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Cutting edge research on the treatment of allergies and asthma. This site also includes pollen and spore counts from locations around the country. The Allergy Report |
NEW YORK, Jul 07 (Reuters Health) - About twice
as many adults suffer from allergy-induced asthma today than 20 years ago,
researchers report.
Investigators found that rates of smoking had
nothing to do with the doubling of asthma cases since the 1970s, as the
number of
people who smoked declined dramatically during
this period.
According to the report published in the July
8th issue of the British Medical Journal, a rise in the prevalence of allergies
among
adults probably fueled the increase in allergy-induced
asthma.
Dr. Mark N. Upton of the University of Glasgow,
Scotland, and colleagues write, "The prevalence of asthma in adults has
increased more than twofold in 20 years, largely
in association with trends in (allergies)."
The researchers compared rates of allergic and
non-allergic asthma, hay fever and other respiratory problems among married
couples surveyed during the 1970s, and in their
children, who were surveyed in the 1990s.
Hay fever was included in the survey to enable
the research team to indirectly examine trends in allergy rates, since
allergies can
trigger asthmatic symptoms.
Results show that both asthma and hay fever increased
in smokers and nonsmokers. The rate of asthma rose to 8% in1996,
from 3% between 1972-1976 among people who never
smoked. The rate of hay fever in this group climbed to 20% from 6%
during the same period.
Among people who smoked, asthma increased to
5% from 2%, and hay fever rose to 16% from 5%, the report indicates.
Over the same time period, rates of smoking declined
by 50% in both men and women.
In other findings, fewer people complained of
frequent chest wheezing and shortness of breath in 1996 despite the increase
in
asthma. Upton and his team suggest that better
asthma medications may underlie this finding, as prescriptions for inhaled
steroids
rose more than sixfold between 1980 and 1990.
SOURCE: British Medical Journal 2000;321:88-92
Emmett V. Glass, MS, Department of Internal Medicine,
Division of Allergy and Immunology; Glen R. Needham,
PhD, Acarology Laboratory, Department of Entomology;
Donald L. McNeil, MD, FRCP, Department of Internal
Medicine, Division of Allergy and Immunology,
The Ohio State University, Columbus, Ohio. E.V. Glass is a
Research Associate 2-B/H in the Department of
Internal Medicine, Division of Allergy and Immunology; Dr.
Needham is an Associate Professor in the Acarology
Laboratory, Department of Entomology; and Dr. McNeil
is an Assistant Professor in the Department of
Internal Medicine, Division of Allergy and Immunology, The
Ohio State University, Columbus, Ohio.
Abstract
There is a sense of urgency in the healthcare
community to effect a change in the trend of increasing asthma
morbidity and mortality. The allergic component
in the etiology of this condition may be underestimated and
indoor allergens such as dust mites may play
a major role. Preventing the sensitization or continued exposure
of the allergic asthmatic patient to mite allergens
by employing appropriate management strategies could prove
beneficial and, ultimately, much less costly
than pharmacologic therapy. In households, mites occur in mattresses,
pillows, carpets, and in any other area with
appropriate ecologic factors for their survival. The allergens produced
by mites in the genus Dermatophagoides, one of
the principal sources of house dust allergens, fall mainly into
two immunologically important groups: Der I (Der
pI, Der fI) and II (Der pII, Der fII). Generally, for significant
improvement of asthmatic symptoms to occur, the
concentration of the predominant mite allergen, Der p I, must
be reduced to less than 2mcg/g dust or mite populations
decreased to 100/g dust. Procedures for reducing mite
numbers in homes have employed both physical/mechanical
(reducing relative humidity, encasing mattresses and
pillows in plastic, etc.) and chemical (acaricides,
protein denaturants, etc.) means. This article will review the
current state of knowledge of dust mite control
strategies and their implications for the allergic asthmatic patient.
