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A colour atlas of allergy
134
Reviews of recent pubhcatlons--Fd Chem. Toxic. Vol 28, No. 2
because the cell line apparently consists of multipotent broncho-alveolar stem cells and can be manipulated to differentiate or transform into different respiratory-tract epithelial cells by the application of different culture conditions Elsewhere, valuable insights into potential mechanisms of toxicity are given on the alleviating effect of radical scavengers on damage to alveolar macrophages by ozone and nitrogen dioxide (Alink and Rietjens, Wageningen, The Netherlands). As always at such meetings, the in vitro assays predominated over animal experiments (23 presentations compared with five on animal models), doubtless because in w t r o systems have the advantage of short testing procedures and low costs. Nevertheless, in the animal section, an extensive study on a doslmetric model of lung deposition and retention of inhaled cadmium in the rat makes a most interesting contribution to the book. This method, according to the author, has the advantage of being adaptable to both different particle sizes and human activity conditions. The main topics covered in the second half of the book are biological momtorlng epidemlology and environmental control and legislation. There is a cumbersome study on the excretion of formic acid in the urine of the population around Aachen, in West Germany, where confounding factors are multipllcative, and another demonstrating the asbestos fibre content in the lung was higher in an exposed group than in the reference group! A more straightforward study in Italy confirms the association between styrene exposure in the production of reinforced polyester resins and increased chromosome aberrations in peripheral lymphocytes In general, however, this section is not of the same standard as the more stimulating communications from the experimental scientists working in the field of environmental research. [Klara MIIIer--BIBRA] A Colour Atlas of Allergy. By W. F. Jackson and R. Cerlo. Wolfe Medical Pubhcatlons Ltd. London, 1988. pp, 126. £30.00 ISBN 0-7234-0914-5. This book is one in a series of titles of medical atlases specializing in the systematic collection and publication of high-quahty diagnostic photographs. I emphasize that this is a medical atlas and most certainly not a coffee-table book on allergy--the vast majority of the photographs are not suitable for a general audience and cover in gruesome and graphic detail the more unpleasant aspects of allergic reactions Although this book is primarily directed at clinicians, it does usefully demonstrate the wide range of conditions that may ensue following an interaction between an allergen and the immune system. The book opens innocently enough by briefly outlining the basic mechanisms of the immune system and concludes with a concise classification of the various allergic reactions under the classic Coombs and Gell format (types 1-4), everything is nicely tabulated and easy to follow. Chapter 2 outlines the various approaches available for allergy diagnosis and emphasizes the value of patient questionnaires
and history-taking, and the practical aspects of prick- and patch-test procedures for detecting and differentiating between immediate and delayed-type reactions. In Chapter 3 the pace quickens; here the first of the allergic skin disorders are introduced in excellent small summary tables, which classify the various eczemas as endogenous, exogenous, metabohc and deficiency syndromes, and so-called "unclassified". There are appropriate subdivisions within each section and again excellent and concise tables, which in turn direct the reader to the photographic examples. This chapter in particular cites examples of contact dermatitis caused both occupationally and within the home, and may well be of interest to health officers in industry who are concerned with the treatment and prevention of dermatitis eczematous reactions in their workforce. Chapter 4 takes us from the 'PG' certificate to the real 'X-rated' photographs dealing with "adverse" (an understatement if ever there was one!) drug reactions. Within this context, the drug or its metabolites are viewed as foreign targets by the immune system, but unfortunately in many instances the drug is bound to, or intimately associated with, host tissue and the reaction produced can be catastrophic. In its milder forms the response is merely an unsightly skin rash. However, more severe forms may manifest themselves as toxic epidermal necrolysis, better known as the scalded-skin syndrome. Allergic drug reactions represent a major headache in drug development programmes. Problems arise owing to individual susceptibilities and the wide spectrum of reactions that can be produced. Skin rashes are the most common manifestations but other organ systems may also be affected, the most serious immediate consequences being the problem associated with anglo-oedema and, of course, anaphylaxis. Other drugs, however, may lead to the development of more chronic illness, namely the drug induced/ drug dependent autolmmune-type disorders. The predictability of drug-associated allergy unfortunately seems to have lagged behind drug development--the art of diagnosis remains retrospective and depends on chnlcal observation, good sense and possibly a little detective work. The remaining chapters cover more specialized areas of allergy Including reactions within the eyes, ears and nose (the problems and life history of nasal polyps are discussed in most graphic detail in Chapters 5 and 6, respectively), allergic conditions within the lungs and gastro-intestlnal tract, autolmmune disease and lmmunodeficlency states including AIDS (Chapters 7-10). Again, each chapter is very visual and beautifully presented. The book is clearly a valuable adjunct to clinical practice and a necessary medical-school text. It emphasizes the problems of allergy and undoubtably confirms the severity of some of the drug/chemical allergic reactions--as a consequence it may have a place in Industrial/occupational libraries. However, by and large the book is for the clinic/medical school--it is not a standard descriptive allergy text and is not recommended for general reading. [Steve Nicklin--BIBRA]
