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Respiratory Infections in Allergy and Asthma: Lung Biology in Health and Disease; Volume 178

Posted on: Tuesday, 23 August 2005, 03:00 CDT

Respiratory Infections in Allergy and Asthma: Lung Biology in Health and Disease; Volume 178 By Sebastian L. Johnston and Nikolaos G. Papadopoulos, eds. New York, NY; Marcel Dekker, 2003; 756 pp; $225

How unfair! Only one health, and so many diseases

Victor Schlichter

Since eternity, infections have plagued mankind and caused untold human suffering. Even today, respiratory viral infections are the most common cause of seeking relief from the physician. Another disease known to occur since antiquity is asthma, and, much to everyone's consternation, morbidity due to this intriguing illness has rapidly increased over the last few decades. Not too long ago. it would appear strange if these two entities were spoken about in the same breath. However, recent insights have indicated that an amalgam of these two conditions exists and that this nexus could possibly be emerging as a major cause for concern.

The editor of the Lung Biology in Health and Disease series must be complimented for persuading Drs. Sebastian L. Johnston and Nikolaos G. Papadopoulos to edit this state-of-the-art monograph, Respiratory Infections and Allergy and Asthma, a field that is very complex, in which information is rapidly evolving. This volume is divided into eight parts and comprises 29 chapters. The introductory chapter must be singled out for a succinct and lucid overview of asthma, especially in terms of immunology, the role of the airway epithelium, and airway remodeling. This chapter sets the pace for the rest of the book.

Part two on "Epidemiology" has four chapters that acquaint the reader with recent advances in understanding of the interaction between viral infections and asthma. The paradox of viruses being protective as well as a trigger for asthma has been debated and is well-covered here. The five chapters on immunopathology explore at length the mechanisms of the disease process induced by viruses, and outside of this volume it would not be easy to find such in-depth knowledge on this subject assimilated in one place. The section on "Models of Viral Infections and Virus-Induced Asthma" would be extremely useful to anyone who is working in this area. The chapter on "Human Experimental Models of Virus Infection and Asthma" highlights the importance of such a tool to study the role of viruses in asthma and other atopic disorders. The experimental protocol and relevant safety concerns are elegantly summarized here.

The next two parts of the book discuss clinical aspects and the role of virus infections in asthma. The chapter on "Virus-Induced Wheeze in Young Children: A Separate Disease?" details the evidence that this disorder is distinct from atopic asthma of childhood. The complex interrelationship between the common cold and asthma exacerbations, and the effect of a virus on other allergic manifestations including rhinitis, conjunctivitis, sinusitis, and otitis media are exhaustively analysed. The epidemiology of wheezing that is associated with upper respiratory tract infections in children, as well as the role of respiratory syncytial viruses in the development of asthma are splendidly elucidated.

Over the last decade, the effect of Chlamydia and Mycoplasma on asthma has generated immense interest, and consequently the association between atypical infections and asthma severity is presented here in four chapters. The concluding section (on treatment) commences with a chapter on the antiinflammatory actions of macrolides in asthma, and also covers treatment prospects for the common cold and management strategies for virus-induced asthma exacerbations.

This brilliant monograph is adroitly structured and extensively referenced, and is backed by many "reader-friendly" figures and tables. Although there appears to be a degree of overlap between some chapters, this may be unavoidable in a volume wherein a broad, international spectrum of researchers put to paper their extensive learning on a subject that is still to be completely illuminated. All told, Respiratory Infections in Allergy and Asthma is a "must- read" text for all those working to alleviate the suffering of fellow human beings afflicted by asthma.

Ashok Shah. MD

Delhi, India

Copyright American College of Chest Physicians Aug 2005

Source: Chest

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