ALLERGY

Some Selected Abstracts:

1.

 Heytman M, Rainbird A. Use of alpha-agonists for management of anaphylaxis occurring under anaesthesia: case studies and review. Anaesthesia. 2004 Dec;59(12):1210-5.

Department of Anaesthesia, The Townsville Hospital, Douglas, QLD 4814, Australia.

Anaphylaxis is an uncommon but serious complication of anaesthesia. Most current guidelines for the management of anaphylaxis list only epinephrine as a vasopressor to use in the event of cardiovascular collapse. We present two cases of anaphylaxis under anaesthesia where return of spontaneous circulation was refractory to epinephrine, but occurred following the administration of the alpha-agonist metaraminol. Potential advantages and disadvantages of using epinephrine in this setting, the role of alpha-agonists and some potential mechanisms accounting for their role in successful management are reviewed.

2.

Peat JK, Mihrshahi S, Kemp AS, Marks GB, Tovey ER, Webb K, Mellis CM, Leeder SR. Three-year outcomes of dietary fatty acid modification and house dust mite reduction in the Childhood Asthma Prevention Study. J Allergy Clin Immunol. 2004 Oct;114(4):807-13.

Discipline of Paediatrics and Child Health, Children's Hospital at Westmead Clinical School, University of Sydney, Australia.

BACKGROUND: Two factors thought to influence the risk of asthma are the promoting effect of sensitization to house dust mites and the preventive effect of increased omega-3 fatty acids. Although house dust mite allergen avoidance has been used as a preventive strategy in several trials, the effect of omega-3 fatty acid supplementation in the primary prevention of asthma and allergic disease is not known. OBJECTIVE: To measure the effects of dietary supplementation with omega-3 fatty acids and house dust mite allergen avoidance in children with a family history of asthma. METHODS: A total of 616 children at high risk of asthma were enrolled antenatally in a randomized controlled trial, and 526 children remained in the trial at age 3 years. The outcomes were symptoms of allergic disease and allergen sensitization. RESULTS: There was a significant 10.0% (95% CI, 3.7-16.4) reduction in the prevalence of cough in atopic children in the active diet group ( P=.003; number needed to treat, 10) but a negligible 1.1% (95% CI, -7.1 to 9.5) reduction cough among nonatopic children. There was a 7.2% (95% CI, 10.11-14.3) reduction in sensitization to house dust mite in the active allergen avoidance group ( P=.05; number needed to treat, 14). No significant differences in wheeze were found with either intervention. CONCLUSION: These results suggest that our interventions, designed to be used in simple public health campaigns, may have a role in preventing the development of allergic sensitization and airways disease in early childhood. This offers the prospect of reducing allergic disease in later life.

3.

 Kalliomaki MA, Isolauri E. Probiotics and down-regulation of the allergic response. Immunol Allergy Clin North Am. 2004 Nov;24(4):739-52, viii. Review.

Combined Program in Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Charlestown, MA 02129, USA. marko.kalliomaki@utu.fi

The first clinical trials with probiotics, especially in the treatment of atopic eczema, have yielded encouraging results. Experimental studies have found that probiotics exert strain-specific effects in the intestinal lumen and on epithelial cells and immune cells with anti-allergic potential. These effects include enhancement in antigen degradation and gut barrier function and induction of regulatory and proinflammatory immune responses, the latter of which occurs more likely beyond the intestinal epithelium. Future studies should address more accurately how these and other possible mechanisms operate in the complex gastrointestinal macroenvironment in vivo and how these mechanisms are related to the clinical effects in a dose-dependent manner.

4.

Kull I, Almqvist C, Lilja G, Pershagen G, Wickman M. Breast-feeding reduces the risk of asthma during the first 4 years of life. J Allergy Clin Immunol. 2004 Oct;114(4):755-60.

