December 2016 - February 2017
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.
Early Introduction of Foods – The Saga Continues
Recent research has indicated that early introduction of certain foods may actually prevent the development of food allergy. Most significantly, a study last year revealed that patients who had early introduction of peanut protein in the form of a powder between the ages of 4-11 months had a tenfold decrease rate of food allergy to peanut compared to children who did not eat peanut between the ages of 4-11 months.
A recent follow-up study to that study revealed that the same children who ate peanut at an early age still did not have an increase in peanut allergy between the ages of 5-6 after a group of these children were restricted from eating peanut. This newer study reveals that early introduction of peanut protein seems to prevent a person from developing peanut allergy at a later age even if that person has not eaten peanut on a regular basis.
Another study looked at 1,303 infants who were breast fed exclusively up until age 3 months. After that time, one group of these children continued to breast feed and another group was assigned to early introduction of six common food allergens to their diet: Peanut, egg, cow’s milk, sesame, whitefish and wheat. Rates of food allergy were then compared between these two groups when the children were one to three years old. The prevalence of peanut or egg allergy was significantly reduced for children who consumed 2 grams of peanut or egg white protein per week compared to those who did not. Early introduction of the six foods was difficult to achieve in infants but was safe with no episodes of severe reactions and no problems related to breast feeding or growth. This study showed no significant reduction in food allergies with early introduction of multiple potentially allergenic foods except possibly for peanut and egg. This certainly makes the notion that widespread early introduction of a variety of foods may not decrease the likelihood of food allergy. However, it seems as if early introduction of peanut protein will decrease peanut allergy in large populations. Further testing is necessary.
These conflicting studies with foods also point to the possibility that there may be a group of patients for which early avoidance of major food allergens is helpful. In other patients, early avoidance of food allergens may be detrimental. We simply don’t know as of yet which patients are most likely to have problems if they are not exposed to a certain food at a certain point in their lives.
New Medications For Severe Asthma
A new medication, Nucala (mepolizumab), has been FDA-approved and is now available for patients with severe asthma. It is a once-a-month subcutaneous injection, like an allergy shot (for patients who have severe asthma symptoms). Nucala (mepolizumab) has been shown to be of benefit for patients, especially patients with allergic-triggered asthma. Unlike regular allergy shots, Nucala (mepolizumab) does not have a build-up phase. If you have any questions regarding this, please ask one of our office staff.
Asthma And Viral Disease
Asthma symptoms can sometimes be more common in certain individuals during the winter months. Reasons for this include not only cold temperatures which can trigger asthma symptoms and irritate the airway, but certain viruses, such as influenza, have a seasonal picture. Viruses tend to spread in areas of the world where there is less sunlight and where people tend to be indoors and in close contact with each other. This tends to happen more commonly in the wintertime than other times of the year. Also, indoor air can often be very dry, especially during very cold times of the winter. This promotes drying of the airways which then leads to irritation of the airways which is fertile breeding ground for bacteria and viruses to grow. Young children between the ages of one and four with reactive airways disease seem to be at greatest risk of having severe symptoms during the wintertime. Early treatment of these flare-ups can be very effective in preventing life-threatening situations and hospitalizations. If you have any questions regarding reactive airways disease or asthma symptoms in the wintertime, please do not hesitate to ask our office.