[Medscape Respiratory Care 2(6), 1998. ©
1998 Medscape, Inc.
Introduction
Asthma affects 14 to 15 million Americans and
is now the most common chronic disease afflicting children.[1,2]
The clinical manifestations of this under-appreciated
disease are potentially severe and life-altering. Both
prevalence and mortality associated with asthma
are increasing.[3,4] Themisconception that children "outgrow"
asthma lends further support to the importance
of early diagnosis and intervention in minimizing the subsequent
onset of disease. Although some believe there
is a tendency to under-diagnose its severity, most cases of asthma
are mild, with 50% of asthmatics having symptoms
weekly. Recent findings support an allergic component of asthma
in at least 55% of all cases.[5-7]
Asthma Pathogenesis: Implications
for Management
The histopathologic chronic inflammation associated
with asthma is apparent long before clinical manifestations and
supports the theory that intervention at the
time of symptom presentation may be too late. One compelling challenge
is treating the disease at the earliest point
in an attempt to prevent progression and reduce potential adverse side
effects of long-term corticosteroid therapy,
such as osteoporosis. Kjellman[8] referred to the "allergic snowball,"
in
which triggers such as pollution, genetic predisposition,
infections, or allergens induce an allergic response over a
prolonged period. Therefore, preventive measures
should be instituted early (ideally, before or at the time of other
interventional measures), because once active
treatment is begun, it may be too late to substantially alter the disease
course. The purpose of this report is to broaden
the healthcare professional's concept of prevention to include control
of asthma allergies in the home or other indoor
environments, with emphasis placed on mechanical and chemical
strategies for house dust mite reduction.
 |
Allergens implicated in the development of extrinsic
(allergic) asthma include house dust mites (Fig. 1), animal dander,
mold spores, and cockroach.[12] Some or all may
be present in the homes of the patient.[5] Reducing the exposure to
dust mite by relocating children to a dust-freeenvironment
reduces the incidence of asthma.[13] However, dust mite
allergy must exist before any proven benefits
can be expected from dust mite elimination. That is, the patient must be
sensitized to dust mites in order to evoke an
allergic response.[6] Only a small fraction of dust mite particles are
inhaled everyday, and only once they become airborne
(ie, as a result of vacuuming). The effect of chronic exposure to
dust mite appears cumulative, in that it produces
an overall increase in bronchial hyperresponsiveness as opposed to
serving as a trigger for acute attack.
Conclusion
Despite their importance to public health, current
options for successful control of house dust mites as a preventive
strategy for asthma are few. Studies show
that reducing the amount of dust and/or house dust mites decreases clinical
allergy symptoms in susceptible individuals.[55]
Generally, for significant improvement of asthmatic symptoms to
occur, the concentration of the predominant mite
allergen Der pI must be reduced to less than 2 mcg/g dust or mite
populations decreased to 100/g dust.[29] Procedures
for reducing mite numbers in homes have employed both physical
(vacuuming, encasing pillows and mattresses in
plastic, etc.) and chemical (acaricides, protein denaturants, etc.)
strategies. Recall that strategies for mite control
should be based upon the allergenic load and the asthmatic status of
the patient. In other words, does the control
strategy significantly reduce mite numbers to lessen the burden on
dust-sensitive individuals? In addition, the
safety of acaricides forwidespread use should be determined and methods
for combining them with other strategies should
be investigated and outlined in an overall protocol. Doing so will
provide the most effective means for controlling
dust mites and their allergens. The studies reviewed in this article
suggest that currently available products for
control of dust mites and their allergens offer only short-term solutions.
Thus, the search for a long-lasting, safe product
to control this problem is warranted. Dust mite-induced allergy and
asthma will remain significant medical concerns
until safe and practical measures are obtained for
controlling mite populations.
COLD WEATHER
Some people develope an allergy to cold In winter,
if you go outside for even a few minutes, you may breaks out in
hives. With the hives come an aching pain.
In summer, the same thing happens when you swims too long in cold
water. The pain and rash disappear when you warm
up. What is this condition and what can be done to help
tolerate cold better? ? ? ?
The description of the problem certainly suggests
it is an allergy to cold (cold urticaria). Urticaria, or hives,
is characterized by localized swelling of skin
or mucous membranes. The welts can vary from a fraction of an
inch to several inches across. Cold exposure
is just one of many causes of urticaria, but it is an important one.