Department of Occupational and Environmental Health, Stockholm County Council, Sweden. inger.kull@sma.sll.se

BACKGROUND: The evidence for a preventive effect of breast-feeding on asthma and other allergic diseases in childhood is inconclusive. OBJECTIVE: The aim of this study was to investigate the effect of breast-feeding on asthma and sensitization to airborne allergens among children up to 4 years of age. METHODS: A birth cohort of 4089 children was followed. Exposure data were collected at 2 months and 1 year of age. The total dose of breast milk was estimated by combining periods of exclusive and partial breast-feeding. Outcomes data were collected at 1, 2, and 4 years of age. The response rate at 4 years was 90%, and 73% participated in a clinical investigation, including blood sampling for analysis of specific IgE and lung function testing. Children with onset of wheeze during lactation (n=217) were excluded in some of the analyses to avoid disease-related modification of exposure. RESULTS: Exclusive breast-feeding for 4 months or more reduced the risk of asthma at the age of 4 years (odds ratio [OR], 0.72; 95% CI, 0.53-0.97), irrespective of sensitization to common airborne allergens ( P=.72). Excluding children with wheeze during lactation tended to strengthen the risk estimate (OR, 0.64; 95% CI, 0.46-0.88). A duration of 3 months or more of partial breast-feeding seemed to offer additional protection; exclusive breast-feeding for 3 to 4 months combined with partial breast-feeding for 3 months or more resulted in an OR of 0.44 (95% CI, 0.21-0.87). The effects tended to be stronger in children without heredity for allergy ( P interaction=.36). CONCLUSION: Breast-feeding reduces the risk of asthma during the first 4 years of life.
Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

11277.    Allen-Ramey FC, Duong PT, Riedel AA, Markson LE, Weiss KB. Observational study of the effects of using montelukast vs fluticasone in patients matched at baseline. Ann Allergy Asthma Immunol. 2004 Oct;93(4):373-80.

11278.    Axon AD, Hunter JM. Editorial III: Anaphylaxis and anaesthesia--all clear now? Br J Anaesth. 2004 Oct;93(4):501-4. 

11279.     Bateman ED, Boushey HA, Bousquet J, Busse WW, Clark TJ, Pauwels RA, Pedersen SE; GOAL Investigators Group. Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study. Am J Respir Crit Care Med. 2004 Oct 15;170(8):836-44.

11280.     Brooks DE, Graeme KA. Airway compromise after first rattlesnake envenomation. Wilderness Environ Med. 2004 Fall;15(3):188-93. Review.

11281.     Chavannes N, Schermer T, Akkermans R, Jacobs JE, van de Graaf G, Bollen R, van Schayck O, Bottema B. Impact of spirometry on GPs' diagnostic differentiation and decision-making. Respir Med. 2004 Nov;98(11):1124-30.

11282.     Dinakar C. Exhaled nitric oxide in the clinical management of asthma. Curr Allergy Asthma Rep. 2004 Nov;4(6):454-9. Review.

11283.     Fiocchi A, Besana R, Ryden AC, Terracciano L, Andreotti M, Arrigoni S, Martelli A. Differential diagnosis of IgE-mediated allergy in young children with wheezing or eczema symptoms using a single blood test. Ann Allergy Asthma Immunol. 2004 Oct;93(4):328-33.

11284.     Gelb AF, Schein A, Nussbaum E, Shinar CM, Aelony Y, Aharonian H, Zamel N. Risk factors for near-fatal asthma. Chest. 2004 Oct;126(4):1138-46.

11285.     Gomez R, Colas C, Sebastian A, Arribas J. Respiratory repercussions in adults with a history of infantile bronchiolitis. Ann Allergy Asthma Immunol. 2004 Nov;93(5):447-51.

11286.  Gupta PP, Gupta KB, Agarwal D, Sood S. Tropical pulmonary eosinophilia misdiagnosed as Miliary tuberculosis. Indian Journal of Allergy Asthma and Immunology. 2004 Jan-Jun; 18(1): 41-44.

11287.     Heytman M, Rainbird A. Use of alpha-agonists for management of anaphylaxis occurring under anaesthesia: case studies and review. Anaesthesia. 2004 Dec;59(12):1210-5.

11288.     Hiscock H, Jordan B. 1. Problem crying in infancy. Med J Aust. 2004 Nov 1;181(9):507-12. Review.

11289.     Kronander UN, Falkenberg M, Zetterstrom O. Prevalence and incidence of asthma related to waist circumference and BMI in a Swedish community sample. Respir Med. 2004 Nov;98(11):1108-16.

11290.     MacFaul R. Trends in asthma hospitalisation: is this related to prevention inhaler usage? Arch Dis Child. 2004 Dec;89(12):1158-60. 

11291.     McKeever TM, Britton J. Diet and asthma. Am J Respir Crit Care Med. 2004 Oct 1;170(7):725-9.   

11292.     Mehta SV, Parkin PC, Stephens D, Keogh KA, Schuh S. Oxygen saturation as a predictor of prolonged, frequent bronchodilator therapy in children with acute asthma. J Pediatr. 2004 Nov;145(5):641-5. Erratum in: J Pediatr. 2004 Dec;145(6):864.

