Being overweight increases susceptibility to indoor pollutants among urban children with asthmaBackground Both being overweight and exposure to indoor pollutants, which have been associated with worse health of asthmatic patients, are common in urban minority populations. Whether being overweight is a risk factor for the effects of indoor pollutant exposure on asthma health is unknown. Overweight or obese participants also had more asthma symptoms associated with nitrogen dioxide (NO2) exposure than normal-weight participants, although this was not observed across all types of asthma symptoms. Weight did not affect the relationship between exposure to coarse particulate matter measuring between 2.5 and 10 μm in diameter and asthma symptoms. Relationships between indoor pollutant exposure and health care use, lung function, or pulmonary inflammation did not differ by weight. Conclusion Being overweight or obese can increase susceptibility to indoor PM2.5 and NO2 in urban children with asthma. Interventions aimed at weight loss might reduce asthma symptom responses to PM2.5 and NO2, and interventions aimed at reducing indoor pollutant levels might be particularly beneficial in overweight children. Kim D. Lu, Patrick N. Breysse, Gregory B. Diette, Jean Curtin-Brosnan, Charles Aloe, D'Ann L. Williams, Roger D. Peng, Meredith C. McCormack, Elizabeth C. Matsui Being overweight increases susceptibility to indoor pollutants among urban children with asthma The Journal of Allergy and Clinical Immunology - April 2013 (Vol. 131, Issue 4, Pages 1017-1023.e3, DOI: 10.1016/j.jaci.2012.12.1570) Full text: http://www.jacionline.org/article/S0091-6749(13)00006-7/fulltext
New study showed IgGs to food are variable in healthy and symptomatic people
The data set is extremely important and helpful to demonstrate a broad variability of antigen-specific IgG responses to foods in normal subjects. In addition, the IgG concentrations (distributions) show only modest "general variations" (rather group effects), depending on gender, living region, age group and "chronic symptoms". Based on these results, it will be impossible to define any clear cut-off for IgG assays to (the tested) foods for individual prediction (of any disease). In summary, the data indirectly support the uselessness of IgG tests to(the tested) foods for diagnostic purposes.
Variable Food-Specific IgG Antibody Levels in Healthy and Symptomatic Chinese Adults
Liu-Xin Wu, Hong Li,Zhi-Jian Sun, Jing-Bo Li, Hong-Xia Jiang, Zhi-Heng Chen, Qi-Bin Wang, Wei-Wei Chen
Read more free online:
The World Allergy Week is just around the corner. It will take place from 8 to 14 April 2013. We encourage all EAACI members, National Societies and Patient Organisations to take this opportunity and increase the awareness about the Food Allergy and Anaphylaxis Campaign!
The goal of the campaign is to enhance knowledge of food allergy in the European community, as well as awareness on the sharp increase of food allergy and the triggers of anaphylaxis among policy makers and to educate the public on how to react in case of emergency.
EAACI believes that effectively managed food allergy can only be achieved through education and prevention, and for this purpose has developed different educational elements and materials such as video, flyers and posters in several languages as well as the Food Allergy and Anaphylaxis Declaration, to inform and activate European legislators about food allergy, its prevalence and to provide a roadmap of the policy-level actions required to make a substantial improvement in the everyday lives of food allergy sufferers.
Now the World Allergy Week is approaching, on behalf EAACI we ask you to use these materials and help disseminate these actions.
Joining our voices will make us heard!
Rapid follow-up with primary care essential
Patients with asthma have impairments in their quality of life, especially when they experience a flare-up of the symptoms. These exacerbations lead to significant time lost from work, school and other leisure activities. There is potential for serious sequelae such as emergency department (ED) visits and hospitalisations.
Irish Medical Times
In his latest Clinical Update, Gary Culliton looks at severe presentations of asthma, which in some cases may be life-threatening, as well as international guidance on methods of prevention, testing and treatment.
Raise Awareness, Relieve the Burden
of Respiratory Allergies in Europe
Sign the Call to Action
After identifying allergies as serious chronic diseases and major issue areas across Europe, EFA initiated a four year project focusing on respiratory allergies in Europe. Among many objectives is raising awareness, increasing the ability to identify early symptoms and provide early diagnosis, as well as the provision of European guidance on appropriate management and control of exacerbations for patients and medical professionals. On 22 November, 2011 EFA joined EU policymakers and the European respiratory allergy community at the European Parliament for the EFA Book Launch Event of the EFA Book on Respiratory Allergies. Participants were informed of the current trend that by 2015, one in every two Europeans may suffer from an allergy. Help EFA’s effort to relieve the burden of respiratory allergies on European societies by signing the Call to Action today!
Climate Change and Our Environment: The Effect on Respiratory and Allergic Disease
- Charles S. Barnes, PhD,
- Neil E. Alexis, PhD, MHS, MS,
- Jonathan A. Bernstein, MD,
- John R. Cohn, MD,
- Jeffrey G. Demain, MD,
- Elliott Horner, PhD,
- Estelle Levetin, PhD,
- Andre Nel, MD, PhD,
- Wanda Phipatanakul, MD, MS
The allergy community must therefore adapt, as physician and research scientists always have, by anticipating the needs of patients and by adopting practices and research methods to meet changing environmental conditions.
