Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials
Objective:
To evaluate the effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication.
Design:
Systematic review of randomized controlled trials.
Data sources:
Electronic databases and hand search of reviews, bibliographies of books and abstracts and proceedings of international conferences.
Review methods:
Included trials had to be randomized or quasi-randomized and controlled, using fermented milk-based probiotics in the intervention group, treating Helicobacter-infected patients and evaluating improvement or eradication of H. pylori as an outcome.
Results:
The search identified 10 eligible randomized controlled trials. Data were available for 963 patients, of whom 498 were in the treatment group and 465 in the control group. The pooled odds ratio (studies n=9) for eradication by intention-to-treat analysis in the treatment versus control group was 1.91 (1.38-2.67; P<0.0001) q="5.44;" p="0.488)." q="13.41;" p="0.144)." p="0.41;" q="68.5;">
Conclusion:
Fermented milk-based probiotic preparations improve H. pylori eradication rates by approximately 5-15%, whereas the effect on adverse effects is heterogeneous.
Jan 30, 2009
Efficacy and safety of 5-grass pollen sublingual immunotherapy tablets in patients with different clinical profiles of allergic rhinoconjunctivitis
The optimal dose of grass pollen tablets for sublingual immunotherapy (SLIT) in allergic rhino conjunctivitis patients was previously established in a multinational, randomized, double-blind, placebo-controlled study in 628 adults. Patients were randomized to receive once-daily 5-grass pollen sub lingual tablets of 100 IR (index of reactivity), 300 IR or 500 IR, or placebo starting 4 months before the pollen season.
Objective
The aim of this complementary analysis was to determine whether 300 IR 5-grass pollen SLIT-tablets is effective in different subtypes of patients who are allergic to grass pollen. Methods
Different subgroups could be identified regarding comorbidities (with or without asthma during the grass-pollen season), sensitization (mono/polysensitization) and symptom severity. An additional exploratory analysis was performed within four subgroups based on pre-treatment assessment: Group 1=high specific IgE; Group 2=high symptom scores; Group 3=high skin sensitivity; Group 4=any of Group 1, 2 or 3. Results
Asthma and sensitization status were not significant covariates as the average Rhinoconjunctivitis Total Symptom Score (RTSS) was identical for patients with and without grass-pollen asthma, as well as for mono- and polysensitized patients. Across the four subgroups, average RTSSs (± SD) for the optimal dosage (300 IR) were 3.91 ± 3.16, 3.83 ± 3.14, 2.55 ± 2.13 and 3.61 ± 2.97, for subgroups 1, 2, 3 and 4, respectively.ancovashowed that in Group 1 average RTSS did not differ significantly with different doses of SLIT. In Groups 2, 3 and 4, doses of 300 IR and 500 IR were significantly more effective than 100 IR and placebo . All doses of SLIT administered in this study can be considered safe in the patients investigated.
Conclusions
The risk-benefit ratio validates the use of 300 IR tablets in clinical practice in all of these patient subgroups, regardless of severity profile, sensitization status and presence of asthma.
Objective
The aim of this complementary analysis was to determine whether 300 IR 5-grass pollen SLIT-tablets is effective in different subtypes of patients who are allergic to grass pollen. Methods
Different subgroups could be identified regarding comorbidities (with or without asthma during the grass-pollen season), sensitization (mono/polysensitization) and symptom severity. An additional exploratory analysis was performed within four subgroups based on pre-treatment assessment: Group 1=high specific IgE; Group 2=high symptom scores; Group 3=high skin sensitivity; Group 4=any of Group 1, 2 or 3. Results
Asthma and sensitization status were not significant covariates as the average Rhinoconjunctivitis Total Symptom Score (RTSS) was identical for patients with and without grass-pollen asthma, as well as for mono- and polysensitized patients. Across the four subgroups, average RTSSs (± SD) for the optimal dosage (300 IR) were 3.91 ± 3.16, 3.83 ± 3.14, 2.55 ± 2.13 and 3.61 ± 2.97, for subgroups 1, 2, 3 and 4, respectively.ancovashowed that in Group 1 average RTSS did not differ significantly with different doses of SLIT. In Groups 2, 3 and 4, doses of 300 IR and 500 IR were significantly more effective than 100 IR and placebo . All doses of SLIT administered in this study can be considered safe in the patients investigated.
Conclusions
The risk-benefit ratio validates the use of 300 IR tablets in clinical practice in all of these patient subgroups, regardless of severity profile, sensitization status and presence of asthma.
Jan 28, 2009
Allergy
Allergy - a disease characterized by a modified (high) sensitivity of the human body or animal to the factors of the environment. Allergy symptoms vary greatly and depend on what organs and systems of the body exposed to the allergen.
The treatment of allergy is a fairly difficult task.
For the treatment of allergies are usually applied:
1. Anti -
2. chromoens (chrome-glycane ).
3. The most modern way to treat allergies can be considered ASID
The treatment of allergy is a fairly difficult task.
For the treatment of allergies are usually applied:
1. Anti -
2. chromoens (chrome-glycane ).
3. The most modern way to treat allergies can be considered ASID
Jan 26, 2009
Why Allergy Meds Worsen Restless Leg Syndrome - Histaminergic Clinical And Autopsy Abnormalities In Restless Legs Syndrome
Johns Hopkins Researchers at Neuroscience 2008 - People with restless leg syndrome often have found that sleep-inducing allergy drugs worsen their symptoms. Now, researchers at the Johns Hopkins University School of Medicine have discovered a possible reason for that and help explain why RLS in general interferes with sleep but doesn't seem to result in daytime drowsiness. The common thread, the researchers say, is that histamine receptors - proteins found on the surface of some cells that are triggered by histamine - in the brain work to modulate nerve responses.
When activated, histamine receptors stimulate alertness or wakefulness.
To sort out the relationship they suspected, the researchers first gave RLS patients either a true sedative or diphenhydramine, the active ingredient in many allergy medications that tames histamine and induces sleepiness. They found that while sedatives had little to no effect on RLS, diphenhydramine made the RLS as much as three to four times worse. The team then looked at autopsied brains from RLS patients for possible differences in histamine receptor location and found that the substantia nigra, the part of the brain implicated in RLS, contained a higher number of histamine-3 receptor proteins, suggesting that this molecular pathway is more active in people with RLS.
"Five out of six patients in our study showed this elevated number of histamine receptor proteins," says Richard Allen, Ph.D., a research associate in neurology at Hopkins.
"The histamine system appears to alter the balance of the nervous system so that one is not sleepy in the daytime, even with sleep loss, which might explain why RLS patients can get by on so little sleep. This also suggests that histamine receptors might be a new target for study and therapy of RLS."
When activated, histamine receptors stimulate alertness or wakefulness.
To sort out the relationship they suspected, the researchers first gave RLS patients either a true sedative or diphenhydramine, the active ingredient in many allergy medications that tames histamine and induces sleepiness. They found that while sedatives had little to no effect on RLS, diphenhydramine made the RLS as much as three to four times worse. The team then looked at autopsied brains from RLS patients for possible differences in histamine receptor location and found that the substantia nigra, the part of the brain implicated in RLS, contained a higher number of histamine-3 receptor proteins, suggesting that this molecular pathway is more active in people with RLS.
