Archive for the ‘Airway Allergy’ Category
Sunday, December 25th, 2011
For many years indoor Christmas trees have bee suspected to be a source of allergen induced asthma, rhinitis and respiratory problems during the period from mid December to early January. It was thought that coniferous tree pollen, incidental grass and weed pollens on the tree and oleoresins secreted by Fir trees were to blame. However a recent study in the US, has found that coniferous Christmas trees carry and sustain significant amounts of mould spores. Common allergenic moulds such as Cladosporium, Aspergillus, Alternaria and Penicillium are found in significant amounts on Christmas trees and raise indorr mould levels from 300 to 5000 spores per cubic metre of indoor air. Exposure to the spores trigger chronic respiratory conditions such as allergic asthma, rhino-sinusitis and chronic bronchitis (COPD). Spraying the tree with a mist containing household bleech such as Milton (sodium hypochlorite) kills off moulds and prevents their growth on the trees and subsequent indoor mould contamination.
Reference: Identification of mold on seasonal indoor Coniferous trees. Annals of Allergy, Asthma & Immunology 2011 106:6: 543-544
Tags: alternaria, aspergillosis, christmas allergies, christmas tree, cladosporium, mould allergy
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Thursday, September 1st, 2011
Urban air pollution is a serious public health hazard and has been associated with exacerbations of chronic respiratory illnesses due to airway mucus membrane irritation and increased oxidative stress. However no convincing link between air pollution and allergic sensitisation has been shown in the scientific literature. We know that nitrogen dioxide, ozone and diesel exhaust particulate matter in air pollution can predispose to increased respiratory infections, aggrevate asthma, bronchiectasis and chronic bronchitis (COPD), but any link to actually triggering allergic sensitisation is less clear. Certainly diesel exhaust particles have been shown to absorb grass pollen grains and increase the pollen load in the nose and lungs, thus making hay fever and hay asthma symptoms worse for city dwellers and those living near motorways.
Reference: Kelly FJ, Fussell JC. Air pollution and airway disease. Clinical and Experimental Allergy 2011 (41) 1059-1071
Tags: air pollution, bronchiectasis, bronchitis, copd, diesel exhaust, oxidative stress, ozone
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Tuesday, August 2nd, 2011
Recent medical research shows that our middle-class obsession with cleanliness and avoiding weaning until late in infancy has rebounded in a western-world epidemic of childhood wheezing, sneezing and eczema with seven fold increases in peanut, cat, dust mite and pollen allergies. We are now encouraged rather to throw the cat in the cot, smother the baby in peanut butter and get those snotty cousins around to cough on little Hector. Yes, early exposure to farmyard dirt, bacteria, furry pets and nuts seems to be good and paradoxically prevents allergies, especially if there is high allergen exposure in the first few months of life. Health warnings to avoid allergens such as peanut in pregnancy and early infancy have actually led to increased peanut allergies and allergic sensitization in childhood.
Reference Clinical and Experimental Allergy July 2011:
Wegienka G, Johnson CC, Havstad S, Ownby DR, Nicholas C, Zoretti EM, Lifetime dog and cat exposure-and cat-specific sensitization at age 18 yrs Clinical and Experimental Allergy 2011 (41) 979-986
Erwin EA, Woodfolk JA, Ronmark E, Perzanowski M, Platts-Mills TAE The long-term protective effects of domestic animals in the home. Clinical and Experimental Allergy 2011 (41) 920-922
Kim JS, Jarvinen. Peanuts for preschoolers: less preposterous than previously perceived? Clinical and Experimental Allergy 2011 (41) 914-916
LEAP study (www.leapstudy.co.uk)
http://www.independent.co.uk/life-style/health-and-families/features/crunch-time-for-peanut-allergies-885074.html
Tags: allergen exposure, alllergic sensitisation, health warnings, peanut allergies
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Monday, May 2nd, 2011
Many different so-called wonder-cures for hay fever have come and gone over the years. This is particularly evident online, as one searches for a drug-free natural alternative to conventional hay fever medication. The problem is that many of these remedies, which sound attractive at face value , have no track record or clinical evidence base. Mere anecdotal reports of efficacy aren’t robust enough to allow their large-scale endorsement by the medication regulatory authorities. However many people do find them enticing and feel they do help alleviate those incapaciaiting hay fever symptoms that so badly affect our work, school and social lives during the peak pollen season when we really want to be outdoors enjoying the summer.
