Clinical & Experimental AllergyVolume 44, Issue 10 p. 1205-1205 Editor's ChoiceFree Access The Editor takes a closer look at some of this month's articles First published: 22 September 2014 https://doi.org/10.1111/cea.12396AboutSectionsPDF 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 Adherence: the key to success in treatment of chronic airway disease The main cause for treatment failure in asthma and rhinitis is suboptimal adherence to inhaled corticosteroids 1. The need to take these medications regularly to obtain maximum effect even when asymptomatic is a particular problem for seasonal allergic rhinitis (hay fever) where symptoms are often episodic. The reasons for suboptimal adherence are complex, but the key to successful management is good education both in the rationale for treatment and inhaler technique. Telemedicine has found its way into most corners of health care, but there is relatively little published on its potential role in allergic disease. Therefore, Pizzulli and colleagues (pp. 1246–1254) have undertaken an original study looking at the value of telemonitoring on adherence to topical corticosteroids in children with severe hay fever. They demonstrated an improvement in both adherence and disease knowledge, and the informatics platform was positively received by the study participants. No improvement was seen in disease control, but pollen counts were low during the study period, and the study may also have been relatively underpowered for treatment efficacy endpoints. Antonio Pizzulli Estimated frequency (normal approximation) of daily consumption of mometasone in 63 children with hay fever, by allocation to AllergyMonitor or to usual care. [see figure 3 in A. Pizzulli et al. (pp. 1246–1254)]. Asthma and viral exacerbations: basophils get in on the act It is well established that upper respiratory tract viral infections particularly with rhinovirus are associated with the majority of exacerbations of asthma. The mechanisms involved have been studied in detail although the precise pathways involved remain elusive. Basophils have been relatively ignored as a player in the rhinovirus–asthma axis. However, the role of basophils may need to be reconsidered following the paper by Agrawal et al. (pp. 1266–1273), in which they have made the original observation that basophils become activated after rhinovirus infection with the maximal effect seen as late as 3 weeks after infection. A deterioration in asthma control is often prolonged after rhinovirus infection including an increase in airways hyperresponsiveness that can last for several weeks. It is intriguing to think that basophils, often the bridesmaid to mast cells, may be responsible. Rachana Agrawal Basophile Granulocyte. [Photo credit: User CS99 at German Wikipedia; Wikimedia Commons]. Patterns of inflammation in asthma: does it depend on your age? Asthma can start at any age, and there is an increasing interest in whether asthma that develops in older people is in any way different to asthma that develops in childhood or early adulthood. Evidence that this might be the case comes from a paper by Brandenberger and colleagues (pp. 1282–1292), who investigated the nature of the inflammatory response to house dust mite challenge in young and old mice. Interestingly, they found that whereas there was more airway hyperresponsiveness in young mice, there was a greater inflammatory response in the older mice which included a Th17-neutrophilic component. One might speculate that this may be due to the development of a different microbiota in the airways of the older mice. As steroid responsiveness is closely linked to Th2 responses in asthma, this raises the possibility that older asthmatics may be more resistant to inhaled corticosteroids. This observation now needs to be translated into clinical asthma. Christina Brandenberger Representative light photomicrographs of lung tissue sections stained with haematoxylin and eosin, showing a peribronchiolar and perivascular mixed inflammatory cell infiltration in HDM mice (arrows). b: bronchiolar airspace, a: alveoli, v: blood vessel, scale bar: 50 lm. [see figure 1b in Brandenberger et al. (pp. 1282–1292)]. Reference 1Bourdin A, Halimi L, Vachier I et al. Adherence in severe asthma. Clin Exp Allergy 2012; 42: 1566– 74. Caption to cover illustration: Patient taking a mannitol bronchial challenge test for diagnosing asthma (Image courtesy of Dr Brian Lipworth, Scottish Centre for Respiratory Research, Univ of Dundee Ninewells Hospital and Medical School). This logo highlights the Editor's Choice articles on the cover and the first page of each of the articles. Volume44, Issue10October 2014Pages 1205-1205 ReferencesRelatedInformation
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