and, for the severest forms, high intensity UVB), narrow-band UVB has definitely confirmed its place.

-----
Comments and questions welcome :
Pr. Claude Molina and/or Dr Jacques Gayraud
EAACI PAAM 2011 abstract submission deadline 10 August 2011

The 2nd Pediatric Allergy and Asthma Meeting, PAAM 2011, will be held in the wonderful city of Barcelona, Spain, 13 – 15 October 2011, and will be attended by internationally renowned speakers from around the world.

The scientific programme addresses not only specialists in pediatric allergology, but also general pediatricians, specialists in pediatric pulmonology and gastroenterology, general practitioners and researchers dealing with children with allergic diseases. Therefore we strongly suggest that you do submit your work to this spectacular audience.

There will be a mixture of plenary sessions and symposia as well as interactive clinical and practical sessions. In other words, there will be plenty of opportunities to present your work and get it noticed by the top experts in the field of pediatric allergy and asthma.

The attractive programme will provide an excellent opportunity for scientific and social communication, interaction and inspiration as well as networking with leading experts, physicians, scientists and decision makers. Don’t miss this opportunity and join us at the PAAM 2011!

Submit your abstract here
The 2nd Pediatric Allergy and Asthma Meeting, PAAM 2011, will be held in the wonderful city of Barcelona, Spain, 13 – 15 October 2011, and will be attended by internationally renowned speakers from around the world. The scientific programme addresses not only specialists in pediatric allergology, but...

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EAACI Online Elections for the Sections', IGs and JMA Representatives are now open and will close on 1 April at midnight CET.  You may choose from a list of selected candidates, and cast your vote for the representative of your choice!  As you have to make decision out of many candidates, you have the opportunity to read their nomination form and for every JMA candidate, a CV is available and a photo is displayed online.  For the elections' procedures, you may click here.  You will be informed of the outcome of the elections' process in due time.  Now, follow the link below to vote!

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PhARF is a collaboration between Uppsala University and Phadia AB.  It is based on an international Scientific Committee comprised of internationally recognized scientists in the field of allergy. The committee meets once a year to select candidates for the Award.  Now is the time to nominate to the PhARF Award 2011.  The deadline for Nomination is December 31st, 2010.  The Award amounts to USD 50.000. 

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Claude MOLINA & Jacques GAYRAUD

1 Anaphylaxis: new developments
2. Pigeon breeders’ disease : utility of a provocation test
3. Long-term protection against allergy  of growing up on a farm
4. IgE allergy to cephalosporins : cross-reactivity and tolerability of other β-lactamins
5. Plea for non-surgical treatment of child adenoidal hypertrophy

1.  Anaphylaxis: new developments
Theme: Emergency
Key words: Anaphylaxis, biomarkers, Patient education, Epinephrin self-injection

The Task Force of the US Academies of Allergy and Immunology has, under Phil Libermann’s leadership (JACI 2010 126 3 477-480), published a series of new recommendations on this theme.
Thus, on a physio-pathological point of view, it appears that the classic mediator cascade – histamine, leukotrienes, prostaglandins, all derived from the mast cell / basophil couple – is no longer the only culprit, so that a number of patients do not respond to epinephrine any more. It is the case for intra-vascular coagulation shock which should be treated with an anti-fibrinolytic such as tranexamic acid and for hypotension associated with anaphylaxis and producing nitric oxide calling for treatment by methylene blue. A number of biomarkers are mentioned, such the classical trypsin and histamine, but also: carboxypeptidase, and hydrolase PAF : their low serum levels being  a witness of bad prognosis.
On a clinical level the authors underline the need to maintain the subject in recumbent position until symptoms disappear, deaths having occurred after assuming prematurely an upright position
Biphasic reactions take place in one quarter of serious or even lethal cases.
Among  etiological factors, food allergy (FA) represents in  USA 30% of causes of death whereas asthma is a risk factor for severe FA. Hymenoptera sting, latex, anaesthetics, biological drugs including allergenic immunotherapy, intense practice of sport, sperm allergy, are the classic triggering agents.
Prevention depends on individual factors such as age, occupation, home location (distance to a medical centre for instance), but the most important strategy seems to be patient training, above all if the subject has presented a previous reaction to an insect sting or immunotherapy. Patients are taught to auto-inject epinephrine using a pre-filled syringe and a needle long enough to reach the muscle (ex : mg 0.15/ml 0.3 in an adult). Indications of hospitalisation in an intensive care unit and  treatment by anti-histamines, corticoids  and oxygen, are mentioned in a chart, noted in this 46-page, 310-references report.

