hen Dr. Bruce S.Bochner was beingconsidered in 2002

to head the Johns HopkinsDivision of Allergy & ClinicalImmunology, other centersaround the country were try-ing to recruit him. But, Dr.Bochner says, when Hopkinsmade the offer, it really wasa no-brainer: “This being thelargest, most successful and,humbly put, best allergygroup in the country, whenthe opportunity came along, I took it.” We caught up withthis clinician scientist to hearhis thoughts about the futureof the division.

First, what do you see as the division’s strengths?We’re an internationally rec-ognized program, one of thefew in the country with anNational Institutes of Health(NIH) grant for training aca-demic allergists. One of ourgreatest strengths is having 30faculty who see patients, teachand/or do research, collabo-

rating to study all aspects ofallergic diseases. While ourexpertise is diverse, we needto recruit new young faculty,but it’s not like building fromscratch. It may be a whilebefore the division has myinfluence and flavor. But I’drather take over as command-er of the best ship in the fleetthan build the next big ship inthe fleet.

New clinical challenges? I take great pride in the quali-ty of care provided by our fac-ulty, fellows, and staff. In auniversity setting, we can takethe time to practice medicinethe right way, without worry-ing about the profit motive.

However, one goal is to pro-vide more efficient clinicalcare. At certain times of theyear, patients have to wait toolong to get an appointment.Because complicated patientsare often referred to us, clinicsdo not always run on time,and patients may wait toolong before being seen.Finally, I would like to expandsome of our more uniqueservices, like testing for food,drug, and latex allergies andchallenging and desensitizingfor drugs such as aspirin.

Your research goals? Because there are no perfectanimal models for asthma andallergic diseases, it’s really crit-ical to move new therapiesinto humans as efficiently aspossible. Our group is reallygood at developing researchideas in the laboratory thatcan be safely tried in humans.

The battle against asthma? We have good medicines tocontrol asthma, but not acure. We’re involved in devel-oping and testing new thera-pies because they may providenew treatments for thosewith asthma, including oursickest patients.

Any new technologies? We’re using gene chips, whichallow you to measure thepresence of thousands ofgenes from cells or a tissuesample. For example, we cannow compare normal andasthmatic lung specimens,and determine what genes areover- and under-expressed.

Then what? Then the job is to figure outwhich of those genes actual-ly cause or perpetuate thedisease. The approach yieldsbroad, unbiased snapshotsof what’s going on. This maysuggest new and unanticipa-ted targets for future thera-peutic research.

There’s still plenty of that? Yes, the good news is that theNIH has doubled its budget.We used to have a 10 to 15percent chance of getting agrant funded, which was adeterrent for the junior per-son considering an academiccareer. Now there’s a 20 to 25percent chance of funding.

The take-home message? Bigger salaries can be found inprivate practice and in the pharmaceutical industry.We chose academic medicinebecause it allows us to helpmany patients, as well as toengage in the intellectual challenges of teaching anddoing research. We all enjoyinteracting with colleaguesand presenting our work atmeetings around the world. In academics, we can reallymake a difference.

AllergicReactions

A semiannual publication ofJ O H N S H O P K I N S M E D I C I N EDivision of Allergy & Clinical Immunology

Volume 1, Number 1Spring/Summer 2004

W

An Interview With the New Allergy Division Director

Inside this issue

Stop and Smell the Roses 2

Allergen Season Calendar 3

Medication Update 4

New Website Launched 4

Our Mission 5

Our Clinical Practice 5

“In academics, we canreally make a difference.”

Go Ahead: Stop and Smell the Roses

What are rosefever and hayfever?

“Rosefever” is really afolk name for allergicsymptoms that occur during the peak seasonfor grass pollen allergies—in late spring to earlysummer, when roses arein bloom. “Hayfever” isa common name for symp-toms that occur during thepeak season for ragweedpollen allergies—in latesummer to early fall,when hay is harvested.Neither is associated witha fever.

