Atopic march and "thunderstorm asthma"
Hopefully you have received your February issue of the Annals of Allergy, Asthma and Immunology and have read and benefitted from its contents. But, just in case you have not yet had a chance to read in detail or if you happened to miss these, I want to call to more articles to your attention for you to read that should be able to help you in your practice.
As you hopefully have noted, the emphasis in this month’s Annals is the allergic march. We all are aware that this typically begins in the skin as atopic dermatitis. A review by Adrian Lowe, PhD and colleagues explores the evidence to suggest that there may be strategies that can be used to actually prevent AD and, by extension, the allergic march itself. The authors explore a hypothesis that asserts that the systemic immune changes associated with the development of AD is responsible for the march from skin to respiratory (rhinitis, asthma) and even systemic allergic disease (food allergy). A straightforward intervention plan in the use of emollients in infants to alter the march is discussed and the current evidence presented.
Another article of considerable interest in by Donald W. Cockroft, MD, FACAAI and colleagues whose perspective article hypothesizes that the reactions commonly labeled “thunderstorm asthma” are a manifestation of an early asthma response with high morbidity and increased mortality risk. The evidence for this is well presented and discussed and it gives pause to suggest that asking about circumstances surrounding an acute asthma exacerbation should include questions about the weather (particularly proximity to a thunderstorm).
On behalf of our entire editorial team, thank you for your support of the Annals. As always, we would love to hear your comments – positive or negative – that can help us make our journal more useful to you.
Gailen D. Marshall, Jr., MD, PhD, FACAAI