New Research On The Origins Of Asthma And Allergies Presented At Annual Meeting
Main Category: AllergyAlso Included In: Respiratory / Asthma
Article Date: 15 Mar 2008 - 6:00 PDT
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Viral illnesses that produce wheezing are very common in early childhood, but not all children who wheeze in the first several years of life go on to develop asthma. D.J. Jackson, MD and colleagues at the University of Wisconsin, Madison presented their study at the 2008 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting in Philadelphia.
Wheezing with respiratory syncytial virus (RSV) infections has previously been associated with increased risk of developing asthma later in childhood. Jackson and colleagues confirmed this finding, but discovered a novel finding as well: wheezing illnesses during the first three years of life caused by rhinovirus, the most common cause of "colds" in children and adults, were the strongest predictor of asthma at age 6 years.
Exposure to diesel exhaust particles and indoor endotoxin during early childhood increases the risk for persistent wheeze at age three
Diesel exhaust particles (DEP) and endotoxin, found in bacteria, may act together to promote wheezing in young children, according to a new study presented at the 2008 AAAAI Annual Meeting in Philadelphia.
Children enrolled in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a NIEHS sponsored study, were evaluated at age 3. Exposure to high levels of DEP prior to age 1 was associated with a two-fold increased risk for wheezing. Children exposed to both DEP and high levels of endotoxin were at risk for wheezing at age three.
Patrick Ryan, PhD and colleagues at the University of Cincinnati in Cincinnati, Ohio concluded that children exposed to DEP during infancy may be at increased risk for the development of wheezing at age 3, and this relationship is modified by indoor exposure to endotoxin.
Allergens in urban elementary schools and homes of children with asthma
William Sheehan, MD and colleagues at Children's Hospital Boston, Boson, MA studied the association between allergens in schools and childhood asthma. They investigated allergen exposure in schools compared to homes with a specific focus on children with asthma. This new study was presented at the 2008 AAAAI Annual Meeting in Philadelphia.
The study was based on collecting 66 samples from various rooms in four Northeastern US urban elementary schools and 38 student bedrooms. Samples were analyzed for cat, dog, cockroach, dust mites, and mouse urinary protein.
The study, presented at the 2008 AAAAI Annual Meeting in Philadelphia, shows higher levels of mouse urine, but lower levels of dust mites in schools versus homes. It is important to recognize that children with asthma may encounter varying levels of allergens in environments outside the home, such as schools.
Exposure to mouse allergens in US homes is associated with asthma symptoms
Asthma, which remains a significant public health concern in the U.S., affects millions of Americans. To evaluate the importance of mouse allergen in asthma, Päivi Salo, PhD and colleagues at the National Institute of Environmental Health Sciences examined whether elevated levels of mouse allergen were associated with asthma among the study participants.
Although mouse allergen is a well-recognized allergen in occupational settings, it has only recently been recognized as an important allergen in homes. To date, the majority of the research has focused on inner-city homes in which mouse allergen has been found to be ubiquitous. The findings from the NSLAH suggest that the presence of mouse allergen in U.S. homes is surprisingly common even outside urban areas. Of the surveyed homes, 82% had detectable levels of mouse allergen and, in 35% of the homes; allergen concentrations exceeded a level that has been associated with increased mouse allergen sensitization rates. Elevated levels were most commonly found in high-rise apartments and mobile homes, older homes, and low-income homes.
The results showed that in allergic individuals, higher levels of mouse allergen significantly increased the likelihood of having asthma symptoms. Because elevated levels of the allergen were not restricted to inner-city areas, this study suggests that mouse allergen is an important household allergen outside of urban environments. For allergic individuals, reducing allergen levels in the home is an essential part of asthma control and treatment. Therefore, mice may not be welcome visitors in homes where allergic and asthmatic individuals reside.
Health care utilization is higher among patients whose asthma is not well-controlled
The study by Theresa Guilbert, MD and colleagues aimed to determine whether asthma control is associated with increased healthcare resource utilization. This new study was present at the 2008 AAAAI Annual Meeting.
