Archive for the ‘Causes’ Category

Lung DCs Legitimate Targets For Treating Asthma

December 30, 2006

Allergic asthma is caused by an unwanted immune response known as a Th2 cell response. Most treatments for asthma currently target this Th2 cell response and its downstream effects. However, immune cells known as dendritic cells (DCs) are crucial activators of all T cell responses, including the Th2 cell response in asthma, so therapies that target DC function in the airways might represent a new way to treat individuals with allergic asthma.

Now, in a study appearing in the November issue of the Journal of Clinical Investigation, Bart Lambrecht and colleagues from Erasmus University, The Netherlands, have shown that inhalation of the immunosuppressive drug FTY720 suppresses the symptoms of allergic asthma in a mouse model of the disease. Inhalation of FTY720 suppressed the allergic Th2 cell response in the lungs by preventing lung DCs from leaving the lungs and going to the site at which they activate the allergic Th2 cell response. This demonstration that targeting lung DCs can suppress allergic asthma in mice might open new avenues of research for the development of drugs that target DC function to treat individuals with allergic asthma.

Asthma and the Obesity Connection

December 27, 2006

A new asthma gene provides an unexpected link between asthma and obesity according to a research team at Sydney’s Garvan Institute, who are also part of the Cooperative Research Centre for Asthma and Airways.

Bennett Shum and colleagues have found that a fatty acid binding protein called aP2, which is already known for its role in diabetes and obesity, is also present in the lung where it is crucial in controlling inflammation in asthma.

About one in ten adults and one in six children in Australia now suffer from asthma. Its incidence in Western countries increased markedly over the last 20 years and has purportedly been linked to the rise in obesity.

“There’s up to three times the risk of being asthmatic if you are obese: the more obese, the greater the risk. We know that obese asthmatics who lose weight have large improvements in their asthma,” says asthma project leader Dr Michael Rolph.

Various triggers such as dust mites and pollen bring on asthma attacks, which are characterized by inflammation of the airways, a tightening of the surrounding muscles, and excess mucus production.

The scientists used a technique called gene profiling to discover novel genes that regulate airway inflammation and found very high levels of aP2 in human lung cells that had been tricked into thinking they were undergoing an asthma attack.

“We were really surprised to find aP2 in the lung”, said Shum. “So, we then looked at what would happen when we removed this gene in mouse models: mice without aP2 are protected from asthma attacks”.

“These findings suggest that blocking aP2 function is a novel approach for asthma treatment and other inflammatory lung diseases,” he added.

Perceived Control Improves Asthma Health Status

December 19, 2006

Patients with asthma who believe they have control of their condition are likely to report improved asthma-related health status and have a decreased risk of severe asthma attacks.

In a new study out of the University of California, San Francisco, researchers followed 865 patients (mean age 60 years) hospitalized for asthma for a median of 1.9 years after hospital discharge. Researchers collected demographic information, asthma history, perceived asthma control, and measured emergency department (ED) visits and hospitalizations for asthma.

Results indicated that greater perceived control was associated with better physical health status, better asthma-related quality of life, fewer days of restricted activity due to asthma, and lower asthma severity scores. A multivariate model also showed that greater perceived control was associated with significantly decreased prospective risk of ED visits and hospitalizations for asthma.

This study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

New Standard Certifies Pillows Asthma Friendly

December 14, 2006

A new certification standard has been launched this holiday season to help people with asthma and allergies find pillows that are more suitable for them. The Asthma and Allergy Foundation of America (AAFA) reports that pillows and other bedding can be home to millions of dust mites and other allergens that cause asthma symptoms. Now, AAFA has launched the asthma friendly(R) Certification Program in the U.S. to help consumers identify the best tools for controlling and reducing allergen exposure in the home.

Medical experts advise that reducing exposure to dust mites should be a critical part of everyone’s allergy and asthma management plan. “Dust mites are among the most common indoor allergens,” says Clifford W. Bassett, MD, of the Long Island College Hospital of Brooklyn and Assistant Clinical Professor of Medicine. “We can’t emphasize enough how important it is to get tested to learn if you have allergic sensitivities and to take steps to reduce exposure to dust mites.”

The “asthma friendly” certification program is a joint effort between the nonprofit AAFA and the international research and testing organization, Allergy Standards Limited (ASL). Standards are written for different types of products then manufacturers submit products for laboratory testing to determine if they meet the standards and qualify for the “asthma friendly” certification mark. Abstracts of the standards and information about the program are online at http://www.asthmafriendly.com.

The first “asthma friendly” certified pillows will be available at Bed Bath and Beyond this holiday. Other certified products, such as stuffed toys, are already on the shelves at major retailers including Target, Kohl’s, Build-a-Bear Workshop, FAO Schwartz and Learning Express. See a list of certified products and retailers online at http://www.asthmafriendly.com. Next year, certified vacuum cleaners, paints, flooring and other types of items will also be available.

