Anaphylaxis

Book review Anaphylaxis By Novartis Foundation. John Wiley and Sons, Ltd, New York, February 2004, 196 pages, hard cover, $135.00. This wonderful, little volume (196 pages in a compact 6 ⫻ 9-in frame, which travels nicely) is the progeny of a Novartis Foundation symposium held in London, England, in February 2003. The Novartis Foundation is an “international scientific and educational charity” previously known as the CIBA Foundation. It was established in 1947 by the CIBA Company, which later merged with Sandoz to form Novartis. The foundation operates independently in both the “study and general knowledge of science, and in particular encourages international cooperation in scientific research.” Certainly, this nicely done book on anaphylaxis reflects the high quality of the efforts of the Novartis Foundation. The attendees of the symposium read like a “who’s who” in the field of anaphylaxis and anaphylactoid reactions. In fact, one of the delights of reading this work is the fact that we are privy after each chapter, which originally was given as a presentation to the group, to the free-flowing discussion regarding the topic in question. These discussions themselves are worth the price of the text. The topics range from basic issues such as “The High Affinity Receptor for IgE, Fc ␥ RI” presented by Henry Metzger, to a clinically relevant discussion of “Epinephrine (Adrenaline) in the First-aid Out-ofHospital Treatment of Anaphylaxis” given by Estelle Simons, to a delightful “History and Classification of Anaphylaxis” authored by Johannes Ring, Knut Bracow, and Heidrun Behrendt. The editors at Novartis have ensured that all of these chapters, including the free-flowing discussions following each, are crisply tailored, intelligible, and reasonably succinct. The breadth and scope of the topics will give almost anyone in the field of allergy something to enjoy. Including those mentioned above, there are chapters on “Rethinking ThII Antibody Responses and Allergic Sensitization,” “Fatal Anaphylaxis in the UK,” anaphylaxis of various causes such as those due to insect venom, anesthetics, and radiocontrast, and “The Human Heart as a Shock Organ in Anaphylaxis.” Thus, the breadth and scope of this disorder are adequately covered. The volume therefore has something of interest to

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the clinician, would serve as a welcome addition to the library of any clinical allergist, and is certainly a “must” for those of us who have a special interest in anaphylaxis. As noted, the excellent editorial work of the Novartis personnel has made this text relatively easy to read throughout, and all chapters are well done. Thus, it is difficult to select any particular chapter as the highlight of the text (because they are all so good). Nonetheless, there were some that, by virtue of my personal interest, I found especially enjoyable. My particular choices in this regard were based not only on the chapter itself but also on the discussions following each chapter. As noted, each chapter was originally given as an oral presentation, then discussed by the group as a whole. I found these discussions fascinating, especially those following the chapters on “Rethinking ThII Antibody Responses and Allergic Sensitization,” “Cytokine Enhancement of Anaphylaxis,” and “New Approaches for the Treatment of Anaphylaxis.” Perhaps I am a little biased because of my interest in the topic, but I found no particular weakness in this text. The reader must understand, however, that this is not a textbook in the classic sense of the word, and therefore the chapters are not collated with a common thread in mind. They are somewhat disparate in their topics, and perhaps one might find it difficult to see how some of the discussion, and the presentations themselves, apply directly to the field of anaphylaxis. Nonetheless, they are all worth reading. But, make no mistake, some of these are not for sissies. The concepts discussed often require a sound knowledge of basic science and sometimes a somewhat specialized understanding of the area pertinent to the field of the author. Sometimes the reading requires particularly intense concentration in this regard. Nonetheless, it is worth the effort, especially for anyone with a given interest in anaphylaxis. In summary, it is truly a gift to our field to have convened the cerebral efforts of this “blue ribbon group” for such a concerted effort that has been edited and collated so well. The Novartis Foundation deserves a round of applause and those who attended our thanks for their contributions. PHIL LIEBERMAN, MD University of Tennessee College of Medicine Germantown, Tennessee

ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY