Allergy News

April 23, 2007 -- A stomach bacterium that causes ulcers and is linked to stomach cancer may make asthma less likely.

That news appears in the Archives of Internal Medicine.

The bacterium is called Helicobacter pylori (H. pylori). It is associated with ulcers and increased risk of stomach cancer.

H. pylori is found worldwide, but it's more common in developing countries, note Yu Chen, PhD, MPH, and Martin Blaser, MD.

by Erwin W. Gelfand, MD

Patients with severe and refractory asthma suffer from numerous complications, fatal disease, and utilize a large proportion of healthcare resources. Treatment options are certainly limited, and it is unclear what underlies their refractoriness to conventional therapy. Whether they are "resistant" to therapy with glucocorticoids or the pathophysiologic pathways involved in their disease are not sensitive to glucocorticoids is unclear at present.

Some phenotypic differences in patients with refractory asthma have emerged, such as a greater involvement of neutrophils, but the relevance of these data are not clear. Among the candidates identified as perhaps playing a role in refractory asthma is tumor necrosis factor-alpha (TNF-alpha), a pleiotropic inflammatory cytokine that is expressed in mast cells^[1] and is present in higher concentrations in bronchoalveolar fluid from patients with asthma, particularly in bronchoalveolar lavage (BAL) fluid from patients with more severe asthma.^[2]

An intravenous infusion of a solution of sodium bicarbonate -- better known as baking soda -- reduces respiratory distress and excessive acidity of body fluids in children with a life-threatening asthma flare-up, according to a report from the Netherlands.

High blood acidity, or acidosis, causes the heart to contract less strongly, reduces the effectiveness of beta-agonist bronchodilators used to treat asthma, and may stimulate rapid, shallow breathing, Dr. Corinne M. P. Buysse and her colleagues point out in the medical journal Chest.

They explain that treatment with sodium bicarbonate has been shown to relieve bronchial spasm and restore the response to bronchodilators. However, doctors have avoided the use of intravenous sodium bicarbonate for fear of increasing levels of carbon dioxide in the blood.

Scientists have identified a gene that could lead to a breakthrough in the treatment of asthma, with tablets replacing steroid inhalers.

As a result of work carried out at Dundee University, researchers believe that drugs currently used to treat diabetes could be adapted to control acute asthma attacks.

Until now asthma treatments have been dominated by steroid therapies which can often have serious side effects.

Children who start drinking fresh milk from the farm early on are less likely to develop allergies when they are of school age, according to Swiss scientists.

But why more people are suffering allergies remains unclear, say researchers at Basel University, who have begun a study involving more than 14,000 children.

Cows' milk as food for infants has a bad reputation. From a nutritional perspective it does not fulfil the dietary requirements of babies, and children who are fed only cows' milk for too long often suffer an iron deficiency.

A fresh study by the Environmental Health section of the National Public Health Institute shows a strong link between asthma in children and dampness in the building structures of the home.

According to an article in the upcoming edition of the European Respiratory Journal, at least one in ten, and possibly as many as one in five cases of asthma among children are linked with water damage in the building.

The onset of asthma is the result of the cumulative effect of many factors. Nevertheless, in the 1990s there was a rapid increase in cases of asthma in Finland, as well as an increase in damage caused by dampness in buildings.

Newswise — Children in this country suffer from asthma more than any other chronic illness, and new research finds African-American children with the condition have a greater risk than others of experiencing severe symptoms that escalate into an emergency.

Previous research has shown that in comparison with white and Hispanic children, African-Americans have a higher rate of asthma, are hospitalized more and face more disability due to the condition. Because of this, “we suspected they might also exhibit relatively more severe asthma symptoms at the time of hospitalization,” said Yu Bai, a doctoral candidate at Pennsylvania State University.

Bai and his colleagues analyzed the records of 7,726 white, African-American and Hispanic children up to age 19 who were admitted to Pennsylvania hospitals in 2001 for asthma symptoms. The researchers then examined how the physician reported the severity of the children’s condition and ranked them either as “emergency” or “non-emergency” admissions.

British scientists reported last spring in the journal Nature Genetics that people who suffer from both eczema and asthma carry the same gene mutation and concluded that in some cases eczema may actually lead to asthma.

