Archive for the ‘Airway Allergy’ Category
Tuesday, June 1st, 2010
Mould or fungal spores contained in black mildew which grows both indoors in damp bathrooms, kitchens and cellars and outdoors on dead leaves particularly in autumn can trigger severe asthma and chronic rhino-sinusitis. The main fungal culprits namely Cladosporium and Aspergillus can trigger brittle and difficult to treat asthma as well as chronic sinusitis in allergy prone individuals. This mould allergic asthma may occur as change-of-season epidemics and result in severe asthma attacks often necessitating hospitalisation and ICU admission.
Moulds and fungal spores are also recognised causes of a number of respiratory problems especially in immune-compromised leukaemic and transplant patients, elderly with chronic bronchitis, children with cystic fibrosis and those suffering with HIV and TB. In northern Europe a delayed hypersensitivity to the Aspergillus mould may result in Acute Bronchopulmonary Aspergillosis (ABPA) which causes progressive lung damage with cavities (bronchiectasis) and severe disability.
In addition to Aspergillus and Cladosporium other allergy trigger factors in difficult to treat asthma may be common environmental fungal spores such as Alternaria, Penicillium (mouldy fruit), Botrytis (blight) and even common skin fungi such as Candida (thrush) and Trichophyton (ringworm) mould spores. This condition is called SAFS or Severe Asthma with Fungal Sensitivity which is ordinarily very difficult to treat with resultant severe asthma exacerbations despite high doses of inhaled preventer and reliever medication. Recent research has highlighted the probability that up to 60% of these patients may respond well to antifungal medication such as itraconazole and amphotericin B.
Reference: Denning DW, Driscoll B R, Hogaboam CM , Bowyer P Niven RM, The link between fungi and severe asthma; a summary of the evidence. European Respiratory Journal 2006; 27:615-626
Tags: abpa, aspergillosis, autumn asthma, fungus sensitivity, itraconozole, mould allergy, safs
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Friday, April 16th, 2010
The Volcanic dust and ash cloud currently drifting over western Europe from Iceland is unlikely to cause any acute health risk or exacerbate allergies and asthma in the United Kingdom. Volcanic ash contains fine grains that may irritate the airways, as well as associated sulphur gas, but the amount that falls to earth and reaches ambient air is likely to be very small. Scientists believe it will be equivalent to Sahara desert sand particles that are regularly drawn up into the atmosphere and then sprinkled down over Britain. Allergy and allergic asthma sufferers should continue to use their preventer and reliever inhalers as usual and see their GP if they have any health concerns.
Reference: Skynews.com
Tags: allergic asthma, reliever inhaler, volcanic ash
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Wednesday, March 10th, 2010
The grass pollen hay fever season is fast approaching and those of you prescribed oral immunotherapy should have now commenced treatment at least 2 months before the summer season kicks off in May. For the rest of us, make sure you start taking antihistamine medication at least for a week before those innocent looking lawns and fields start their unrelenting attack on our upper airways.
Specific grass desensitization to Timothy grass pollen as a treatment for allergy and hay fever has been available for the last 3 years. This sublingual (SLIT) tablet contains a Timothy grass pollen extract which dissolves away under the tongue where it is absorbed promoting immune tolerance to grass pollen when taken over a 3 year period. Although expensive at over £2 per day, Grazax is an additional option for those severe hay fever sufferers (with allergic rhinoconjunctivitis) not responding to conventional antihistamine medication and nasal steroid sprays. It can be prescribed on the NHS but many health authorities deem it too expensive for the 30% improvement in hay fever symptoms and reduced medication requirements documented in clinical studies. Many desperate hay fever sufferers have therefore turned to private prescriptions of this disease modifying hay fever tablet.
