The Hilltop Allergy Letter
VOLUME 16    NUMBER 2
MARCH 2017 - MAY 2017
 

INTRODUCTION
    We welcome all new and established patients to our newsletter.  This is formulated four times a year to inform patients and the medical community with regard to new developments in asthma, allergies, and clinical immunology.  Please feel free to take this home with you and share it with family and friends. 

SEVERE FOOD ALLERGY IN ADOLESCENCE
A recent study looked at 3,153 children in Sweden for a history of food allergy.  About 1% of these adolescents had a history of severe food allergy reactions.  Only 2.6% of these patients who had reactions used epinephrine.
Seventy-five percent of these adolescents with food allergy had experienced symptoms since infancy.  The most common foods were peanut, tree nuts, egg and soy.  Those with severe food allergies were often noted to have food allergy to more than one food.  Source:  Clinical and Experimental Allergy 2016, Vol. 46, pgs. 1575-1587.

E-CIGARETTES GOOD OR BAD?
    There is continued debate over the health effects of E-cigarettes, including their potential for benefit in patients as an alternative to tobacco smoking vs. concern about unknown long-term health consequences.  The use of E-cigarettes has risen sharply in recent years, particularly among teenagers and young adults.  Studies of E-cigarettes, liquids and aerosols, have identified chemicals of E-cigarettes that could be potentially toxic, although the toxicity appears to be lower than tobacco smoke particles. 
For long-term smokers, using E-cigarettes rather than tobacco might improve health outcomes, although this has not been conclusively noted in the medical literature.  While nicotine-free E-cigarettes are available, nicotine-containing E-cigarettes are much more common with short- and long-term affects noted in these cigarettes.  Limited data suggests that E-cigarette use may have lower harm than tobacco smoking.  However, the health outcomes of long-term E-cigarettes remain unknown.  There is also concern that E-cigarettes may promote nicotine addiction in young individuals who might otherwise have been non-smokers.  Whether E-cigarettes actually promote transition to tobacco smoke remains to be seen.  Editorial Comment:  I believe E-cigarettes are useful as a bridge between tobacco smoke and full smoking cessation.  However, I believe in the long run the best option is not smoking at all.
Source:  New England Journal of Medicine 2016, Vol. 375, pgs. 1372-1381.


DOES HAVING A HISTORY OF HAY FEVER DECREASE YOUR RISK OF A HEART ATTACK?
Both heart disease (coronary artery disease) and allergic disease involve inflammation.  While asthma has been linked to an increased risk of heart disease and heart attacks, including death from heart attacks, there is conflicting evidence as to whether or not allergic rhinitis (nasal allergies, hay fever) increases your risk of heart disease.  Data from a large study looking at 110,000 patients with a diagnosis of hay fever (allergic rhinitis) showed a significantly lower risk of heart attacks in patients who had nasal allergies. 
The question is whether treatment for nasal allergies may be beneficial in decreasing heart disease as many patients with nasal allergies will treat them. The take-home message is patients with nasal allergies may have some genetic factor that protects them from serious heart disease.  Fortunately, there is no evidence that treating hay fever symptoms increases your risk of heart disease.   Source:  Annals of Allergy, Asthma and Immunology 2016, Vol. 117, pgs. 359-364.
 



 


 


 

           

 

 


 



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