"Five out of six patients in our study showed this elevated number of histamine receptor proteins," says Richard Allen, Ph.D., a research associate in neurology at Hopkins.
"The histamine system appears to alter the balance of the nervous system so that one is not sleepy in the daytime, even with sleep loss, which might explain why RLS patients can get by on so little sleep. This also suggests that histamine receptors might be a new target for study and therapy of RLS."
Food Allergy And Intolerance
One of the busiest weeks at the start of the year is about to hit Allergy UK. Since Christmas and the New Year, the volume of calls from people suffering with symptoms which could be related to food have been steadily climbing.
The majority of people contacting us will be suffering food sensitivity, a true food allergy affects only a small number of the population, in the region of 2% but for this 2% it is unbelievably difficult particularly as a mistake could be life threatening.
With the food allergy and intolerance awareness week people who have been silently suffering wondering what could be causing their problems will often decide to telephone and just check out what they could possibly do to identify the cause of their symptoms and what to do about it.
Thousands of people suffer from food related illnesses and symptoms such as Irritable Bowel Syndrome, Coeliac Disease, Migraine, Eczema , joint pains etc. yet are unaware of how they should manage their conditions and this is where Allergy UK can help.
Whether suffering from food allergy or food intolerance life is severely impacted making social events a nightmare, reducing productivity at work and limiting achievements in education. However there is good news in that due to the increased awareness of the problems, that in the region of 45% of the population suffer, increased attention is being paid to producing special 'free from' food which is a million miles away from the tasteless food of a few years ago.
In a recent survey carried out by Allergy UK many people mentioned specific supermarkets and the 'free from' foods they produce and we want to know more, so we are currently carrying out an online vote on both the above websites, on the shopping habits of those with food allergy and intolerance problems. We suspect from comments made to us, that shoppers will completely change their regular store if they discover a particular supermarket has a range of 'free from' foods that suit them.
We want to know whether this is really the case, whether ease of finding the product, price etc. are major factors. We want to hear from people with food problems about the services they want and expect to be provided by the supermarkets. Food Allergy and Food Intolerance Awareness week with your help will enable us to do this.
The majority of people contacting us will be suffering food sensitivity, a true food allergy affects only a small number of the population, in the region of 2% but for this 2% it is unbelievably difficult particularly as a mistake could be life threatening.
With the food allergy and intolerance awareness week people who have been silently suffering wondering what could be causing their problems will often decide to telephone and just check out what they could possibly do to identify the cause of their symptoms and what to do about it.
Thousands of people suffer from food related illnesses and symptoms such as Irritable Bowel Syndrome, Coeliac Disease, Migraine, Eczema , joint pains etc. yet are unaware of how they should manage their conditions and this is where Allergy UK can help.
Whether suffering from food allergy or food intolerance life is severely impacted making social events a nightmare, reducing productivity at work and limiting achievements in education. However there is good news in that due to the increased awareness of the problems, that in the region of 45% of the population suffer, increased attention is being paid to producing special 'free from' food which is a million miles away from the tasteless food of a few years ago.
In a recent survey carried out by Allergy UK many people mentioned specific supermarkets and the 'free from' foods they produce and we want to know more, so we are currently carrying out an online vote on both the above websites, on the shopping habits of those with food allergy and intolerance problems. We suspect from comments made to us, that shoppers will completely change their regular store if they discover a particular supermarket has a range of 'free from' foods that suit them.
We want to know whether this is really the case, whether ease of finding the product, price etc. are major factors. We want to hear from people with food problems about the services they want and expect to be provided by the supermarkets. Food Allergy and Food Intolerance Awareness week with your help will enable us to do this.
Living With Nut Allergy
The incidence of nut allergy is on the increase in Western societies, as is the attention it receives from the public and from the media, yet little research has been carried out on the impact of living with the condition.
A University of Leicester research project is now to look at the views and experiences of children and their families living with nut allergy, which accounts for the majority of severe food-related allergic reactions. Peanut allergy, which currently affects around 1 % of children, is the most common food trigger of anaphylaxis.
Funded by MAARA (Midlands Asthma and Allergy Research Association), Dr Emma Pitchforth, of the University's Department of Health Sciences, is carrying out a qualitative study involving interviews with children and their parents. Depending on the age of the child, they may be interviewed separately or with their parents.
The two-year research project is being carried out with colleagues Dr David Luyt and Dr Emilia Wawrzkowicz, consultant paediatricians involved in the management of childhood allergies.
From these investigations, the team hope to understand better the impact on family and everyday life of living with these allergies. They will be looking at sources of information and strategies families use to cope.
The interviews will be audio-recorded (with permission) and the resulting transcriptions will help the researchers to identify recurring themes. All data is anonymous and confidential.
Dr Pitchforth commented: "First allergic reactions to nuts usually develop in children at a young age and do not resolve as they get older. This means that for those affected nut allergy is a permanent, potentially life-threatening condition.
"Clinical management of nut allergy typically involves educating children and their families to avoid all products containing nuts. They need to learn to recognise early signs of allergic reaction and to administer self-injectable epinephrine when they need to.
"The number of deaths resulting from nut allergy is extremely low, but it is a risk and patients are told to avoid all types of nuts and their traces, and to carry an 'Epi-pen' at all times, in case they suffer an anaphylactic shock."
University Of Leicester
A member of the 1994 Group of universities that share a commitment to research excellence, high quality teaching and an outstanding student experience.
- Ranked top for student satisfaction in England (jointly with Oxford) among mainstream universities (average score of 4.4 out of 5 for overall satisfaction)
- Ranked as a Top 20 university by The Sunday Times University Guide, The Guardian University Guide and the UK Good University Guide
- One of just 23 UK universities to feature in world's top 200- Shanghai Jiao Tong International Index, 2005-07.
- Ranked in top 200 world universities by the THES (Times Higher Education Supplement)
- Short listed University of the Year in 2007 by The Sunday Times and Short listed Higher Education Institution of the Year - THES awards 2005 and 2006
- Ranked top 10 in England for research impact by The Guardian
- Students' Union of the Year award 2005, short listed 2006 and 2007
Founded in 1921, the University of Leicester has 19,000 students from 136 countries. Teaching in 18 subject areas has been graded Excellent by the Quality Assurance Agency- including 14 successive scores - a consistent run of success matched by just one other UK University. Leicester is world renowned for the invention of DNA Fingerprinting by Professor Sir Alec Jeffreys and houses Europe's biggest academic Space Research Center.
90% of staff are actively engaged in high quality research and 13 subject areas have been awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level. The University's research grant income places it among the top 20 UK research universities. The University employs over 3,000 people, has an annual turnover of £184m, covers an estate of 94 hectares and is engaged in a £300m investment programme among the biggest of any UK university.
A University of Leicester research project is now to look at the views and experiences of children and their families living with nut allergy, which accounts for the majority of severe food-related allergic reactions. Peanut allergy, which currently affects around 1 % of children, is the most common food trigger of anaphylaxis.
Funded by MAARA (Midlands Asthma and Allergy Research Association), Dr Emma Pitchforth, of the University's Department of Health Sciences, is carrying out a qualitative study involving interviews with children and their parents. Depending on the age of the child, they may be interviewed separately or with their parents.