Nasal pollen filters have been around in various guises for over 100 years, but some recently developed nasal plug filters with effective HEPA (high efficacy particle arresting) filters seem on first impression to provide encouraging protection from pollen, although not yet readily available on the UK market.
Nasal sprays that deposit a fine protective film of particles that impede pollen deposition on the nasal membranes have reached the local market. Most have no proven efficacy in clinical trials but seen harmles enough, and these include Prevalin thixotropic and Nasaleze micro-gel barrier sprays which seem to have a soothing effect on the nose.
Portable infra-red light treatments directed into the nose using using two small probes have been purported to help symptoms, although the exact physiological basis on which they work seems unclear. A number of these products have also reached the UK market and can be bought at health stores or online. Products now available in the UK include Bionase and Medinose, Lumie Haylight Light diodes.
Modern acupauncture meridean activating devices such as Hay band and Qu-Chi acupressure bands worn on the arm are readily available on the internet, but again their effectiveness in controlling hay fever has not been proven.
Taking a daily teaspoonful of locally-produced honey, starting a few months prior to the pollen season, may or may not be effective in providing a form of pollen desensitisation. Medibee bee pollen capsules seem less likely to effect a hay fever cure especially when the sales phrase is (“bees don’t get hay fever”). As far as I can remember from my GSCE biology days, bees don’t have a nose in the first place.
www.quackwatch.com
http://www.dailymail.co.uk/health/article-1378328/Is-allergy-real-just-reaction.html
Tags: allergy gimmicks, bionase, hayband, haylight, medibee, medinose, nasal filter, nasal light, nasaleze, prevalin, quchi, thixotrophic
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Friday, April 1st, 2011
Spring has suddenly broken through the icy winter and the trees are covered in blossom this April. But this is a time of discomfort and suffering for those tree pollen allergic hay fever sufferers who will experience itching, sneezing, watering nose and irritatingly painful eyes. Silver birch pollen will be pouring from dangling catkins suspended from dormant trees coming back to life again after the long cold winter. Silver Birch pollen contains a particulary potent allergy provoking substance called Bet V 1 otherwise known as Profilin, which is curiously also contained in fresh apples, pears and stone fruit such as peaches, nectarines, cherries and plums. In addition, Profilin is found in hazelnuts and walnuts as well as vegetables such as celery, carrot, potato and tomato. Fortunately most afflicted will only experience itching of the mouth, palate and throat if they eat these foods in the raw form. Cooking these foods damages the Profilins and makes them less allergy provoking. These pollen-food cross reactions are usually irritating but rarely ever lead to more serious allergic reaction such as anaphylaxis and will respond promptly to antihistamine medication such as cetiriizine, loratadine and fexofenadine.
Visit our webpage on hay fever and oral allergies for more information
www.allergy-clinic.co.uk/airway-allergy/hayfever
http://www.allergy-clinic.co.uk/airway-allergy/oral-allergy-syndrome
Tags: apple allergy, betv1, blossom allergy, cetirizine, fexofenadine, fruit allergy, hay fever april, loratadine, oral allergy syndrome, profilin, silver birch pollen, stone fruit allergy
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Wednesday, March 9th, 2011
Conventional first line treatments for hayfever and allergic eyes (conjunctivitis) are non-sedating antihistamine medication. However there is growing evidence that topical nasal sprays containing low dose steroids control both nasal symptoms (such as congestion, rhinorrhoea, sneezing and itching) and eye symptoms (such as itching/ burning, tearing/watering and redness) in persistent allergic rhinitis and conjunctivitis. The recommended nasal sprays containing fluticasone, mometasone or triamcinolone only need to be used once daily into the nose but should be continued throughout the tree and grass pollen hay fever season for best results. Just in case you are now totally confused; the beneficial effects are when the nose spray is discharged into the nose only - these sprays should never be discharged onto or into the eyes.
