Not afraid of allergy 不再恐懼過敏

 文/ 楊樹文

兩天的研討會結束了，我有很大的收獲。包括最新的臨床醫學、辦活動的經驗、學術論文、友誼交流。

這是我第一次當大會的總幹事，在這裡我要感謝蔡易晉主任，大會會長的厚愛及寬容，給我機會參與。

我也要感謝葉國偉理事長的支持、美卿姐的大力協助。

讓我們先看看兒免醫師大合照。

 Prof Gary Wong (目前是 NEJM 的副主編)

Dr Gary WK Wong, Professor, has been working in the Department of Paediatrics at the Chinese University of Hong Kong for over 20 years. He obtained his undergraduate medical education from the University of Alberta, Canada. He subsequently received fellowship training at University of British Columbia, and Children’s Hospital of British Columbia, Canada. He returned to Hong Kong and joined the Chinese University of Hong Kong in 1990. He subsequently went to the Children’s Hospital at Munich as a research fellow in 2001. Dr Wong has strong interest in different aspects of allergic and autoimmune diseases. In particular, he is interested in the epidemiology and environmental determinants of asthma and related allergic disorders. He is currently an executive member of the Global Initiative for Asthma and he is one of the steering committee members of the ISAAC (International Study of Asthma and Allergies in Childhood) research group. He is also one of the executive members of the Asia-Pacific Association of Pediatric Allergy, Respirology and Immunology (APAPARI). Among other duties within several editorial boards, he is also the Associate Editor for Australasia of Pediatric Pulmonology. Dr Wong also participates actively in the Paediatric and medical communities in Hong Kong. He is the current Council member of the Hong Kong Society of Respirology (HKSPR). He is also the Chairman of the Asthma Focus Group of the HKSPR.

Prof Wong 不藏私，把論文投稿的武功秘極傳授給大家。並鼓勵大家好好想研究的題材。學術論文，就是要解決目前沒有辦法、尚未清楚的病因及藥物原理。

江東和主任 Umbilical Cord blood transplantation: application in primary immunodeficiency disease

 江主任已治療好多位病童，也給兒免醫師所診斷的罕見疾病帶來盼望 !

 李文益教授 

Immune Defects in Active mycobacterial diseases- from a viewpoint of pediatricians caring patients with primary 

immunodeficiency diseases

TRECs 

黃璟隆理事長comment

黃理事長跟Prof Gary Wong 是好朋友。常常交換醫學上的知識，也積極帶新手主治醫師進入研究。

勞苦功高的大會會長蔡易晉主任及美卿姐。

 謝奇璋教授 Primary immunodeficiencies in the post-genomic age

Identify PID-causing gene mutations using NGS Approach for patients with severe combined immunodeficiency (SCID)

 Prof Gary Wong, Chief Tsai and Dr Yong SB

 Prof Lin talk: treatment of lupus nephritis update 

Take home messages:

1.MMF has taken the role of cyclophosphamide and azathioprine
2.Rituximab is effective but not proven in RCT
3.Belimumab is registered for the use in lupus (not tested in lupus nephritis)

邱益煊部長分享 (Seborrheic dermatitis) 脂漏性皮膚炎治療。

張詠森醫師論文口頭報告

Atopic dermatitis, Melatonin, and Sleep disturbance

異位型皮膚炎的病童，其睡眠品質差，以SCORAD 指數去評估日常生活症狀。

Melatonin 退黑激素 與血中的IgE的濃度 對於睡眠干擾的重要因子。

黃璟隆理事長教學， 主題是青少年特異性關節炎

目前有很好的藥物治療，包括口服、針劑的生物治劑。

病人需規律在眼科追蹤 Uveitis. 

Tocilizumab in active polyarthritic JIA
safety: 
Incidence of adverse events in all patients (n=179) 39.1%, serious adverse events 7.3%

adverse events: infection

Efficiency:
Physician's global assessment: marked effective 51.3%,
effective after 28 weeks treatment: 44.9%

理事長葉國偉醫師與會員交流。

楊崑德教授 Herd immunity 

族群免疫與免疫治療發展

3 types of Herd immunity 

1. Herd immunity of Natural infections: enterovirus, dengue 

2. Herd immunity from prophylactic vaccine: MMR, Pertusis, JE

3. Herd immunity revived by immunotherapy: BMT, Anti-PD1, CAR

歐良修主任 : 益生菌在過敏疾病的優缺點

WAO guideline suggest: 

1. using probiotics in pregnant women at high risk for having an allergic child

2. using probiotics in women who breastfeed infants at high risk of developing allergy

3. using probiotics in infants at high risk of developing allergy

Prof. Patrick Sai-Cheong Leung: Immunotherapy of Shellfish allergy

對海鮮過敏的病患，藉由  免疫治療(allergen specific immuotherapy)，發現 tropomyosin 是關鍵。

Three approaches: 1. hypoallergens 2. T cell epitope peptides 3. Mimotopes of shrimp tropomyosin

Prof. Eric Gershwin : The hygiene Hypothesis: Is Dirt Good for you?

Evolution, changes in flora, particular epidemiology of immune disorders

江伯倫教授勉勵大家，繼續進行兒童免疫學的研究。

  Happy Ending !