Asthma
Poorly controlled asthma costly
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Poorly controlled asthma more than doubles healthcare costs associated with the disease and threatens educational achievement through a dramatic increase in school absence, according to researchers at National Jewish Health. The research team reported in the August 2011 issue of The Archives of Allergy, Asthma & Immunology that children with “very poorly controlled” asthma missed an average of 18 days of school each year, compared to 2 or less for other asthma patients.
“This study looks for the first time at how effective and ineffective management of severe asthma impacts cost ,” said Stanley Szefler, MD, lead author and Professor of Pediatrics at National Jewish Health. “It highlights the toll that poorly controlled asthma takes on children. It also points to an opportunity – with proper attention and education, many, if not most, of those children could gain control over their asthma, thus reducing healthcare costs, improving their lives and their chances for success.”
The researchers studied 628 children ages 6 to 12 with severe or difficult-to-treat asthma. They evaluated direct medical costs – medications, unscheduled office and emergency visits, and hospital admissions – and indirect costs as measured by school/work days lost. Costs were evaluated at baseline, 12 months and 24 months. Patients were divided into three groups - very poorly controlled, not well controlled and well controlled asthma, according to NIH guidelines.
Protein associated with allergic response causes airway changes in asthma patients
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Changes that occur in the airways of asthma patients are in part caused by the naturally occurring protein interleukin-13 (IL-13) which stimulates invasion of airway cells called fibroblasts, according to a study conducted by researchers at Duke University. The study is the latest effort by researchers to better understand the processes that are involved in airway remodeling that can cause breathing difficulties in patients with asthma. The findings were published online ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.
“In the present study, we show for the first time that airway fibroblasts, isolated directly from patients with asthma and stimulated with IL-13, invade in significantly greater numbers than those isolated from normal control subjects,” said Jennifer Ingram, PhD, assistant research professor of medicine at Duke University.
“In this novel mechanism of airway remodeling in asthma patients, IL-13 acts in combination with other mediators produced by cells in the airways: transforming growth factor-β1 (TGF-β1), which causes cellular changes, and matrix metalloproteinases (MMPs), which act to break down proteins,” she added. “Together, these agents cause cellular changes that lead to loss of lung function in asthma patients.”
Landmark Study Shows Suboptimal Asthma Care
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Researchers assessed asthma burden and treatment practice in the U.S. based on results of the recently completed Asthma Insight and Management telephone survey in a new study presented at the American College of Allergy, Asthma and Immunology annual meeting in Phoenix, Nov. 11-16. The asthma survey, the most comprehensive in the U.S. in the past 10 years, reported 73 percent of patients experienced asthma symptoms or an asthma attack in the past 12 months, 63 percent were affected by asthma throughout the year, and 41 percent believed their asthma was interfering with their life. Authors conclude that “despite the availability of asthma management guidelines and effective asthma treatments, asthma care is inferior, underscoring the need for improved patient education and use of written action plans.”
Title: Patient-Reported Asthma Burden and Treatment Practice in the United States: Results of the Asthma Insight and Management Survey
Lead Author: Eli O. Meltzer, MD, ACAAI Fellow
Acetaminophen use in adolescents linked to doubled risk of asthma
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New evidence linking the use of acetaminophen to development of asthma and eczema suggests that even monthly use of the drug in adolescents may more than double risk of asthma in adolescents compared to those who used none at all; yearly use was associated with a 50 percent increase in the risk of asthma.
The research results will be published online on the American Thoracic Society’s Web site ahead of the print edition of the American Journal of Respiratory and Critical Care Medicine.
“This study has identified that the reported use of acetaminophen in 13- and 14 year old adolescent children was associated with an exposure-dependent increased risk of asthma symptoms,” said study first author Richard Beasley, M.D., professor of medicine, at the Medical Research Institute of New Zealand on behalf of the International Study of Asthma and Allergies in Childhood (ISAAC).
Asthma and Eczema Sufferers Have a Lower Risk of Developing a Cancer
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Men who had a history of asthma or eczema generally had a lower risk of developing cancer, according to a study carried out by researchers at INRS–Institut Armand-Frappier, the Research Centre of the Centre hospitalier de l’Université de Montréal, and McGill University. The findings, published in the Annals of Allergy, Asthma & Immunology, show that male eczema sufferers had a lower risk of lung cancer while those with a history of asthma had a similar effect in relation to stomach cancer.