Why does smelling arose sometimes make me sneeze, even if I am not allergic to it?

Some people with allergiescan be particularly sensitive to strong scents—especially during theirallergy seasons, when theyare already experiencingsymptoms. This sensitivityis not a true allergicresponse, but more like anirritation. Other exam-ples of such irritantsinclude cigarette smokeand strong perfumes.

Rarely, florists, profes-sional rose growers andavid rose gardening hob-byists may develop trueallergic responses to rosepollens while handling theroses, since they mayshake the heavy pollengrains directly into con-tact with the nose or eyes.

ye-catching, heaven-

scented blooms

should be enjoyed,

not avoided—even by most

allergy sufferers. If you

have kept a wary distance

for years, you may have

trouble approaching that

red, red rose. But this kind

of red is not an alert to

danger, because ornamental

plants generally do not pro-

duce aeroallergens.

Aeroallergens are tiny,

airborne particles that

can trigger allergic

reactions when they

come in contact with

a membrane lining the

nose or throat or covering

the eye. While sneezing,

coughing, and red-rimmed

eyes can be caused by pol-

lutants, irritants, and infec-

tions, true allergic symp-

toms only can be caused by

an aeroallergen if a person

is allergic to it, if enough

particles are present to pro-

duce an allergic reaction in

that person, and if the par-

ticles are small enough to

interact with the human

immune system. When an

Eaeroallergen floats onto a

membrane, it initiates a

microscopic chain reaction,

which results in the release

of substances like histamine

and leukotrienes with the

consequent allergic symp-

toms. Allergic symptoms

may include sneezing

and/or a runny, clogged

nose, coughing, post-nasal

drip, itchy eyes, nose and

throat, and watery, red-

rimmed, swollen eyes.

Showy, fragrant flower-

ing plants typically do not

produce allergic reactions,

because their pollens are

not airborne, are small in

number, and are large in

size. Their big, sticky,

heavy pollen grains are car-

ried by insects like butter-

Q & A

flies and bees, instead of by

the wind. In contrast,

plainer-looking plants like

trees, grasses, and weeds, as

well as some molds, pro-

duce microscopically small,

lightweight pollens or

spores in great number,

that are easily carried by

the wind.

One major exception is

ragweed. This weed agres-

sively invades the land-

scape, filling large fields,

and is showy in its produc-

tion of enormous clus-

ters of tiny pollen

grains. A single

plant can produce a million

pollen grains, and it takes

as few as ten grains to pro-

duce symptoms in allergic

individuals. The yellow of

ragweed is a warning signal

to ragweed allergy sufferers

that they should be taking

allergy medication. Because

ragweed’s pollen grains are

numerous and windborne,

victims will suffer allergic

symptoms whether they

are blocks away from a

ragweed plant or up close

and personal.

For more information about allergy medications, talk to your doctor or visit us at www.hopkins-allergy.org.

2

TREE POLLENS

Juniper

Willow

Elm

Maple

Birch

Alder

Poplar

Beech

Sycamore

Ash

Oak

Hickory

Walnut

GRASS POLLENS

Timothy

Orchard

Bermuda

WEED POLLENS

Sorrel

Plantain

Lambsquarters

Pigweed

Sage

Ragweed

MOLD SPORES

Aspergillus

Penicillium

Alternaria

Fusarium

Cladosporium

Helminthosporium

Botrytis

DUST PART ICLES

Dust mites

Roaches

ANIMALS

Cats

Dogs

JAN FEB MAR APR JUN JUL AUG SEP OCT NOV DECMAY

ALLERGENS

Season Peak of season

Allergy Season Calendar*

* F o r t h e m i d - A t l a n t i c r e g i o n

Courtesy of J O H N S H O P K I N S M E D I C I N EDivision of Allergy & Clinical Immunology

Clinical Care Unit: (410) 550-2300

3

RXolair Offers Relief Xolair (Omalizumab) has

been approved by the U.S.

