JACI: In Practice November 2021 Issue Highlights Podcast
In this month’s podcast, JACI: In Practice Associate Editor David Khan gives a summary of our November 2021 issue on the theme of Common Comorbidities Encountered by Allergists in Practice, including a description of the Theme Reviews and other Feature Articles and a presentation of the Highlights of the Original Articles in the issue.
Read the issue: https://www.jaci-inpractice.org/issue/S2213-2198(21)X0011-6
This issue’s theme is Common Comorbidities Encountered by Allergists in Practice, and the cover portrays some of the multiple comorbidities that may occur in the “shadow” of patients with asthma, allergic rhinitis, food allergy, and atopic dermatitis. Comorbidities can be defined in different ways but are often considered coexisting diseases that can influence another disease or in some cases be considered in the differential diagnosis. Inducible laryngeal obstruction (ILO) (a.k.a. vocal cord dysfunction) is an example of a disease that can co-exist with asthma but does not directly affect asthma itself. However, ILO needs to be identified as its symptoms mimic asthma but require different therapy. Thus, it is important for the clinician to not only focus on what is in the “light” and may be obvious, but also delve into the “shadows” and identify comorbidities that may be directly influencing the atopic disease or, in the case of asthma, need to be considered in the differential diagnosis.
This theme issue has 5 separate reviews on comorbidities. The first review by Drs Diaz-Cabrera, Sánchez-Borges, and Ledford (https://www.jaci-inpractice.org/article/S2213-2198(21)00978-8/fulltext) focuses on the comorbid diseases of atopy, including asthma, allergic rhinitis, food allergy, and atopic dermatitis. The review explores pathogenic links among these disorders, including the role of barrier dysfunction and genetic predisposition. The untimely death of one of the authors, Mario Sánchez-Borges, makes this article all the more special as a remembrance of our beloved colleague. The second review by Drs Gibson, McDonald, Granchelli, and Olin (https://www.jaci-inpractice.org/article/S2213-2198(21)00974-0/fulltext) explores pulmonary comorbidities that impact asthma, namely chronic obstructive pulmonary disease (COPD), ILO, dysfunctional breathing, and bronchiectasis. How these diseases can be misdiagnosed as asthma, be confused with the symptom burden of asthma, and modify asthma treatment is discussed in a very clear fashion. This is a must-read for all who manage adults with asthma. The third review by Drs Drs Althoff, Ghincea, Wood, Holguin, and Sharma (https://www.jaci-inpractice.org/article/S2213-2198(21)00979-X/fulltext) discusses the relationship between the very common comorbidities of obesity, obstructive sleep apnea, and gastroesophageal reflux (GERD) and their interrelationships with asthma. Each comorbidity is carefully reviewed in terms of an analysis of the literature, pathophysiology, the impact of treating the disorder on asthma outcomes, and knowledge gaps. The fourth review by Drs Cardet, Bulkhi, and Lockey (https://www.jaci-inpractice.org/article/S2213-2198(21)00973-9/fulltext) discusses numerous non-respiratory comorbidities in asthma. This is a very interesting review on a wide range of disorders, including, but not limited to, diabetes, hypertension, atherosclerotic cardiovascular disease, osteoporosis, and mental health disorders. Potential mechanisms and a review of clinical studies in humans are carefully discussed, and the reader will likely find this information very enlightening and thought provoking. The last review by Drs Petrov, Adatia, Jolles, Nair, Azar, and Walter (https://www.jaci-inpractice.org/article/S2213-2198(21)01057-6/fulltext) is a case-based discussion of various pulmonary disorders that may mimic asthma as well as pulmonary diseases associated with antibody deficiency and serves as a reminder to clinicians to always have a high index of suspicion in immunodeficiency patients and asthma patients not responding well to conventional therapy.
We are indebted to Editorial Board members Richard Lockey and Anne Fulbrigge for coordinating this very unique theme issue and for contributing a well-crafted Theme Editorial (https://www.jaci-inpractice.org/article/S2213-2198(21)00986-7/fulltext) that adds context to all of these theme concepts. In addition to all of the above, this issue contains 3 Original Articles covering the diverse topic of comorbidities. The editors are confident that this theme issue will bring comorbidities “out of the shadows” and make our readers more adept at identifying and managing them to improve outcomes in patients with the common atopic diseases we manage on a daily basis.
Image credit: Special thanks to AJScience Partners, LLC for rendering the cover artwork.
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