Thursday May 23, 2013
It has been nearly a decade since the last major new development in asthma therapy, Xolair, was FDA approved and became available for use in the United States. Despite the availability of inhaled coritcosteroids (ICS), combination products containing ICS and long-acting bronchodilators (LABAs) such as Advair, leukotriene blockers such as Singulair, as well as Xolair -- more than half of asthmatics have uncontrolled asthma. A recent study on a new drug, called dupilumab, showed promising results for the treatment of patients with moderate to severe persistent asthma. Dupilumab is a monoclonal antibody directed against interleukin-4, a signaling chemical that drives the production of IgE and the proliferation of allergic cells in the body. Subjects were given weekly injections of dupilumab for 1 month (and continued for up to 3 months), then attempted to reduce and/or stop their usual asthma medications. Patients taking dupilumab were able to stop using ICS and LABAs with fewer asthma symptoms than those who were given placebo. While this small study shows promising results, dupilumab is likely years away from becoming available as an FDA-approved drug for the treatment of asthma.
Tuesday May 14, 2013
A woman with a severe peanut allergy states that she is withdrawing from the University of Washington over concerns for her own health and safety. The university initially placed signs outside of the woman's classrooms declaring the rooms to be "peanut/nut-free". Recently, the school has removed these signs and has simply sent letters to other students politely asking them to cooperate with a nut-free policy within the classroom. The school states that the signs presented a false sense of security and did not guarantee that the rooms would truly be nut-free.The woman no longer feels safe as a result of the change, and therefore has decided to withdraw from the university.
This is another example of complete absurdity related to allergic diseases. First of all, there is no evidence to support the notion that a person with peanut allergy would be at danger of an allergic reaction without the direct exposure or consumption of peanut-containing foods. The smell of peanuts does not result in allergic reactions -- there is no protein in odors (which cause food allergic reactions); volatile organic compounds are present in food odors, which don't cause allergic reactions . Second, there is no way to completely ban peanuts within a classroom, which would be required to ensure the safety of the individual. How would the ban be enforced? Are other students searched for peanuts prior to entering the classroom? What would the penalty be? What about the rights of the other students to eat peanuts? Does the university obtain a "peanut-sniffing" dog to roam the classroom to find the contraband? If so, what about the other students with dog allergies? Third, when does a 26-year old woman become responsible for herself, and less reliant on what the university can or cannot provide? What happens when this person enters the workforce?
In my opinion as an allergist, the school acted appropriately. The woman described in this story has both unrealistic fears about her medical condition and unrealistic expectations about what sacrifices others around her need to make in order for her to feel safe.
Monday May 13, 2013
Summer is nearly upon us, with those hot sunny days and warm nights. Time to spend more time outdoors, at the beach or in the pool. Along with sun exposure comes the need to use sunscreen to prevent sunburn and long-term sun damage. But with the increased use of sunscreen comes the potential for an unintended reaction -- sunscreen allergy. Sunscreen has the potential to cause contact dermatitis to many of the active ingredients. This leads to any itchy, bumpy, red rash where the sunscreen was applied. Topical steroids are often helpful to treat the rash, but the culprit sunscreen should then be followed. This may prevent the ability of a person to spend time in the sun due to a fear of using sunscreen. However, there is a way to find out which chemical caused the reaction, and which sunscreen may be tolerated. Finding the right sunscreen can result in having safe, healthy sun exposure this summer!
Sunday May 12, 2013
Spring hay fever season finds people desperate to find relief from their nasal allergy symptoms. Natural therapies, without the use of medicines, are becoming more popular, especially among allergy sufferers. It is a popular notion that eating honey is a natural remedy for symptoms of allergies and asthma. Honey contains various ingredients, including pollen allergens and components of honeybees. Locally produced honey would be expected to contain local plant pollens to which a person would be allergic, and therefore is the preferred type of honey for allergies. It makes sense that consuming pollen-containing honey would improve allergies, much like how sublingual immunotherapy works. And, the fact that many people have experienced anaphylaxis from eating honey means that there may be enough pollen to stimulate the immune system. Read more to find out if eating local honey is a good idea for treating your hay fever symptoms.