AAFA recommends the following simple tips for controlling dust mites at home:

– Reduce humidity throughout the house, keeping humidity below 50 percent.

– Wash bed sheets weekly in 130-degree hot water to kill dust mites and their eggs.

– Keep pets off of beds and out of bedrooms to minimize pet dander — a food source for dust mites.

– Look for asthma friendly(R) certified pillows and other bedding.

New Target For Asthma Treatment

December 10, 2006

Cincinnati scientists have found further evidence that certain defensive white cells in the body cause or play a major role in the symptoms experienced by asthma patients.

Their findings, scientists say, could lead to the identification of a new treatment “target” to help the estimated 17 million asthma sufferers in the United States.

The scientists, at the University of Cincinnati (UC) Academic Health Center and Cincinnati Children’s Hospital Medical Center, report their results in the Proceedings of the National Academy of Sciences.

Working with genetically altered mice, the Cincinnati researchers studied a group of cells called eosinophils. Originally evolved to defend the body against parasite infection, a problem no longer common in the Western world, eosinophils are known to accumulate during allergic responses–and especially in mucous in the lungs of asthma patients.

“Researchers have been looking at the role of eosinophils in asthma for decades,” says research associate and first author Patricia Fulkerson, PhD. “Since people in the Western world don’t have parasites in their guts to the extent they used to, the question is what eosinophils do now?”

“Previous studies linking eosinophils to asthma were done in single models,” Fulkerson explains. “We increased the power of our study by looking at multiple models, and by doing that we show a strong role for eosinophils in mucous production in asthma.”

The researchers, led by Professor Marc Rothenberg, MD, PhD, of UC College of Medicine and Cincinnati Children’s Hospital Medical Center, also showed that eosinophils contribute to the recruitment of the immunity-regulating proteins known as cytokines, a process that allows mucous to accumulate in the lung.

“Previously most scientists looked at one model at a time–eliminating as many eosinophils as possible, inducing each model with asthma, and then watching what happens in an allergic response,” Fulkerson explains. “Using just one model, however, it’s difficult to determine the role of eosinophils versus that model’s own genetic strategy.”

So instead of a single model, Rothenberg, Fulkerson and their colleagues used three different ones. They studied one mouse model in which eosinophils don’t develop from bone marrow, as they should, and two models in which eosinophils remain in the blood stream instead of rallying into the lung tissue to protect against asthma.

They then looked at the characteristics that all three models had in common so they could attribute any alteration in their appearance (or phenotype) to eosinophils, and not to that particular model’s genetics.

In the absence of eosinophils, the researchers report, they found that allergen-induced mucous production dropped in all models, suggesting that “eosinophils play a big role in mucous production in response to an allergen challenge.”

The researchers also report that eosinophils alter the lungs’ “micro environment” by stimulating production of the signaling cytokines. Involved in triggering the body’s immune defense mechanism to take action against infection, cytokines are responsible for almost all the characteristics of asthma.

“If cytokines are produced in the lungs, you’ll end up with asthma,” says Fulkerson. “But we found in eosinophil-free models that the cytokines that together produce almost all the visible symptoms of asthma–known as IL (interleukin) 4 and IL 13–were markedly reduced.

Having shown that eosinophils play an important part in mucous production and airway obstruction in asthma, the researchers’ next goal was to determine how they actually do that.

Examination of mouse lung tissue revealed increased genetic activity associated with the characteristics of asthma: mucous, airway obstruction and hyperactivity.

“We took two of these models and looked at changes in gene expression in the lung caused by eosinophils,” says Fulkerson. “We only picked up the genes that were in common in both models, so we can say the changes were eosinophil dependent versus model dependent.

“So now we have this list of genes that are eosinophil dependent in an experimental animal model and we’re identifying new pathways that have never been attributed to eosinophils before,” Fulkerson adds. “Now we and other researchers will pursue this to learn exactly what eosinophils are doing to those pathways and to see how we can block their contributions to asthma.

Some of these genetic pathways were known to be important in asthma, says Fulkerson, but no one had previously attributed them to eosinophils.

“That’s the exciting part,” she says. “If we can prevent eosinophils from being activated, then perhaps we can develop new targets for treatment. The goal is to find new approaches to asthma, because although we can treat asthma symptoms fairly well, we’re not so good at dealing with the long-term consequences.

“And this doesn’t only involve asthma. There are a lot of other diseases, especially digestive diseases, in which we see high levels of eosinophils that don’t belong there,” Fulkerson says.

Diet May Help Prevent Allergies And Asthma

December 9, 2006

A recent publication from the Global Allergy and Asthma European Network (GA2LEN) (1) provides new insights into the role that diet may play in the development of allergies, especially in children. The work suggests that the significant changes in European diets over the past 20-40 years may have contributed to the increased incidence of allergic diseases in both children and adults seen over this period. Members of the nutrition work package responsible for the report consider that its findings are just the beginning of GA2LEN’s potential role in greater understanding of this complex area.

The prevalence of allergic diseases has increased dramatically over the past few decades, especially in children. One child in three is allergic today and one in two people in Europe are likely to be suffering from at least one allergy by 2015. It is generally agreed that a combination of heredity and environmental factors is responsible for the development of the allergy and asthma. However, the evolution of these diseases has been far too rapid for genetics to be the sole explanation. Among the wide range of environmental factors under discussion, changes in the European diet in the last 20-40 years are considered to be a possible explanation. Indeed, the way in which children are fed early in life may have a direct effect on the subsequent development of asthma and allergies, according to a recent publication from the Global Allergy and Asthma European Network (GA2LEN). (1)

In a paper entitled “Nutrition and allergic disease”, published this year in Clinical and Experimental Allergy Reviews, 12 European experts working together in the GA2LEN nutrition work package present the evidence and define fertile topics for future research. (2) The work package team is led by Professor Philip C Calder, Institute of Human Nutrition, University of Southampton. (3)

Key findings: breastfeeding, early diet and probiotics

The three main areas producing key findings are breastfeeding, intake of certain nutrients, and probiotics. (4)

Exclusive breastfeeding, that is providing the infant with no other liquid or food other than breast milk, is believed to be effective in reducing subsequent development of allergies. It appears that exclusive breastfeeding for four months helps protect the child from cow’s milk protein allergy until 18 months, reduces the likelihood of dermatitis (skin allergy) until three years, and reduces the risk of recurrent wheeze (or asthma) until six years’ of age. However, the longer term effects of breast feeding on allergic outcomes are not known and require investigation.

The protective effect of four months of exclusive breastfeeding is important for all children but it is especially valuable for those at high risk of developing allergies. Children are at high risk of developing allergies if one or both parents are affected by allergic disease. If it is not possible for the high-risk child to be breastfed, hypoallergenic formula combined with avoidance of solid foods for 4-6 months offers an alternative source of protection. The studies show that hypoallergenic formula helps prevent cows’ milk protein allergy developing before the age of five years and offers protection against atopic dermatitis (eczema or other skin allergy) until the age of four years.

A second major area of importance appears to be the components of the diet. For example, antioxidants in the diet, such as vitamin C, vitamin E and selenium coming mainly from fruit and vegetables, may have a protective effect. Furthermore, different fats found in milk, butter, vegetable oils and fish may have different effects on development of allergies and asthma. Although it is difficult to find clear-cut evidence, it appears that reducing sodium intake, increasing magnesium intake, eating apples and other fruit and vegetables, and avoiding margarine might help some asthmatics. However much of the research conducted to date has not been systematic in its approach and this makes the drawing of hard conclusions very difficult.

The role of probiotics and prebiotics in the diet is promising. Living organisms such as probiotics appear to protect against the development of allergies by producing changes in the bacteria in the gut that stimulate the immune system. A double blind, placebo-controlled study has recently shown that probiotics can help reduce the risk of atopic disease. This is an important area for future research.

Meeting the challenge

The review highlighted several areas in nutrition and diet that appear to be fruitful for future research in allergic disease, and therefore for future disease control. In particular, it has highlighted gaps in relation to specific effects of maternal and infant nutrition on allergy and asthma in later life. Patients, health professionals and policy makers alike would benefit from such research and from more large-scale studies on diet and allergy. Key focuses should be identification of dietary patterns or factors likely to be involved in altering risk of development of allergies and asthma, and developing the evidence base about whether supplementation with specific fats or probiotics could contribute both to the protection and treatment of allergic diseases. The studies required will need to be large and to be well planned, designed and executed. They are likely to require cross-country collaboration.

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Notes:

1. GA2LEN – the Global Allergy and Asthma European Network is a “Network of Excellence” funded by the European Union 6th Research Framework Programme. It consists of 26 research centres spread throughout Europe, as well as the European Academy of Allergology and Clinical Immunology (EAACI) and the European Federation of Allergy and Airways Diseases Patients Associations (EFA).

2. The 72-page peer-reviewed paper entitled “Nutrition and allergic disease” is published in Clinical and Experimental Allergy Reviews 6: 117-188, 2006 Blackwell Publishing Ltd.

3. The article represents the work of Workpackage 2.1 of GA2LEN. Correspondence should be addressed to the workpackage leader, P. C. Calder, BSc, PhD, DPhil, Professor of Nutritional Immunology, Institute of Nutrition, University of Southampton, UK.

4. The full list of indicators comprises: Sodium and potassium, magnesium, lipids including fatty acids in milk, butter, vegetable oils and fish, antioxidants, including fruit and vegetable intake, flavonoids and flavonoid-rich foods, Vitamin C, Vitamin E, b-Carotene, Vitamin A, selenium, zinc and copper, and probiotics and prebiotics.