The study interviewed patients receiving any prescription asthma treatment in the past year. Patients whose asthma was not well-controlled at baseline had a higher risk of an asthma-related event compared to patients with controlled asthma. Adults with asthma that was not well-controlled were at 4-times greater risk for office visits and 4.5 times greater risk for ER visits. Children with asthma that was not well-controlled were at 4-times greater risk for office visits and tended to have an increased risk of ER visits.
Asthma that is not well-controlled is associated with increased healthcare resource utilization. Asthma control determination using ACT/C-ACT may help clinicians and patients decrease the risk of these events. Additional studies to determine if monitoring asthma control could lead to reduced healthcare resource utilization could be valuable.
These studies were presented at the 2008 Annual Meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI). The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with special interest in the research and treatment of allergic disease.
Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease.
The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries.
American Academy of Allergy, Asthma & Immunology
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Visitor Opinions In Chronological Order (2)
Mice? Get A Cat! And Don't Forget Polyurethane Fumes
posted by Elizabeth F Cole MD on 18 Mar 2008 at 2:17 pmAllergists are stuck on the biological sources of allergens. It really is time to enlarge the vista. Ever hear of the "sick building syndrome"?
No, not full of diesel fumes, but another petrochemical product which is causing dermatitis, asthma, even anaphylaxis. It is found everywhere, and has been for the fifty years since the asthma "epidemic" began. It is in slick print magazines and decals, clothing fabrics (lycra spandex and other "stretch" brands), dyes (even in medications) rugs and rug pads, glues, paints, wood finishes, mattresses (hence the most asthma ER visits are in the middle of the night) and other bedding upholsteries, heating pads, cold packs, and many medically used instruments, tubing, tools, shopping carts, and food and blood packaging.
Your shiny meat wrapping paper, catsup and shampoo squeeze bottles can set you off, if you are allergic to polyurethane. And most imagined "latex" allergy is to the polyurethane used to make it stretch farther and last longer. The ruely latex allergic should also be allergic to other similar to latex biologicals as in avocado and some nuts.
It is noteworthy that a newer delivery system for asthma medication is a disk made of polyurethane to be held, triggered, and put in the mouth for inspiration of the medication. Since allergists usually are not immunologists, and the testing for non-biological allergens requires an in vitro approach, not prick, patch, it seems that a new specialty is required. And since desensitization is not an option, the problems of diagnosis are complex, treatment requires avoidance, not years of shots. And, with so much of our atmosphere clouded with polyurethane, so many things of common use, that is a very difficult assignment to give a patient. Especially because most of the things in our current environments, including the majority of medical instruments and tubing are made of polyurethane, makes acute and chronic asthma treatment even more difficult. It takes about 2 1/2 years or more before refrigerators, furnishings, will have released the most potent of their polyurethane into the atmosphere, Meantime, we all aquire more, even if it is in opening our daily mail..
So, lets start that new specialty of learning the real causes of asthma and other allergic manifestations.
Thank You For Your Article
posted by Allergy Sufferer on 5 Dec 2009 at 1:07 pmTo Dr. Cole--
I have had major allergic reactions to many foods (grains, fruits and nuts) as well as to polyurethane. My allergist has conducted RAST tests for every food available in the test panel, as well as tests for gluten sensitivity. My results were all negative. However, when I stopped eating wheat and gluten the severity of my reactions (which incl. asthma, hives and eczema) lessened enormously. (I have a brother with celiac disease and dermatitis herpetiforma, which led me to the decision to stop eating wheat & gluten products).
I am convinced that I've been having some kind of immunological response for which there is no test. It seems that the major changes in allergy treatment have been in medications, and that there is much room for exploration.
My dermatologist (Washington U in St. Louis) recently told me that he has seen patients with eczema and psoriasis who have experienced a lessening of skin problems with the elimination of wheat and wheat gluten from their diet. These patients also had negative results from standardized tests for gluten sensitivity.
Any additional information you might provide would be very much appreciated.
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