The two-year research project is being carried out with colleagues Dr David Luyt and Dr Emilia Wawrzkowicz, consultant paediatricians involved in the management of childhood allergies.
From these investigations, the team hope to understand better the impact on family and everyday life of living with these allergies. They will be looking at sources of information and strategies families use to cope.
The interviews will be audio-recorded (with permission) and the resulting transcriptions will help the researchers to identify recurring themes. All data is anonymous and confidential.
Dr Pitchforth commented: "First allergic reactions to nuts usually develop in children at a young age and do not resolve as they get older. This means that for those affected nut allergy is a permanent, potentially life-threatening condition.
"Clinical management of nut allergy typically involves educating children and their families to avoid all products containing nuts. They need to learn to recognise early signs of allergic reaction and to administer self-injectable epinephrine when they need to.
"The number of deaths resulting from nut allergy is extremely low, but it is a risk and patients are told to avoid all types of nuts and their traces, and to carry an 'Epi-pen' at all times, in case they suffer an anaphylactic shock."
University Of Leicester
A member of the 1994 Group of universities that share a commitment to research excellence, high quality teaching and an outstanding student experience.
- Ranked top for student satisfaction in England (jointly with Oxford) among mainstream universities (average score of 4.4 out of 5 for overall satisfaction)
- Ranked as a Top 20 university by The Sunday Times University Guide, The Guardian University Guide and the UK Good University Guide
- One of just 23 UK universities to feature in world's top 200- Shanghai Jiao Tong International Index, 2005-07.
- Ranked in top 200 world universities by the THES (Times Higher Education Supplement)
- Short listed University of the Year in 2007 by The Sunday Times and Short listed Higher Education Institution of the Year - THES awards 2005 and 2006
- Ranked top 10 in England for research impact by The Guardian
- Students' Union of the Year award 2005, short listed 2006 and 2007
Founded in 1921, the University of Leicester has 19,000 students from 136 countries. Teaching in 18 subject areas has been graded Excellent by the Quality Assurance Agency- including 14 successive scores - a consistent run of success matched by just one other UK University. Leicester is world renowned for the invention of DNA Fingerprinting by Professor Sir Alec Jeffreys and houses Europe's biggest academic Space Research Center.
90% of staff are actively engaged in high quality research and 13 subject areas have been awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level. The University's research grant income places it among the top 20 UK research universities. The University employs over 3,000 people, has an annual turnover of £184m, covers an estate of 94 hectares and is engaged in a £300m investment programme among the biggest of any UK university.
Jan 20, 2009
Breathe Easier!
Family Guide To Winter Allergies - Ten Tips On Improving Life In The Winter For Both Parents And Children
Spring and summer are not the only seasons that bring misery to those with allergies.
"The end of the pollinating season is good news for people -- both adults and children -- with hay fever and similar summer allergies, but those who are sensitive to mold spores may have to wait until the first frost to find relief. Allergy to mold spores can be more of a problem than pollen allergy because mold grows anywhere and is not limited to a single season. It needs little more than moisture and oxygen to thrive," says Dr. Michael Stewart, chairman of the Department of Otorhinolaryngology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
In addition, Dr. David J. Resnick, acting director of the Allergy Division at the Morgan Stanley Children's Hospital of New-York-Presbyterian, says, "Allergies can trigger or worsen asthma and other respiratory illnesses especially in the winter when families spend more time indoors, which increases their exposure to irritants like dust mites, pet dander, smoke, household sprays and chemicals, and gas fumes -- any and all of which can make their lives miserable."
Drs. Stewart and Resnick offer these 10 tips to make the winter months more bearable for allergy sufferers:
- Keep your indoor humidity level below 35 percent to help prevent the growth of mold and mites.
-Use exhaust fans when showering or cooking to remove excess humidity and odors. Avoid putting rugs in the bedroom, if possible, since wall-to-wall carpeting is an ideal place for dust mites to proliferate.
- When outdoors, keep children from playing in areas that promote mold growth, such as dark, wooded areas.
- Use dust-proof covers for mattresses, box springs and pillows to decrease exposure to allergens, but consult your allergist before undertaking such an expense.
- Wash bed linens and nightclothes in hot water (above 130 degrees) to kill dust mites.
- If you must use a humidifier, keep it clean and change the water frequently to avoid contamination by mold and bacteria. Central humidifiers should be sprayed with an anti-mold agent.
- Don't put plants in the bedroom, since decaying leaves and increased humidity can stimulate growth of mold.
- Adults and children allergic to household pets (dogs and cats) should minimize their contact with them. If you cannot remove the pets from the household, keep them out of the bedroom at all times.
- Children with asthma should get a flu vaccine at the end of October or the beginning of November before the onset of cold weather. Also, keep your child well-hydrated and protected from cold air with proper attire (i.e., a scarf over the mouth).
- Contact your family physician or allergist for proper evaluation and treatment.
"The end of the pollinating season is good news for people -- both adults and children -- with hay fever and similar summer allergies, but those who are sensitive to mold spores may have to wait until the first frost to find relief. Allergy to mold spores can be more of a problem than pollen allergy because mold grows anywhere and is not limited to a single season. It needs little more than moisture and oxygen to thrive," says Dr. Michael Stewart, chairman of the Department of Otorhinolaryngology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
In addition, Dr. David J. Resnick, acting director of the Allergy Division at the Morgan Stanley Children's Hospital of New-York-Presbyterian, says, "Allergies can trigger or worsen asthma and other respiratory illnesses especially in the winter when families spend more time indoors, which increases their exposure to irritants like dust mites, pet dander, smoke, household sprays and chemicals, and gas fumes -- any and all of which can make their lives miserable."
Drs. Stewart and Resnick offer these 10 tips to make the winter months more bearable for allergy sufferers:
- Keep your indoor humidity level below 35 percent to help prevent the growth of mold and mites.
-Use exhaust fans when showering or cooking to remove excess humidity and odors. Avoid putting rugs in the bedroom, if possible, since wall-to-wall carpeting is an ideal place for dust mites to proliferate.
- When outdoors, keep children from playing in areas that promote mold growth, such as dark, wooded areas.
- Use dust-proof covers for mattresses, box springs and pillows to decrease exposure to allergens, but consult your allergist before undertaking such an expense.
- Wash bed linens and nightclothes in hot water (above 130 degrees) to kill dust mites.
- If you must use a humidifier, keep it clean and change the water frequently to avoid contamination by mold and bacteria. Central humidifiers should be sprayed with an anti-mold agent.
- Don't put plants in the bedroom, since decaying leaves and increased humidity can stimulate growth of mold.
- Adults and children allergic to household pets (dogs and cats) should minimize their contact with them. If you cannot remove the pets from the household, keep them out of the bedroom at all times.
- Children with asthma should get a flu vaccine at the end of October or the beginning of November before the onset of cold weather. Also, keep your child well-hydrated and protected from cold air with proper attire (i.e., a scarf over the mouth).
- Contact your family physician or allergist for proper evaluation and treatment.
Cancer, Cardiovascular Diseases, Allergies - Mice As Models For 32 Diseases
Cancer, Cardiovascular Diseases, Allergies - Mice As Models For 32 Diseases- GSF Scientist Coordinates A 2.6 Million Euro Project
Many gene defects which proved to cause diseases have been identified in the meantime - it is important to use this gained knowledge for clinical research now.
