Bibliographic updates

BIBLIOGRAPHY UPDATES IN ALLERGOLOGY

The Monthly choice
June  2015

Claude MOLINA & Jacques GAYRAUD

1.    A New Target in the treatment of Allergic Asthma
2.    Exacerbations in Asthma. predictive factors and Risk Score  
3.    Chronic Rhino-Sinusitis with Polyposis: IL 25 as therapeutic target
4.    Sinus Microbiota and Phenotypes of Chronic Rhino- sinusitis
5.    Peanut Allergy: Ara h2 and Ara h6  best predictors of severity

1. A New Target in the treatment of Allergic Asthma           
N.Krug et al : NEJM 21 May  2015 1987-1996
Theme: Asthma – Respiratory Allergy – Allergy treatment
Key words: Th2 lymphocyte – GATA 3 – DNAzyme – SB010

Therapeutic targeting of GATA 3, an important transcription factor of the Th2 pathway,  with  SB010,  a novel DNA enzyme (DNAzyme) by means of inhalation once daily for 28 days, in a double blind placebo-controlled multicenter clinical  trial, significantly attenuated both late and early asthmatic responses after allergen provocation, in 21 patients with allergic asthma (20 placebo). Sputum eosinophilia was also attenuated, whereas  levels of serum tryptase and plasmatic IL 5 were lower. However allergen-induced FeNO and airways hyper responsiveness were not affected.

2. Exacerbations in Asthma, predictive factors and Risk Score  
E.D.Bateman et al JACI 2015 135 6 1457-1464,                                            
S.J.Teach et al :JACI 2015 135  6  1465-1473.
Theme: Asthma – Respiratory Allergy
Key words:  Asthma exacerbation risk factors - Seasonality

Risk of uncontrolled Asthma at 3 months and a severe exacerbation within 12 months can be estimated from simple clinical assessments. Prospective validation from a large data of 3 studies (7446 patients) showed, on multivariate analysis that GINA step, reliever use, post bronchodilator FEV1, 5-item Asthma ControlQuestionnaire are dominant factors , as well as smoking status and Body Mass Index. Increments in Risk score based on 5 selected predictors increase the risk.
In the second study among 400 inner city children, median age 13 years, exacerbations occurred most commonly in the fall. Multivariate model showed that exacerbation in the previous season was the strongest predictor in fall and Winter whereas a higher requirement for inhaled corticosteroids was the strongest predictor in spring and summer.  Anyway the best predictive power is for fall exacerbations (role of virus).

3. Chronic Rhino-Sinusitis  (CRS) with Polyposis (P) : IL 25 as therapeutic target.
Hyun-WooShin et al JACI 2015  135 6 1476-1485
Theme: Rhinitis – Respiratory Allergy – Allergy treatment
Key words: Nasal Polyposis – IL25

The Korean authors investigated IL 25 expression and its cellular origins in Nasal Polyps (NP) of human subjects using immuno-histo-chemistry, quantitative RT-PCR and ELISA of NP tissue. IL 25 expression was significantly up-regulated in NP mucosa. In NPs, IL 25 nRNA expression positively correlated with the expression of several inflammatory markers.                                      
In a murine model of NP, anti-IL 25 treatment reduced the number of NP,  collagen deposition and inhibited expression of local inflammatory cytokines. These results suggest the novel possibility of treating NP with anti-IL 25 therapy.

4. Sinus Microbiota (SM) and Phenotypes of Chronic Rhino- sinusitis (CRS)
V.R Ramakrishnan et al: 2015  JACI in press
Theme: Respiratory Allergy – Rhino-Sinusitis
Key words: Sinus Microbiota – Actinotinobacteria – Chronic Rhino Sinusitis Phentypes.
 
Analysis of SM in a large cohort of patients reveals that 2 particular Phenotypes of CRS (association with Asthma or Purulence) are characterized by distinct composition of resident bacterial communities.
Biodiversity and bacterial composition, with the presence of relative higher abundance of Actinobacteria, are predictors of better outcome, particularly after surgery *.
PS*  We recommend the book edited by the EAACI  group in 2015 : Global Atlas of   Allergic Rhinitis and Chronic Rhinosinusitis          

5. Peanut Allergy (P.A):Ara h2 and Ara h6  best predictors of severity  AK.Kukkonen et al  Allergy 2015  June  Accepted articles
Theme: Food allergy – Peanut allergy.
Key words: Ara h2 – Ara h6 – Peanut allergy.

Component resolved diagnostic (CRD) coupled with double-blind placebo-controlled challenges and allergen activity of products by IgE microarray inhibition, revealed, in 102 patients of birch endemic region, that co-sensitization to Ara h 2 and Ara h 6 are associated with severe reactions. Spe. IgE to Ara h8 added no diagnostic value. Moreover the products, roasted or not, on the contrary to Ara h 1,2 3 6 and 8,  lacked Ara h9 activity. CRD reduces the need for oral challenges in P.A.

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Last updated 29 September 2015