With the summertime approaching and the annual leave at reach for many of our readers living in the northern hemisphere, it might be the time to make plans to catch up with the reading of those issues of A&I which still lay pending in the website or in the tablets. Fortunately, they are not piling up on desks and chairs any more.
The present issue includes an ample variety of topics, from the allergenic profiling of Acarus gracilis (similar to A. Siro) to the role of toll-like receptor 4 in the patho-physiology of allergic rhinitis, which is the topic of the review paper. Curiously, two papers relate to liver conditions. In the first of those two papers abnormal values of gamma glutamyl transpeptidase are described to be associated to food allergy (peanut, egg, milk, and shrimp). Moreover, egg sensitization was associated to abnormal levels of albumin and alanine transaminase. While novel and interesting, the clinical significance of these findings, from the data in the National Health and Nutrition Examination Surveys 2005-6, are uncertain and the findings should be validated in specifically designed studies. Also of interest is the second paper, in which the authors found a strong association between early stages after liver transplantation and food allergy: the risk of developing IgE-mediated food allergy during the first year after transplantation is three fold that of subsequent years.
One of the papers in the present table of contents is an atypical one and explores de nocebo effect in the context of oral drug provocation tests. The nocebo effect consists of experiencing troublesome symptoms after the administration of a placebo. The paper describes those symptoms and also the risk factors of the effect.
As usually, several papers are devoted to asthma. Two of them explore antioxidant capacity in asthmatics. In the first one, the investigators found significantly lower levels of paroxonase and significant higher levels of total antioxidant capacity and total oxidant status in asthmatics. In the second one, an epidemiological study on the intake of antioxidant foods, the antioxidant eating index (AEI) was inversely associated to lifetime asthma after controlling for important potential confounders such as family history, sensitization, exercise, smoking at home, breast feeding, pet ownership and dampness at home. Still in the realm of asthma, another paper focuses on the consumption of anti-asthmatic drugs. Probably, its most interesting conclusion is that maintenance therapy consumption is poorly in agreement with the recommendations of asthma treatment guidelines, which, again, challenge the usefulness of those guidelines in the real world. Ending up the asthma chapter of this issue of A&I, a paper describes the effect of montelukast on several chemokines in infants with acute bronchiolitis. Interestingly, a significant decrease of IFN-gamma and a significant increase of eotaxin levels were found after five days of treatment.
Other topics covered in the present issue of A&I are: drug allergy; hymenoptera venom allergy; and urticaria. In a series of 100 patients with suspected drug allergy, the condition was only confirmed in 6% of them (even less among pediatric patients): the authors propose a diagnostic algorithm which might save costs. The paper on hymentoptera venom allergy focuses on the importance of component analysis, as patients frequently show multiple sensitizations. The last paper of this miscellaneous group studies the epidemiology of acute urticaria in Caracas (Venezuela), and concludes that extensive complementary tests are probably not cost-effective.
To end, there is also room for a pure immunological paper, in which immunoglobulin replacement therapy is evaluated in patients with predominantly antibody deficiency. The authors found a significant association between anti-IgA antibody presence and adverse reactions, especially in common variable immunodeficiency.
I hope this fourth issue of A&I maintain the interest to our readers.