DUBLIN, Ireland--(BUSINESS WIRE)--Research and Markets has announced the addition of Asthma – Evaluation and Management 2007 Update to their offering.

Patients with asthma require a continuum of preventive, acute, psychological, rehabilitative, education, and self-management interventions to meet their complex health and psychosocial needs. Deaths usually occur in asthma as a result of the lack of appreciation for the severity of an exacerbation, and inadequate prompt home emergency treatment.

Care by a pulmonary or allergy specialist for patients with mild to moderate as well as severe asthma has demonstrated improved outcomes. Improved outcomes related to specialist management (as measured by reduced hospitalizations and ER visits) appear due to the greater use of prophylactic medication and other strategies such as case management.

February 16, 2007 — In children with intermittent asthma, a short course of montelukast resulted in reduction in acute healthcare resources, asthma symptoms, and days lost from school and from work for parents, according to the results of a multicenter, randomized, double-blind, controlled trial reported in the February 15 issue of the American Journal of Respiratory & Critical Care Medicine.

"In children, intermittent asthma is the most common pattern and is responsible for the majority of exacerbations," write Colin F. Robertson, MD, of the Royal Children's Hospital in Melbourne, Australia, and colleagues. "Montelukast has a rapid onset of action and may be effective if used intermittently."

Asthmatics are more likely than other Australians to be obese and suffer other long-term health conditions, a new study says.

Australian researchers have found more than one in five asthma patients are obese, and fewer than half had a normal body mass index.

Only about 38 per cent of middle aged asthmatics had a normal body mass index.

The Australian Institute of Health and Welfare (AIHW) report concluded people with asthma aged 18 to 64 were more likely to be obese than those who had never had asthma, but could not identify the reason.

Researchers have long noted that many asthma sufferers also have atopic dermatitis — often called eczema — a chronic disease of the skin that can leave it red, raw, scaly, tender, oozy and excruciatingly itchy. But scientists are looking at whether such ravaging of the skin creates the conditions that can trigger asthma.

Last spring in the journal Nature Genetics, British scientists reported that people who suffer from both eczema and asthma carry the same gene mutation and concluded that eczema may actually lead to asthma in some cases.

Until now, it had largely been assumed that dander, dust mites, pollen and other allergens that can cause asthma enter the body through the respiratory system. But the researchers said they now believe that they can also enter the body through tiny breaks in the skin’s surface — something that occurs in patients with eczema.

Purpose of review: There is evidence for an association between asthma and air pollutants, including ozone, NO₂ and particulate matter. Since these pollutants are ubiquitous in the urban atmosphere and typically correlated with each other it has been difficult to ascertain the specific sources of air pollution responsible for the observed effects.

Similarly, uncertainty in determining a causal agent, or multiple agents, has complicated efforts to identify the mechanisms involved in pollution-mediated asthma events and whether air pollution may cause asthma as well as exacerbate preexisting cases.

Previous studies have shown that certain lung infections such as Mycoplasma pneumoniae can linger on and contribute to a person later experiencing symptoms of asthma.

Researchers have now identified a particular gene that influences how severe a M. pneumoniae infection may be, which in turn suggests that a different strategy might be needed for treating asthma resulting from this and similar lung infections rather than allergies.

“What this shows is that infectious asthma might have a different mechanism than allergic asthma. Most people think asthma is asthma, but it may be multifaceted,” said Dr. Robert Hardy, an infectious disease specialist at UT Southwestern.

FRANKFURT (MarketWatch) -- AstraZeneca PLC (AZN) said Thursday the findings of a study on respiratory combination drugs by the German Institute for the Evaluation of Drugs, or IQWIG, are inconclusive.

The study found that patients suffering from asthma didn't respond better to combination drugs, such as AstraZeneca's Symbicort, than to the use of two drugs alone.

The study also included GlaxoSmithkline PLC's (GSK) Viani and Schwarz Pharma AG's (SRZ.XE) Atmadisc.

AstraZeneca said in a statement that the IQWIG findings are preliminary and that the institute didn't use the latest clinical data available for the Symbicort drug.

by Mark T. O'Hollaren, MD

Alternaria alternata is a saprophytic mold typically found in soil and plants, and is considered to be primarily an outdoor allergen. It has been associated with episodes of severe, life-threatening attacks of asthma, and sensitivity to Alternaria (ie, as demonstrated with a positive allergy skin test) has been associated with an approximate 200-fold increase in the risk of a life-threatening asthma attack.^[1] Sensitization to Alternaria has also been found to be more common in patients with asthma than in those without asthma.

Salo and colleagues collected data as part of the National Survey of Lead and Allergens in Housing study, and they surveyed a nationally representative sample of over 800 housing units inhabited by over 2400 individuals. They collected dust samples from bed, sofa, or chair, and from the bedroom, living room and kitchen floors, and analyzed for the presence of Alternaria using a polyclonal anti-Alternaria alternata inhibition assay.

WASHINGTON, Jan. 10 (UPI) -- Asthma sufferers are much more likely to use drugs that offer fast relief of symptoms, according to new U.S. research.

About 31 percent of sufferers said they use fast-acting medications, while only 14 percent said they use longer-term, preventive treatments, according to a new study by Health and Human Services' Agency for Healthcare Research and Quality.

Another 31 percent of people with asthma said they use both types of medications, and 24 percent said they use none, according to the study.

After spending just 60 minutes on a beach where a Florida red tide was present, teens and adults with asthma had small but significant decreases in standard measures of pulmonary function, reported Lora E. Fleming, M.D., Ph.D., of the University of Miami Rosenstiel School of Marine and Atmospheric Science.

"In the normal population, inhaled aerosolized red tide toxins can lead to eye irritation, rhinorrhea, nonproductive cough, and wheezing," Dr. Fleming and colleagues reported in the January issue of Chest.

Prague, Jan 6 (CTK) - The number of children suffering from asthma and other respiratory disease has been on the rise in the one million Prague as the number of cars and lorries in the city increases and the air is polluted with dust, daily Pravo writes today.

Pediatricians told the daily that the situation in the city is serious and that it has been worse and worse every year.

"For instance, younger children fall ill and the number of children suffering from asthma is rising. Babies and infants under half a year of age are not an exception," Pravo quotes pediatrician Ivana Nulickova who has a surgery in the city centre as saying.

Reducing salt intake may affect asthma severity and breathing in adults with the condition, says a joint Anglo-American review of the science.

The review looks set to continue to put pressure on the food industry to reach the targets set out by an increasing number of food agencies to cut salt intake. In the USA, UK and Ireland, over 80 per cent of salt intake comes from processed food.

The authors of the new review, Timothy Mickleborough from Indiana University and Andrew Fogarty from the University of Nottingham, analyse both epidemiological and clinical evidence and conclude that, collectively, increased salt intake may increase the severity of asthma for people with the disease.

NEW YORK (Reuters Health) Jan 04 - Total control of asthma, in accordance with guidelines from the Global Initiative for Asthma at the National Institutes of Health, results in the best quality of life, a new report indicates.

The results show that a tangible improvement in quality of life is seen when asthma is totally controlled rather than simply well controlled.

As reported in the European Respiratory Journal for January, Dr. E. D. Bateman, from the University of Capetown in South Africa, and colleagues administered the Asthma Quality of Life Questionnaire (AQLQ) to 1994 patients participating in a study comparing the efficacy of fluticasone alone or in combination with salmeterol.

By Hana R. Solomon, MD

Worldwide, only 10% to 30% of healthcare is provided by conventional, Western, biomedical practitioners. The remainder is delivered either through folk beliefs or alternative traditions.^[1] Complementary and alternative medicine (CAM) has become more popular in the United States over the past few decades. With this increasing popularity of CAM, it is important that practitioners become familiar with this area of medical practice for all diagnoses.

According to the National Center for Complementary and Alternative Medicine (NCCAM), CAM is defined as "a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine.^[2]" The list of modalities included in this definition continually changes as practices are integrated into Western conventional medicine. They also identify 5 concepts, or domains, of CAM:

By David H. Broide, MD, ChB

Asthma is a very common airway disease affecting approximately 20 million individuals in the United States. For many patients with persistent asthma, asthma is well controlled with a regular controller medication, such as an inhaled corticosteroid, and an as-needed beta2-agonist inhaler for symptom relief.^[1] Nevertheless, each year in the United States, there are still approximately 10 million acute attacks of asthma, 2 million asthma urgent care visits, 400,000 asthma hospitalizations, and 4000-5000 asthma deaths, underscoring the fact that asthma is still not well controlled in a large number of asthmatics.^[2] Patients with severe asthma use a significant fraction of the $6.2 billion in annual direct cost expenditure on asthma in the United States.^[3] The development of novel therapeutic options for these asthmatics would be a significant advance.

By Mark T. O'Hollaren, MD Oregon Health and Science University

In the last several years, the concept of "asthma control" has received significant attention. National and international asthma treatment guidelines increasingly stress the fact that those caring for patients with asthma need to be aware of the impact that asthma has on the daily lives of their patients. Asthma care is moving away from focusing primarily on a number, such as pulmonary function tests or peak expiratory flow measurements, to one in which these numbers are combined with other assessments, such as quality of sleep, limitation of activity and exercise, and requirement for rescue medications.

By Dale T. Umetsu, MD, PhD

Allergic asthma is an immunologic disease that is caused by adaptive immune responses to environmental allergens. Asthma is thus characterized by the presence of allergen-specific immunoglobulin (Ig)E, which is produced during adaptive immune response and by the presence of allergen-specific CD4+ Th2 cells producing interleukin (IL)-4, IL-5, and IL-13.^[1] Th2 cells are also generated during adaptive immune responses, and are thought to play a central role in orchestrating the inflammation in asthma, because IL-4 causes isotype switch to IgE; IL-5 enhances the growth and differentiation of eosinophils; and IL-13 causes airway hyperresponsiveness (AHR) -- a cardinal feature of asthma.^[2] The development of these adaptive immune responses with IgE and Th2 cells reflects allergen sensitization, which is a significant risk factor for the development of asthma.

The following summary reviews some of the highlights of the year in asthma research. For fuller accounts, links to the individual articles published in MedPage Today have been provided.

Mortality

Despite the decline in mortality reported at the 2006 annual meeting of American College of Asthma, Allergy & Immunology, asthma still accounts for one of every 250 deaths worldwide, many of which could have been prevented with better medical care.

• ACAAI: Asthma Deaths Decline Worldwide

Toyota Motor Corp. intends to agree to a health-care subsidy plan as part of a settlement with asthma patients who sued Toyota and six other automakers, claiming exhaust fumes from diesel vehicles caused their disease, informed sources said.

The suit, now pending at the Tokyo High Court, seeks compensation from the manufacturers as well as the central government and the Tokyo Metropolitan Government.

The health-care plan was proposed by the metropolitan government last month. Toyota is the first carmaker indicating it intends to accept the plan, the sources said.

By Will Hawkins, WOAI.com Heating & Cooling Expert

Q. We have family members that have allergies or asthma. What can we do about it?

A. Installing a Nature’s Home Media Filter can reduce these problems. The MicroPower Guard air filter will capture microscopic particles, and you only have to change the filter once every three months.

People spend about 90% of their time indoors. The EPA ranked indoor air pollution among the top five environmental dangers to the public. Why? Our homes are sealed, insulated and efficient. While this conserves energy, it locks in allergenic particles, infectious agents and other toxic agents. A quality filter can reduce or eliminate these household pollutants that can cause these health problems.

JAPAN - The proportion of schoolchildren suffering from asthma has more than doubled in the last 10 years to the highest level ever, an education ministry survey showed Thursday.

"In light of the increase not only in asthma but also in other types of allergies, the growth can be attributed to various factors, including air pollution and lifestyles," an Education, Culture, Sports, Science and Technology Ministry official said. "It's difficult to pinpoint a cause."

The preliminary figures are based on health checkup data for about 3.36 million children from kindergarten through high school across the country. The ministry conducted the research between April and June.

LONDON (AFX) - Vectura Group PLC has struck a US collaboration and development deal with a 'leading international pharmaceutical company' for its generic combination asthma therapy, VR315.

In a statement, the British drug developer said it will share the profits from any eventual sales of the product, and could receive up to 63 mln usd in milestone payments.

The therapy is thought to be a copycat version of GlaxoSmithKline PLC's top-selling asthma drug Advair, which generated sales of 3 bln stg last year and will lose patent protection in around 2010.

The report also finds that primary care physicians vary from recommended guidelines to prescribe GlaxoSmithKline's Advair as first-line therapy in cases where it is recommended to start with an inhaled corticosteroid.