Cold urticaria can pose serious
risks if it involves the airway and impairs breathing. For persons with
this
problem, swimming in cold water may lead to drowning.
Every effort should be made to avoid cold
exposure known to cause problems.
The
underlying cause may be hard to establish. It may be familial (inherited)
or occur spontaneously and possibly
clear
over a period of years. In addition, cold urticaria may be a manifestation
of an underlying medical problem
that
warrants attention and treatment. Consequently, an allergic evaluation
should be considered before
addressing
the issue of treatment options.
Food allergy
Do you "react" to certain foods?
Food allergies are nothing to sneeze at. The symptoms--nausea, itchy hives,
breathing difficulty, and swelling--
are miserable. In extreme cases, allergies can
be deadly.
Fortunately,
only 1 to 2 percent of adults suffer from a true food allergy. So why,
then, do as many as one in
three
people believe they're allergic to certain foods?
The answer lies in the confusion between a food allergy and what is more likely a food intolerance.
Food allergy is an immune response
A food allergy is often hereditary. If one of your parents has an allergy, you're twice as likely to develop one.
Normally,
your intestinal tract serves as a barrier between foods and your immune
system. If you're prone
to
a food allergy, this barrier fails. When an offending food (allergen) passes
through your digestive system, your
body
forms antibodies specific to the food. The next time you eat the food,
it reacts with these
antibodies,
triggering an allergic reaction that includes release of histamine and
other chemicals.
Release
of these substances can cause a host of uncomfortable symptoms affecting
your skin, respiratory
system
or stomach and intestines--usually within two hours.
However,
it may be only seconds before someone with a severe allergy may experience
an anaphylactic
(a-na-fi-LAK-tik)
reaction. In this life-threatening condition, several parts of your body
react simultaneously to the
allergen.
The airways in your lungs constrict and the soft tissues in your throat
swell, making it difficult to breathe.
Your
heart beats rapidly. To prevent death, immediate medical attention is essential.
Any
food can cause a food allergy. But few are actually proven to trigger reactions.
The most common offenders
are
peanuts, tree nuts, shellfish (especially shrimp), whitefish, wheat, milk
and eggs.
Food intolerance mimics allergy
Food
intolerances, like food allergies, are adverse reactions to foods. But
food intolerances don't involve
your
immune system. Food intolerances are also much more common than allergies.
It's
easy to confuse an intolerance with an allergy because both conditions
have similar symptoms, such
as
nausea, vomiting, cramping and diarrhea.
If
you have a food intolerance, however, you can usually eat small amounts
of the offending food without
problems.
In contrast, a tiny amount of a food to which you're allergic can trigger
a reaction.
Here are common causes of food intolerances:
Lack
of a digestive enzyme--You may not have adequate amounts of some enzymes
needed to
digest certain foods. Insufficient quantities of the enzyme lactase, for
example, make it difficult to
digest lactose, the main sugar in milk products. Lactose intolerance can
cause bloating, cramping,
diarrhea and excess gas.
Contaminants--Sometimes food poisoning can mimic an allergic reaction.
Some types of
mushrooms and rhubarb, for example, can be toxic. Bacteria in spoiled tuna
and other fish can
also make a toxin that triggers adverse reactions.
Food additives--Sulfites, used to preserve
fruits and vegetables, can make asthma worse in some
people. Other additives, including monosodium
glutamate and coloring agents, can provoke adverse
reactions. Yet sensitivities to additives account
for only 3 to 5 percent of all food intolerances.
Psychological factors--Though not fully understood, sometimes the mere
thought that afood may make you
sick actually does.
Does age affect allergies?
Children
are 10 times more likely than adults to have a food allergy. As your gastrointestinal
system matures, it's
less
apt to allow absorption of food components that trigger allergies.
Children
typically outgrow allergies to milk, wheat and eggs. Severe allergies and
those to tree nuts and
shellfish
are more likely to be lifelong. However, malnutrition and conditions that
suppress your immune
system
increase the likelihood of developing a food allergy at any age.