FDA (Food and Drug

Administration) for treat-

ment of patients with mod-

erate to severe persistent

asthma. It is recognized

that a significant number

of asthmatic patients have

an allergic basis to their

disease because they pro-

duce too much of a certain

protein in the body, called

IgE antibody. Xolair binds

to this allergic antibody in

the blood stream and hence

neutralizes (blocks) its

actions.

Xolair is indicated for

adults and adolescents (≥12

years age) who have moder-

ate to severe asthma that is

Asthma Medication Update

not currently controlled

with inhaled corticoster-

oids, and are sensitive

(allergic) to year-round,

aeroallergens (for example:

dust mites, household pets,

cockroaches, and certain

molds).

Xolair has been shown

to decrease the number of

asthma attacks in patients

with moderate to severe

asthma, and in some

patients it allows a reduc-

tion, and perhaps complete

elimination, of other asth-

ma medications.

For more information,

go to our website at

www.hopkins-allergy.org.

No More CFC Propellants In 1987, the United States

signed an international

treaty, the Montreal

Protocol, agreeing to stop

using chlorofluorocarbons

(CFCs) as refrigerants and

aerosol propellents. CFCs

are the chemical propellants

that have been used in

metered-dose inhalers,

devices that effectively

deliver medicine to the

lungs of people who suffer

from asthma and other lung

diseases like emphysema.

Pharmaceutical companies

have developed metered-

dosed inhalers based on

other propellants as well as

dry powder inhalers, but it

will be a few years before

CFCs will be completely

phased out.

Visit us on the WebNow you can check out our

division’s new website at

www.hopkins-allergy.org to

access more information

about patient care services,

our faculty, or allergic and

immunologic diseases and

their treatments. You also

will find campus maps,

contact information, and

links to other helpful sites

at the Johns Hopkins

Medical Institutions.

w w w .

4

Support Our MissionFinancial support from concerned individuals isessential for high quality patient care and sponsorshipof innovative medical research. If you are interestedin supporting the work of the Johns HopkinsDivision of Allergy & Clinical Immunology, contact:

Bruce S. Bochner, M.D.Director, Division of Allergy & Clinical ImmunologyJohns Hopkins Asthma & Allergy Center5501 Hopkins Bayview Circle, Room 2B.71 Baltimore, MD 21224(410) 550 - 2101

5

Our M issionJ O H N S H O P K I N S M E D I C I N EDivision of Allergy & Clinical Immunology

Director: Bruce S. Bochner, MDClinical Director: Peter S. Creticos, MD

The mission of the Division of Allergy & Clinical Immunology at Johns Hopkins is to promote the treatment and understanding of allergic and immunologic diseases,including asthma, in order to provide optimal patient health by

• providing compassionate, state-of-the-art diagnostic and therapeutic care of adultswith allergic and immunologic diseases

• fostering basic, clinical, and translational allergy and immunology research• training physicians and scientists for academic careers in allergy and immunology

Our C linicalPracticeFaculty:

N. Franklin Adkinson, Jr., MDBruce S. Bochner, MDPeter S. Creticos, MDPhilip S. Norman, MD

Sarbjit Saini, MDAlvin Sanico, MD

Glenn M. Silber, MDAlkis Togias, MD

All of our faculty have expertise in the diagnosis and treatment of asthma, allergicrhinitis, sinusitis, anaphylaxis, urticaria, angioedema, adverse reactions to foods,drugs, latex, and insect stings, and non-AIDS-related deficiencies of the immune system. Some faculty have additional interests and expertise in specialized areas.Evaluations include: allergen skin testing, methacholine challenge, spirometry, andfood and drug challenges. The Dermatology, Allergy and Clinical Immunology(DACI) Reference Laboratory is a full service laboratory that provides specializeddiagnostic measurements to allergists, dermatologists, and clinical immunologists.

Contact us at (410) 550 - 2300 for appointments and referrals.