Reference: Durham SR et al. Long-term clinical efficacy in grass pollen-induced rhinoconjunctivitis after treatment with SQ-standardized grass allergy immunotherapy tablet. Journal Allergy and Clinical Immunology 2010;125:131-38
Tags: allergic rhinitis, allergic rhinoconjunctivitis, antihistamine medication, grass allergy tablet, grass desensitization, grazax, hay fever tablet, immunotherapy, SLIT, timothy grass
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Tuesday, December 22nd, 2009
Although some people have a general aversion to all things Christmas, this is not truly an allergy. But for those genuinely allergic people, the festive season can be a frankly dangerous period. Unprecedented numbers of children have developed nut, fruit and general food allergies in recent years as the allergy pandemic takes hold of our lives on a scale that outstrips global warming and climate change. Christmas time is a highly risky period for these people. Consider the contents of Christmas foods such as cakes, mince pies, puddings, nuts and all those special treats abundantly available during the Festive Season. No wonder it’s a worrying time for parents and allergy sufferers. Even the traditional Christmas tree may be a hotbed of allergens, distributing pollen, moulds and resin inside the home. Whilst a synthetic tree may be as problematic for it may contain allergenic chemicals such as formaldehyde and isocyanates. These chemicals can trigger off asthma, rhinitis, skin allergies and allergic conjunctivitis.
On a more positive note, the traditional Christmas turkey is a particularly low allergy-risk protein and if served together with low allergy-risk vegetables such as rice, sweet potato, cooked carrot, parsnip, beetroot and peas, this can make a particularly suitable Christmas meal for allergy-prone children and their parents. Finish off the festivities with a hypo-allergenic dessert of cooked pears or apricots. The process of cooking foodstuffs tends to reduce the allergy provoking effects on the immune system by slightly changing the molecular structure of the food. If in doubt about allergy-risk friends and visitors always keep a good supply of antihistamine medication on hand just in case…………….
www.allergy-clinic.co.uk/food-allegy/food-allergy-guide
Tags: christmas allergies, christmas turkey, climate change, food aversion, formaldehyde, hypo-allergenic, isocyanates
Posted in Airway Allergy, Food Allergy | No Comments »
Thursday, December 10th, 2009
In the Cincinnati study into Childhood Allergy and Air Pollution, 624 babies and toddlers of allergic parents were assessed and when exposured to a combination of high levels of indoor allergens (such as bacteria from throat infections, house dust mites and mould spores) plus traffic air pollution, this increased their risk of developing wheezing and persistent asthma by six fold. The well-established Hygiene Hypothesis highlights the connection between a sterile home environment in infancy and the risk of deveoping childhood allergies. It was the combined effect of exposure to high levels of indoor allergens (endotoxin) together with the motor car diesel exhaust fumes that seemed to be such a potent trigger for wheezing and persistent airway inflammation. The resultant chronic airway inflammation is also known to retard long-term normal lung development. While in children exposed to moderate levels of indoor or outdoor allergens, only 11 percent developed asthma and in those exposed to low levels of allergen but high level air pollution, 18 percent developed persistent or chronic asthma.
http://www.newswise.com/articles/view/558806/?sc=mwtn
Tags: air pollution, airway inflammation, allergens, childhood allergy, chronic asthma, diesel exhaust, hygiene hypothesis, wheezing
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Monday, November 23rd, 2009
More than five million individuals in the UK receive regular treatment for chronic asthma. Many are unsure about when or how to use inhalers, which reduces the effectiveness of their medication and can be a health risk.
A leading pharmacy group has developed a service, designed to help patients use long-term prescription drugs correctly. They found patients either breathe in too fast or not strongly enough and many individuals don’t seem to be able correctly alter their inhaler technique. These patients are then advised to speak to their GP about finding an alternative asthma medication delivery system. A study at Belfast City Hospital revealed 35 per cent of asthmatic patients used half or less of their prescribed medication, and another 21 per cent used treatment more than prescribed.