Reference: Rodrigo GJ, Neffen H. Clinical and experimental allergy 2011 (41) 160-170
Tags: allergic rhinitis, allergic rhinoconjunctivitis, allergy treatment, eye allergy, eye irritation, fluticasone, hayfever, mometasone, nose sprays, steroid spray
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Tuesday, February 1st, 2011
It’s early February and with the cold weather one forgets that Spring is around the corner. Now is the time to proactively prepare for the hay fever season. First of all the tree pollens will arrive with Silver Birch tree pollen being the main culprit and those sensitive to this aeroallergen will get typical hay fever very early in March. Most hay fever sufferers will have problems when the Grass pollens become prevalent a little later in April/May. Now is the time to prepare as prevention is better than cure. Start your once-daily non-sedating antihistamines 2 to 3 weeks before the season gets under way, for tree pollen allergies, that means starting this month and for grass pollen allergy start in mid March. Take your antihistamine every day during the season for best results, low dose nasal steroid sprays are very effective if taken together with antihistamines for breakthrough symptoms. For those lucky enough to have been prescribed immunotherapy such as Grazax, get your prescription immediately and start taking this oral grass pollen desensitization treatment this month. Other measures such as a daily teaspoonful of local honey, herbal Butterbur and cromoglycate drops (Optrex) may also help and should be started soon. Don’t leave treatment until your eyes are streaming and your nose is like a “Fireworks display”. Be proactive, and plan your hay fever prevention so that the spring and summer months are enjoyable and full of fun rather than being a time of sneeze, itch, coryza and misery.
http://www.allergy-clinic.co.uk/airway-allergy/hayfever/
Tags: allergic rhinitis, allergic rhinoconjunctivitis, allergy prevention, antihistamine, butterbur, grass desensitization, grazax, hayfever, optrex
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Tuesday, November 2nd, 2010
Samter’s triad is a respiratory intolerance to aspirin or salicylate containing medication (such as non-steroidal antiinflammatories NSAI’s), that results in maturity onset asthma and polyps obstructing the nasal passages with exacerbations induced by the intake of salicylate (aspirin) containing medications. This group of medications reduce production of prostaglandins and pain, but may increase production of pro-inflammatory leucotriences in the airways of susceptoible individuals. They may then present with nasal blockage and loss of smell (anosmia), with acute asthma attacks and even urticaria (hives) in middle age. About 5% of asthma sufferers are sensitive to aspirin and salicylate which may trigger asthma attacks when these medications are taken.
Treatment includes withdrawal of all salicylate containing medications (such as aspirin, ibuprofen, diclofenac, indomethacin) and related preservatives such as sodium benzoate and artificial colourings (tartrazine). Paracetamol is usually safe to be taken. Surgical removal of nasal polyps helps but very often the polyps grow back. Steroidal nasal sprays and Montelukast (a leukotiriene receptor antagonist) with slow the regrowth of the polyps and prevent asthma. Desensitisation starting with traces of aspirin to induce tolerance is possible but requires hospitalisation in a specialist unit. An enormous number of foods contain traces of salicylate, thus making a salicylate-free diet impractical except perhaps to avoid excess spicy foods, berriy fruits and strong tea all of which contain high levels of natural salicylate.
Read more….
http://en.wikipedia.org/wiki/Aspirin-induced_asthma
Tags: aspirin allergy, desensitisation, intolerances, montelukast, polyps, salicylate, samters triad
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Saturday, October 16th, 2010
House Dust Mites are tiny spider-like 8-legged creatures called dermatophagoides pteronyssinus. They do not bite and are invisible to the naked eye being only 0.3 mm in length The adult mite lives about 6 weeks, lays 50 eggs and produce 20 faecal pellets per day, which contain the allergen Der P1 (a dermatophagoides digestive enzyme). Der p 1 is the allergy-provoking particle produced by the House Dust Mite that triggers asthma and allergic rhinitis. This protein penetrates clothing, bedding, carpets and upholstery and can remain airborne for prolonged periods. Mites require 70% humidity to survive as they extract water vapour from ambient air to live. The indoor temperature needs to be about 20deg C for them to survive as they are cold-blooded. They do not survive at high altitudes over 1500 metres, in “sterile” hospital environments or in very dry places. House dust mites live on shed human skin flakes and fungal moulds growing on the dead skin flakes make them more edible. Mites have adhesive suckers on their legs with which they cling to carpets and bedding. Predator mites (Cheyletus) who in turn eat the common House dust Mites have less adhesive suckers and are preferentially vacuumed up, allowing allergy-provoking mites to proliferate. Mites will colonize a new mattress within 3 months with up to 10 000 mites inhabiting an average mattress.
Can we get rid of this allergy-provoking scourge? They are extremely difficult to completely eradicate from our bedroom environment. Chemicals that kill mites called acaricides may themselves trigger asthma but read more……….
http://www2.cochrane.org/reviews/en/ab001563.html
Tags: acaricide, cheyletus, dermatophagoides, derp1, dust mite asthma, environment allergy, house dust mite, pteronyssinus
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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
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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 | 1 Comment »
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
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