Within
the past two years, Michael W. Yocum, M.D., a Mayo Clinic allergist, has
seen an increase in adults
diagnosed
with food allergies. Arthritis medications and increased use of aspirin
to prevent cardiovascular
disease
and other illnesses may be involved.
According
to Dr. Yocum, these medications may change the surface of the intestine,
allowing more allergens to
pass
through. Once allergens are absorbed and contact your immune system, the
risk of a reaction increases.
Still, the risk is small. Food allergies remain a relatively rare problem in adults.
What should you do if you suspect a food allergy?
If you regularly
avoid certain foods because you "react" to them, see a physician who is
certified by the American
Board
of Allergy and Immunology. This specialist can distinguish between an allergy
and an intolerance by
using
several diagnostic steps (see "Five steps to diagnose food allergies").
Avoid doctors who use
cytotoxic testing and symptom provocation/neutralization testing, in which
a dose of a
food extract is placed
under your tongue or injected into your skin. Both tests are expensive
and unreliable in
detecting
a food allergy.
The
best you can do for a food allergy is avoid the food. If you have a food
intolerance, your allergist and a
registered
dietitian can help you learn to minimize reactions and avoid unnecessary
food restrictions.
These steps help determine true food allergies:
Step 1--History of your symptoms, including when they occur, which foods
cause problems, the
amount of food needed to trigger symptoms, and whether you have a family
history of allergies.
Step 2--Food diary to track eating habits, symptoms and medication use.
Step 3--Physical examination.
Step 4--Skin prick test to signal activation
of your immune system if you react to a small amount of
food extract pricked into your skin.
Immunoassays are used to check a sample of your blood for
antibodies specific to certain foods.
Neither test is 100 percent accurate. Each test may be more
useful to exclude a food allergy than to diagnose
one.
Step 5--Food elimination-challenge diet
is the "gold standard" test because it can link symptoms to a
specific food. It can't be used, however, if you have severe reactions.
SHRIMP
It is not unusual for shrimp or other seafood
to cause an allergic reaction. The best clue is the occurrence of
hives after eating shrimp and not other
foods. Food allergies can lead to a serious reaction, so it is important
to
talk with your doctor to establish a cause and
get advice concerning treatment other than avoiding the food. It
is
possible to be accidentally exposed to foods
that may be included in salads, etc., even if you attempt to avoid them.
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In response to many inquiries here is a thumbnail note on food allergies. 1. More than likely, if you are allergic to one substance, you have multiple allergies: i.e. allergic to aspirin or penicillin or....then you are allergic to other items, whether they be food or odors or textures. 2.If you know what you are allergic to, you should
avoid the item...even a small amount, because you may be exacerbating
3.You must pay attention to all...all the foods you ingest.If you eat canned or frozen foods, processed and combined with a number of items, make sure that they do not contain, within themselves or added to, items that will give you allergy problems.Read and understand the contents. 4. If you eat bread, cookies or crackers, as an
example, you are ingesting at least three articles that can cause reactions
5. Keep your food fresh, simple and as natural as possible.Use seasonings sparingly. Most contain mold(fungus) or irritants that multiply your reactions. 6. Cook your food sparingly. Use only natural oils(olive oil or butter). The body does not do well with synthetics or highly processed ingredients. Why? Because it only recognizes NATURAL foods or contents. The body is a machine that only works
well with nutrients that it can assimilate within and nourish from.
Synthetics are
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Most people don't think about allergic rhinitis
(nasal allergies) during the winter months. Allergies are usually
SEASONAL AND PERENNIAL ALLERGIES: WHAT THEY
HAVE IN COMMON
THE DIFFERENCES BETWEEN SEASONAL AND PERENNIAL
ALLERGIES
Perennial allergies, which cause symptoms all
year round, usually result from substances you are exposed to every
GET THOSE SEASONAL ALLERGY SYMPTOMS UNDER CONTROL!
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Contact: The Boo Mistress - Olivija
..........
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last edited 6-8-2006