Asthma control is reliant on adequate use of low dose inhaled steroids as preventer medication particularly during the winter months when viral infections are likely to exacerbate asthma attacks.
http://www.dailymail.co.uk/health/diets/article-1229842/Millions-asthma-sufferers-misuse-medication.html
Tags: asthma control, Asthma Medication, asthma preventer, chronic asthma, steroid inhaler
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Saturday, October 17th, 2009
There has recently been a lot of debate in the media about safety of vaccines, particularly relating to the MMR (Measles, Mumps & Rubella) vaccination with unsubstantiated links to Autism and Ashbergers Disease. In addition, the measles vaccine was historically grown on chick embryos, thus running the risk of egg allergen contamination, and consequently recipients could potentially develop anaphylaxis if highly egg allergic. Today the MMR vaccine no longer contains any egg allergen and is absolutely safe to administer to highly egg allergic children.
The influenza and yellow fever vaccines are still cultured on chick egg embryo’s and thus potentially contain egg protein. But the World Health Organisation (WHO) suggests that this is unlikely to be problematic if mildly egg allergic and in those who tolerate egg without anaphylaxis. In severe egg allergy with anaphylaxis, administration of the conventional influenza and yellow fever vaccinations are contraindicated.
Does the same go for the current Swine Flu (H1N1) influenza vaccine? I’m informed that Pandemrix currently being promoted to prevent the second wave of the Swine Flu pandemic is also cultured on chick egg embryos. Fortunately there is an alternative Swine Flu vaccine called Celvapan which is not cultured on egg and therefore safe to give to egg allergic individuals. But the Celvapan vaccine does not contain the immunity enhancing adjuvant Squalene and therefore requires 2 doses 3 weeks apart. Celvapan is also the WHO preferred adjuvant-free Swine flu vaccine to be given during pregnancy.
Annual Flu vaccines are routinely recommended for asthma sufferers as they are generally more prone to viral illnesses, influenza and chest complications. But Asthma sufferers are also a greater risk group for anaphylaxis if concomitantly egg allergic and inadvertently given the egg cultured flu vaccine. If in doubt, 1/10th of the vaccine should be administered under medical supervision as a test dose followed by the 9/10th balance if no reaction occurs within 30 minutes. For detailed advice on egg allergy and Swine Flu vaccinations visit the British Society for Allergy and Clinical Immunology via this link:
http://www.bsaci.org/index.php?option=com_docman&task=doc_download&gid=80
Tags: asthma, autism, egg allergy, flu, H1N1, influenza, mmr, swine, vaccination, yellow fever
Posted in Airway Allergy, Food Allergy | No Comments »
Saturday, October 17th, 2009
The current epidemic of allergic disease seems to be in part related to living in a much cleaner more sterile environment together with a lack of parasitic worm infestations. This leads to an early switch in the infant’s immune systems to reacting in a more allergy prone (TH2) manner and less of a bacteria and viruses (TH1) targeting manner.
In a recent study published in Clinical and Experimental Allergy, investigators found that if mice had their gut infested with parasitic worms, they developed fewer food and airway allergies, but the parasites gave no protection from skin allergies. This is the first evidence that intestinal worms can actually modulate the immune system and “protect” against developing allergies.
A similar study on Vietnamese children showed that if they were treated to eradicate their parasitic gut hookworms, they became much more likely to develop house dust mite allergies and asthma.
Reference: Gastrointestinal nematode infection interferes with experimental allergic airway inflammation but not atopic dermatitis. Hartmann S, Schnoeller C, Dahten A et al. Clin Exp Allergy 2009 (39) 1585-1596.
http://news.bbc.co.uk/2/hi/health/8268584.stm
Tags: hookworm, parasite, prevention, TH2
Posted in Airway Allergy | 2 Comments »
Saturday, October 17th, 2009
Salbutamol is the mainstay of treating acute asthma and relieving wheeze. Some children may not respond to this medication. Up to 100,000 children – 13% of all children with asthma – carry two copies of a gene that renders the blue inhaler drug salbutamol ineffective.
If these children need to use their “reliever” inhaler daily they are 30% more likely to suffer an asthma attack than others, a UK research study shows.
Fortunately it is possible to test for the gene change using a simple mouthwash.
http://news.bbc.co.uk/2/hi/health/8292915.stm
Tags: asthma, reliever, salbutamol, treatment
Posted in Airway Allergy | 1 Comment »