Reviews of recent pubhcatlons--Fd Chem. Toxic. Vol 28, No. 2
because the cell line apparently consists of multipotent broncho-alveolar stem cells and can be manipulated to differentiate or transform into different respiratory-tract epithelial cells by the application of different culture conditions Elsewhere, valuable insights into potential mechanisms of toxicity are given on the alleviating effect of radical scavengers on damage to alveolar macrophages by ozone and nitrogen dioxide (Alink and Rietjens, Wageningen, The Netherlands). As always at such meetings, the in vitro assays predominated over animal experiments (23 presentations compared with five on animal models), doubtless because in w t r o systems have the advantage of short testing procedures and low costs. Nevertheless, in the animal section, an extensive study on a doslmetric model of lung deposition and retention of inhaled cadmium in the rat makes a most interesting contribution to the book. This method, according to the author, has the advantage of being adaptable to both different particle sizes and human activity conditions. The main topics covered in the second half of the book are biological momtorlng epidemlology and environmental control and legislation. There is a cumbersome study on the excretion of formic acid in the urine of the population around Aachen, in West Germany, where confounding factors are multipllcative, and another demonstrating the asbestos fibre content in the lung was higher in an exposed group than in the reference group! A more straightforward study in Italy confirms the association between styrene exposure in the production of reinforced polyester resins and increased chromosome aberrations in peripheral lymphocytes In general, however, this section is not of the same standard as the more stimulating communications from the experimental scientists working in the field of environmental research. [Klara MIIIer--BIBRA] A Colour Atlas of Allergy. By W. F. Jackson and R. Cerlo. Wolfe Medical Pubhcatlons Ltd. London, 1988. pp, 126. £30.00 ISBN 0-7234-0914-5. This book is one in a series of titles of medical atlases specializing in the systematic collection and publication of high-quahty diagnostic photographs. I emphasize that this is a medical atlas and most certainly not a coffee-table book on allergy--the vast majority of the photographs are not suitable for a general audience and cover in gruesome and graphic detail the more unpleasant aspects of allergic reactions Although this book is primarily directed at clinicians, it does usefully demonstrate the wide range of conditions that may ensue following an interaction between an allergen and the immune system. The book opens innocently enough by briefly outlining the basic mechanisms of the immune system and concludes with a concise classification of the various allergic reactions under the classic Coombs and Gell format (types 1-4), everything is nicely tabulated and easy to follow. Chapter 2 outlines the various approaches available for allergy diagnosis and emphasizes the value of patient questionnaires
and history-taking, and the practical aspects of prick- and patch-test procedures for detecting and differentiating between immediate and delayed-type reactions. In Chapter 3 the pace quickens; here the first of the allergic skin disorders are introduced in excellent small summary tables, which classify the various eczemas as endogenous, exogenous, metabohc and deficiency syndromes, and so-called "unclassified". There are appropriate subdivisions within each section and again excellent and concise tables, which in turn direct the reader to the photographic examples. This chapter in particular cites examples of contact dermatitis caused both occupationally and within the home, and may well be of interest to health officers in industry who are concerned with the treatment and prevention of dermatitis eczematous reactions in their workforce. Chapter 4 takes us from the 'PG' certificate to the real 'X-rated' photographs dealing with "adverse" (an understatement if ever there was one!) drug reactions. Within this context, the drug or its metabolites are viewed as foreign targets by the immune system, but unfortunately in many instances the drug is bound to, or intimately associated with, host tissue and the reaction produced can be catastrophic. In its milder forms the response is merely an unsightly skin rash. However, more severe forms may manifest themselves as toxic epidermal necrolysis, better known as the scalded-skin syndrome. Allergic drug reactions represent a major headache in drug development programmes. Problems arise owing to individual susceptibilities and the wide spectrum of reactions that can be produced. Skin rashes are the most common manifestations but other organ systems may also be affected, the most serious immediate consequences being the problem associated with anglo-oedema and, of course, anaphylaxis. Other drugs, however, may lead to the development of more chronic illness, namely the drug induced/ drug dependent autolmmune-type disorders. The predictability of drug-associated allergy unfortunately seems to have lagged behind drug development--the art of diagnosis remains retrospective and depends on chnlcal observation, good sense and possibly a little detective work. The remaining chapters cover more specialized areas of allergy Including reactions within the eyes, ears and nose (the problems and life history of nasal polyps are discussed in most graphic detail in Chapters 5 and 6, respectively), allergic conditions within the lungs and gastro-intestlnal tract, autolmmune disease and lmmunodeficlency states including AIDS (Chapters 7-10). Again, each chapter is very visual and beautifully presented. The book is clearly a valuable adjunct to clinical practice and a necessary medical-school text. It emphasizes the problems of allergy and undoubtably confirms the severity of some of the drug/chemical allergic reactions--as a consequence it may have a place in Industrial/occupational libraries. However, by and large the book is for the clinic/medical school--it is not a standard descriptive allergy text and is not recommended for general reading. [Steve Nicklin--BIBRA]