Dr. Adrian Morris of Surrey Allergy Clinic Tests and Treats allergies » Airway Allergy

Mildew allergy in severe asthma and sinusitis

Dr. Adrian Morris — Tue, 01 Jun 2010 17:51:55 +0000

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

Volcanic ash cloud and allergy

Dr. Adrian Morris — Fri, 16 Apr 2010 14:46:34 +0000

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

Treating hay fever with grass allergy tablet

Dr. Adrian Morris — Wed, 10 Mar 2010 15:09:55 +0000

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

Christmas allergies

Dr. Adrian Morris — Tue, 22 Dec 2009 19:05:50 +0000

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

Motor traffic air pollution increases allergies

Dr. Adrian Morris — Thu, 10 Dec 2009 16:28:55 +0000

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