“Asthma and eczema are allergies brought about by a hyper-reactive immune system – a state which might have enabled abnormal cells to have been eliminated more efficiently, thereby reducing the risk of cancer,” explained Professor Marie-Claude Rousseau of the INRS–Institut Armand-Frappier, one of the co-authors of the research.
The researchers analyzed information that was collected in a study on exposures in the workplace and the risk of developing cancer, undertaken between August 1979 and March 1986. It involved 3,300 men, between 35 and 70 years of age, who had been diagnosed with cancer in one of Montreal’s 18 hospitals, and a control group of 512 people from the general population who did not have cancer.
‘TIMely’ intervention for asthma
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Asthma can be a severely debilitating disease. Its increasing prevalence and the fact that most treatments do not control severe asthma well has stimulated intensive research into genetic susceptibility to asthma in the hope that the information gleaned will lead to new therapeutics. One gene identified as a asthma susceptibility gene is TIM1 and now, a team of researchers, led by Paul Rennert, at Biogen Idec Inc., Cambridge, has generated data in a humanized mouse model of asthma that suggest that targeting TIM-1 protein might have therapeutic benefit in the treatment of patients with asthma. Specifically, the team found that an antibody that bound to a defined region of the TIM-1 protein (a cleft formed within the IgV domain) had therapeutic activity in the humanized mouse model of experimental asthma, ameliorating inflammation and airway hyperresponsiveness.
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TITLE: Antagonism of TIM-1 blocks the development of disease in a humanized mouse model of allergic asthma
Eliminating the source of asthma-causing immune molecules
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Asthma and other allergic diseases are caused by inappropriate immune responses. Soluble IgE molecules, produced by immune cells known as B cells, are key immune mediators of these diseases. Therapeutic targeting of IgE in the blood can neutralize its effects and is an effective treatment for moderate-to-severe allergic asthma.
However, this approach does not halt IgE production and patients need to be treated repeatedly. But now, a team of researchers, at Genentech Inc., South San Francisco, has developed a way to specifically eliminate IgE-producing B cells, providing a potential new long-lasting therapeutic approach to treating asthma and other allergic diseases.
IgE-producing B cells express on their surface an IgE molecule that is slightly different to the IgE molecules that they secrete. The team, led by Lawren Wu, generated a therapeutic molecule known as a monoclonal antibody that targets the portion of human IgE that is contained in IgE molecules on the surface of B cells but not in IgE molecules in the blood.
Does breastfeeding protect against asthma?
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Sticking to a strict diet of mom’s milk during the first 4 months of life may reduce a child’s risk of developing asthma by their eighth birthday, according to a new study.
“Breast milk is the optimal food for infants during the first months of life,” lead researcher Dr. Inger Kull of the Karolinska Institutet in Stockholm, Sweden, told Reuters Health in an email. “But whether or not breastfeeding reduces the risk of asthma has been debated.”
Through her milk, a mother transfers “good” bacteria, antibodies and proteins that can help thwart infection. But the evidence for how breastfeeding might influence the later development of asthma remains confusing, with various studies suggesting protective, neutral and even detrimental effects.
Sleep apnea as common as asthma in German kids
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A new German study suggests that about 3 percent of school-age children may have the nighttime breathing disorder sleep apnea—similar to the country’s rate of childhood asthma.
The findings suggest that there needs to be greater awareness of sleep apnea as a problem among children, researchers report in the European Respiratory Journal.
Obstructive sleep apnea, or OSA, occurs when the soft tissues at the back of the throat temporarily collapse during sleep, causing repeated breathing interruptions. The major symptoms include loud snoring and daytime sleepiness owing to a lack of deep sleep at night.
Parent mentors can improve the asthmatic care of minority children, UT Southwestern researchers find
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UT Southwestern Medical Center researchers have found that informed adults can help families stave off complications associated with asthma. The findings, available online and in the December issue of Pediatrics, suggest that interventions by parent mentors – caregivers of asthmatic children who have received specialized topical training – can effectively reduce wheezing, asthma attacks, emergency room visits and missed adult workdays.
