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GERDWORD FEBRUARY NEWSLETTER
This month's newsletter is a focus on
asthma and allergies. Many children that suffer from reflux also suffer from various
allergies and sometimes asthma. This newletter is a little longer this month and will now
have a specific focus on topics related to reflux or problems that many children with
reflux also suffer from. If you have an idea for something you would like to see this
newsletter focus on, please send me an email!
Just a few notes for this month. Several people have donated items for IARP to sell or
auction to raise money. If you collect Beanie Babies, please contact me for a list of
several we have for sale. If you are in need of a web site, we have a web site designer
who has donated her time and talents for us to auction to raise money. Please email me if
you are interested. All proceeds from these items will go to IARP.
I am looking for people willing to be Local Support Group leaders in their area. This will
involve setting up a group meeting of some kind for reflux parents in your area. If you
are interested in doing this or would like some specific information, please email me.
Have a great month!
Nancy
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For Parents of Children with Asthma, a reflux mom, Karen has started a mailing list for
parents of children with asthma. Contact Karen for more information if you are interested
at Kajimery@aol.com or go to www.onelist.com/subscribe.cgi/moms2asthmatics
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Anti-Reflux Therapy Improves Asthma Symptoms But Not Lung Function
NORTHBROOK, IL -- July 8, 1998 -- The treatment of gastroesophageal reflux (GER) disease
in asthmatics may reduce asthma symptoms and reduce the need for asthma medication but has
minimal or no effect on lung function, according to a new report in this month’s
issue of CHEST, the journal of the American College of Chest Physicians.
The report, carried out by Drs. Stephen Field and Lloyd Sutherland of the University of
Calgary in Alberta, was based on a review of 171 English-language, peer-reviewed studies
involving 326 patients. The object was to measure the effectiveness of anti-reflux therapy
as indicated in the study findings. The association between gastroesophageal reflux (GER)
and asthma has been reported in the literature during the past 35 years, the authors said.
Symptomatic GER is known to be about four to five times more prevalent in patients with
asthma than in other patient groups. Hiatial hernia and esophagitis are also more
prevalent in asthmatics.
The authors reported that of the 171 English-language studies, only 12 were published on
anti-reflux medication in asthmatics with GER. Within these 12, they added, comparison of
findings was difficult because of differences in study design and the fact that different
medications and doses were used over a 15-year period. However, they said, the inclusion
of studies using different regimens was justified by the fact that the outcomes were so
similar.
The analysis of the combined data showed that of asthma patients with GER who were treated
with anti-reflux therapy:
-- asthma symptoms improved in 69 percent
-- asthma medication dose was reduced in 62 percent
-- evening peak expiratory flow improved in 25 percent
-- spirometry (in any of the placebo-controlled studies) did not improve.
Drs. Fields and Sutherland found the findings surprising.
"The challenge for future investigators will be to explain the paradox of the strong
association between GER and asthma and between improvement in asthma symptoms with
anti-reflux therapy and the absence of demonstrable changes in lung function," they
write, adding it remains to be determined which asthmatics will benefit from anti-reflux
therapy.
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TODDLERS WITH RESPIRATORY SYMPTOMS HAVE HIGHER ASTHMA RISK
Children between the ages of three to four years old who have persistent respiratory
symptoms such as cough, wheeze, attacks of shortness of breath, and frequent chest colds
are 8.5 times more likely to develop asthma than children who don't have respiratory
symptoms, according to a new study by physicians in Tucson, Ariz.
The researchers who studied over 900 children participating in the Tucson Epidemiologic
Study of Airways Obstructive Disease, grouped subjects into three categories: "6-11
months," "1-2 years of age," and "3-4 years of age." Of the
children who had no significant respiratory symptoms between 1-and-4 years, only 5 percent
were later diagnosed with asthma. In contrast, 35 percent of children who had symptoms at
3-4 years were later diagnosed with asthma. According to the researchers, the results
illustrate the natural history of asthma in young children. "Our study shows that
wheezing, coughing and frequent chest colds beginning or persisting after the age of 3
years significantly increases the risk of eventual asthma. As indicated in previous
studies, we also believe that there may be two different groups of young children with
lower respiratory tract symptoms," say researchers.
One of these groups, which is known by names such as "wheezy bronchitis" or
"asthmatic bronchitis," is a self-limited illness, which peaks in incidence
during the first year of life and then disappears. Asthma, the other illness, peaks in
incidence later between 3 and 5 years. These illnesses overlap during the preschool years
and are clinically indistinguishable. Viral infections may be responsible for the first
type of illness, and children with relatively small airways are most susceptible. The risk
of asthma may be related to allergic sensitization, conclude researchers, because it is
correlated with skin test reactivity and serum IgE levels.
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Mild Infections Linked to Allergy and Asthma
February 21, 1997 --Johns Hopkins scientists have found the first hard evidence that viral
infections can help cause asthma and allergies, a connection long suspected but never
directly confirmed in the lab. They showed that weak viral infections can cause immune
system B cells to produce immunoglobin E or IgE, a protein that orchestrates the reactions
that cause allergies and many cases of asthma.
"This suggests we might one day be able to reduce the incidence of allergy and asthma
by vaccinating children against mild childhood viral diseases that traditionally haven't
received much attention," says Farhad Imani, Ph.D., instructor of medicine, who
presented his results at the annual meetings of the American Academy of Allergy, Asthma
and Immunology.
