Asthma and Nutrition Research

ASTHMA

ASTHMA - Acupuncture, Homeopathy, Food Allergy, Food Intolerance, Nutrition, Vitamin C, Magnesium, Vitamin B, Fish Oil, Omega-3 Fatty Acid, Yoga, Hypnotherapy, Herbal Medicine, Coleus Forskhollii, Ginkgo Biloba, Tylophora Asthmatica - There are some positive findings regarding unconventional therapies in asthma. Until more definitive and long-term studies are done, it would be premature to recommend any unconventional treatment as more than an adjunct to conventional treatment. Most complementary therapies are cheap in comparison to conventional treatment and may help patients develop a greater sense of control over their disease. Therapies reviewed include acupuncture, homeopathy, food allergy, food intolerance, nutrition, vitamin C, magnesium, vitamin B, fish oil, omega-3 fatty acids, yoga, hypnotherapy, herbal medicine, Coleus forskhollii, Ginkgo biloba and Tylophora asthmatica. "Unconventional Therapies in Asthma: An Overview," Lewith, G. T. and Watkins, A. D., Allergy, 1996;51:761-769. (Address: Dr. G. T. Lewith, University of Medicine, Level D (810) Centre Block, Southampton General Hospital, Tremona Road, Southampton, Hampshire S016 6YD, United Kingdom) 26110 [all, pul]

ASTHMA - Acupuncture, Immune Function - Acupuncture was evaluated in a randomized trial of 38 patients suffering from mild allergic asthma. The treatment group received acupuncture for their allergic asthma according to the rules of Traditional Chinese Medicine, while the control group received acupuncture on points not specific for asthma. The groups were treated 12 times for 30 minutes each over a period of 4 weeks. The treatment group showed increases in CD3+ and CD4+ cells and interleukins 6, 8 and 10, and a decrease of eosinophils in the peripheral blood. In vitro lymphocyte proliferation increased significantly. In 79% of the treated patients, there was improvement in their general sense of condition. The improvement in their condition coincided with changes in immune parameters. "Acupuncture-Immunological Effects in Treatment of Allergic Asthma," Joos, Stefanie, et al, Allergologie, 1997;20(2):63-68. (Address: Stefanie Joos, M.D., Belfortstrasse 1, D-69115 Heidelberg, Germany) 27448 [all, imm, pul]

ASTHMA - Adenosine Monophosphate - Adenosine 5'-monophosphate (AMP) elicits bronchoconstriction by enhancing mast cell mediator release. Heparin given by inhalation in a double-blind, placebo- controlled study of 10 asthmatics attenuated the airway response to adenosine 5'-monophosphate but not to methacholine. "Time Course of Changes in Adenosine 5'-Monophosphate Airway Responsiveness With Inhaled Heparin in Allergic Asthma," Polosa, Riccardo, M.D., Ph.D., et al, Journal of Allergy and Clinical Immunology, March, 1997;99(3):338-344. (Address: Riccardo Polosa, M.D., Ph.D., Istituto Malattie Apparato Respiratorio, University of Catania, Via Pass Gravina 187, 95125 Catania, Italy) 26903 [pul]

ASTHMA - Air Pollution - In evaluating 79 cases of asthma diagnosed at a lung clinic among persons between 20 and 65 years of age compared to 304 randomly picked individuals, it was found that 3 years or more of work in air-polluted occupations resulted in an odds ratio for risk of bronchial asthma of 3.0 in a comparison with work in occupations with slight or no air pollution. Smoking was associated with an almost doubled risk for asthma. The data support an association between occupational exposure to nonspecific air pollution and the development of bronchial asthma. "Bronchial Asthma and Air Pollution at Workplaces," Flodin, Ulf, Ph.D., et al, Scandinavian Journal of Work Environmental Health, 1996;22:451-456. (Address: Dr. Ulf Flodin, Department of Occupational and Environmental Medicine, University Hospital, S-581 85 Linkoping, Sweden) 26772 [all, pul]

