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Update in Allergy and Immunology
1999-2000 Series: Update Sessions from ACP-ASIM's 1999 Annual Session
Margaret Ring Gillock, Editor, and David Cramer, MD, Co-Editor
As might be expected, asthma—both its development and its treatment—heads the list of topics for this Update. Other important areas explored here are effective treatment of rhinitis, proper use of allergen immunotherapy, administration of epinephrine for treatment of anaphylaxis, and the proper duration of immunotherapy for prevention of anaphylactic reactions to insect stings.
Asthma
The cause and treatment of asthma continue to be the foremost topics in the field of allergy and immunology. Indoor allergens, such as those produced by dust mites, cockroaches, and cats, are emerging as very important factors in the genesis and maintenance of asthma symptoms. Control measures for individual factors differ, and these factors may play different roles in various patient populations. Outdoor pollution may enhance and augment the response to allergens as well. This Update explores the strategies for avoiding these allergens, the medications available for treatment, and guidelines for delivering treatment.
Specific Sensitization to Indoor Allergens Is Associated with Perennial Asthma
Platts-Mills TA, Vervloet D, Thomas WR, et al. Indoor allergens and asthma: report of the Third International Workshop. J Allergy Clin Immunol. 1997; 100:S2-S24.
Platts-Mills and colleagues review the findings of the leading indoor-allergen experts in the areas of biology, allergen immunochemistry, molecular biology, immune response, epidemiology of asthma, and the role of allergen avoidance. Allergens discussed include house dust mites, cats, dogs, and cockroaches. The review emphasizes increasing recognition of the importance of the indoor environment's effect on patients with asthma.
Evidence for a dose-response relation between exposure and sensitization has been refined for mites and other allergens. Studies in Australia, France, Germany, Japan, and the United States have confirmed that the pattern of sensitization to specific allergens reflects the mean level of allergen found in homes in the communities where patients with asthma live. …
