Asthma
Steroids Not as Effective in Obese Asthma Patients
Glucocorticoids, the primary controller medication for asthma, are 40 percent less effective in overweight and obese asthma patients than in those of normal weight, according to researchers at National Jewish Health, in Denver. The study also identified a potential mechanism involved in the resistance, which suggests therapeutic targets for future medications.
The study, by Associate Professor of Medicine E. Rand Sutherland, M.D., M.P.H., and his colleagues at National Jewish Health, appears in the first issue for October of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
“This study identifies what could be a significant issue for the 20 million Americans with asthma; specifically, the main controller medication might be less effective if you are overweight or obese,” said Dr. Sutherland. “These findings should spur doctors to carefully evaluate response to treatment in overweight and obese asthmatics and consider optimizing therapeutic regimens as indicated. We also hope they will spur additional research into the treatment of obese patients with asthma.”
Asthma monitoring on the Web
An inexpensive web-enabled device for measuring lung function in patients with asthma and other disorders is being developed by researchers at Texas Instruments, in Bangalore, India, and co-workers. Writing in the International Journal of Biomedical Engineering and Technology, the team explains how the devise could allow physicians to monitor their patients remotely and quickly instigate medical attention in an emergency.
Spirometers are commonly used to measure lung capacity and the response of breathing during therapy. However, the widespread application of spirometers is limited in the developing world and in remote regions because of the high instrument cost of the instrument and a lack of specialist healthcare workers trained in its use.
Texas Instruments researcher N.C.S. Ramachandran is an expert in high-speed and low-power digital design and is working with professor of electrical engineering Vivek Agarwal of the Indian Institute of Technology, Bombay, India, on the development of an inexpensive and easy to operate spirometer that can be quickly hooked up to an internet connection through built-in web and data encryption software.
Note to pediatricians: Taper meds in kids with stable asthma
A study of how pediatricians prescribe asthma medications suggests that while most would readily increase a child’s medication if needed, many are reluctant to taper off drug use when less might be best. A report on the study, led by Johns Hopkins Children’s Center researchers, appears in the July issue of Pediatrics.
“Asthma medications can have serious, albeit infrequent, side effects, and while under-treatment is undeniably a big problem, not stepping down treatment when a child is doing well may be too,” says lead investigator Sande Okelo, M.D., an asthma specialist at Hopkins Children’s.
In the research, conducted among 310 pediatricians nationwide, 40 percent said they would not step down high-dose treatment even if a child’s symptoms were well controlled and infrequent.
Caregivers often expose asthmatic kids to smoke
Secondhand exposure to cigarette smoke is an asthma trigger in children and a new study shows that smoking by the primary caregiver and daycare provider are important sources of smoke exposure in children with asthma.
In the study, children with asthma who were exposed to secondhand smoke “had as much smoke exposure as if their mother smoked,” Dr. Harold J. Farber told Reuters Health.
Children with a double hit of smoke exposure - from both their daycare provider and primary caregiver - had the highest levels of nicotine metabolites in their urine, said Farber, of Texas Children’s Hospital in Houston.
Aspirin may help prevent asthma in women
In a large study of healthy women, taking low doses of aspirin reduced the occurrence of asthma, investigators at Harvard Medical School report.
Two recently reported studies among adult men and women have indicated a significant reduction in the risk of newly diagnosed asthma associated with regular aspirin use, lead investigator Dr. T. Kurth and colleagues note.
To further investigate, the Boston-based researchers analyzed data from the Women’s Health Study, in which more than 37,000 female health professionals age 45 and older with no previous history of asthma were randomly assigned aspirin 100 milligrams every other day or placebo.
Culture-specific asthma education has benefits
Educating asthma sufferers in a way that is specific and appropriate to their individual and cultural needs can make a positive difference in their quality of life, researchers have found.
“Culture-specific programs, in comparison to generic education programs or usual care, were effective at improving asthma related quality of life for adults and asthma knowledge scores for children and parents,” Emily Bailey told Reuters Health.
However, “There is not enough evidence at this stage to say that culture-specific programs will show an improvement for asthma exacerbations,” said Bailey, of Menzies School of Health Research in Queensland, Australia.
Obesity worsens impact of asthma
Obesity can worsen the impact of asthma and may also mask its severity in standard tests, according to researchers in New Zealand, who studied lung function in asthmatic women with a range of body mass indexes (BMIs).
This is the first prospective study to reveal a significant comparative difference in how the airways and lungs respond to a simulated asthma attack in obese and non-obese individuals.
The research is reported in the first issue for May of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. It establishes a direct link between obesity and the development of a phenomenon known as “dynamic hyperinflation”—when air breathed into the lungs cannot be exhaled. This often occurs with acute asthma, but is more frequent in obese individuals.
Asthma ‘drops’ may treat allergic asthma in kids
Children who suffer from asthma triggered by allergens - so-called allergic asthma—may benefit from an “under the tongue” therapy designed to increase tolerance to offending allergens, and, in turn, decrease asthma symptoms and medication use.
Research shows that sublingual immunotherapy, or SLIT, reduces symptoms and use of rescue medication use in children with allergic asthma, according to a report in the medical journal Chest. SLIT involves the oral administration of allergen extracts, either through soluble tablets or drops.
Dr. Giorgio Walter Canonica, of the University of Genoa, Italy, and colleagues pooled data from nine randomized, controlled clinical trials in order to assess the efficacy of SLIT in the treatment of allergic asthma in children.
Acid-blockers in pregnancy up kids’ asthma risk
Children whose mothers took stomach acid-blocking medication during pregnancy have increased odds of developing asthma, a Boston team announced here at the annual meeting of the American Academy of Allergy, Asthma and Immunology.
The findings were presented by Dr. Elizabeth H. Yen of Children’s Hospital, Boston. Her group analyzed data from three national Swedish healthcare registries to examine acid-blocker use by pregnant women in relation to rates of asthma in their children.
Increased Allergen Levels in Homes Linked to Asthma
Results from a new national survey demonstrate that elevated allergen levels in the home are associated with asthma symptoms in allergic individuals. The study suggests that asthmatics that have allergies may alleviate symptoms by reducing allergen exposures inside their homes. The work was carried out by researchers at the National Institute of Environmental Health Sciences (NIEHS), the University of Iowa, Rho Inc., and the Constella Group. The team’s findings may help millions of Americans who suffer from asthma.
“Indoor allergen exposures are of great importance in relation to asthma because most people spend a majority of their time indoors, especially at home,” said Darryl Zeldin, M.D., a Principal Investigator in the Laboratory of Respiratory Biology at NIEHS and senior author on the paper.
Asthma is one of the most common chronic ailments in the United States, affecting more than 22 million people. Asthma has been shown to be triggered by a wide range of substances called allergens.
Handling Pesticides Associated with Greater Asthma Risk in Farm Women
New research on farm women has shown that contact with some commonly used pesticides in farm work may increase their risk of allergic asthma.
“Farm women are an understudied occupational group,” said Jane Hoppin, Sc.D., of the National Institute of Environmental Health Sciences and lead author of the study. “More than half the women in our study applied pesticides, but there is very little known about the risks.”
Menopausal Women May Have an Increased Asthma Risk
Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women, according to a new study in the Journal of Allergy and Clinical Immunology (JACI).
The study, “Lung function, respiratory symptoms, and the menopausal transition,” can be found in the articles in press section of the JACI Web site, http://www.jacionline.org. The JACI is the peer-reviewed journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).
Antibiotic treatment targets difficult asthma
Hunter researchers have shown that a commonly available antibiotic can improve the quality of life of patients with difficult asthma, and may also generate significant health care savings.
Results of a study published in the American Journal of Respiratory and Critical Care Medicine, a top international journal, indicate that macrolide antibiotics could prove a successful therapy in conjunction with current asthma treatment.
Family history a risk factor for asthma death
An analysis of genealogy records linked to death certificates in Utah suggests that the risk of dying from an asthma attack is hereditary.
Dr. Craig C. Teerlink and associates at the University of Utah in Salt Lake City identified 1553 asthma-related deaths in a registry of all Utah deaths since 1904.
Study Links Asthma and Post-Traumatic Stress Disorder
For the first time, a study has linked asthma with post-traumatic stress disorder (PTSD) among adults in the community. The study of male twins who were veterans of the Vietnam era suggests that the association between asthma and PTSD is not primarily explained by common genetic influences.
The study included 3,065 male twin pairs, who had lived together in childhood, and who had both served on active military duty during the Vietnam War. The study found that among all twins, those who suffered from the most PTSD symptoms were 2.3 times as likely to have asthma compared with those who suffered from the least PTSD symptoms.
