Clinical issues in the allergist-immunologist’s office due to racial differences

May 13, 2019

Where has the spring gone? Much of our country has had a great deal of moisture that will nourish many fields of grass. I suspect this will keep many of us busy with patient matters well into the summer. I do hope you will still have time to thumb through the pages of the May issue of the Annals of Allergy, Asthma and Immunology. As always, we have multiple different features to try to appeal to the interests of the broadest number of our readers as possible. This month’s emphasis is on the clinical issues in the allergist-immunologist’s office because of racial differences. We have a broad number of articles that address this, either directly or indirectly, as specific components of illness that we know differ by race are considered. I would like to point out a few key articles for you to read and consider.

This month we have multiple perspectives, review articles and original science for you. Jonathan Spergel, MD, PhD, FACAAI discusses the immunology of esophagitis and the ancestral differences based upon race. This is accompanied by two perspective articles that use Latin American examples to demonstrate the impact of race on allergy-related conditions. Arachu Castro, PhD, MPH discusses the impact of health equity on the clinical course of asthma in children from various Latin American and Caribbean countries. Finally, Pedro Giavina-Bianchi, MD, PhD explores the similarities and differences between drug hypersensitivity reactions in various Central and South American countries to provide social context to health disparities that we see in our country as well. All of these articles address our topic of the month and will undoubtedly stimulate your consideration of patients that may have similar heritages and geographic considerations that impact their illnesses.

One other don’t miss article is our monthly CME review article. This month’s is written by Emma Guttman-Yassky, MD, PhD and colleagues and explores racial differences in atopic dermatitis (AD). It is often pondered as to whether racial differences in terms of incidence, prevalence, severity of morbidity and mortality rates are influenced primarily by racial genetics, social influences, geographic considerations or some combination of the three. Dr. Guttman-Yassky shows that AD is more severe in African – compared to European – Americans but is also higher and more severe in Africa and Oceania compared to other parts of the world. They also describe racial differences in immune and inflammatory mechanisms including genetic differences between various racial populations. This offers hope that future studies can reveal information that might assist patients, particularly those with more severe disease, to more effectively manage their AD.

As always, we welcome your comments and invite you to write to us about articles that are impactful to you – either positive or negative – so that we can share your comments with other colleagues.

Gailen D. Marshall, Jr., MD, PhD, FACAAI