2.  Pigeon breeders’ disease : utility of a provocation test
Theme: Respiratory allergy, Allergens
Key words: Pigeon breeders’ disease, Hypersensitivity pneumonitis, Primitive Interstitial pneumonitis, Avian Antigens provocation test, Body temperature.

The Mexican authors who published this text in 1998 under the leadership of A.Ramirez (AJRCCM 1998 158 3 862-8698), came back to it in 2010 (AJRCCM 2010 182 pages 1086-87) on the occasion of a critical study by Dr Kern, dug up by the editors who apologise for not having published it sooner.
The authors, who had observed  the frequency of bird pets in Mexican homes, had underlined in their initial report the usefulness of a provocation test induced by avian antigens, particularly in differentiating Pigeon Breeders’ Disease (PBD), which is a form of hypersensitivity pneumonitis, from Primitive Interstitial Pneumonitis (PIP) whose prognosis is more serious.
17 patients with confirmed PBD were compared to 17 PIP and 5 healthy control subjects. After the provocation test (PT) an increase in body temperature and a decrease in FVC, SaO2 and PaO2 were observed in the 17 patients with PBD and in 3 with PIP, the healthy subjects showing no reaction.
The authors undertook then a serious statistical study, which was the object of the critical letter. In their answer, they admit that, when a patient with PIP shows a negative response to the PT, one can be 100% sure that he does not have PBD. When the PT is positive, the positive predictive value, i.e. the possibility of having PBD, is higher than 80%. But the authors insist that the critical value for positive predictive value (‘cut point’) should be a 0.5° raise in body temperature, an increase which allows them to display 76% sensitivity and 81% specificity.
This discussion brings us back to the diagnosis criteria for PBD and underlines the utility, going beyond clinical and radiological signs, the value of serum precipitating antibodies, and if possible broncho-alveolar lavage, showing predominance of CD4 lymphocytes, all methods helping to avoid lung biopsy which reveals alveolar and interstitial pneumonitis  leading to chronic fibrosis.
But, as the authors also recognise, simply taking the subjects out of their home environment for 2 or 3 days leads to a decrease in many symptoms, while bringing them back home and re-exposition act as a provocation test.

3.  Long-term protection against allergy of growing up on a farm
Theme: Epidemiology
Key-words: Protection against allergy, Urbanization levels, Farming environment

Many studies have shown the low prevalence of allergic rhinitis in farmers and their children, thus deducing the allergy-protective effect of childhood farm environment, which was confirmed by several epidemiological studies.
The Swedish authors (J.Eriksson et al : Allergy 2010 65 1397-1403) wished to go further and discover whether this protection is conserved throughout adulthood and how it corresponds to different degrees of urbanization ; the level of urbanization being defined by the new living conditions, either in a small town (2 to 10,000 inhabitants), a medium-size town (over 100,000 inhabitants) or a large town such as Gothenburg (700,000 inhabitants).
In 2008 a questionnaire on respiratory health was sent to 30,000 subjects aged 16-75, of whom 29,218 could be traced and 18,087 (62%) responded. The questionnaire included questions on allergic rhinitis, asthma, respiratory symptoms and possible determinants.
The subjects were stratified into age groups of 15 years.
As expected, those who had lived on a farm during their first 5 years of life had a considerably lower prevalence of allergic rhinitis in their adulthood, and in all age groups, even among the oldest (61-75 years) and in both the 16-45 year and the 46-75 year groups.
But a significant trend of increasing prevalence was observed with increasing degrees of urbanization, independent of the protective effect of childhood in a farming environment.
As a conclusion, the authors believe that childhood life on a farm does provide a lifelong protective effect against allergic rhinitis.
But the increasing prevalence in urban surroundings can be observed as much in those raised on a farm as in those not, which proves that the deleterious influence of urbanisation is as bad for the child as for the adult, whether or not they have grown up in a farming environment.

4.  IgE allergy to cephalosporins : cross-reactivity and tolerability of other β-lactams
Theme: Drug allergy
Key words: Beta lactams, Cephalosporins, Penicillins, Monobactam, Carbapenems, Skin tests.