Also within the German National Genome Research Network (NGFN), a large number of genes were discovered which cause diseases in their defect form.
In order to foster the further research activities on these genes as effectively as possible, the German Federal Ministry for Education and Research (BMBF) has initiated a new project. For as many as 32 genes, mutant mouse lines were established to investigate how these genes contribute to the occurrence of diseases.
Professor Martin Hrabé de Angelis, Director of the GSF Institute of Experimental Genetics (IEG), is in charge with the coordination of this project which is funded with a total of 2.6 million Euros.
The selected genes are thought to be connected with a broad variety of illnesses such as breast cancer, prostate cancer, cardiovascular diseases, immune deficiency syndromes (allergies, neurodermitis), rheumatic diseases and diseases caused by the environment like Crohn's Disease. These genes will be mutated in the mouse models in order to examine the effects of the respective gene defect. "Genes can be switched off, but also be hyper-activated by mutations which allows us to investigate both the loss and the overproduction of the gene product", states Hrabé de Angelis.
The mouse models will be submitted to the NGFN Clinical Research Groups which will identify the corresponding genes for further investigation. At the same time, the German Mouse Clinic (GMC), which is also directed by Hrabé de Angelis, will serve as a centre of information for all mouse models.
Here the mice will be examined and characterised across all diseases - a general check carried out by collecting the data on more than 240 different parameters going from external appearance, metabolism to behaviour. "The concept entirety constitutes the added value of this project", emphasises Hrabé de Angelis, "due to the Mouse Clinic, it is safeguarded that the highest number of gene mutations possible will be registered".
After a certain lead time, the data concerning the mice will also be stored in the European Mouse Mutant Archive (EMMA) to make them available to all interested scientists.
In addition, a close relationship with the European EUCOMM Consortium is planned whose coordinator, Professor Wolfgang Wurst, is also established at the GSF. EUCOMM too is devoted to clarifying disease genes functions, "so that we will make use of the synergies in any case", guarantees Hrabé de Angelis.
For capacity reasons, three biotechnology companies will provide the manufacturing of the mouse models: Artemis Pharmaceuticals GmbH, gen Oway and Ingenium Pharmaceuticals AG.
These companies are leading in the field of certain mutation technologies and are therefore able to quickly implement them - time is an important factor here as the mice are supposed to become available to scientists as soon as possible.
New Therapeutic Target For Asthma, Allergies and Cancer
Potential New Therapeutic Target For Asthma, Allergies And Cancer
Virginia Commonwealth University researchers have identified how a bioactive molecule involved with allergy, inflammation and cancer is transported out of mast cells, according to findings published online this week in the Proceedings of the National Academy of Sciences.
Mast cells are specialized cells that react to allergy-causing agents by releasing substances that trigger the body's allergic response, leading to conditions like asthma and hives. Among the molecules released by mast cells that participate in the allergic response is sphingosine-1-phosphate. This molecule is also implicated in cancer.
The work by the VCU investigators opens up a new approach to treating asthma, which affects about 15 million Americans and is increasing in incidence and mortality, especially among African-Americans. It also has implications for other allergic disorders and for cancer in terms of developing drugs that inhibit the transport of SIP out of cells.
Sarah Spiegel, Ph.D., professor and chair, VCU Department of Biochemistry, and colleagues reported how S1P, which also regulates many important physiological functions in cells, is transported out of mast cells. S1P is produced by all cells and secreted by some cells into the circulation where it can bind to specific S1P receptors. Until now, researchers have not known the mechanism by which S1P is transported out of cells.
"Our study shows that mast cells can use a special kind of transporter that has long been known to be used by cancer cells to push anti-cancer drugs out and help them survive the treatment," said Spiegel. "Our study is the first to establish a mechanism by which S1P can be exported out of mast cells and perhaps by cancer cells as well."
In previous research, Spiegel's team found that S1P levels are significantly elevated in fluid collected from the lungs of asthmatic patients after exposure to an allergen. Those findings led Spiegel's team to believe that mast cells could be a source of S1P. Mast cells are found in all body tissues and rapidly produce and secrete a number of inflammatory substances such as histamine and S1P when activated by an inflammatory stimulus. Spiegel said that S1P in turn amplifies allergic and inflammatory responses. Therefore, S1P secreted from mast cells can orchestrate many allergic responses, including asthma.
This work was supported by a grant from the National Institutes of Health.
The team included researchers Poulami Mitra, a Ph.D. candidate, Carole A. Oskeritzian, Ph.D., Shawn G. Payne, Ph.D., from the VCU Department of Biochemistry; Michael A. Beaven, Ph.D., a researcher with the National Heart, Lung, and Blood Institute; and Sheldon Milstien, Ph.D., a neuroscientist with the National Institute of Mental Health.
Virginia Commonwealth University researchers have identified how a bioactive molecule involved with allergy, inflammation and cancer is transported out of mast cells, according to findings published online this week in the Proceedings of the National Academy of Sciences.
Mast cells are specialized cells that react to allergy-causing agents by releasing substances that trigger the body's allergic response, leading to conditions like asthma and hives. Among the molecules released by mast cells that participate in the allergic response is sphingosine-1-phosphate. This molecule is also implicated in cancer.
The work by the VCU investigators opens up a new approach to treating asthma, which affects about 15 million Americans and is increasing in incidence and mortality, especially among African-Americans. It also has implications for other allergic disorders and for cancer in terms of developing drugs that inhibit the transport of SIP out of cells.
Sarah Spiegel, Ph.D., professor and chair, VCU Department of Biochemistry, and colleagues reported how S1P, which also regulates many important physiological functions in cells, is transported out of mast cells. S1P is produced by all cells and secreted by some cells into the circulation where it can bind to specific S1P receptors. Until now, researchers have not known the mechanism by which S1P is transported out of cells.
"Our study shows that mast cells can use a special kind of transporter that has long been known to be used by cancer cells to push anti-cancer drugs out and help them survive the treatment," said Spiegel. "Our study is the first to establish a mechanism by which S1P can be exported out of mast cells and perhaps by cancer cells as well."
In previous research, Spiegel's team found that S1P levels are significantly elevated in fluid collected from the lungs of asthmatic patients after exposure to an allergen. Those findings led Spiegel's team to believe that mast cells could be a source of S1P. Mast cells are found in all body tissues and rapidly produce and secrete a number of inflammatory substances such as histamine and S1P when activated by an inflammatory stimulus. Spiegel said that S1P in turn amplifies allergic and inflammatory responses. Therefore, S1P secreted from mast cells can orchestrate many allergic responses, including asthma.
This work was supported by a grant from the National Institutes of Health.
The team included researchers Poulami Mitra, a Ph.D. candidate, Carole A. Oskeritzian, Ph.D., Shawn G. Payne, Ph.D., from the VCU Department of Biochemistry; Michael A. Beaven, Ph.D., a researcher with the National Heart, Lung, and Blood Institute; and Sheldon Milstien, Ph.D., a neuroscientist with the National Institute of Mental Health.
Using Air Filters Can Help Reduce Allergies And Asthmatic Attacks
Studies Have Shown That Using Air Filters Can Help Reduce Allergies And Asthmatic Attacks
What Causes Asthma?
