Friday June 23, 2017



August 04

GERD (gastroesophageal reflux disease) and EoE (eosinophilic esophagitis)

What is the clinical significance of differentiating GERD (gastroesophageal reflux disease) from EoE (eosinophilic esophagitis)? One of the earliest studies on EoE reported a cohort of children with esophageal eosinophilia who were diagnosed with GERD deemed refractory to medical therapy, the majority of whom underwent fundoplication without improvement. The children were subsequently shown to respond symptomatically and histologically to an elemental diet. EoE should be considered in patients with "refractory reflux" before consideration of antireflux surgery. Although this scenario is more commonly encountered in pediatrics, prospective adult studies have detected EoE in 1%–4% of patients with reflux symptoms failing PPI therapy. On the other hand, committing patients with suspected EoE to long-term steroid or elimination diet therapy who might otherwise respond to PPI (proton pump inhibitors) is also important. The safety profile of PPI is established, whereas the long-term physical and psychosocial implications of topical steroids and dietary intervention are unknown. As the controversy over distinguishing GERD from a PPI responsive form of EoE continues, an empiric therapeutic trial of PPI therapy in suspected EoE patients seems the most practical strategy.

August 04

Immunologist discoverer of of the gene that governs the immune systemís reaction to foreign bodies dies at the age of 90

Baruj Benacerraf, the geneticist and immunologist who earned the 1980 Nobel Prize for his discovery of the gene that governs the immune system’s reaction to foreign bodies, died on August 2, 2011of pneumonia, at the age of 90.

Benacerraf started his Nobel Prize winning work with a chance observation. He had immunized a group of guinea pigs with a synthetic antigen, expecting to see all of the animals develop an immune response. But only about 40 percent of the rodents reacted, suggesting that individual genetic differences controlled the response. He then grouped the animals into responders and non-responders, and through a series of cross-mating experiments, confirmed that the response was controlled by a single dominant gene.

Interestingly, Benacerraf himself became allergic to guinea pigs as a result of the experiments, but it was “a small price to pay for the success of this project,” he wrote an autobiography published in the Annual Reviews of Immunology (ARJ) in 1991.

Hugh McDevitt and Allen Chinitz at Stanford University School of Medicine later discovered that Benacerraf’s “immune response” gene coded the major histocompatibility complex (MHC) molecule, which at the time was considered to be primarily involved in graft rejection. This connection illustrated that both graft rejection and pathogen rejection were mediated by the same molecule, and led the way for an understanding of autoimmune disease, organ transplantation, and differences in how individuals in a population respond to the same pathogen.


Reference The ScientistDaily (

August 03

Asthma Comorbidities

Asthma is often associated with various comorbidities. The most frequently reported asthma comorbid conditions include rhinitis, sinusitis, gastroesophageal reflux disease, obstructive sleep apnea, hormonal disorders and psychopathologies. These conditions may, first: share a common pathophysiological mechanism with asthma; second: influence asthma control, its phenotype and response to treatment; and third: be more prevalent in asthmatic patients but without obvious influence on this disease. For many of these, how they interact with asthma remains to be further documented, particularly for severe asthma. If considered relevant, they should, however, be treated appropriately. 

August 02

Climate Change

Human activity is disrupting Earth’s climate, and the rising emissions of greenhouse gases are accelerating that disruption. Some of the health consequences of climate change are straightforward: warmer temperatures, changes in the hydrologic cycle, increased ground-level ozone, and enhanced pollen production will increase exposure to heat stress, alter patterns of infectious disease, and compromise air quality. 

• Climate change has brought about an earlier start to spring and later end to fall, and these changes to seasonality, along with higher CO2 concentrations, yield both longer pollen seasons and more pollen production from many allergenic plants. (Dr. Bielory reported earlier and prolonged ragweed seasons in Proceedings National Academy of Science (March) 2011.

• Allergic respiratory disease, particularly asthma, is already associated with a quarter of a million deaths annually worldwide.

Read more: The Coming Health Crisis - The Scientist - Magazine of the Life Sciences

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Location: Springfield, NJ
Today's Date: June 23, 2017
Station Director: Leonard Bielory, M.D
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