Allegy & Immunology News
Alcohol Use Lowers Rheumatoid Arthritis Risk
Alcohol consumption was associated with a significant reduction in susceptibility to rheumatoid arthritis (RA), a retrospective British study found.
Nondrinkers had an odds ratio for RA of 4.17 (95% CI 3.01 to 5.77) compared with those who consumed alcohol on more than ten days per month (P for trend <0.0001), James R. Maxwell, MBBS, and colleagues from the University of Sheffield, in England, reported online in Rheumatology.
Meta-Analysis Confirms Febuxostat Utility in Gout Patients
A meta-analysis has found that febuxostat (Uloric), a nonpurine xanthine oxidase inhibitor, was able to lower serum uric acid to normal levels (less than 6 mg/dL) in gout patients after barely a month of therapy, researchers reported here. Pooled data from five studies of more than 1,000 patients, found that progressively stronger doses of febuxostat substantially lowered serum uric acid levels within a month compared with placebo, with the strongest dose (120 mg) producing a 68 times greater chance of reaching normal levels within 28 days, said Jean H. Tayar, MD, assistant professor of medicine at the University of Texas M.D. Anderson Cancer Center, Houston.
Morbidity of respiratory illness in children with asthma
Exacerbations of childhood asthma and rhinovirus infections both peak during the spring and fall, suggesting that viral infections are major contributors to seasonal asthma morbidity. Kim and Olenec et al (p 1001) evaluated rhinovirus infections during peak seasons in children with asthma and analyzed relationships between viral infection and illness severity. Although viral infection appeared to be nearly universal, the atopic children experienced more frequent and severe virus-induced illnesses when compared with those children without evidence of allergen-specific IgE; conversely, nonatopic children were twice as likely to have asymptomatic infections (see Figure). The authors conclude that the combination of viral infection and allergy increases the morbidity of respiratory tract illnesses in children with asthma.
Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use
An article in the Journal of Allergy and Clinical Immunology sought to investigate disease variables associated with VitD insufficiency in patients with childhood asthma and interaction of VitD with corticosteroid-mediated anti-inflammatory responses. They analyzed 25-hydroxyvitamin D serum levels in 100 asthmatic children to investigate relationships between 25-hydroxyvitamin D levels and patients' characteristics. They determined VitD's effects on dexamethasone (DEX) induction of mitogen-activated protein kinase phosphatase 1 and IL-10 in PBMCs. Overall it was found that corticosteroid use and worsening airflow limitation are associated with lower VitD serum levels in asthmatic patients. VitD enhances glucocorticoid action in PBMCs from asthmatic patients and enhances the immunosuppressive function of DEX in vitro.
Nasal Eosinophilia Correlates with Lower Airway Inflammation
It is noteworthy that there is a clear clinical, epidemiological and pathophysiological association between upper and lower airway inflammation in rhinitis and asthma. A study in Clinical and Experimental Allergy compared the eosinophil counts in induced sputum and nasal lavage fluids in asthma, checking their association and the accuracy of nasal eosinophilia as a predictor of sputum eosinophilia by a cross-sectional study. After adjusted for upper airway symptoms sputum eosinophilia was associated with 52 times increase in odds of nasal eosinophilia, whereas each 1% increase in bronchodilator response was associated with 7% increase in odds of nasal eosinophilia, bringing further evidence that upper airway diseases are an important component of the asthma syndrome.
Methotrexate Withdrawal at 6 vs 12 Months in Juvenile Idiopathic Arthritis in Remission
Novel therapies have improved the remission rate in chronic inflammatory disorders including juvenile idiopathic arthritis (JIA). Therefore, strategies of tapering therapy and reliable parameters for detecting subclinical inflammation have now become challenging questions. To analyze whether longer methotrexate treatment during remission of JIA prevents flares after withdrawal of medication and whether specific biomarkers identify patients at risk for flares, a prospective, open, multicenter, medication-withdrawal randomized clinical trial including 364 patients (median age, 11.0 years) with JIA recruited in 61 centers from 29 countries between February 2005 and June 2006. Overall, in patients with JIA in remission, a 12-month vs 6-month withdrawal of methotrexate did not reduce the relapse rate and it was shown a higher MRP8/14 concentrations were associated with risk of relapse after discontinuing methotrexate.
Low-Dose Colchicine Effective, Safe in Acute Gout
Low-dose colchicine (Colcrys) was as effective as the commonly prescribed high-dose regimen for pain reduction in acute gout and had a much better side-effect profile, a multicenter randomized trial found.
A total of 37.8% of patients in the low-dose group were responders, compared with 32.7% of those in the high-dose group and 15.5% of those in the placebo group (P=0.005 and P=0.034, respectively, versus placebo), according to Robert A. Terkeltaub, MD, of the University of California, San Diego, and colleagues.
Shots Relieve Children's Hay Fever, Cut Expenses
Allergy vaccinations reduce total health-care costs in children with hay fever by one-third and drug prescription costs by 16 percent, according to a 10-year U.S. study. Researchers compared the medical claims for 2,770 children with hay fever (allergic rhinitis) who received allergy vaccinations with the claims of 11,000 children with allergic rhinitis who didn't receive allergen immunotherapy.
Vacuum Assisted Delivery Increase Late Onset Asthma
Perinatal factors during delivery might modulate fetal immunological development and thereby be associated with the development of allergic diseases and asthma later.There was a higher prevalence of doctor-diagnosed asthma at any time of life among children who were delivered by vacuum extraction (RR 1.80, 95% CI 1.27–2.56; P < 0.001) in comparison with spontaneously delivered children. In particular, this risk was increased as regards late-onset asthma (RR 2.41, 95% CI 1.52–3.81; P < 0.001). Perinatal effects had less impact on the development of other asthma, atopy or hay fever.
Lupus Worse in Blacks, Hispanics Than in Whites, Study Finds
Blacks and Hispanics appear more likely than whites to develop the most common form of the autoimmune disease lupus and to develop more severe complications from it, new research shows.
Lupus, also known as systemic lupus erythematosus (SLE), a chronic inflammatory disease that often affects the joints, kidneys, blood and nervous system, is generally known to strike women more often than men and some ethnic groups more than others. Its severity can range from mild to fatal.
Allergy drugs may fight diabetes, obesity
Over-the-counter allergy and asthma drugs helped obese, diabetic mice lose weight and control their blood sugar, researchers reported on Monday. Three other studies strongly linked obesity and type-2 diabetes to a dysfunctional immune system, and researchers said these findings could lead to better drugs or perhaps even vaccines to treat the effects of both conditions.
Treatment of patients with new onset Type 1 diabetes with a single course of anti-CD3 mAb teplizumab preserves insulin production for up to 5 years
Clinical Immunology Abstract
Anti-CD3 mAbs may prolong β cell function up to 2 years in patients with new onset Type 1 diabetes (T1DM). Teplizumab caused transient reduction in circulating T cells, but the recovered cells were not new thymic emigrants because T cell receptor excision circles were not increased. There was a trend for reduced loss of C-peptide over 2 years with drug treatment (p = 0.1), and insulin use was lower (p < 0.001).
Obesity May Dampen Response to Asthma Meds
New research suggests that obesity may not worsen asthma, as many experts have thought, but it could dampen the response to medications commonly used to manage the chronic condition.