“Childhood asthma disproportionately affects urban minority children,” said Dr. Glenn Flores, professor of pediatrics and the study’s lead author. “Asthma mortality among African-American children alone is almost five times higher than for white children. The goal for this study was to determine whether parent mentors would be more effective than traditional asthma care in improving asthma outcomes for minority children.”
Mentors in the study were parents or caregivers who got professional training from a nurse asthma specialist and a program coordinator on a variety of asthma-related topics. Training sessions and a manual were used to present examples of improving asthmatic care and focused on the importance of consistent treatment. The manual also discussed keeping asthmatic children out of hospitals, asthma medications and triggers, and cultural issues that can affect care.
Sweet! Sugared Polymer a New Weapon Against Allergies and Asthma
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Scientists at Johns Hopkins and their colleagues have developed sugar-coated polymer strands that selectively kill off cells involved in triggering aggressive allergy and asthma attacks. Their advance is a significant step toward crafting pharmaceuticals to fight these often life-endangering conditions in a new way.
For more than a decade, a team led by Bruce S. Bochner, M.D., director of the Division of Allergy and Clinical Immunology at the Johns Hopkins University School of Medicine, has studied a unique protein known as Siglec-8. This protein, whose name is an acronym for Sialic Acid-binding, Immunoglobulin-like LECtin number 8, is present on the surfaces of a few types of immune cells, including eosinophils, basophils and mast cells. These different cell types have diverse but cooperative roles in normal immune function and allergic diseases. When functioning correctly, they are a valuable aid to keeping the body healthy and infection-free. However, in allergic reactions and asthma attacks, the cells unleash an overwhelming response that typically harms the body more than it helps.
Asthma: Epidemiology, etiology and risk factors
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An article http://www.cmaj.ca/press/cmaj080612.pdf on the epidemiology, cause and risk factors of asthma is the first in a special report on asthma in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca designed for clinical practitioners. This review looks at risk factors for persistent asthma at different ages, including prenatal, infancy, childhood and adulthood.
Genetics, environment and host characteristics are risk factors for asthma. The significant increases in the incidence of asthma and geographic variation in prevalence rates support the idea that the environment plays a large role in the current asthma epidemic. As well, environmental triggers may affect asthma differently during various life stages and risk factors may change over time.
The report comes from the researchers conducting the Canadian Healthy Infant Longitudinal Development (CHILD) Study, a multicentre Canadian study involving 5000 pregnant women with the aim of better understanding the development of allergy and asthma in children.
Traffic pollutants may fuel adult asthma: study
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A new study provides more evidence that breathing in traffic-related pollutants is unhealthy—for kids and adults.
The study, report in the journal Thorax, suggests a link between asthma that develops in adulthood and increased exposure to traffic-related pollutants. Previous research linked childhood-onset asthma with traffic pollutants.
In the current study, researchers looked at associations between traffic-related air pollution and “new-onset” asthma among 2725 Swiss adults. None of them had ever smoked.
Parent stress, air pollution up kids’ asthma risk
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Children with stressed-out parents may be more prone to developing asthma associated with environmental “triggers” such as high levels of traffic-related pollution and tobacco smoke, hints a study published today.
In the study, researchers found that children whose parents reported high levels of psychological stress and who were exposed to cigarette smoke in the womb and to traffic-related pollution early in life had a much higher risk of developing asthma, compared to children only exposed to pollution.
“We found that it was children exposed to the combination of air pollution and life in a stressful environment who were at highest risk of developing asthma,” Dr. Rob McConnell, deputy director of the Children’s Environmental Health Center at University of Southern California, Los Angeles, told Reuters Health.
Inactivity, Obesity Factors in Adult Asthmatics Higher Health Care Use
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Health care use is higher in adult asthmatic patients when compared with non-asthmatic patients, and inactivity and obesity are contributing to this increase, according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).
Shilpa Dogra, MSc, of the Lifespan Health and Performance Laboratory at York University in Toronto, Ontario, Canada, and colleagues, also found that overnight hospital stays were more common in inactive asthmatic patients regardless of body mass index (BMI), whereas both BMI and physical activity were important determinants of physician consultations.
Investigators analyzed self-reported data of an adult population of 6,835 with asthma and 78,051 without asthma from the 2005 Canadian Community Health Survey (CCHS), a nationally representative population-based cross-sectional survey. Their findings include:
