Journal of Allergy and Clinical Immunology

#Polyunsaturated fatty acids linked to reduced #allergy risk

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High levels of polyunsaturated fatty acids (PUFAs) in children’s blood are associated with a reduced risk of asthma or rhinitis at the age of 16 years, suggests new research from Sweden’s Karolinska Institutet published in the Journal of Allergy and Clinical Immunology.

The findings are based on analyses of long-chain omega-3 and omega-6 fatty acids from blood samples from 940 children at age eight from the prospective Swedish birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiology). 

The study found that children who had higher blood levels of long-chain omega-3 fatty acids at the age of eight years were less likely to have developed asthma or rhinitis by the age of 16 years. High levels of the omega-6 fatty acid, arachidonic acid were associated with a reduced risk of asthma and rhinitis at 16. Among children with asthma or rhinitis at the age of eight years, higher blood levels of arachidonic acid were associated with a higher probability of being symptom-free at age 16 years.

The authors said the findings add to the evidence that PUFAs can influence subsequent allergic disease in childhood.

Karolinska Institutet. Press Release: Polyunsaturated fatty acids linked to reduced allergy risk. 05 December 2017. Available from:

Magnusson J, Ekström S,Kull I et al. Polyunsaturated fatty acids in plasma at 8 years and subsequent allergic disease. Published online 05 December 2017. Journal of Allergy and Clinical Immunology. DOI: 10.1016/j.jaci.2017.09.023


Early exposure to pet and #pest allergens may prevent #asthma in children

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The new findings suggest exposure to certain allergens early in life may prevent asthma from developing.
Children exposed to high indoor levels of pet or pest allergens during infancy have a lower risk of developing asthma by seven years of age, new research reveals. The findings, published in the Journal of Allergy and Clinical Immunology , may help to inform strategies to prevent asthma from developing.
While previous studies have established that reducing allergen exposure in the home helps control established asthma, the new findings suggest that exposure to certain allergens early in life, before asthma develops, may have a preventive effect.
The observations come from the large US Urban Environment and Childhood Asthma (URECA) study, which is investigating risk factors for asthma among children living in urban areas, where the disease is more prevalent and severe.
Among 442 seven-year-old children, 130 children (29%) had asthma. Higher concentrations of cockroach, mouse and cat allergens present in dust samples collected from the children’s homes during the first three years of life were linked to a lower risk of asthma by age seven years. There was a similar association for dog allergen, although it was not statistically significant. Additional analysis indicated that exposure to higher levels of these four allergens at age three months was associated with a lower risk of developing asthma.

New category of # skin disorders proposed

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The proposed category of auto-inflammatory keratinisation diseases would have two qualifying criteria.

An international collaboration led by scientists at Nagoya University in Japan is proposing that a new category of genetic skin diseases is defined.

In an article published in the Journal of Allergy and Clinical Immunology , the authors point out that among the genetic causes/predisposing factors for inflammatory keratinisation disorders, several factors are associated with auto-inflammatory mechanisms. They are advocating for the novel and unique concept of auto-inflammatory keratinisation diseases (AIKDs).

The authors propose that conditions which meet the following criteria be defined as AIKDs: “First the primary and main inflammation sites are the epidermis and the upper dermis. Second, inflammation in the epidermis and upper dermis leads to hyperkeratosis, which is the main and characteristic phenotype of AIKDs.”

“We have been finding more and more of these auto-inflammatory related skin diseases and it’s time we recognise this as a new category of inflammatory keratinisation disease,” said co-author of the paper, Kazumitsu Sugiura. “A better understanding of the root causes of skin problems is the only way for physicians to help patients manage their conditions and develop more effective treatments.”

New study provides hard data on food allergies

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It comes as anecdotal evidence continues to suggest food allergies are on the rise.

In recent years there has been an abundance of anecdotal evidence suggesting an increasing prevalence of food allergies but epidemiological data using patients’ electronic health records (EHRs) remain sparse.

Now scientists have sought to provide hard evidence on allergy prevalence through an analysis of medical records of 2.7 million patients.

After examining the data from health records of US patients, they found food allergy or intolerance were documented for 3.6 per cent of the population studied.
Of the 103,659 identified reactions to foods, 48.1 per cent were potentially IgE-mediated (affecting 50.8 per cent of food allergy or intolerance patients) and 15.9 per cent were anaphylactic.

The highest rates of food allergies or intolerance were among females (4.2 per cent versus 2.9 per cent) and persons of Asian descent (4.3 per cent versus 3.6 per cent).

The study identified shellfish as the most commonly reported food allergy (0.9 per cent) followed by fruit or vegetable (0.7 per cent), dairy (0.5 per cent), and peanut (0.5 per cent).

Writing in the Journal of Allergy and Clinical Immunology , the authors said the spectrum of severity observed with food allergy highlights the critical need for more allergy evaluations.

Can Vitamin D in pregnancy prevent childhood asthma?

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For the first time, research has shown that higher prenatal vitamin D levels can effectively alter the immune response of infants.

Vitamin D is a well-recognised immune modulator, and vitamin D deficiency during pregnancy is hypothesised to influence disease development in offspring.

A new study has demonstrated for the first time that prenatal vitamin D supplements can positively modify the immune system of neonates, which could help to protect against asthma and respiratory infections.

As part of the study, women were randomised to receive either a supplement of 4,400IU of vitamin D3 per day during the second and third trimesters of pregnancy versus the recommended daily intake (RDI) of 400IU/day.
Supplementation with 4400IU resulted in an enhanced broad-spectrum proinflammatory cytokine response of cord blood mononuclear cells to innate and mitogenic stimuli, with an average 1.7- to 2.1-fold increase in levels of several proinflammatory cytokines (GM-CSF, IFN-γ, IL-1β, IL-6, and IL-8), a higher gene expression level of TLR2 and TLR9, a greater than 4-fold increase in IL-17A production after polyclonal T-cell stimulation, and an enhanced IL-10 response of cord blood mononuclear cells to dexamethasone treatment in culture.

The findings are published in the Journal of Allergy and Clinical Immunology .

La exposición pre y posnatal a los ftalatos del plástico aumenta el riesgo de alergias de niños (J Allergy Clin Immunol)

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El riesgo se mantiene hasta la siguiente generación.

Científicos de la Universität Leipzig y el Deutsches Krebsforschungszentrum (DKFZ) han observado que una mayor exposición pre y postnatal a los ftalatos, un compuesto químico utilizado en muchos plásticos, puede provocar modificaciones epigenéticas en los niños que aumenten su sensibilidad a desarrollar alergias.

En concreto, según los resultados de su trabajo que publica “Journal of Allergy and Clinical Immunology”, la exposición a estos compuestos se asocia a un mayor riesgo de asma alérgico en niños cuyas madres han estado expuestas a ellos durante su embarazo y en el periodo de lactancia.

A diario el ser humano está en contacto con innumerables compuestos químicos presentes en los plásticos como los ftalatos, que se usan para hacer estos productos más flexibles, que pueden entrar en el organismo a través de la piel, los alimentos o la respiración.

“Es un hecho bien conocido que los ftalatos afectan nuestro sistema hormonal y, por tanto, pueden tener un efecto adverso sobre el metabolismo o la fertilidad, pero eso no es todo”, según el inmunólogo Tobias Polte, uno de los autores del estudio, tras observar que también interfiere en el sistema inmune.

Al inicio del estudio, los investigadores analizaron la orina de un grupo de mujeres embarazadas en busca de metabolitos de ftalatos, y vieron que los niveles de concentración en cada caso se correlacionaban con la aparición de asma alérgica en sus niños.

“Hubo una relación clara entre las concentraciones más altas del metabolito del ftalato de bencilbutilo (BBP) en la orina de la madre y el riesgo de asma alérgico en sus hijos”, ha añadido Irina Lehmann, también autora de este trabajo.

Los investigadores fueron capaces de confirmar los resultados de la cohorte madre-hijo en un modelo de ratón en el que los roedores fueron expuestos a una determinada concentración de ftalato durante el embarazo y el período de lactancia, lo que llevó a concentraciones comparables del metabolito BBP en la orina a las observadas en las mujeres.

En este caso, los descendientes mostraron una clara tendencia a desarrollar asma alérgico, un riesgo que incluso se mantuvo a la siguiente generación. Entre los ratones adultos, en cambio, no hubo aumento de los síntomas alérgicos.

“Por lo tanto, el factor tiempo es decisivo: si el organismo está expuesto a los ftalatos en las primeras etapas del desarrollo, esto puede tener efectos sobre el riesgo de enfermedad para las dos generaciones posteriores”, explica Polte.

Para intentar determinar en qué influía esta exposición, los investigadores analizaron de cerca los genes de los ratones nacidos de las madres expuestas y observaron diferentes grupos metilo en su ADN, a niveles más altos de lo habitual.

En el curso de esta modificación epigenética del ADN, los grupos metilo se unen a un gen que funciona como una especie de candado y, por tanto, evita que se lea su código, lo que significa que la proteína asociada no puede producirse.

“Es como si los ftalatos aparentemente desconecten los genes decisivos por medio de la metilación del ADN, haciendo que la actividad de estos genes se reduzca en los ratones jóvenes”, según concluye este experto.

Omalizumab effectively treats cold urticaria and symptomatic dermographism

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Omalizumab was well tolerated in patients with cold urticaria who were unresponsive to antihistamines.

Findings from two separate clinical studies, published in the Journal of Allergy and Clinical Immunology , suggest the monoclonal antibody, omalizumab is highly effective against different types of urticaria.

As part of two investigator-initiated, multicentre, randomised, placebo-controlled trials, researchers from Charité-Universitätsmedizin Berlin used omalizumab to treat two different patient groups; 61 patients with symptomatic dermographism and 31 patients with cold urticaria, for a period of three months.

They found treatment with omalizumab led to significant improvements in symptoms in both groups of patients, and prevented symptoms in nearly half of all patients with cold urticaria and symptomatic dermographism, even after exposure to relevant stimuli. Treatment was well tolerated in cold urticaria patients unresponsive to antihistamines.

“Our results show that patients with severe forms of physical urticaria can benefit from treatment with omalizumab,” says Prof. Martin Metz. While the drug is licensed in Europe for use in patients with chronic spontaneous urticaria, Prof Metz said “given our data on the drug’s effectiveness in patients with cold urticaria and symptomatic dermographism, we are hopeful that the drug will be made available to both of these patient groups.”

Verapamil reduces endoscopic features and symptoms of chronic rhinosinusitis

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Researchers are reporting promising results from a new trial.

The results of a randomised, double-blind, placebo-controlled trial published in the  Journal of Allergy and Clinical Immunology , suggest the cardiac drug verapamil may be an effective treatment for chronic rhinosinusitis with nasal polyps (CRSwNP).
In the study of 18 patient, verapamil improved both endoscopic features and clinical symptoms in patients with CRSwNP. Sino-nasal outcome test (SNOT-22) and Lund-Kennedy endoscopic scores were significantly reduced. Effects were decreased in patients with higher BMI and mucus P-glycoprotein levels.
As a caution, a low dose of 80mg three times/day, was used. Based on the limited effects in some patients, the dose was determined to be insufficient for a large proportion and the trial was terminated early.

However, senior author, Benjamin S Bleier, assistant professor of otolaryngology at Harvard Medical School, described the findings as promising.
“Chronic rhinosinusitis with nasal polyps is among our most challenging diagnoses to treat, because these patients essentially have chronic, lifelong inflammation that needs chronic, lifelong treatment,” he said Dr Bleier. “We observed no significant side effects at the doses we used, and we are very encouraged by the results of this first step toward a more targeted therapy for our patients.”

El consumo de leche de vaca fresca reduce el riesgo de asma en niños (J Allergy Clin Immunol)

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Sus componentes sirven como precursores para la síntesis de sustancias antiinflamatorias.

Un estudio elaborado por la Ludwig-Maximilians-Universität de Munich (Alemania) ha verificado que los niños que consumen leche de vaca fresca en lugar de industrial tienen menor probabilidad de desarrollar asma y alergias que aquellos que consumen leche procesada.

El efecto protector al asma es atribuible al hecho de que la leche fresca contiene más omega 3 que la leche procesada. No obstante, los mismos autores del estudio se abstienen a recomendar el consumo de leche fresca, ya que esto puede contener microorganismos patógenos.

La investigación se realizó sobre más de mil niños, de edad hasta seis años que viven en áreas rurales. Los factores estudiados han sido su alimentación y enfermedades. El estudio ha revelado que la proporción de niños que ha desarrollado asma en ese rango de edad es inferior a aquellos que han consumido regularmente leche fresca.

Tabea Brick, miembro del equipo de investigadores, argumenta que es posible que este efecto pueda ser explicado por el alto contenido de grasas y niveles superiores de omega 3 encontrados en la leche fresca de granja. Esta sustancia es esencial para la salud pero no puede ser sintetizada en el cuerpo humano y, por lo tanto, debe ser obtenida de fuentes dietéticas. El omega 3 contiene efectos fisiológicos positivos. “Por ejemplo, sus componentes sirven como precursores para la síntesis de sustancias antiinflamatorias” indica Tabea Brick.

Las conclusiones del estudio pueden encontrarse en “Journal of Allergy and Clinical Immunology”.