Key words: Allergy, Climate change, Workgroup report
There has been considerable recent interest in developing therapies for food allergy, an increasingly common and highly morbid disorder for which strict dietary elimination and ready access to epinephrine remain the standard of care. While both oral …
2013 Jan 3. doi: 10.1136/thoraxjnl-2012-202698. [Epub ahead of print]
Azithromycin for prevention of exacerbations in severe asthma (AZISAST): a multicentre randomised double-blind placebo-controlled trial.
, Vanderstichele C
, Jordens P
, Deman R
, Slabbynck H
, Ringoet V
, Verleden G
, Demedts IK
, Verhamme K
, Delporte A
, Demeyere B
, Claeys G
, Padalko E
, Verschakelen J
, Van Maele G
, Deschepper E
, Joos GF
Department of Respiratory Medicine, Ghent University Hospital, , Ghent, Belgium.
Patients with severe asthma are at increased risk of exacerbations and lower respiratory tract infections (LRTI). Severe asthma is heterogeneous, encompassing eosinophilic and non-eosinophilic (mainly neutrophilic) phenotypes. Patients with neutropilic airway diseases may benefit from macrolides.
We performed a randomised double-blind placebo-controlled trial in subjects with exacerbation-prone severe asthma. Subjects received low-dose azithromycin (n=55) or placebo (n=54) as add-on treatment to combination therapy of inhaled corticosteroids and long-acting β(2) agonists for 6 months. The primary outcome was the rate of severe exacerbations and LRTI requiring treatment with antibiotics during the 26-week treatment phase. Secondary efficacy outcomes included lung function and scores on the Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ).
The rate of primary endpoints (PEPs) during 6 months was not significantly different between the two treatment groups: 0.75 PEPs (95% CI 0.55 to 1.01) per subject in the azithromycin group versus 0.81 PEPs (95% CI 0.61 to 1.09) in the placebo group (p=0.682). In a predefined subgroup analysis according to the inflammatory phenotype, azithromycin was associated with a significantly lower PEP rate than placebo in subjects with non-eosinophilic severe asthma (blood eosinophilia ≤200/µl): 0.44 PEPs (95% CI 0.25 to 0.78) versus 1.03 PEPs (95% CI 0.72 to 1.48) (p=0.013). Azithromycin significantly improved the AQLQ score but there were no significant between-group differences in the ACQ score or lung function. Azithromycin was well tolerated, but was associated with increased oropharyngeal carriage of macrolide-resistant streptococci.
Azithromycin did not reduce the rate of severe exacerbations and LRTI in patients with severe asthma. However, the significant reduction in the PEP rate in azithromycin-treated patients with non-eosinophilic severe asthma warrants further study. CLINICALTRIALS.GOV NUMBER: NCT00760838.
Clinical efficacy of 300IR 5-grass pollen sublingual tablet in a US study: The importance of allergen-specific serum IgE
- Linda S. Cox, MD,
- Thomas B. Casale, MD,
- Anjuli S. Nayak, MD,
- David I. Bernstein, MD,
- Peter S. Creticos, MD,
- Laurence Ambroisine, MSc,
- Michel Melac, MD,
- Robert K. Zeldin, MD
Received 29 March 2012; received in revised form 6 July 2012; accepted 9 August 2012. published online 02 November 2012.
Adults with grass pollen allergy and Rhinoconjunctivitis Total Symptom Scores of 12 or greater (scale, 0-18) during the previous grass pollen season were randomized in a double-blind, placebo-controlled study to receive 300IR 5-grass pollen sublingual tablet or placebo starting 4 months before and continuing through the pollen season. The primary efficacy end point was the daily Combined Score (CS; scale, 0-3), which integrates symptoms and rescue medication use.
Four hundred seventy-three participants were randomized. The mean daily CS over the pollen period was significantly lower in the active treatment group versus the placebo group (least-squares mean difference: −0.13; 95% CI, −0.19 to −0.06; P = .0003; relative reduction: 28.2%; 95% CI, 13.0% to 43.4%). In placebo-treated participants, the daily CS least-squares mean was 0.32 in the subgroup with baseline timothy grass–specific serum IgE of less than 0.1 kU/L (n = 23) and 0.46 in those with baseline timothy grass–specific serum IgE of 0.1 kU/L or greater (n = 204). The most frequent reported adverse events were oral pruritus, throat irritation, and nasopharyngitis. There were no reports of anaphylaxis, and no actively treated participant received epinephrine.
In US adults with grass pollen–induced allergic rhinoconjunctivitis, preseasonal and coseasonal treatment with 300IR 5-grass pollen sublingual tablet demonstrated clinically meaningful efficacy, especially in study subjects with measurable timothy grass–specific serum IgE. Use of 300IR 5-grass pollen sublingual tablet was safe and well tolerated. A requirement for a measurable level of allergen-specific serum IgE should be considered in future studies in this field.
Key words: Double-blind, placebo-controlled trial, allergy, allergic rhinoconjunctivitis, grass pollen, specific immunotherapy, sublingual immunotherapy tablet, combined score, grass-specific IgE