For several years the team of Italian allergists led by A.Romano has been interested in this theme and has undertaken a new prospective survey in 98 subjects having presented one or more reactions, of which 84 of an anaphylactic type, to cephalosporins (Cs) and who had positive skin tests to those antibiotics (JACI 2010126 5 994-999). The aim was to assess the cross-reactivity with other β-lactams such as penicillins, but also with monobactams (astreonam) and carbapenems, and the tolerability of these drugs in case of necessity.
All the patients – 68 women and 30 men of 13 to 90 years of age, all IgE allergic to Cs – underwent skin tests and serum-specific IgE assays with penicillin reagents, as well as skin tests with aztreonam, imipenem/cilastatin and meropenem .Subjects with negative tests were challenged with the last three drugs and amoxicillin (l®).
The results are the following : 25% of the subjects allergic to Cs shown positive skin tests to penicillins, and only 3.1% to aztreonam (A), 2% to imipenem/clastatin (I) and 1% to meropenem (M).
The risks of cross-reactivity with penicillins were statistically three times higher for the Cs whose side-chain structures are similar (cephalotin, cefamandole) or identical (cefaclor, cephalexine, cefatrizine) than for Cs with different side-chains (ceftriaxone, ceftazidime, cefuroxime, cefazoline, cefoperazone, cefonicid). In those cases, a preliminary positive skin test require an antibiotic different from the β-lactams, or even a desensitisation to penicillins. But a negative test removes all doubts about their use.
As to the provocation tests for A, I or M, these were negative except for one urticarial reaction to I, thus confirming their low cross-reactivity with Cs. It is then possible to conclude like the good clinicians authors, that 75% of the Cs-allergic subjects can tolerate penicillins and more than 95%  tolerate As, Is, and Ms. For the latter ones, a negative skin test allows their use with very low risk.
These conclusions are validated by the ‘Task Force on Practice Parameters’ on drug allergy (Annals of Allergy Asthma & Immunol 2010 105 259-273) representing all the US Academies of Allergy.

5.  Plea for non-surgical treatment of child adenoidal hypertrophy
Theme : Ear-Nose-Throat allergies
Key words : Aenoids, Nasal corticoids, Beclomethasone, Flunisolide, Fluticasone, Momethasone.

In a well-documented report, G.Scadding (Pediatric Allergy & Immunol 2010 21 1095-1106) recalls that adenoidal hypertrophy (AH), often associated with that of tonsils (T), are common disorders among children and can induce various problems such as snoring, nasal congestion, sinusitis, recurring middle ear otitis, and even obstructive sleep apnea. In the long run, it is even the cause of neuro-psychological or cardiovascular troubles, and growth retardation. No wonder surgical ablation is the commonest strategy, despite the detailed list of complications, which range from immediate or delayed local haemorrhage to anaesthesia complications.
That is why a number of alternatives have been suggested. The frequency of physio-pathological links between AH and allergic inflammation is underlined, particularly association with allergic rhinitis.
The intranasal use of corticosteroids (INS) was then attempted by several teams and for different drugs, always in double-bind tests.
The first trials concerned Beclomethasone in nasal spray for 2 to 4 weeks followed by 16 to 24 weeks according to the authors and at a rate of 336 to 400µg/d with significant results on AH and the symptomatic score.
With Flunisolide , a study of 178 children aged 3-6 revealed a decrease in the size of AHs, thus avoiding surgery.
Fluticasone was used by the author (unpublished study) in 40 children registered on an adenoidectomy waiting list, with no great clinical success as compared with the control group, but  histological study of the AHs showed a decrease in T-activated cells of the adenoid tissue, revealing product penetration into the AHs but not into the tonsils.
Finally, 3 randomised trials with Momethasone furoate ( 100µg/d) for periods of 6 to 8 weeks produced excellent results among which an interesting effect on an antibiotic-resistant otitis.
The unfounded fears concerning the use of INS in children for long periods of time, as well as the minimal local side effects, do not contra-indicate such treatments.
INS therefore represent an efficient alternative for a number of children. Other studies are necessary to define the most suitable INS, as well as dosage and duration of treatment.


Source:  CEFCAP
You may send comments on these brief news to cme.inallergy.online@wanadoo.fr


Dedicated to Franz MARRACHE  In memoriam


Claude MOLINA & Jacques GAYRAUD


Comparison of the skin prick-test and IgE to diagnose house-dust mite allergy

Theme: Allergens
Key-words: skin prick tests, specific IgEs, D.Pteronyssinus, D.Farinae


A group of South-Korean ENT specialists (Jung Yong Gi et al :American Journal of Rhinology and Allergy Juin 2010 24 3 226-229), noting that some patients show a discrepancy between skin prick-tests and specific IgEs (by Phadia Immuno Cap), had the idea to compare these two types of test, with 692 subjects suffering from mite allergic rhinitis and to interpret the results according to age  group in order to draw appropriate guidelines.