11293.     Milgrom H. Anti-IgE therapy in children with asthma. Minerva Pediatr. 2004 Oct;56(5):469-79. Review.

11294.     Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004 Nov;15(4):783-98, vi. Review.

11295.     Payne DN, Qiu Y, Zhu J, Peachey L, Scallan M, Bush A, Jeffery PK. Airway inflammation in children with difficult asthma: relationships with airflow limitation and persistent symptoms. Thorax. 2004 Oct;59(10):862-9.

11296.     Peat JK, Mihrshahi S, Kemp AS, Marks GB, Tovey ER, Webb K, Mellis CM, Leeder SR. Three-year outcomes of dietary fatty acid modification and house dust mite reduction in the Childhood Asthma Prevention Study. J Allergy Clin Immunol. 2004 Oct;114(4):807-13.

11297.     Perry TT, Matsui EC, Conover-Walker MK, Wood RA. Risk of oral food challenges. J Allergy Clin Immunol. 2004 Nov;114(5):1164-8.

11298.    Rademaker M. Allergic contact dermatitis to a sanitary pad. Australas J Dermatol. 2004 Nov;45(4):234-5.

11299.     Redmond AM, James AW, Nolan SH, Self TH. Premenstrual asthma: emphasis on drug therapy options. J Asthma. 2004 Oct;41(7):687-93. Review.

11300.     Schaub B, von Mutius E. The marketing of asthma and allergies. Lancet. 2004 Oct 16;364(9443):1389-90. 

11301.     Sicherer SH, Teuber S; Adverse Reactions to Foods Committee. Current approach to the diagnosis and management of adverse reactions to foods. J Allergy Clin Immunol. 2004 Nov;114(5):1146-50. 

11302.     Simons FE, Peng Z. Early-onset cellulitis after insect bites: allergic inflammation. Ann Allergy Asthma Immunol. 2004 Dec;93(6):606; author reply 606-7. 

11303.     Smith H, White P, Annila I, Poole J, Andre C, Frew A. Randomized controlled trial of high-dose sublingual immunotherapy to treat seasonal allergic rhinitis. J Allergy Clin Immunol. 2004 Oct;114(4):831-7. 

11304.  Storms W, Chervinsky P, Ghannam AF, Bird S, Hustad CM, Edelman JM; Challenge-Rescue Study Group. A comparison of the effects of oral montelukast and inhaled salmeterol on response to rescue bronchodilation after challenge. Respir Med. 2004 Nov;98(11):1051-62.
Pathogenesis

11305.     Busse WW, Leung DY. New series: Perspectives in asthma. J Allergy Clin Immunol. 2004 Nov;114(5):1022.  

11306.     Cantorna MT, Zhu Y, Froicu M, Wittke A. Vitamin D status, 1,25-dihydroxyvitamin D3, and the immune system. Am J Clin Nutr. 2004 Dec;80(6  Suppl):1717S-20S. Review.

11307.     Chhabra SK. Does increased dietary salt intake worsen asthma? Indian J Chest Dis Allied Sci. 2004 Oct-Dec;46(4):247-9.

11308.     Cookson W, Moffatt M. Making sense of asthma genes. N Engl J Med. 2004 Oct 21;351(17):1794-6. 

11309.     Coppieters Y, Piette D. Targeting pupils at risk of occupational asthma. Patient Educ Couns. 2004 Oct; 55(1):136-41.

11310.   Goldrosen MH, Straus SE. Complementary and alternative medicine: assessing the evidence for immunological benefits. Nat Rev Immunol. 2004 Nov;4(11):912-21. Review.

11311.     Humphris CJ. Chemical danger. Lancet. 2004 Nov 27;364(9449):1937.

11312.     Isolauri E, Rautava S, Kalliomaki M. Food allergy in irritable bowel syndrome: new facts and old fallacies. Gut. 2004 Oct;53(10):1391-3.

11313.     Kalliomaki MA, Isolauri E. Probiotics and down-regulation of the allergic response. Immunol Allergy Clin North Am. 2004 Nov;24(4):739-52, viii. Review.

