Managing Allergy

This is a practical book for clinicians setting out the options for effective management of chronic disease. There have been enormous advances in knowledge and understanding of the scientific and clinical aspects of allergic disorders over recent years. This book provides an evidence-based overview of therapy for allergy, showing how increased understanding translates into clinical practice, with a discussion of promising future therapeutic agents. This comprehensive review volume provides clinicians with a thorough understanding of the factors which will enable them to formulate an appropriate strategy for treatment and long-term management for each individual patient. It sets out integrated prevention and management strategy for allergic disorders. It is relevant both to hospital doctors and to GPs. It emphasizes importance of the patient viewpoint in the management of disease. Cover Page......Page 1 Title: Managing Allergy......Page 2 ISBN 1846920256......Page 3 Contents (with page links)......Page 4 Editors and contributors......Page 6 PART I: Diagnosis......Page 9 Introduction......Page 11 What to accomplish by setting the diagnosis......Page 12 Establishing an allergy diagnosis......Page 13 Information on the IgE system......Page 15 Dose–response relationship between exposure to allergens and formation of sIgE......Page 16 Using sIgE results for risk assessment in patients with allergy......Page 18 The natural course of allergy development (Allergy March)......Page 22 Conclusion......Page 23 PART II: Allergic airway disease......Page 27 Introduction......Page 29 Time course of the increase in allergic disease and asthma......Page 30 Epidemiological evidence on the role of allergens in the development of asthma......Page 32 The cat paradox......Page 33 Severe asthma in adults......Page 35 Relevance to management of asthma......Page 36 Conclusions......Page 38 Introduction......Page 43 Fungi implicated......Page 44 Allergens......Page 45 Allergic bronchopulmonary aspergillosis (ABPA)......Page 46 Severe asthma with fungal sensitisation......Page 49 Occupational asthma and extrinsic allergic alveolitis caused by fungi......Page 51 Conclusion......Page 52 Introduction......Page 55 Is it rhinitis?......Page 56 Treatment of rhinitis......Page 60 Introduction......Page 73 Pathogenesis......Page 76 Natural history and epidemiology of asthma in CS......Page 80 Proposed mechanisms linking chronic sinusitis to asthma (Table 5.2)......Page 81 Clinical course......Page 84 Allergen avoidance / immunotherapy: the role of allergy in CHES......Page 85 Conclusion......Page 90 References......Page 91 PART III: Skin......Page 99 Introduction......Page 101 Irritant and allergic contact eczema (dermatitis)......Page 102 References......Page 114 Introduction......Page 119 Conclusion......Page 134 References......Page 135 PART IV: Systemic......Page 137 Introduction......Page 139 Background: what is latex and where does it come from?......Page 140 Latex allergens......Page 142 Relevant epidemiology......Page 143 References......Page 153 Introduction......Page 155 Conclusion......Page 162 References......Page 163 Introduction......Page 165 Food allergens......Page 168 Management of food allergy......Page 176 References......Page 179 Introduction......Page 187 Features of anaphylaxis......Page 189 References......Page 198 Introduction......Page 201 Site 2: Anti-IgE......Page 202 Site 3: Chromones......Page 204 Site 4: Anti-inf ammatory drugs—corticosteroids (glucocorticoids)......Page 206 Site 5: Antihistamines......Page 209 Site 6: Anti-leukotrienes—leukotriene receptor antagonists and synthesis inhibitors......Page 212 Site 7: Bronchodilators—β2-stimulants......Page 214 References......Page 215 Introduction......Page 221 Mechanisms......Page 222 SIT for venom anaphylaxis......Page 224 Effects of SIT on the natural history of allergic disease......Page 227 Safety......Page 228 Future directions......Page 229 Conclusion......Page 230 References......Page 231 Introduction......Page 233 How to achieve a major reduction in exposure......Page 234 Allergen avoidance in the treatment of allergic disease......Page 236 Environmental control in the prevention of allergic disease......Page 242 Conclusion......Page 244 References......Page 245 Introduction......Page 251 Anti-cytokine therapies......Page 252 Cytokine therapies......Page 257 PDE4 inhibitors......Page 258 Inhibition of intracellular signalling mechanisms......Page 259 Chemokine receptor antagonists......Page 260 Conclusion......Page 261 References......Page 262 What the future holds—on genes and environment......Page 265 What the future holds—the relevance of IgE antibody responses to different groups of allergens......Page 269 References......Page 272 Acronyms/ Abbreviations......Page 275 Index (with page links)......Page 279