Download ALLSA 2005 Congress – Advances in Asthma and Food Allergy

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CONGRESS REPORT
ALLSA 2005 CONGRESS – ADVANCES IN
ASTHMA AND FOOD ALLERGY
Dr Ahmed Manjra, Congress Convenor, and his congress committee are to be congratulated on the successful congress held at the Elangeni Hotel, Durban
from 26 to 28 August. This was a first for ALLSA – the
first congress organised in conjunction with the
American Academy of Allergy, Asthma and Clinical
Immunology. Five international speakers from Canada
and the USA presented papers covering the latest
advances in asthma and food allergy. The August 2005
issue of Current Allergy & Clinical Immunology contained some of the presentations and many congress
abstracts, so this report gives just a flavour of what
was on offer.
Prof. Sami Bahna receiving his Life Membership
Award.
Dr Navin Singh, Prof. Cas Molala, Prof. Matt Haus and
Dr Ahmed Manjra, Congress Convenor.
Prof. Paul O’Byrne with Dr Ahmed and Mrs Arshaad
Manjra.
Prof. Fernando Martinez of the Arizona Respiratory
Centre, University of Arizona, covered the complex
topic of genetics and environmental interactions in
asthma. After discussing a number of studies (twin
studies and familial studies) and looking at the nine
genes that are more consistently associated with asthma-related phenotypes, he noted that the studies are
conspicuously inconsistent. While he agreed that this
could be attributed to ‘bad’ studies (too small, not making the same comparisons), he did not feel this was the
main problem. The lack of consistency is telling us
something very important. What we usually expect
from genetics is what it is most successful at, i.e.
monogenic diseases like cystic fibrosis where there is
direct genetic mapping, a direct link from genotype to
phenotype. Many were expecting genetic mapping to
work the same way for more complex diseases, but it
Dr Andrew Lopata looks on while Prof. Fernando
Martinez admires his Zulu basket.
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doesn’t. Bluntly put, there is no single gene for asthma.
He concluded that the best strategies will be those that
investigate the inteactions between genes and environmental aspects.
Prof. Sami Bahna of the LSU School of Medicine,
Louisiana, discussed the dilemma of reactions to food
additives. Additives may be present in dyes, antioxidants, flavouring (MSG), preservatives, antimicrobials
and stabilisers. The task of assessing reactions is complicated by the vast number of additives used –
approved food additives in the USA total 2 977! Prof.
Bahna listed the possible reactions to additives including anaphylaxis: respiratory, gastrointestinal, dermatological, musculoskeletal and neurological symptoms,
many of which are often not documented. It is thought
that reaction to food additives is underdiagnosed
because it is difficult to look for them – more commonly a diagnosis is made when they are seen to aggravate
existing atopy. The diagnostic approach involves ruling
out hidden food additives (screen for food protein, read
labels) and a careful medical history of reactions (check
for seemingly unrelated foods or foods prepared in a
certain way or place). Trials involve a blind challenge,
challenge with the suspected allergen, and challenge at
incremental doses. Management would involve identifying the additives if possible, warning patients to read
labels and minimise consumption of commercially prepared food, and take antihistamines if they are going to
eat out. Prof Bahna mentioned that the problem is complicated by the fact that food additives are not only
found in food. An infant with cow’s milk allergy had ana-
Current Allergy & Clinical Immunology, November 2005 Vol 18, No.4
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Prof. Cas Motala presents Prof. Emil Bardana with his
Life Membership Award.
phylaxis when nappy ointment was applied. The ointment contained only 5% calcium caseinate, but it was
enough to cause anaphylaxis. How was the mother to
know that there was ‘milk’ in the nappy ointment?
A symposium on the changing relationship between
academia and the pharmaceutical industry with Prof.
Matt Haus outlining the pharmaceutical viewpoint and
Dr Sharon Kling presenting the case for academia provoked some interesting discussion, as did a debate
between Prof. Paul O’Byrne of McMaster University,
Hamilton, Canada, and Prof. Elvis Irusen on singleinhaler therapy vs fixed-dose combination therapy for
asthma. Free presentations and posters provided information on a range of interesting studies, and a popular
innovation this year was the session entitled: The year
in review. Prof. Sami Bahna reviewed selected papers
on food allergy published in the last 12 months and
Prof. Emil Bardana reviewed his choice of the most
important recently published allergy papers. Another
excellent session, also presented for the first time this
year, was Clinical case studies – various presenters
described unusual cases of asthma, food allergy,
anaesthetic allergy and urticaria/angioedema and invited discussion from the floor.
The gala dinner provided an opportunity for delegates
to relax and enjoy themselves. Overseas speakers
were honoured with life membership of ALLSA and
presented with Zulu craft baskets. The ALLSA research
awards were presented (details appear in the
Chairman’s report on p. 199 in this issue) and Prof.
Mohamed Jeebhay was awarded the Discovery prize
for the Best Free Paper/Poster of the congress. Journal
awards for the Best Article and Best Photograph published in Current Allergy & Clinical Immunology over
the past year went to Dr Michael Levin and Dr George
du Toit respectively.
Prof. Bob Lanier receiving his Life Membership Award.
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Dosage and directions for use
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Children between the ages of 2 and 11 years: The
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For more information contact Spurgeon Steyn, ScheringPlough (Pty) Ltd, 011-922-3300.
Current Allergy & Clinical Immunology, November 2005 Vol 18, No. 4
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