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Study: Delta FVC a better test of adolescent asthma remission
The percentage drop in forced vital capacity (delta FVC) at the provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) can differentiate between symptomatic asthma and clinical remission during adolescence, according to a study in Chest. Scientists at Seoul National University Hospital in Korea studied whether delta FVC was higher in adolescents with symptomatic asthma (n=40) than in those with clinical remission (n=80). The mean delta FVC of 15.5 percent in the symptomatic group was significantly higher than the 12.8 percent in the remission group with bronchial hyperresponsiveness or in the 11.5 percent in the remission group without bronchial hyperresponsiveness. Delta FVC appeared to be a better marker for discriminating between symptomatic asthma and remission than the PC20. 

Many allergic teens gambling with food
As many as 42 percent of teenagers with food allergies admit to risky eating habits, such as knowingly eating foods labeled "may contain" allergens, according to a survey presented at the 2006 AAAAI Annual Meeting in Miami Beach. Researchers at Mount Sinai School of Medicine in New York, polled 174 teenagers, whose average age was 16 years old. They also reported that many teens do not always carry self-injectable epinephrine. Only 43 percent reported carrying it to sports events, and less than 65 percent carry it “with friends, at school or dance events, or on dates.” They were most likely to carry self-injectable epinephrine when traveling (94 percent) or going out to eat (81 percent).

BMI may affect asthma drug response
A higher body mass index (BMI) in asthmatics appears to be linked to a decreased response to inhaled corticosteroids, according to a study in the European Respiratory Journal. However, subjects’ response to leukotriene antagonists was unaffected by BMI. Scientists at the University of Michigan Health System, Ann Arbor, looked at data from four double-blind trials in which more than 3,000 patients with moderate asthma were randomized to montelukast sodium, beclomethasone or placebo. Measures included days of asthma control, lung function (FEV1) and use of a rescue inhaler. The study was funded by Merck, manufacturer of Singulair.  

Nickel, gold among top 10 contact dermatitis allergens
Nickel and gold are among the leading causes of contact dermatitis, according to a study presented at the American Academy of Dermatology annual meeting, in San Francisco. Researchers at the Mayo Clinic analyzed results from contact dermatitis testing conducted on 3,854 patients. Each subject was tested with an average of 69 allergens, and 69 percent had at least one positive reaction and half had two or more positive reactions.
The study also confirmed that patch testing is effective for identifying contact allergens.   

Infant antibiotics use tied to childhood asthma
Babies treated with antibiotics before 12 months old are twice as likely to develop asthma in childhood, according to a study in Chest. Canadian researchers at University of British Columbia, Vancouver, reviewed seven studies made up of 12,082 children and compared exposure to at least one antibiotic to no exposure in the first year of life. The team also reviewed data from five studies made up of 27,167 children, comparing antibiotic dosing. That review showed that for each extra course of antibiotics during the first year of life a child was 1.16 times more likely to develop asthma.   

FDA approves new primary immunodeficiency treatment
The FDA has approved an immunoglobulin product for subcutaneous use. The product, with the trade name Vivaglobin (ZLB Behring), can be given subcutaneously on a weekly basis using an infusion pump. http://www.vivaglobin.com
 

New Practice Parameter reveals
complexity of food allergy management
The Joint Task Force on Practice Parameters, representing the ACAAI, the American Academy of Allergy, Asthma and Immunology (AAAAI) and the Joint Council of Allergy, Asthma and Immunology (JCAAI), has published “Food Allergy: A Practice Parameter” this month in Annals of Allergy, Asthma & Immunology.

“The practice parameter on food allergy represents more than 10 years of research and investigation of literature by members of the Joint Task Force,” said Dr. Jean A. Chapman, Cape Girardeau, Mo., a chief editor. “Designed to improve patient care, the guidelines provide practicing physicians with an evidence-based, broadly accepted approach to the diagnostic evaluation and management of IgE-mediated (allergic) food reactions.”

Components of the practice parameter include an annotated algorithm that presents the major decision points for evaluation of patients suspected of having food allergy; summary statements; and sections on diagnosis and management, which are the core of the practice parameter.

“Each summary statement in the parameter is followed by supporting text. The text includes graded references that document reliability, thereby assuring a better grade of evidence,” Dr. Chapman said.

The 68-page Annals Supplement includes a detailed discussion of skin prick or puncture tests, serologic tests for specific IgE and oral food challenges. Sections discuss successful avoidance, risk factors and prevention of food allergy. Cross-reactivity of food allergy, adverse reactions to food additives, genetically modified foods, and future directions also are discussed. Recommendations for food allergy management in special settings and circumstances are included, where patients have an increased risk for unintentional food allergy exposure.


ACAAI membership at an all-time high
The ACAAI recruited 259 new members last year, bringing its total membership to an all-time high of 5,085. Of these, the average age of the 205 new physician members is 36 years.

Following is a list of the physicians who sponsored the most U.S. applications:

A. Wesley Burks, 7 Larry Hagan, 5 William Klaustermeyer, 5 Bryan Martin, 5 Charlotte Cunningham-Rundles, 4 Blanca E. Del Rio Navarro, 4 J. Andrew Grant, 4 James L. Baldwin, 3

Anita Gewurz, 3 Paul Greenberger, 3 Rhoda Kagan, 3 Jay Portnoy, 3 Sujatha Ramesh, 3 Arlene Schneider, 3 Laurianne Wild, 3

The states that provided the most new members are Texas (22), California (18), New York (17), Maryland (10), Pennsylvania (9), Missouri (9), Colorado (7) and Ohio (7).

The College invites members who are ABAI-certified to apply for Fellowship, using the membership application downloadable from the Web site.

The College honored 45 newly elected Fellows at the 2005 Convocation.
 

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 64 (Part B) of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al. Review questions were written by Drs. Karla R. Davis, Walter Reed Medical Center; and Anne K. Ellis, McMaster University.