With 336 D.Pteronyssimus allergic patients, prick-tests appeared more useful than IgEs in detecting allergy for the under-50s (p? 0.0001), whereas for the 350 D.Farinae allergic, specific IgEs were more reliable in all age groups ; however prick-tests on those subjects were less useful for the over-30s (p? 0.0001).

As expected, but it is reassuring to read scientific and statistical confirmation, it is recommended for the diagnosis of over-50 subjects to use specific IgEs (ImmunoCap) rather than skin tests, whereas prick-tests are advised as first choice with the under-30s.

Similarly, attention should be drawn to the recent publication by the American Allergy Academies (Human IgE antibody serology : R.G.Hamilton JACI 126 Juillet 2010 33-38) which indicates a number of variations, around 15%, between results of different procedures of specific IgE detection as available in the US (Phadia, Siemens, Hycor). This could in fact reveal the existence of different populations of IgEs. That is why, in the future, we should not be satisfied with a single biological result but try to obtain information on the test type and several other parameters : among others, antibody concentration,  specific /total IgE ratio, epitope specificity, all factors of ultimately disease expression.


Predicting side effects of immunotherapy to hymenoptera venom

Key-words: bee venom, wasp venom, serum tryptase concentration, specific immunotherapy

A very important multicenter German-Italian-French-Swiss study under the auspices of our eminent colleague, Professor Wutrich  (F.Rueff et al  JACI July 2010  126  1 105_111), reminds us that the VIT initiated in the 1980s and widely recognised for its efficiency may be associated with side effects, some severe and even requiring emergency intervention.
680 patients were enrolled in this prospective study. Its aim was to assess the baseline serum tryptase concentration and other clinical parameters which are routinely recorded during the build-up phase, so as to try to predict the occurrence of these severe reactions : type of VIT (rush or standard procedure), patient’s age, gender, culprit insect (bee or wasp), magnitude of sting reaction, associated cardiovascular medication, venom specific IgEs. All these factors were then statistically treated.

57 patients (8.4%), required an emergency intervention during VIT, a frequency significantly higher in conjunction with a higher serum tryptase concentration. This predictive correlation is higher when VIT was performed for wasp rather than bee venom.
However the other factor significantly associated to side effect severity is bee venom allergy.

In conclusion, before wasp venom VIT, serum tryptase concentration must be measured, a high rate identifying patients with a high risk of side effects.

However experience shows that it is also necessary to carefully monitor patients subject to bee venom immunotherapy.


High burger consumption and child’s asthma risk

Theme : Asthma
Key-words : asthma, diet, hamburger, ISAAC study, ‘Mediterranean’ diet


It is one of the conclusions of the highly-reliable research team of the Epidemiology Institute of Ulm University (Germany) who studied the effect of diet on asthma prevalence and allergic sensitisation with children in the ISAAC international study (G.Nagel Thorax 2010 65 516-522).

Thus, between 1995 and 2005, studies were carried out in 29 centres in 20 European countries on 50 004 school children aged 8 to 12 ; with half of them (29 579) skin prick testing for usual allergens was performed. Parental questionnaires were used to collect information on diet and allergy.

The conclusions are as follows: fruit intake is statistically associated with low prevalence of asthma wheeze, in affluent as well as other countries. The same is true of fish consumption in affluent countries and cooked green vegetables in non-affluent countries.

However overall, high burger consumption was associated with high lifetime asthma prevalence, a prevalence much lower with fruit, green and fish consuming subjects.

It should be noted that none of the food items was associated with allergic sensitisation. Nor with atopic wheeze, except for fruit or fruit juice consumption.

On the whole the so-called ‘Mediterranean’ diet is associated with low prevalence of wheeze and asthma.

As a conclusion diet may be associated with asthma or asthma-like wheezing, regardless of any allergic sensitisation. These results speak strongly in favour of  the protective role against asthma, of a reasonable, balanced diet, rich in fruit and vegetables and low in meat : the ‘Mediterranean’ diet.


Pediatric asthma emergency visits and atmospheric pollution

Theme: Asthma
Key-words: child asthma, air pollutants, ozone


It is well-known that some air pollutants are responsible for asthma exacerbations in children. However this new survey conducted by several teams of the University of Atlanta (US) is an attempt to specify the lag between daily pollutant concentration and symptom emergence, by collecting paediatric asthma emergency department visits and/or admissions, identifying one or more of the main culprit pollutants, measuring their concentrations and appreciating the dose-response effect (M.Strickland et al AJRCCM 2010 182 307-316).

