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sthma risk tied to oral contraceptives, age at menarche
Endogenous and exogenous sex hormones may influence asthma symptoms, according to a study in the Journal of Allergy and Clinical Immunology. Investigators at the University of Southern California, Los Angeles, studied 905 menstruating females between 13 and 28 years old who had participated in the Children's Health Initiative. Subjects who reached menarche before age 12 had a 2.08-fold increased risk of asthma after puberty, compared with those who reached menarche after age 12. Among subjects without asthma history, those who used oral contraceptives had a 1.75-fold increased risk for wheezing and a higher risk of exercise-induced wheezing.

Esomeprazole helps lung function in some asthmatics
Treatment with proton pump inhibitor esomeprazole may improve peak expiratory flow in asthma patients who also have gastroesophageal reflux disease and nocturnal respiratory symptoms, according to a study in the American Journal of Respiratory and Critical Care Medicine. Scientists from Tampere University Hospital in Finland studied 770 patients with moderate to severe asthma, dividing them into three groups: those with GERD, nocturnal respiratory symptoms or both. Subjects randomly received either twice daily esomeprazole 40 mg or a placebo for 16 weeks. Overall, esomeprazole did not significantly improve morning peak expiratory flow. However, in subjects with GERD and nocturnal respiratory symptoms, treatment with esomeprazole was associated with an 8.7 L/min and 10.2 L/min improvement in morning and evening peak expiratory flow, respectively. 

Kids sensitive to cold air twice as likely to develop asthma
Children whose lungs are sensitive to cold air may be at higher risk for asthma later, according to a study presented at the American Thoracic Society's international conference, in San Diego. Researchers from the University of Arizona tested 450 children whose average age was 6 to determine if their lung function was affected by cold, dry air. The participants were tested again at 22 years old. The study found that children with lungs sensitive to cold, dry air at 6 years old were twice as likely to develop asthma by age 22.

Study: Long-acting beta agonists may up asthma exacerbation risk
Researchers from Santa Clara Valley Medical Center in San Jose, Calif., and Cornell University, Ithaca, N.Y., analyzed data from 19 randomized, placebo-controlled trials involving 33,826 subjects with asthma, and their findings were published in Annals of Internal Medicine. Pooled results from the meta-analysis found that long-acting beta agonists increased exacerbations requiring hospitalization 2.6 times that of subjects receiving placebo. Compared with placebo, life-threatening exacerbations were 1.8 times higher, and asthma-related deaths 3.5 times higher. Similar risks were recorded for salmeterol and formoterol and among children and adults.

Board of Regents approves position statement on physician extenders
The ACAAI Board of Regents approved the following position statement at its May 6 meeting concerning the employment of physician extenders:

“Physician extenders can be a valuable asset for the practicing allergist/immunologist. Physician extenders should only function, however, under the appropriate supervision (as defined by state stature) of an allergist/immunologist and must be adequately trained in the procedure(s) that they are performing. The allergist/immunologist is always responsible for the safety of the patient and, therefore, is responsible for the competence of the physician extender. Physician extenders should be carefully evaluated on a continuing basis in regard to the procedure(s) that they are given responsibility for performing. The allergist/immunologist needs to recognize that licensing requirements for physician extenders will vary from state to state.”

The ACAAI Practice Guidelines Committee, chaired by Richard A. Nicklas, developed the position statement. The Board requested the statement in response to member inquiries.

Joint Task Force publishes comprehensive SLIT review
A Joint Task Force of ACAAI and AAAAI’s Immunotherapy and Allergy Diagnostic Committees completed a comprehensive review article on sublingual immunotherapy (SLIT). The report was published in the May issue of the Journal of Allergy and Clinical Immunology.

“The College recommends this review to members and others interested in learning about SLIT,” said ACAAI President Dr. William K. Dolen. “SLIT is currently considered investigational in the United States. Allergen extracts do not currently have FDA approval for use in SLIT. Because SLIT is considered investigational, most insurance does not cover the cost of therapy,” he said.

The Task Force concluded that, although there is evidence that SLIT is an effective treatment, many questions remained unanswered, including effective dose, treatment schedules, and overall duration of treatment. The safety and efficacy of SLIT have not been adequately studied in high-risk individuals, such as patients with severe asthma.

“The College will not issue a statement recommending use of SLIT until appropriate studies have been conducted in adults and children with products approved by the FDA for sublingual use, and the results support routine clinical use in the United States,” Dr. Dolen said.

Job Source offers job seekers free personalized services
The “Job Source” on the ACAAI Web site has several features to make job searches and career advancements easier than ever.

Easy to use Resume Builder allows job seekers to:

•	Build a professional resume with template content.
•	Customize a resume with fonts, colors and content.
•	Upload an existing resume and maintain its formatting.
•	Store multiple resumes.
•	Post a resume online so that employers can find you (confidentially, if  desired).
•	Create and send a cover letter along with a resume.

My Site section allows you to:

•	Easily create and maintain your own password-protected career Web site.
•	Include a home page with an introduction.
•	Upload a photo or image of your choice.
•	Post your resume.
•	List your references.
•	Upload or link to articles you’ve written or published.
•	Provide your unique Web site URL to anyone you wish, including potential employers.

All features are free to job seekers and easy to use with simple instructions and templates. Visit www.acaai.org/Member and select JOB SOURCE to learn more and get started today. If you have any questions about the ACAAI Job Source, contact our customer care team at 888-884-8242 or infor@healthecareers.com.
 

Immunology Review Corner
Welcome to the Board Review Corner, prepared by Dr. Karla R. Davis, senior representative of ACAAI’s fellows-in-training (FITs) to the Board of Regents. The Board Review Corner is your chance to test your Board preparedness.

To refer to a previous Board Review Corner, click the “Archive” link in the left column.

Immunology Review Corner: Chapter 70 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al. Review questions were written by Dr. Karla R. Davis, Walter Reed Medical Center.