Asthma is an allergic reaction that can be brought on by a variety of triggers including certain foods, medicines, organisms, dander, mold and airborne pollution. An asthmatic attack can be very frightening for both the asthmatic and their friends and family. While an air purifier alone is not sufficient to remove all allergens and asthmatic triggers from a home, they can be an effective component in your arsenal.
Including Air Purifiers in your Arsenal to help Combat Asthma Attacks
A quality air purifier alone cannot trap all household allergens that may contribute to asthmatic attacks. The reason for this is that not all allergens are or remain airborne. For example, many people with allergies are allergic to dust mite droppings (feces) which fall out of the air and into carpeting, upholstery and linens rather quickly due to their relatively large size. In addition, allergy attacks can be brought on by the presence of certain organisms which are immune to air purification, such as cockroaches.
In a September, 2004 study co-funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS), and published in the New England Journal of Medicine it was found that a HEPA air filter, when used in conjunction with dust mite proof mattress and pillow covers, cockroach extermination and a HEPA vacuum, dramatically reduced asthma symptoms.
Though no air cleaning system can remove all allergens from a home, studies have shown they can significantly reduce the levels of air born allergens and irritants, in some cases, by up to 90%. The HEPA filter has long been used in laboratory experiments, and has been proven to reduce the level of particles in the air. Many air filtration systems rely solely on HEPA technology, or, include a HEPA filter as part of a multi-filtration system.
Multi Filter Air Cleaning Systems
There are purifiers available today that combine more than one type of air filtration technology. The HEPA filter is a widely known, effective and popular air filter. Newer technologies include ionization and UV filters, which, when combined with a HEPA, can trap or kill allergens and particles that are much smaller in size than was previously possible. There are some UV filters that can effectively treat airborne pollutants that are down to 0.001 microns in size. The HEPA air filter traps particles as tiny as 0.3 microns. Ionization technology for air filtration works by negatively producing negatively charged ions which attach themselves to contaminants. These contaminants then drop from the air, resulting in cleaner air to breathe. The HEPA operates by physically trapping particles that go through the filter. While the UV method works by killing or destroying germs.
While no air filtration system alone can remove all potential allergens from the air, they can definitely help reduce them. Subsequently helping to reduce the number of allergic or asthmatic attacks an individual may experience. Much of this depends on what the individual is allergic to, what filtration system they choose, and what other allergen-removal methods they employ in their home environment. A quality air purifier can be a valuable tool in fighting allergies and the effects of asthma.
What Causes Asthma?
Asthma is an allergic reaction that can be brought on by a variety of triggers including certain foods, medicines, organisms, dander, mold and airborne pollution. An asthmatic attack can be very frightening for both the asthmatic and their friends and family. While an air purifier alone is not sufficient to remove all allergens and asthmatic triggers from a home, they can be an effective component in your arsenal.
Including Air Purifiers in your Arsenal to help Combat Asthma Attacks
A quality air purifier alone cannot trap all household allergens that may contribute to asthmatic attacks. The reason for this is that not all allergens are or remain airborne. For example, many people with allergies are allergic to dust mite droppings (feces) which fall out of the air and into carpeting, upholstery and linens rather quickly due to their relatively large size. In addition, allergy attacks can be brought on by the presence of certain organisms which are immune to air purification, such as cockroaches.
In a September, 2004 study co-funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS), and published in the New England Journal of Medicine it was found that a HEPA air filter, when used in conjunction with dust mite proof mattress and pillow covers, cockroach extermination and a HEPA vacuum, dramatically reduced asthma symptoms.
Though no air cleaning system can remove all allergens from a home, studies have shown they can significantly reduce the levels of air born allergens and irritants, in some cases, by up to 90%. The HEPA filter has long been used in laboratory experiments, and has been proven to reduce the level of particles in the air. Many air filtration systems rely solely on HEPA technology, or, include a HEPA filter as part of a multi-filtration system.
Multi Filter Air Cleaning Systems
There are purifiers available today that combine more than one type of air filtration technology. The HEPA filter is a widely known, effective and popular air filter. Newer technologies include ionization and UV filters, which, when combined with a HEPA, can trap or kill allergens and particles that are much smaller in size than was previously possible. There are some UV filters that can effectively treat airborne pollutants that are down to 0.001 microns in size. The HEPA air filter traps particles as tiny as 0.3 microns. Ionization technology for air filtration works by negatively producing negatively charged ions which attach themselves to contaminants. These contaminants then drop from the air, resulting in cleaner air to breathe. The HEPA operates by physically trapping particles that go through the filter. While the UV method works by killing or destroying germs.
While no air filtration system alone can remove all potential allergens from the air, they can definitely help reduce them. Subsequently helping to reduce the number of allergic or asthmatic attacks an individual may experience. Much of this depends on what the individual is allergic to, what filtration system they choose, and what other allergen-removal methods they employ in their home environment. A quality air purifier can be a valuable tool in fighting allergies and the effects of asthma.
Associations Between Exposure To Traffic-Related Air Pollution And The Allergic Diseases In Children
Under the direction of the Helmholtz Zentrum Munchen, a German research group studied in a longitudinal study, over six years, whether associations are identifiable between the onset of a topic diseases and exposure to air pollutants originating from traffic.
The scientists based their analysis, on the one hand, on the corresponding distance of the parental home to streets busy with traffic, and on the other hand, modeled values, for the respective residential addresses of the children, of air pollution with fine dust, diesel soot and nitrogen dioxide.
The research team led by Dr. Joachim Heinrich of the Institute of Epidemiology of the Helmholtz Zentrum München compared, with this, the data of 3,061 six-year old children from Munich and its surroundings.
From birth, their development has been tracked within the scope of the so-called GINI and LISA studies. The studies are led by Prof. Dr. H.-Erich Wichmann of the Helmholtz Zentrum München, and, among other things, are aimed at the study of behavioral and environmental risk factors for allergic diseases. In the current analysis, the results of medical research and regular parental interviews were considered. Moreover, the appearance of the specific IgE antibodies against common allergens in blood serum was tested in children at the age of 6.
The scientists were able to estimate individual values of exposure of children to fine dust and nitrogen dioxide, with the help of calculation models. It was shown that an escalation of asthmatic bronchitis and allergic sensitization to pollen and other common allergens occurred with increasing exposure to fine dust. Increased exposure to nitric oxide was linked to increases in eczema.
Connections were noted, in particular, between the appearance of asthmatic bronchitis, hay fever, eczema and allergic sensitization, on the one hand, and residential environment, on the other: compared with their contemporaries living in more distant places, children who lived less than 50 m from a very busy main road were between 1 % and 50 % more likely to contract these diseases.
Statistical analysis of the data showed a lower risk with increasing distances to the main roads.
Joachim Heinrich and his colleagues consider the results of their research to be clear evidence of the disadvantageous effects of air pollution from traffic on the causes of allergies and a topic diseases. In the past, epidemiological studies on this subject failed to supply a clear picture, although the effects of laboratory experiments and inhalation studies are well-known.
The scientists based their analysis, on the one hand, on the corresponding distance of the parental home to streets busy with traffic, and on the other hand, modeled values, for the respective residential addresses of the children, of air pollution with fine dust, diesel soot and nitrogen dioxide.
