Clinical & Experimental AllergyVolume 44, Issue 3 p. 301-301 Editor's ChoiceFree Access The Editor takes a closer look at some of this month's articles First published: 22 February 2014 https://doi.org/10.1111/cea.12285AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat In vivo confocal microscopy: a window to the allergic eye Vernal keratoconjunctivitis is a severe form of allergic eye disease which can cause lasting damage if not adequately controlled. The mechanism is presumed to involve adaptive type 2 immune responses to allergens, and therefore, the role of dendritic cells is of particular interest. In a novel study, Liu et al. (pp. 362-370), have used a technique called in vivo confocal microscopy to identify and enumerate dendritic cells in the conjunctiva, limbus and peripheral cornea before and after treatment with immunosuppressive eye drops. They observed increased numbers before treatment compared with healthy subjects and a return towards normal within 3 months of treatment. This technique offers a novel biomarker to study the effectiveness and mechanism of action of new treatments for allergic eye disease. Chien Jien-Wen In vivo confocal microscopy image of dentritic cells. (See figure 4 of M. Liu et al., pp. 362–370). Allergic bronchopulmonary mycoses (ABPM): more than just Aspergillus fumigatus There is increasing interest in the role of fungal allergy in asthma, particularly in its more severe manifestations (1). Most attention has been focused on A. fumigatus as the causative organism although in a recent study 27 species of thermotolerant fungi were cultured from the sputum of people with asthma (2). Many people with severe asthma present with features suggestive of ABPM, but there is no evidence of sensitization to fungi and sputum culture is negative. However, there are relatively few commercially available fungal allergens compared with the thousands of potentially allergenic fungi which we can use to test for fungal allergy. In addition many fungi, particularly basidiomycetes, are difficult to culture in vitro. One such basidiomycete that has been associated with ABPM, particularly in the far east, is Schizophyllum commune. Toyotome and colleagues (pp. 450-457) have advanced the field by characterizing the first allergen from this fungus, Sch c 1 which is a homologue of glucoamylase. This reagent can now be used to help investigate in detail the role of S. commune in asthma. Takahito Toyotome Aspergillus fumigatus (conidial head) stained with cotton blue. [Photo courtesy of Takahito Toyotome]. Occupational asthma: potential dangers of disinfectants in health care workers There is an increased incidence of asthma in healthcare workers. Healthcare workers are exposed to a number of known allergens and irritants such as latex, aldehydes and cleaning products including chlorine-based cleaners (bleach) and quaternary ammonium compounds (QACs). Exposure to the latter has been associated with anaphylaxis to general anaesthetics. Gonzales and colleagues (pp. 393-406) undertook a survey of healthcare workers to determine whether QACs could be responsible for asthma in healthcare workers. They found a 7.5-fold increase in the incidence of asthma and a 3.2-fold increase in the incidence of rhinitis in healthcare workers exposed to QACs with the highest risk associated with dilution of disinfectants. No link was found to other potential agents, and the risk was not associated with increased IgE to QACs. This important study emphasizes the importance of identifying healthcare workers at risk of occupational asthma and rhinitis due to QACs and the development of processes to minimize exposure. Maria Gonzalez A disinfectant containing QAC's. (Photo credit: © Tokumeigakarinoaoshima; Wikimedia Commons). References 1Agarwal R, Chakrabarti A, Shah A et al. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy 2013; 43: 850– 73. 2Agbetile J, Fairs A, Desai D et al. Isolation of filamentous fungi from sputum in asthma is associated with reduced post-bronchodilator FEV1. Clin Exp Allergy 2012; 42: 782– 91. Caption to cover illustration: Vernal conjunctivitis (Photo credit: Wikimedia Commons). This logo highlights the Editor's Choice articles on the cover and the first page of each of the articles. Volume44, Issue3March 2014Pages 301-301 ReferencesRelatedInformation