Thus in 1993-2004, 91 386 admissions or consultations by children aged 5-17 in 41 Atlanta area hospitals were counted, while at the same time the concentrations in gaseous and particulate pollutants were measured by urban stationary monitors with rate ratios adapted to the warm (May to October) and the cold (November to April) seasons. The data was subjected to Poisson generalised linear models in the framework of a cross-over analysis.

Results show that Ozone on the one hand, and primary pollutants from traffic sources (SO², NO, NO², CO) on the other, are directly and independently associated with asthmatic children’s consultations and emergency hospital admissions. Their effects are most blatant on the very day of their presence in the ambient atmosphere, even in low concentration.

Thus these pollutants are harmful for the asthmatic child, and quite rapidly, even when concentrations are low. This serious information should be taken into consideration by public health officials and all practitioners.

The harmful role of ozone is further underlined, in the same journal  (M.Stafoggia et al AJRCCM 2010 182 376-384), with elderly and vulnerable subjects (women, diabetics), by an inter-regional Italian team who reveal high mortality rates within this type of population, mainly from respiratory and cardiac diseases.


IgE sensitisation to Aspergillus and lung function in asthma

Theme: Asthma
Key-words: Aspergillus, aspergillosis, asthma, Aspergillus-specific IgE, sputum neutrophils


Allergic broncho-pulmonary aspergillosis (ABPA) is well-known as a frequent complication of ancient asthma ,characterized by a dual sensitisation ( IgE and IgG precipitating antibodies) , but all the biological and clinical consequences of the colonisation of  asthmatic  airways by Aspergillus are less clear.

An English team from Leicester lead by A.Fairs (AJRCCM 2010 16 July a.o.p) therefore undertook research on 79 asthmatic subjects classified into 3 groups: (1) IgE-sensitised (skin tests ?3mm and IgE?0.35 kU/L), (2)IgG-only-sensitised ( IgG ?40 mg/L) and (3) non-sensitised. These were compared to 14 healthy controls. Sputum culture towards detection of Aspergillus in all those patients was compared with clinical assessment data.

Results are as follows :

Culture was positive in 40 subjects from group 1 (IgE-sensitised) i.e. 63%, 13 of group 2 (IgG only) i.e. 39%, 26 of group 3 (non-sensitised) i.e. 31%, and 7% of controls.

Sensitised patients all had  lung function lower than the non-sensitised ones (post-bronchodilator FEV1 68% versus 88% of the predicted value), p?0.05 ; they also had more bronchiectasis (68% versus 35%)  p?0.05 and more sputum neutrophils (80.9% versus 49.5% p?0.01).

In a multilinear regression model, IgE sensitisation to Aspergillus and sputum neutrophil count are important predictors of lung function (p=0.016), followed by fungus culture and eosinophil cell count in sputum.

In conclusion, Aspergillus detection in asthmatics’ sputum is statistically associated with an IgE sensitisation,  neutrophilic airway inflammation and reduced lung function, with permanent airway fixed obstruction therefore appearing as a damaging effect of fungus colonisation.


Source:  CEFCAP
You may send comments on these brief news to cme.inallergy.online@wanadoo.fr


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ALDER HEY – THE ROYAL LIVERPOOL CHILDREN'S NHS TRUST


Salary - £74,504 - £100,446

Alder Hey Children’s NHS Foundation Trust is one of the largest and busiest children’s hospitals in Europe. The Trust has a world class reputation for providing care for sick children and a proud history of medical achievement and clinical innovation.

We are seeking applications for a permanent full time Consultant in Paediatric Allergy.  This newly funded post offers an exciting opportunity to join and support the further development of our Paediatric Allergy Service.   The successful applicant will provide and support a primarily outpatient and day case service within the Trust, and will work with the team to develop network based, integrated services both within the Trust and in partnership with secondary and primary care.

If you are interested and have the appropriate qualifications and are already on the General Medical Council’s Specialist Register, hold your CCST or are within six months of the appropriate CCST award at time of interview, we would be delighted to hear from you. 

For an informal discussion please contact Dr Tina Dixon on 0151-293-3641 or Dr Caroline Jones, Clinical Director for Medical Specialities on 0151 2284811 ext. 2221

If you are interested in applying to this post please go to www.jobs.nhs.uk quoting reference number RM452E.

The advert will close when sufficient applicants have been received.