The research team led by Dr. Joachim Heinrich of the Institute of Epidemiology of the Helmholtz Zentrum München compared, with this, the data of 3,061 six-year old children from Munich and its surroundings.
From birth, their development has been tracked within the scope of the so-called GINI and LISA studies. The studies are led by Prof. Dr. H.-Erich Wichmann of the Helmholtz Zentrum München, and, among other things, are aimed at the study of behavioral and environmental risk factors for allergic diseases. In the current analysis, the results of medical research and regular parental interviews were considered. Moreover, the appearance of the specific IgE antibodies against common allergens in blood serum was tested in children at the age of 6.
The scientists were able to estimate individual values of exposure of children to fine dust and nitrogen dioxide, with the help of calculation models. It was shown that an escalation of asthmatic bronchitis and allergic sensitization to pollen and other common allergens occurred with increasing exposure to fine dust. Increased exposure to nitric oxide was linked to increases in eczema.
Connections were noted, in particular, between the appearance of asthmatic bronchitis, hay fever, eczema and allergic sensitization, on the one hand, and residential environment, on the other: compared with their contemporaries living in more distant places, children who lived less than 50 m from a very busy main road were between 1 % and 50 % more likely to contract these diseases.
Statistical analysis of the data showed a lower risk with increasing distances to the main roads.
Joachim Heinrich and his colleagues consider the results of their research to be clear evidence of the disadvantageous effects of air pollution from traffic on the causes of allergies and a topic diseases. In the past, epidemiological studies on this subject failed to supply a clear picture, although the effects of laboratory experiments and inhalation studies are well-known.
Omega 3 Fats Active Against Child Allergies
Omega-3 fats seem to have a protective effect on allergies in children.
One year olds whose mothers had ingested fish oil during pregnancy and breastfeeding had considerably fewer allergic reactions than children whose mothers did not take this supplement, according to a study from Linkoping University in Sweden.
The study, which started in 2005, comprised 145 pregnant mothers with families at heightened risk of developing allergy and asthma. From the 25th week of pregnancy through the third month of nursing, they were asked to take nine capsules of oil every day. Half of them were given fish oil with high levels of omega-3 fatty acids, and the other half were given a placebo in the form of soybean oil.
The study was doubly blind, that is, neither the participants nor the researchers knew who had received what.
It turned out that the "fish-oil children" had fewer than half as many reactions to eggs at the age of one year as the placebo group did. This is an important discovery, since allergic reactions to eggs early in life are strongly correlated with the later development of allergic disorders like eczema and asthma.
All of the children are now two years old and have undergone a clinical examination regarding eczema, been scratch-tested for eggs, milk, and cats, and left a blood sample.
The idea that the difference is truly an effect of the omega-3 fats is supported by an immunological study of the mothers' blood. The women who were given fish oil had less prostaglandin E2 in their blood than the others. This is a substance that triggers allergic immune responses, and it is known that it is depressed when the concentration of omega-3 increases.
"We have been able to show that omega-3 influences the mother's immunological profile in a less inflammatory direction.
Theoretically this can also affect the child's immune system, which is supported by the results of the scratch-tests," says the immune biologist Malin Fageras Bottcher, who led the study together in collaboration with the child allergist Karel Duchen.
One year olds whose mothers had ingested fish oil during pregnancy and breastfeeding had considerably fewer allergic reactions than children whose mothers did not take this supplement, according to a study from Linkoping University in Sweden.
The study, which started in 2005, comprised 145 pregnant mothers with families at heightened risk of developing allergy and asthma. From the 25th week of pregnancy through the third month of nursing, they were asked to take nine capsules of oil every day. Half of them were given fish oil with high levels of omega-3 fatty acids, and the other half were given a placebo in the form of soybean oil.
The study was doubly blind, that is, neither the participants nor the researchers knew who had received what.
It turned out that the "fish-oil children" had fewer than half as many reactions to eggs at the age of one year as the placebo group did. This is an important discovery, since allergic reactions to eggs early in life are strongly correlated with the later development of allergic disorders like eczema and asthma.
All of the children are now two years old and have undergone a clinical examination regarding eczema, been scratch-tested for eggs, milk, and cats, and left a blood sample.
The idea that the difference is truly an effect of the omega-3 fats is supported by an immunological study of the mothers' blood. The women who were given fish oil had less prostaglandin E2 in their blood than the others. This is a substance that triggers allergic immune responses, and it is known that it is depressed when the concentration of omega-3 increases.
"We have been able to show that omega-3 influences the mother's immunological profile in a less inflammatory direction.
Theoretically this can also affect the child's immune system, which is supported by the results of the scratch-tests," says the immune biologist Malin Fageras Bottcher, who led the study together in collaboration with the child allergist Karel Duchen.
Peak Pollen Season Is Now - Australia
Hay fever sufferers and people with asthma; beware - peak pollen season is now until late November, according to the latest asthma alert issued by the National Asthma Council Australia.
"There is so much hype at the start of spring about pollen-triggered asthma and allergy that many people don't realize that the real danger period is actually late spring and sometimes even early summer," warned Professor John Wilson, National Asthma Council Australia chairman.
"These are the four to six weeks of the year when plant-based and pollen-related asthma is at its peak," Prof Wilson explained. "Then as summer progresses, pollen distribution tends to fall off and prevailing winds make pollen less of an issue."
For people with asthma, major thunderstorms at this time of the year can also compound the problem, triggering sudden and severe asthma attacks and an increase in hospital admissions.
"The combination of plenty of pollen in the atmosphere and heavily laden rain clouds, characteristic of thunderstorms, is hazardous," Prof Wilson said.
"When precipitation occurs, the pollen grains become wet and expand and then burst into smaller particles which can be breathed deep into the lungs, triggering asthma.
"Consequently, thunderstorms increase the allergen load caused by plant species such as rye grass, Bermuda grass and birch and a range of others, exacerbating asthma symptoms."
To minimize the impact of seasonal asthma and allergy, the National Asthma Council Australia encourages people with known allergies to continue to take their preventative medications to reduce hay fever, rhinitis and asthma, as well as their symptom reliever.
"People with asthma must have an up-to-date written asthma action plan, detailing what to do when symptoms worsen and it is important to avoid exposure to triggers," Prof Wilson stressed.
"For many, at this time of the year, it's better indoors than out."
"There is so much hype at the start of spring about pollen-triggered asthma and allergy that many people don't realize that the real danger period is actually late spring and sometimes even early summer," warned Professor John Wilson, National Asthma Council Australia chairman.
"These are the four to six weeks of the year when plant-based and pollen-related asthma is at its peak," Prof Wilson explained. "Then as summer progresses, pollen distribution tends to fall off and prevailing winds make pollen less of an issue."
For people with asthma, major thunderstorms at this time of the year can also compound the problem, triggering sudden and severe asthma attacks and an increase in hospital admissions.
"The combination of plenty of pollen in the atmosphere and heavily laden rain clouds, characteristic of thunderstorms, is hazardous," Prof Wilson said.
"When precipitation occurs, the pollen grains become wet and expand and then burst into smaller particles which can be breathed deep into the lungs, triggering asthma.
"Consequently, thunderstorms increase the allergen load caused by plant species such as rye grass, Bermuda grass and birch and a range of others, exacerbating asthma symptoms."
To minimize the impact of seasonal asthma and allergy, the National Asthma Council Australia encourages people with known allergies to continue to take their preventative medications to reduce hay fever, rhinitis and asthma, as well as their symptom reliever.
"People with asthma must have an up-to-date written asthma action plan, detailing what to do when symptoms worsen and it is important to avoid exposure to triggers," Prof Wilson stressed.
"For many, at this time of the year, it's better indoors than out."
Food Allergies Could Be Fought With Friendly Bacteria In Alcoholic Milkshake
Feeding babies alcoholic milk may help to protect against some food allergies. Kefir, a traditional fermented drink, is consumed in Eastern Europe as a health food, and is often used to wean babies, as it is easily digested.
Food allergy prevalence is especially high in children under the age of three, with around 5-8% of infants at risk. Currently the only treatment is avoidance of the problematic food.
"Friendly" bacteria in kefir may play a role in blocking the pathway involved in allergic responses, Lisa Richards reports in Chemistry & Industry, SCI's fortnightly magazine. Research published 16 October 2006(DOI 10.1002/jsfa2469) in the SCI's Journal of the Science of Food and Agriculture has shown that the milk drink inhibits the allergen specific antibody Immunoglobulin E (IgE). IgE is involved in immune responses to inactivate organisms that might cause disease. However, in the presence of allergens it can also activate cells responsible for the release of histamine, a chemical which stimulates allergic responses, such as inflammation and constriction of airways.
Ji-Ruei Liu's team of scientists at the National Formosa University, Yunlin, Taiwan, fed mice the milky drink, and found that after 3 weeks, the amount of ovalbumin (OVA) specific IgE was reduced three-fold. Ovalbumin is an allergenic protein found in egg whites, which cause most allergies in young children. Kefir is also reported to prevent food antigens from passing through the intestinal wall.
Liu believes that the milky drink could be a promising tool in the prevention of allergies. "In the future, maybe we can screen out the certain components (bacterial strains or bioactive peptides) from kefir and utilize them in medicine," he said.
Also in this weeks Chemistry & Industry, UK firm Rigest are looking for backers to develop an air sanitizing system using an enzyme found naturally in human tears. Lactoperoxidase can attack and kill microbes such as 'flu viruses and the bacteria responsible for MRSA. The system could be used to sanitize the air in airplanes and hospital sick bays.
Food allergy prevalence is especially high in children under the age of three, with around 5-8% of infants at risk. Currently the only treatment is avoidance of the problematic food.
"Friendly" bacteria in kefir may play a role in blocking the pathway involved in allergic responses, Lisa Richards reports in Chemistry & Industry, SCI's fortnightly magazine. Research published 16 October 2006(DOI 10.1002/jsfa2469) in the SCI's Journal of the Science of Food and Agriculture has shown that the milk drink inhibits the allergen specific antibody Immunoglobulin E (IgE). IgE is involved in immune responses to inactivate organisms that might cause disease. However, in the presence of allergens it can also activate cells responsible for the release of histamine, a chemical which stimulates allergic responses, such as inflammation and constriction of airways.
Ji-Ruei Liu's team of scientists at the National Formosa University, Yunlin, Taiwan, fed mice the milky drink, and found that after 3 weeks, the amount of ovalbumin (OVA) specific IgE was reduced three-fold. Ovalbumin is an allergenic protein found in egg whites, which cause most allergies in young children. Kefir is also reported to prevent food antigens from passing through the intestinal wall.
Liu believes that the milky drink could be a promising tool in the prevention of allergies. "In the future, maybe we can screen out the certain components (bacterial strains or bioactive peptides) from kefir and utilize them in medicine," he said.
Also in this weeks Chemistry & Industry, UK firm Rigest are looking for backers to develop an air sanitizing system using an enzyme found naturally in human tears. Lactoperoxidase can attack and kill microbes such as 'flu viruses and the bacteria responsible for MRSA. The system could be used to sanitize the air in airplanes and hospital sick bays.
Jan 19, 2009
Urticaria
Urticaria
Definition
Urticaria - the notion that covers a group of diseases, the main symptom of which is an urticarial element on the skin. With all the variety of etiological factor for all types of urticaria characterized by a common pathogenetic mechanism-increase vascular permeability of micro circulatory course and bed acute edema development in the area of surrounding the vessels. In case of spreed affection on subcutaneous and submucosal layers of dermis develops angioneurotic edema (Bannister's disease). According to flow can be acute and chronic (more than 6 weeks) case.
Rash is characterized by itch of varying intensity, complete reversibility of elements.
On the basis of etiological among the most frequent forms of urticaria mark out the following types:
Allergic
Idiopathic
Temperature
Demographic
Vibration
cholinergic
Contact
Another rash
unspecified urticaria
Angioneurotic edema (swelling Quincke's)
Survey
1. Mandatory laboratory studies:
Clinical analysis of blood;
An overall analysis of urine;
Biochemical analysis of blood (total protein, total bilirubin and direct), ALT, ACT, blood glucose, creatinine, uric acid);
RW, HIV;
Coprogramma.
This amount of mandatory testing is adequate for patients with allergic, contact, vibration, temperature urticaria forms.
In case of unspecified, idiopathic electrodermatogramic urticaria, it is recommend to include in the list of mandatory following of survey to identify the functional or organic violations:
Revmtests (ANF, AT to DNA, DRR cryoprecipitate);
Bacteriological study (excrements, material from the mucous oropharynx);
Coprocystoscopy;
Differential detection of AT to AG toxocariasis, echinococcus, opisthorchid flukes, trichina and (or) other parasites, given the regional pathology.
2. Allergological survey:
Allergologic anamnesis (including pharmacological and food);
Prick and scarification skin tests with atopic allergens and intradermal tests with infectious allergens;
Tests: cold (Duncan-test), the heat, with the rovings;
In patients with suspected urticaria, are available in this hospital tests in vitro or in vivo.
The second and third paragraphs of the survey are sick outside exacerbation urticaria and receive antihistamine and GMP drugs.
3. Mandatory instrumental studies.
Bicycle ergometry to exclude cholinergic urticaria.
In the case of idiopathic, unspecified, dermographism urticaria are following tool shed research for the purpose to find the functional and organic violations:
Ultrasound of the abdominal cavity;
EGDS;
ECG.
4 Further research tool.
R-grafia WGCs and PIP (for reasons).
5. Consultations of experts:
Allergist (optional)
In idiopathic, unspecified, demographic urticaria are hold further consultations: the gynecologist, rheumatology, dentist, ENT, parasitology, endocrinology and others (for reasons).
Additional instrumental and laboratory tests are appointed on the advice of consultants.
Description: The wide range of surveys with idiopathic, unspecified, demographic forms of urticaria can be justified with the urticaria reaction may be a symptom of various diseases such as autoimmune, parasitic, cancer, or the result of functional disorders of the gastrointestinal tract, chronic inflammatory diseases (disbacteriosis bowel , periodontitis, etc.).
