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Make up TIB 2/9/06 10:57 AM Page 204 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. 204 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 Make up TIB 2/9/06 10:57 AM Page 205 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. PRODUCT NEWS NASONEX IS NOW INDICATED FROM THE AGE OF 2 YEARS! Nasonex Aqueous Nasal Spray is indicated for use in adults, adolescents and children between the ages of 2 and 11 years to treat the symptoms of seasonal allergic or perennial allergic rhinitis. In patients who have a history of moderate to severe symptoms of seasonal allergic rhinitis, prophylactic treatment with Nasonex Aqueous Nasal Spray is recommended prior to the anticipated start of the pollen season. Dosage and directions for use Adults and adolescents: The usual recommended dose for prophylaxis and treatment is two sprays (50 µg/spray) into each nostril once daily (total dose 200 µg). Once symptoms are controlled, dose reduction to one spray into each nostril (total dose 100 µg) may be effective in some patients for maintenance. Children between the ages of 2 and 11 years: The usual recommended dose is one spray (50 µg/spray) in each nostril once daily (total dose 100 µg). For more information contact Spurgeon Steyn, ScheringPlough (Pty) Ltd, 011-922-3300. Current Allergy & Clinical Immunology, November 2005 Vol 18, No. 4 205