Socrates and allergy medicine

Professor Alessandro Fiocchi discusses the launch of “Debates in Allergy Medicine”, a new article collection in the World Allergy Organization Journal

Sometimes it is impossible to recognize the logical thread new ideas follow. We unconsciously pull them from all sorts of our experiences. Given the fact that the idea came to me quite spontaneously while I was going for a walk in the streets of Rome on a calm summer night, I think this is what happened to me with the Debates in allergy medicine series.

Allergy in literature

Let’s take a step back. As a reader, author and editor of scholarly journals, I can see the level of communication increasing among the different regions of the world in epidemiology, clinical sciences, and research. This partly reflects the proliferation of medical journals in recent years. Looking at allergy journals alone, the number of those included in the Journal Citation Reports (JCR) increased from 15 in 2004 to 24 in 2014, and many others are not yet included in the JCR.

Like many colleagues in my field, I appreciate the wealth of scholarly resources available for research and the opportunities to publish my work, which is greatly enabled by Internet connectivity. At the same time, I wonder if we are in the process of losing culture for the sake of information. Sometimes one has the impression that there are more writers than readers. This may translate into a multiplication of areas of discussion, risking the creation of cultural enclaves where specialists discuss only among themselves and ignore the debates taking place in other areas of the scientific world.

Sometimes one has the impression that there are more writers than readers.

A place for interdisciplinary discussion

For example, the discipline of allergy shares borders with other disciplines such as dermatology, ENT medicine, gastroenterology, respiratory medicine, and pharmacology. It occurred to me that in the current publications panorama a forum for confrontation between specialists of different areas on issues of common interest is missing.

Our new article collection, Debates in allergy medicine is proposed to help fill this gap. In particular, the article series aims to offer a place for opposing opinions where readers may consider the different lines of reasoning and make their own evaluations. We hope this may add to research in some way. The first controversy presented in the collection, Food intolerance does not exist and Food intolerance does exist, may help to explain the scope of the series.

The topic of “food intolerance” vs. “food allergy” is one that involves pediatricians, gastroenterologists and allergists. Indeed, sometimes they use the term “food intolerance” to indicate not only lactose intolerance but also reactions attributed to food proteins. This question of nomenclature is not merely nominalist but risks to involve clinical decisions.

Therefore, we asked to two distinguished colleagues, Sten Dreborg and Yvan Vandenplas, to discuss the reasons why the term “intolerance” should or should not be used in the area of allergy. At the World Allergy Organization Journal we have found the result promising, and we are now curious to receive comments by readers and observe the debate that eventually could originate.

Form conveying substance

These kinds of considerations in clinical medicine and the need for reaching across existing boundaries among specialties have been on my mind for a while now. However, I had no idea how to translate this into a publication. At this point, Classics must have inspired me, since one of my most vivid college memories is my philosophy teacher talking in a very passionate way about Socrates.

In Socratic dialogues, the purpose of the dialectic method was the resolution of a disagreement through rational reasoning and discussion

In Socratic dialogues, the purpose of the dialectic method was the resolution of a disagreement through rational reasoning and discussion. Dialectics is what we are looking for in this series. That is, a “pro” article and a “con” article will expose different points of views on a given topic in allergy medicine. Two different invited authors will discuss these opinions. The articles will undergo peer review but by the same reviewers when possible in order to better evaluate methodological aspects of the papers and their adherence to the topic.

Other questions that Debates in allergy medicine articles are raising in the coming months are the use of specific immunotherapy for atopic dermatitis, and the long-term effects of allergen exposure on food tolerance. My hope is that allergists, immunologists and gastroenterologists will join their efforts to reach a common language, and we will benefit from solid science, frank language and willingness to discuss the different opinions.

I would like to sincerely thank Erika Jensen-Jarolim, Co-Editor-in-Chief, and our colleagues on the Journal Editorial Board, for their time and contributions to this project. We hope that this series will be of value to our worldwide audience of allergists and all physicians interested in allergy and related conditions. If so, these debates will ultimately benefit the clinical management of patients.

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