Have Asthma? You Likely Have an Allergy as Well

Asthma is becoming an epidemic in the United States. The number of Americans diagnosed with asthma grows annually, with 26 million currently affected. And according to a new study, nearly two-thirds or more of all asthmatics also have an allergy, which can make this spring season particularly bothersome.

The study, which is published in the April issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), found that an astonishing 75 percent of asthmatic adults aged 20- to 40-years-old, and 65 percent of asthmatic adults aged 55 years and older, have at least one allergy.

“Allergists have known the prevalence of allergies among asthmatic children is high at 60 to 80 percent, but it was thought allergies were not as common in asthmatic adults,” said allergist Paula Busse, MD, lead study author. “These findings are important, and can help lead to proper diagnosis and treatment.”

A total of 2,573 adults were studied in a National Health and Nutrition Examination Survey (NHANES). A panel of 19 allergens was used to detect allergy among asthmatics.

While asthma is frequently associated with children, it is not uncommon among adults 60 years and older, affecting three to seven percent. This number is likely higher, however, because asthma is often underdiagnosed in older adults.

“Both asthma and allergies can strike at any age, and are serious diseases,” said allergist Richard Weber, MD, ACAAI president. “Anyone who thinks they may be having symptoms of an allergy or asthma should see a board-certified allergist. Allergists are experts in diagnosing and treating both conditions.”

According to the ACAAI, more than 50 million Americans have an allergy, a number which is also on the rise. Is the link between asthma and allergies a reason?

“It could be one of many creating this perfect storm for allergies,” said Dr. Weber. “Other factors, such as the hygiene hypothesis, climate change and an increase in awareness and education can also be reasons for this growth.”

Those that have symptoms of asthma or allergy can get tested for free, through the ACAAI Nationwide Asthma Screening Program. Allergists will hold screenings at about 100 locations nationwide. Screenings can be found by visiting www.acaai.org/nasp.
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Mild Winter Produces Early Rise in Tree Pollen in Midwest

The Gottlieb Allergy Count, reported by Joseph Leija, MD, will officially begin Monday, March 18, weeks earlier than the usual April 1 start date. For the past week, Dr.Leija has been monitoring the air daily in preparation.

“Today the tree pollen was moderate, which is high for this time of year, and I can see the many budding treetops from the Gottlieb rooftop where the pollen-catching equipment is located,” said Leija, who has been performing the Gottlieb Allergy Count for more than two decades. “So far, what I am seeing in 2013 is equal to what I saw in 2012, which was a very early and especially bad allergy season.”

Leija, performs the official allergy count for the Midwest on behalf of the National Allergy Bureau, and conducted an initial count for the season on Monay, March 11 at 7 a.m. In 2012, Dr. Leija, an allergist, retired from seeing patients but he continues his public health crusade for improved breathing by performing the Gottlieb Allergy Count. In 2012, Dr. Leija issued four air-quality alerts.

"I believe today’s pollen count may actually be higher and some tree pollen has been washed away by the steady rain last night and today," said Dr. Leija, who, at 6 a.m. and in the rain, climbed the stairs to the roof atop Gottlieb Memorial Hospital, part of Loyola University Health System.

Dr. Joseph Leija, allergist at Loyola’s Gottlieb Memorial Hospital, is solely certified by the National Allergy Bureau to perform the daily official allergy count for the Midwest, usually from April – October. Due to the mild winter season, the practice he founded is seeing a dramatic increase in those suffering from respiratory illness and allergies. Dr. Leija will begin reporting the count two weeks early, on March 18, due to elevated pollen counts.

An octagenerian, Dr. Leija rises before dawn to collect specimens from his pollen catching-machine atop Gottlieb and deliver the count to the public by 7 a.m. The Gottlieb Allergy Count is available in English, Polish and Spanish, through Twitter: at Gottliebhospital.org and in English at 1-866-4-POLLEN (476-5536).

Air pollution primes children for asthma-related cockroach allergy

Researchers at the Columbia Center for Children's Environmental Health untangle complex web of factors behind high rates of asthma in urban environment.

An allergic reaction to cockroaches is a major contributor to asthma in urban children, but new research suggests that the insects are just one part of a more complex story. Very early exposure to certain components of air pollution can increase the risk of developing a cockroach allergy by age 7 and children with a common mutation in a gene called GSTM may be especially vulnerable.