"We've suspected that there might be a connection since the late 70s, when studies
found that kids who had more viral infections were more likely to have asthma and allergy
later in life," said Imani. More recent animal studies have shown that viral
infection can increase IgE levels in the blood. In in vitro studies, Imani and his
colleagues exposed human B cells, which recognize and attack a particular type of
intruder, to rhino and vaccinia viruses. B cells normally attack germs with immunoglobins
type M or G (IgM or IgG). Imani found that after viral infections, many of the cells
switched to making IgE.
"Basically, if you have a group of B cells that is producing IgE, you're going to be
allergic to whatever that group of B cells is sensitive to," Imani explains.
Ironically, stronger viruses capable of causing serious disease were less likely to
trigger the switch to IgE than wimpier viruses rapidly defeated by the immune system.
"This appears to be because the weaker viruses activate anti-viral protein kinase, a
protein that the B cell uses to defend itself," Imani explains. "This kinase
also helps stimulate the start of IgE production in the B cell."
The more sophisticated viruses have found ways to evade the kinase, but many simpler
viruses still cannot avoid it. "These weaker viruses might not cause much suffering
during the infection, but they could be causing pain farther down the road by helping the
development of allergies." Imani plans further studies both to determine which
viruses will switch on IgE and to flesh out the link between the activation of anti-viral
protein kinase and the start of IgE production.
The study was funded by the American Lung Association, the National Institutes of Health,
and the Hopkins School of Medicine.
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Formula Feeds Do Not Increase Subsequent Risk Of Allergy In Children
LONDON, ENGLAND -- July 22, 1998 -- Cows' milk formula fed to babies in the first few days
of life does not increase their risk of allergy in later life, finds research in the
Archives of Disease in Childhood. Controversy has raged over the issue for some time.
Current practice favours a strict diet of breastfeeding to prevent the development of
eczema and rhinitis.
Over 1,500 new-born babies were fed either a formula feed containing cows' milk protein or
a placebo that contained no protein during the first three days of life. All the babies
were then breastfed. They were assessed by researchers from The Netherlands when a year
old and again when they were two years old, to detect any allergic reactions, such as
wheezing, eczema and rhinitis.
The researchers found virtually no difference between the two groups at the first
assessment, with babies fed cows' milk seven per cent more likely to develop allergic
reactions. But by the second assessment, babies fed cows’ milk were six per cent less
likely to develop allergic reactions. Babies whose parents were allergic were twice as
likely to have allergic reactions themselves, but these findings were not affected by the
feeds they had received.
The authors say that their findings should reassure mothers who cannot fully breast feed
their newborns.
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Skin Rashes Linked To Food Allergies In Kids
MONTREAL, QC -- March 5, 1998 -- The prevalence of food allergy in kids with skin rashes
seems to be considerably higher than in the general population, according to a study
published in journal Pediatrics Electronic Pages. Based on their findings, the researchers
recommend that physicians evaluate kids with skin rashes for possible food allergies.
Studies have shown that atopic dermatitis (AD), a form of eczema, is a chronic and
relapsing inflammatory skin disorder that usually begins in infancy or early childhood and
involves the cheeks, hands and feet. Research has found that about 60 percent of kids with
AD evaluated by double-blind, placebo-controlled food challenge experienced a positive
reaction to food.
The children in the current study were selected from a group of children six months to 20
years with a history of a persistent eczematous rash in two or more predilection sites
despite the use of topical corticosteroids who had been referred to a pediatric
dermatologist.
Patients were assigned an AD symptom score and were screened for food-specific serum IgE
antibodies to six which are known to be the most allergenic in children foods (milk, egg,
wheat, soy, peanut, fish). The levels of food-specific serum IgE were determined by the
CAP System fluoroscein-enzyme immunoassay (CAP); patients with a value 0.7 kIUa/L were
invited for an additional allergy evaluation. Those with CAP values below the cutoff were
considered not food allergic.
Kids who met one of the following criteria for at least one food were considered allergic:
reaction on food challenge; CAP value more than the 95 percent confidence interval
predictive for a reaction; convincing history of an acute significant (hives, respiratory
symptoms) reaction after the isolated ingestion of a food to which there was a positive
CAP or prick skin test.
Of the 41 children with positive specific IgE values, 31 were evaluated further, 19
underwent a total of 50 food challenges, with 11 kids experiencing 18 positive challenges
(94 percent with skin reactions). Six children had a convincing history with a predictive
level of IgE; five had a convincing history with positive, indeterminate levels of IgE;
and one child had predictive levels of IgE (to egg and peanut) without a history of an
acute reaction.
The results found that about one third of the children in the study (37 percent) had
clinically significant IgE-mediated food hypersensitivity without a significant difference
in age or symptom score between those with or without food allergy.
_________________________________________________
Steam: good for the pores, bad for food allergy sufferers
If you are allergic to a certain food, you may also be allergic to its
steam. When breathed in, this steam can carry allergens into the lungs and cause the same
reaction that would occur if the food itself was ingested. For instance, we know of a man
who was very aware of his severe shrimp allergy and always avoided eating it. However, as
he was enjoying his own shrimp-free meal in a restaurant, shrimp being steamed at the next
table sent him into anaphylactic shock, and he died.
A recent study on shrimp steam confirms this reaction. Two shrimp were cooked in water,
with the subsequent steam tested for allergens by a sophisticated distillation apparatus.
Finding at least two shrimp allergens in the steam of cooking shrimp, researchers
concluded that steam inhalation may cause allergic reactions in sensitive individuals.
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