Asthma: January 2007 Archives

New research suggests that different treatments may be needed for chronic asthma, depending on whether it results from allergies or lung infections.

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.

BOSTON, Jan. 15 -- Aspirin may reduce the risk of new-onset asthma in adult males, according to a retrospective analysis of a longitudinal study of thousands of physicians.

A post hoc analysis of data from the Physicians' Health Study, which investigated the role of aspirin in preventing first heart attacks, revealed that men who took 325 mg of aspirin every other day had a 22% reduction in risk of new onset asthma, found Tobias Kurth, M.D., Sc.D., of Brigham and Women's Hospital here, and colleagues.

Moreover, the possible protective effect of aspirin was not modified by baseline risk factors including smoking, body mass index, or age, but the benefit appeared to be greater among younger men, the researchers reported in the January issue of the American Journal of Respiratory and Critical Care Medicine.

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.

MIAMI -- Harmful algal blooms known as red tides release toxins that can leave people with asthma gasping still harder for air, reported researchers here.

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.