ASTHMA - Air Pollution - Asthma is the leading chronic illness in pediatrics. In evaluating 416 children admitted for acute asthma in a French hospital over a 24-month period, there was no relationship between weather parameters or outdoor air pollution and acute asthma requiring pediatric admission. There was a trend between S02 levels and the number of admissions with a delay of 3 to 5 days. "Asthma in Children, Acute Effects of Air Pollution: An Epidemiological Study in Le Havre Area," Le Roux, P., et al, Revue Francaise DžAllergologie, 1997;37(2):176-182. 27570 [all, env, pul]

ASTHMA - Air Pollution, Emergency Room - In evaluating emergency room visits for asthma during the winters of 1988 and 1989 through 1991 and 1992, there was a consistent relationship found between emergency room visits for asthma and particulate matter which was equal to or less than 10 um in diameter. In the same day, nitrogen dioxide concentrations were also associated with asthma ER visits, while ozone was not. Relative risks for particulate matter being associated with asthma ER visits was temperature-dependent. There was higher risk at lower temperatures. One of the principal sources of particulate matter in this area is residential wood combustion. "Air Pollution and Emergency Room Visits for Asthma in Santa Clara County, California," Lipsett, Michael, et al, Environmental Health Prospectives, February, 1997;105(2):216-222. 27485 [all, env, pul]

ASTHMA - Alcohol - This article notes a case report of alcohol- induced asthma in a Caucasian female. This report was in response to a letter stating that alcohol-induced asthma was restricted to Asians. "Alcohol-Induced Asthma: Not Only in Asians," Zellweger, J. P., M.D., Journal of Allergy and Clinical Immunology, June, 1997;99(6):860. 27696 [all]

ASTHMA - Allergy - Skin-contact allergy, food allergies, and other allergies not involving the respiratory tract may have a significant impact on the later development of hyperactive airways and asthma. "Childhood Allergies Predispose Patients to Asthma," Branch, David R., Skin and Allergy News, March, 1997;28. 26851 [all, pul]

ASTHMA - Alpha-1-Antitrypsin Deficiency, Atopy, Emphysema - In evaluating 43 consecutive patients with alpha-1-antitrypsin deficiency (alpha1-ATD), it was found that asthma is more common in patients with alpha1-ATD than in those without it. The lack of alpha1-AT in airways increases the likelihood of developing asthma. It is believed that individuals with alpha1-ATD lack a major antiprotease defense against airway inflammation that makes them more susceptible to allergen-mediated asthma, and subsequently progressive airway obstruction. "Atopy, Asthma, and Emphysema in Patients With Severe ą-1-Antitrypsin Deficiency," Eden, Edward, et al, American Journal of Respiratory and Critical Care Medicine, 1997;156:68-74. 28139 [all, pul]

ASTHMA - Amaryllis - Individuals who work in greenhouses around various decorative flowers may develop occupational asthma that is IgE-dependent. This is a case report of a 50-year-old man who had been working in a greenhouse where amaryllis plants were cultivated. After 1 year he developed rhinitis and shortness of breath. He had a smoking history of 30 years and had perennial rhinitis for about 15 years. He had an elevated eosinophil count and he had specific IgE antibodies against amaryllis petal, stem and pollen by RAST testing. This patient had a diagnosis of occupational asthma due to an IgE-mediated reaction to amaryllis plant parts. "Occupational Asthma to Amaryllis," Jansen, A. P. H., et al, Allergy, 1996;51:847-854. (Address: A. P. H. Jansen, Allergologen Maatschap Arnhem, Velperweg 26, 6824 BJ Arnhem, The Netherlands/31 026-3515020 (Fax)) 26112 [all, pul]

ASTHMA - Amino Acid - This study evaluated 10 atopic asthma patients aged 23 to 37 compared to 6 nonatopic controls with an age range of 24 to 31 years for amino acids and related compounds in bronchoalveolar lavage fluid. High pressure liquid chromatography revealed the presence of 25 compounds. Asparagine, phosphoethanolamine and taurine were significantly increased in asthmatic patients. The evaluation of amino acids and related compounds in bronchoalveolar lavage fluid may be a potential diagnostic tool for pulmonary disorders. "Levels of Amino Acids and Related Compounds in Bronchoalveolar Lavage Fluids of Asthmatic Patients," Hofford, James M., et al, American Journal of Respiratory and Critical Care Medicine, 1997;155:432- 435. (Address: James M. Hofford, M.D., 211 Oakwood Road, Wilmington, DE 19803 U.S.A.) 26800 [all, pul]

ASTHMA - Anaphylaxis, Exercise, Food - This is a case report of a 14-year-old boy with a history of asthma since age 10 who had experienced 3 episodes of exercise-induced anaphylaxis. The episodes were first triggered by a meal of salami, pasta, Parmesan cheese, tomatoes, beef, bread, and an apple. His second and third triggering meals contained rice, butter, bread, Parmesan, mascarpone, spinach, carrots, a peach, artichokes, potatoes, red wine, and a pear. Cultured salami casings from the patient's home yielded P. lanoso-caeruleum colonies. The patient was skin-tested for foods and molds and showed a positive reaction for the molds, with the strongest positive reaction associated with P. lanoso-caeruleum. The authors note that although molds and mites, which contaminate food, are known to cause contact urticaria and food allergy, this is the first report of a food and exercise-induced reaction to any type of contaminant. Neither ingestion of P. lanoso-caeruleum nor running alone was sufficient to trigger the reaction. "Exercise- Induced Anaphylaxis After Food Contaminant Ingestion in a Double- Blinded, Placebo-Controlled, Food-Exercise Challenge," Fiocchi, Alessandro, M.D., et al, Journal of Allergy and Clinical Immunology, September, 1997;100(3):424-425. 28223 [all, pul]

ASTHMA - Aniseed - This is a case of a butcher with work-related asthma. Skin prick testing showed positive reactions to aniseed extract. The patient had high levels of anti-aniseed antibodies. A bronchial challenge with aniseed extract showed an immediate response without a late response. This patient had occupational asthma from aniseed dust sensitization. "Occupational Asthma Induced by Aniseed," Fraj, J., et al, Allergy, 1996;51:337-339. (Address: Dr. Juan Fraj, Servicio de Alergologia, Hospital Clinico Universitario Lozano Blesa, C. San Juan Bosco 15, 50009 Zaragoza, Spain) 26231 [all, pul]

ASTHMA - Antioxidant, Bronchial Reactivity, Magnesium, Vitamin C - In a random sample of adults, it was found that those with bronchial hyperreactivity and seasonal allergic-type symptoms did not differ from controls with respect to the presence of atopy and an increased risk of symptoms associated with the lowest intake of zinc. The lowest intakes of vitamin C and manganese were associated with more than five-fold increased risks of bronchial reactivity. Decreasing intakes of magnesium were also significantly associated with an increased risk of bronchial hyperreactivity. The reduction in antioxidant intake in the British diet over the last 25 years may be associated with an increased risk of asthma over this time period. "Bronchial Reactivity and Dietary Antioxidants," Soutar, A., et al, Thorax, February, 1997;52(2):166-170. (Address: A. Soutar, Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, United Kingdom) 27734 [all, pul]

ASTHMA - Arachidonic Acid, Phospholipase A2 - Sixteen individuals with allergic asthma were challenged with an antigen and compared to 10 control subjects. Phospholipase A2 and arachidonic acid were increased in the bronchoalveolar lavage fluid after antigen challenge in the asthmatic group. Phospholipase A2 may play an important role in the generation of arachidonic acid in patients with asthma. The metabolites of arachidonic acid, cysteinyl leukotrienes, appear to play a significant role in the pathogenesis of asthma. These leukotrienes are potent bronchoconstrictors and produce edema of the airways. Arachidonic acid is released by the action of phospholipase A2 on lipid membranes, and may serve as a substrate for 5-lipoxygenase with the resultant formation of these leukotrienes. Release of arachidonic acid from mast cells is also calcium dependent. The increased activity of phospholipase A2 and its ability to generate leukotrienes suggests a potential role in clinical asthma. "Phospholipase A2 and Arachidonate Increase in Bronchoalveolar Lavage Fluid After Inhaled Antigen Challenge in Asthmatics," Bowton, David L., et al, American Journal of Respiratory Critical Care Medicine, 1997;155:421-425. (Address: David L. Bowton, M.D., Pulmonary and Critical Care Medicine, Medical Center Blvd., Winston-Salem, NC 27157-1054 U.S.A.) 26799 [all, pul]

ASTHMA - Atopy, Family Size - In evaluating 11,924 families, the following factors were highly associated with child's asthma or wheezing: motheržs or father's asthma or wheezing, other atopic conditions in the mother or father, and 3 or more siblings compared with no siblings. The association with family size was negative with regard to wheezing and asthma. "Family Size, Atopic Disorders in Parents, Asthma in Children, and Ethnicity," Rona, Roberto J., Ph.D., et al, Journal of Allergy and Clinical Immunology, 1997;99(4):454-460. 27135 [all, pul]

ASTHMA - Autoimmune Vasculitis, Aortic Stenosis - Ten percent of adult asthmatics can have their symptoms induced by aspirin. Asthma attacks induced by aspirin are related to the inhibition of cyclooxygenase in the lungs of sensitive patients, and not to the body's reaction to aspirin. Signs of autoimmunity have been observed in some patients with aspirin-induced asthma. Fifty- five percent of aspirin-induced asthmatics have antinuclear antibodies and 6% have clinical signs of autoimmunity. "Autoimmune Vasculitis and Aortic Stenosis in Aspirin-Induced Asthma (AIA)", Szczeklik, A., et al, Allergy Net, 1997;52:352- 354. 27566 [all, pul]

ASTHMA - Beta-Agonist, Death - In this letter, the authors express doubt that beta-agonists are an explanation for the great majority of both epidemic and non-epidemic asthma deaths. The authors do not believe the association between beta-adrenoceptor agonist use and life-threatening asthma is causal. The authors believe that the pattern of use, especially with increasing use of inhaled beta-adrenergic agonists over time, signifies a loss of control of asthma which is much more predictive of an adverse event than the actual amount used. "The Asthma Death Problem Revisited," Ernst, Pierre and Suissa, Samy, British Journal of Clinical Pharmacology, 1997;43:339-341. 27460 [all, pul]

ASTHMA - Beta-Agonist, Overuse - This letter to the editor questions the safety of the regular use of beta-agonists among patients with mild asthma. Epidemiologic studies performed by these researchers have shown that excessive use of beta-agonists is associated with a very high risk of fatal or near-fatal asthma. The threshold of safety is about 1« canisters per month. Monitoring monthly use of beta-agonists is extremely important. A pattern of increasing use over time is a more important predictor of an imminent fatal or near fatal asthma attack than regular use or even regular use of excessive quantities. Over a 6-month period, an increase of 1 canister in the monthly use of a beta-agonist or a doubling of the monthly use is a critical warning sign of an impending serious asthma attack. Initiating or increasing inhaled corticosteroids is probably warranted. The authors feel that beta-agonists should be used only as needed. "Albuterol in Mild Asthma," Suissa, Samy, Ph.D. and Ernst, Pierre, M.D., The New England Journal of Medicine, March 6, 1997;336(10);729. (Address: Samy Suissa, Ph.D./Pierre Ernst, M.D., Royal Victoria Hospital, Montreal, QC H3A 1A1, Canada) 26825 [all, pul]