In cases where a vacancy receives a high volume of applicants, we may bring the closing date forward. You are therefore advised to submit your completed application form as early as possible

If you have not been offered an interview within 6 weeks please accept that on this occasion you have not been successful. The Trust would like to thank you for your interest and look forward to receiving future applications from you.


Deadline for applidations:  30th of July 2010
Claude MOLINA & Franz MARRACHE

* Doxycycline or steroids in the treatment of nasal polyps
* Anaphylaxis and asthma
* Fibronectin and repair of asthmatics’ airway epithelium
* Anti-infliximab IgE, non IgE antibodies and induction of severe anaphylactic reactions
* Chronic urticaria in children Doxycycline or steroids in the treatment of nasal polyps

ENT teams of Belgium, Germany, the Netherlands and Australia have tried to compare the effects of oral corticosteroids (C)and Doxycycline (D) in treating chronic rhinosinusitis with nasal polyps (NP) in a randomised, double-blind, placebo-controlled trial. 47 patients were concerned.

Cs are given for 20 days in decreasing doses from 32 to 8 mg/day. D is administered during the same period at the dose of 200 mg on the first day followed by 100 mg/day once daily ; the subjects were followed for 12 weeks and assessed by nasal endoscopy for nasal peak inspiratory flow, and markers of inflammation were measured in nasal secretions : ECP (Eosinophilic Cationic Protein), IgE (Immunoglobulin E), MMP9 (Matrix Metalloproteinase 9) and in blood samples : ECP, Eosinophils, IL5α.

Results : C and D each significantly decrease nasal polyp size compared with placebo.
On a clinical level, C and D improve nasal congestion with loss of smell, and rhinorrhea with rear nasal flow. But, as for C, those symptoms recur rapidly after the last dose, unless efficiency is maintained by local treatment.
On a biological level, C effects are maximal at week 3 and last till week 8 with decreasing ECP, IL5 and IgE in nasal secretions and dropping blood eosinophils followed by a swift rebound. However D effect is more moderate but lasts until week 12 with reduced levels of ECP, MM9 and myeloperoxydase (a marker of inflammation with neutrophils).
This shows that beside D’s well known anti-microbe effects, the authors observe an unexpected anti-inflammatory effect of the treatment, going as far as inhibiting the tissue destruction underlying in mucosal inflammation.
Finally, if C and D significantly reduce the inflammatory symptoms of nasal mucosa as well as local and blood markers, D is preferable to C for a long term reduction of polyps (instead of a recurrence after 2 months with C per os).
Therefore Doxycycline deserves a significant place in the treatment of nasal polyps (possibly in association with local Cs) for its contribution to avoiding or delaying as much as possible a surgical ablation.

Key words: chronic rhinosinusitis, nasal polyps, Doxycycline, steroids

Anaphylaxis and asthma

The epidemiologic aspect of the association between these two entities is tackled by two recent publications, a European one (A.Gonzalez-Perez et al de Barcelone JACI Mai 2010 1098-1104 ) from a British database, and an American one (C.Irribaren et al :Annals of Allergy, Asthma Immunol 2010 104 5 371-377) stemming from a major health organisation in North Carolina.
In the first study, based on a filing system dating back to 1985 which includes 177,000 asthmatics aged  10 to 79 who had presented an anaphylactic episode (due to food, medications, wasp or bee stings, latex and others, by order of frequency), the incidence rates are significantly found to be 21.28 per 100,000 person-years with the no-asthma subjects and 50.45 in the asthmatic cohort, i.e. approximately twice as high.
In the study conducted in the USA, the 1996-2006 comparison of a 526,406-strong cohort of asthmatics with a control cohort aged 24 on average, matched according to sex, age and ethnic origin, the incidence of an anaphylactic episode is 19.9 per 100,000 person-years with healthy subjects and 109.0 or 5 times as high with the asthmatics.
In the British cohort the risk appears statistically greater in severe asthmas than in the moderate cases ; the incidence rate is higher with women than men ; within the asthmatics, the patients at risk include subjects suffering from rhinitis, from concomitant eczema, and users of antihistamines or steroids. It is worth noting that not a single death occurred in that cohort.
In the American cohort, the trend toward an increased anaphylactic incidence can be observed in the case of severe asthma, and in relation with some food or bee or wasp sting allergy. On the contrary the evolution of the anaphylactic episode is not influenced by the degree of severity of the asthma.
True, as underlined by European and international experts, the description of the Anaphylactic Shock as a serious/severe, fast-appearing allergic accident, with predominance of skin and respiratory symptoms, and potentially lethal, should be adopted in all countrie