11314.     Kawano T, Matsuse H, Kondo Y, Machida I, Saeki S, Tomari S, Mitsuta K, Fukushima C, Obase Y, Shimoda T, Kohno S. Tacrolimus reduces urinary excretion of leukotriene E(4) and inhibits aspirin-induced asthma to threshold dose of aspirin. J Allergy Clin Immunol. 2004 Dec;114(6):1278-81.

11315.     Kollmeier AP, Eddleston J, Zuraw BL, Christiansen SC. Recurrent anaphylaxis linked to 1pantoprazole. J Allergy Clin Immunol. 2004 Oct;114(4):975-7.

11316.     Kull I, Almqvist C, Lilja G, Pershagen G, Wickman M. Breast-feeding reduces the risk of asthma during the first 4 years of life. J Allergy Clin Immunol. 2004 Oct;114(4):755-60.

11317.     Mendell MJ. Commentary: air conditioning as a risk for increased use of health services. Int J Epidemiol. 2004 Oct;33(5):1123-6. Epub 2004 Aug 19.

11318.     Moffitt JE. Reactions to insect bites and stings: what about the orphan insects? Ann Allergy Asthma Immunol. 2004 Dec;93(6):507-9.

11319.     Norman PS. Sublingual swallow immunotherapy in the new world.Ann Allergy Asthma Immunol. 2004 Nov;93(5):405-6.

11320.     O'Hagan DT, Rappuoli R. The safety of vaccines. Drug Discov Today. 2004 Oct 1;9(19):846-54. Review.

11321.     Openshaw PJ, Yamaguchi Y, Tregoning JS. Childhood infections, the developing immune system, and the origins of asthma. J Allergy Clin Immunol. 2004 Dec;114(6):1275-7.

11322.     Wal JM. Bovine milk allergenicity. Ann Allergy Asthma Immunol. 2004 Nov;93(5 Suppl 3):S2-11. Review.

11323.     Weinberger M. Respiratory infections and asthma: current treatment strategies. Drug Discov Today. 2004 Oct 1;9(19):831-7. Review. 

11324.  Wickelgren I. Immunology. Policing the immune system. Science. 2004 Oct 22;306(5696):596-9.

Therapy:

11325.     Abbott A. Beta-blocker goes on trial as asthma therapy. Nature. 2004 Nov 4;432(7013):7.

11326.     Anchor J, Settipane RA. Appropriate use of epinephrine in anaphylaxis. Am J Emerg Med. 2004 Oct;22(6):488-90.

11327.     Barnes PJ. Decision making in asthma therapy--what is important in clinical practice? Respir Med. 2004 Oct;98 Suppl B:S1-3. 

11328.     Chamberlain LJ, Bauer L.  The crucial role of the vanishing school nurse. Arch Pediatr Adolesc Med. 2004 Nov;158(11):1091; author reply 1091-2. 

11329.     Crompton GK. How to achieve good compliance with inhaled asthma therapy. Respir Med. 2004 Oct;98 Suppl B:S35-40. Review.

11330.     Ducharme FM, Rowe BH.  Intramuscular versus oral methylprednisolone in asthma. Lancet. 2004 Dec 4;364(9450):2000-1.

11331.     Pascual JC, Fleisher AB. Tacrolimus ointment (Protopic) for atopic dermatitis. Skin Therapy Lett. 2004 Nov;9(9):1-5.

11332.     Prakash V, Gupta K, Sharma S, Gaur S N. A comparative evaluation of the efficacy of inhaled beclomethasone dipropionate budesonide and fluticasone propionate in the management of bronchial asthma. Indian Journal of Allergy Asthma and Immunology. 2004 Jan-Jun; 18(1): 33-38.

11333.     Ramires R, Caiaffa MF, Tursi A, Haeggstrom JZ, Macchia L. Novel inhibitory effect on 5-lipoxygenase activity by the anti-asthma drug montelukast. Biochem Biophys Res Commun. 2004 Nov 12;324(2):815-21.

11334.     Schummer W, Schummer C, Wippermann J, Fuchs J. Anaphylactic shock: is vasopressin the drug of choice? Anesthesiology. 2004 Oct;101(4):1025-7. 

11335.     Simons FE. Advances in H1-antihistamines. N Engl J Med. 2004 Nov 18;351(21):2203-17. Review.

11336.     Vanderhoof JA, Young RJ. Current and potential uses of probiotics. Ann Allergy Asthma Immunol. 2004 Nov;93(5 Suppl 3):S33-7. Review.

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