Wednesday August 23, 2017

Articles:225


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August 30

Can Living With Dogs or Cats Prevent Asthma in Kids?

By Katherine Hobson

If Wilbur can’t get past the co-op board, will a dog or cat do?

If kids who live in close proximity to farm animals seem to develop asthma at lower-than-average rates, can urban or suburban children reap the same benefits by acquiring a dog or cat?

That was our first question after reading a recent WSJ story by Shirley Wang, which covered a study suggesting the greater variety of microbes farm kids are exposed to seem to be beneficial. The first author of the study told Wang that conventional house pets wouldn’t likely offer the same benefit; the pig and cow exposure seemed to confer the benefit.

The theory behind the general “hygiene hypothesis” is that we’re all born with a predilection for allergies, but early exposure to microbes can help tilt the developing immune system in the other direction, says Leonard Bielory, an allergist and immunologist at Rutgers University’s Center for Environmental Prediction and director of the STARx Allergy and Asthma Center. “The more sterile the environment, the more [the disposition to allergies] remains,” he tells the Health Blog. All this happens in the first couple of years of life.

Leonard Bacharier, an associate professor of pediatrics at the Washington University School of Medicine and a co-author of a 2003 commentary on pets and childhood asthma published in Pediatrics, says the jury is still out on whether early life exposure to furry domesticated pets can help fend off asthma — studies have come down on either side of the question. Not all varieties of dirt and grime — from cat dander to cockroaches to dust mites — are helpful, he says. “There are very specific things [prompting] very specific immune reactions,” he says.

And we don’t yet know exactly what’s important. One theory is that endotoxin, a component of a certain type of bacteria found in the feces of animals, notably farm animals, is the beneficial element. But endotoxin levels may just be a marker for exposure to bacteria, Bacharier says.

One thing is certain: exposing older kids to pets in the hopes of preventing or ameliorating allergies or asthma isn’t going to help, and in the case of existing disease, will likely hurt. The 2003 commentary says that while pediatricians shouldn’t recommend removing furry pets from a home before a baby comes along, “it seems a poor choice to suggest that parents with asthma acquire cats or dogs before a child is born in an attemptto prevent future allergic disease, as siblings or the parents themselves may be sensitive and have more illness because of the pets.” Nor is bringing a pet into a home “consistently and completely protective,” it says.

The Hygiene Hypothesis 

In medicine, the hygiene hypothesis is a hypothesis that states that a lack of early childhood exposure to infectious agents, symbiotic microorganisms (e.g., gut flora orprobiotics), and parasites increases susceptibility to allergic diseases by suppressing natural development of the immune system. Other diseases, such as the rise of autoimmune diseases and acute lymphoblastic leukemia in young people in the developed world, have also been linked to the hygiene hypothesis.

Wall Street Journal Health Blog 

February 25, 2011

 

August 29

Anti-IgE Therapy and Steroids - Can you take both?

Omalizumab is a recombinant humanized monoclonal anti-IgE antibody that recognizes IgE at the same site as the high-affinity receptor for IgE. The monoclonal antibody complexes with free IgE block the binding of IgE to the cell membrane high-affinity receptor for IgE of mast cells and basophiles and inhibit cell activation and mediator release. Omalizumab is a treatment option limited to patients with elevated serum levels of IgE (30–700 IU/mL). Its current indication is for adolescents and adults with moderate to severe (United States) or severe (Europe) allergic asthma who remain uncontrolled after treatment with a high dose of corticosteroids plus long-acting β-agonists. These patients are at a high risk of suffering severe exacerbations and death and have the greatest medical need with associated economic cost.Oral corticosteroids are effective in some of these patients with severe asthma but they are associated with significant side effects.

Data from a recently published study indicate that the efficacy of add-on omalizumab in patients with moderate-tosevere allergic asthma is accompanied by an acceptable safety profile.

CHEST. 2011;139(1):28-35.


August 28

Artificial Human Liver - The future of drug testing

As a step towards improving the drug safety prediction capabilities of mice, researchers at the Massachusetts Institute of Technology (MIT) developed artificial humanized mouse livers and implanted them into mice. The team found that the ectopic livers responded to drugs in ways that are very similar to the way a human liver does, paving the way for safer and more efficient testing of drugs.

Chen, A.A., D.K. Thomas, L.L. Ong, R.E. Schwartz, T.R. Golub, and S.N. Bhatia. 2011. Humanized mice with ectopic artificial liver tissues. Proc. Natl. Acad. Sci. USA 108:11842-11847.


August 27

Immunological Treatment of Psoriatic Arthritis

Pasoriatic arthitis appears to be respond to nonsteroidal anti-inflmamtory drugs (NSAIDs), glucocorticoids (steroids such as prednisone) and synthetic disease modifying agents (DMARDs). The available evidence suggests an acceptable efficacy and safety profile of both NSAIDs and synthetic DMARDs (methotrexate, cyclosporine A, sulfasalazine and leflunomide) in psoriatic arthritis. More evidence is available supporting the efficacy of anti-tumour necrosis factor (anti-TNF) agents (adalimumab, etanercept, golimumab and infliximab) in treating the signs and symptoms of psoriatic arthritis as well as reducing radiographic progression.


August 26

LASIK Surgery, Allergy and Dry Eye Disorders

Ocular allergy is often underdiagnosed and has been previously reported as the cause for ocular irritation and visual problems reported after having laser correction of vision (LASIK) in the from of dry eye disease.LASIK surgery has been associated with increased anterior surface inflammatory processes that include dry eye syndromes and ocular allergy. A specific condition known as diffuse lamellar keratitis is one complication of LASIK that has been linked to atopic (allergic ) individuals. LASIK causes significant inflammation in normal eyes, which is only exacerbated in atopic patients. In addition, poorer outcomes of LASIK procedures have been reported in patients with moderate to severe ocular allergies and chronic forms of allergic conjunctivitis is an absolute contraindication to the LASIK procedure. Thus, atopy may be a contributing factor in patients with patients with post-LASIK dry eye symptoms. 

Curr Opin Allergy Clin Immunol. 2011 Aug 4. [Epub ahead of print]

Allergic complications with laser-assisted in-situ keratomileusis. Bielory BPO'Brien TP

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami - Miller School of Medicine, Palm Beach Gardens, Florida, USA.


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Today's Date: August 23, 2017
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