Researchers at the Columbia Center for Children's Environmental Health at the Mailman School of Public Health published the findings, the first on this interplay of risk factors, in the February 6 online edition of the Journal of Allergy and Clinical Immunology.

"Allergy to cockroach is one of the greatest risk factors for asthma in low-income urban communities," says lead author Matthew Perzanowski. PhD. "Our findings indicate a complex relationship between allergen and air pollution exposures early in life and a possible underlying genetic susceptibility. Combined, these findings suggest that exposures in the home environment as early as the prenatal period can lead to some children being at much greater risk for developing an allergy to cockroach, which, in turn, heightens their risk of developing asthma."

Dr. Perzanowski and his co-investigators looked at 349 mother-child pairs from the Center's Mothers & Newborns study of environmental exposures in Northern Manhattan and the Bronx. During the mother's pregnancy, exposure to cockroach allergen (protein in feces, saliva or other remnants of the insects) was measured by collecting dust from the kitchen and bed. Researchers also sampled air to measure the mother's exposure to polycyclic aromatic hydrocarbons, or PAH (combustion products that are harmful components of air pollution). Presence of the GSTM1 mutation was determined through blood samples. At ages 5 and 7, the children had blood tests to identify the presence of IgE antibodies—an immune marker of allergy.

The researchers found that 279 or 80% of homes tested positive for high levels of cockroach allergen. By age 7, 82 of 264 children tested, or 31%, had cockroach allergy. Presence of higher levels of cockroach allergen led cockroach allergy only in children whose mothers also had been exposed to higher levels of PAH during pregnancy. This result, the authors say, suggests that PAH enhances the immune response to cockroach allergen.

The combined impact of the two exposures was even greater among the 27% of children with a common mutation in the GSTM gene. This mutation is suspected to alter the ability of the body to detoxify PAHs.

The study suggests that minimizing exposure to PAH during pregnancy and to cockroach allergen during early childhood could be helpful in preventing cockroach allergies and asthma in urban children.

"Asthma among many urban populations in the United States continues to rise," says senior author Rachel Miller, MD. "Identifying these complex associations and acting upon them through better medical surveillance and more appropriate public policy may be very important in curtailing this alarming trend."

Geographic factors can cause allergies, asthma

Those living near the equator may find themselves sneezing and wheezing more than usual. And the reason may not be due to increasing pollen counts. According to a new study in the February issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), living in locations closest to the equator can put you at increased risk of developing allergy and asthma.

"UV-B rays exposure is higher for people living in areas closer to the equator," said Vicka Oktaria, MPH, lead study author. "This increase in UV-B may be linked to vitamin D, which is thought to modify the immune system. These modifications can lead to an elevated risk of developing allergy and asthma."

Previous studies have shown that latitude can reflect a variation in airborne allergens due to climate, housing and social and cultural differences. This study is one of the first using the individuals latitude location and UV-B exposure to examine the association with allergy and asthma.

"Allergies and asthma are serious diseases that can be life-threatening if not diagnosed and treated properly," said allergist Richard Weber, MD, ACAAI president. "Both conditions can be more than bothersome for people, no matter their geographic location, and can last year-round."

According to ACAAI, many people that have an allergy also experience asthma symptoms. In fact, an estimated 75 to 85 percent of asthmatics have an allergy.
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Fast food and excessive hygene blamed for allergy increase in Europe

Paediatricians at Vienna's Medical University have raised the alarm about an increase of a third in the number of child allergy sufferers - blaming fast food and excessive hygiene.

The experts say that the allergies are a growing problem for children and even food allergies are on the increase, as well as the more common allergies such as asthma, eczema and hay fever.

They estimate that one in every five children in Europe now suffers from an allergy and it's getting worse.

Professor Dr Zsolt Szepfalusi says one possible cause is that people are deciding far too early on to have a clean and hygienic life.

"The so-called hygiene hypothesis is that a certain amount of dirt is healthy and tends to protect one from allergies."

But the medics also say that current diet may also be to blame.

"We have much more pasteurised and cooked food stuffs. This fast food industry didn't exist 20 years ago on such a scale and that has certainly had a strong influence on our digestive process - and in particular in the development of allergies."

He added that parents who believe that children have an allergy should get medical advice as soon as possible because early treatment means a better chance of an effective treatment.

Source: The Australian Independent