Definition
Urticaria - the notion that covers a group of diseases, the main symptom of which is an urticarial element on the skin. With all the variety of etiological factor for all types of urticaria characterized by a common pathogenetic mechanism-increase vascular permeability of micro circulatory course and bed acute edema development in the area of surrounding the vessels. In case of spreed affection on subcutaneous and submucosal layers of dermis develops angioneurotic edema (Bannister's disease). According to flow can be acute and chronic (more than 6 weeks) case.
Rash is characterized by itch of varying intensity, complete reversibility of elements.
On the basis of etiological among the most frequent forms of urticaria mark out the following types:
Allergic
Idiopathic
Temperature
Demographic
Vibration
cholinergic
Contact
Another rash
unspecified urticaria
Angioneurotic edema (swelling Quincke's)
Survey
1. Mandatory laboratory studies:
Clinical analysis of blood;
An overall analysis of urine;
Biochemical analysis of blood (total protein, total bilirubin and direct), ALT, ACT, blood glucose, creatinine, uric acid);
RW, HIV;
Coprogramma.
This amount of mandatory testing is adequate for patients with allergic, contact, vibration, temperature urticaria forms.
In case of unspecified, idiopathic electrodermatogramic urticaria, it is recommend to include in the list of mandatory following of survey to identify the functional or organic violations:
Revmtests (ANF, AT to DNA, DRR cryoprecipitate);
Bacteriological study (excrements, material from the mucous oropharynx);
Coprocystoscopy;
Differential detection of AT to AG toxocariasis, echinococcus, opisthorchid flukes, trichina and (or) other parasites, given the regional pathology.
2. Allergological survey:
Allergologic anamnesis (including pharmacological and food);
Prick and scarification skin tests with atopic allergens and intradermal tests with infectious allergens;
Tests: cold (Duncan-test), the heat, with the rovings;
In patients with suspected urticaria, are available in this hospital tests in vitro or in vivo.
The second and third paragraphs of the survey are sick outside exacerbation urticaria and receive antihistamine and GMP drugs.
3. Mandatory instrumental studies.
Bicycle ergometry to exclude cholinergic urticaria.
In the case of idiopathic, unspecified, dermographism urticaria are following tool shed research for the purpose to find the functional and organic violations:
Ultrasound of the abdominal cavity;
EGDS;
ECG.
4 Further research tool.
R-grafia WGCs and PIP (for reasons).
5. Consultations of experts:
Allergist (optional)
In idiopathic, unspecified, demographic urticaria are hold further consultations: the gynecologist, rheumatology, dentist, ENT, parasitology, endocrinology and others (for reasons).
Additional instrumental and laboratory tests are appointed on the advice of consultants.
Description: The wide range of surveys with idiopathic, unspecified, demographic forms of urticaria can be justified with the urticaria reaction may be a symptom of various diseases such as autoimmune, parasitic, cancer, or the result of functional disorders of the gastrointestinal tract, chronic inflammatory diseases (disbacteriosis bowel , periodontitis, etc.).
Jan 6, 2009
Atopic dermatitis (AD)
Definition of Atopic Dermatits
Atopic dermatitis - chronic allergic inflammation of the skin surface, accompanied by itch, often combined with the presence of respiratory manifestations of immediate allergy: allergic rinoconjuctivitis's, atopic bronchial asthma.
The degree of severity of AD is determined by the prevalence of skin, location, availability of respiratory manifestations of atopic and the availability of secondary purulent infection.
To assess the severity of the skin, as well as to the effectiveness of therapy should be used Semiquantitative method - scale SCORAD (Scoring of Atopic Dermatitis), a score of six of objective and subjective symptoms, which are recorded in the grade sheet.
AD is characterized by a high content of total serum IgE and sensitization to multiple allergens atopic (domestic, epidermal, fungi, pollen, food).
At AD there are violation of blood of T-cell regulation (the predominance of Th2-response), which may determine the presence of IgE-indirect reactions. For the AD is characterized by a high degree of colonization of Staph. aureus; viral infection caused by Herpes simplex, Varicella, by virus of warts and molluscum contagiosa, as well as fungal infections (dermatomycosis caused by Trichophyton, high procent of colonization conditionally pathogenic mushroom genus Candida albicans, parapsilosis, Rhizopus spp., Spegazzinia tessarthra, Pitirosporum ovale). Of the opportunistic diseases most frequent is range pathology of the gastrointestinal tract: stomach ulcer and a duodenum, a violation of Intestinal microflora, as well as pockets of chronic infection, disease of ENT organs,of mental disturbances and of cataracts.
Survey
1. Mandatory laboratory and instrumental studies:
Clinical analysis of blood (in deviation from the norm, 1 time every 10 days);
Biochemical analysis of blood (total protein, bilirubin, ALT, AST, urea, creatinine, fibrinogen, C-reactive protein, glucose) once, in the case of plasmapheresis - control of total protein before each session;
Determination of blood group, Rh-factor;
RW, HIV;
An overall analysis of urine, if necessary - an analysis of urine on Nechiporenko once;
Immunological examination (level of total serum IgE, subpopulations of lymphocytes);
Bacteriological study of faeces (stool analysis on dysbacteriosis) upon receipt and check in 2 weeks after the end of corrigent treatment;
Esophagogastroduodenofiberscopy - when you are admission;
ECG (electrocardiogram);
X-ray research of accessory sinuses of nose - when you receive.
2. Additional studies:
Ultrasound of the abdominal cavity, pelvic, kidney - on medical testimony;
X-ray of the chest - on medical testimony.
3. Allergological survey:
Allergologic histories;
Skin tests with atopic allergens (scarifications, prick);
Determination of specific IgE antibodies to atopic allergens (using the methods of MAST, RAST);
Provocative tests if necessary (nasal, conjunctival).
4. Mandatory consultation:
Allergist;
Dermatologist;
Therapist;
Gastroenterologist;
ENT;
Endocrinologist;
Neuropsychiatrist.
In diffuse AD staging of skin tests can be conducted only after a remission / relative remission of the skin.
Characteristics of treatment
We recommend that you stick gipoallergennoy diet.
Treatment.
Step 1 - blocking of worsening (in the case of expressed aggravation of skin process with the phenomen of partial erythrodermatitis, eczema, lymphadenopathy, hypothermia) shall take place within 3 -7 days, in some cases - for 10 days:
intravenously(i.v.) drop-by-drop introduction: hemodez-n 200 ml per day - every day;
Clemastin (tavegil) 2.0 ml per 100 ml of 0.9% solution, sodium chloride 1-2 times a day;
Dexamethasone (dexone) 4-8 mg per 100 ml of 0.9% solution, sodium chloride 1-2 times per day (total dose of dexone course are 8-64 mg depending on the severity and incidence of skin).
Therapeutic plasmapheresis in the blood or intermittent fraktsionatore method: 3-4 session with removal for 1 session 1000 ml of plasma. Replacement is done protein solution is equivalent in terms of protein and saline. Plasmapheresis is contraindicated in case of aggravation of pyodermia and other pockets of chronic infection. Multiplicity sessions, 2 times a week.
Step 2 - correction of associated diseases, and rehabilitation centers of chronic infection.
3rd stage - per achievement of clinical remission, a specific immunotherapy (SIT) causallymarking allergens expedited basis, if necessary - against the backdrop of antihistamine medications or ketotifen. SIT should be conducted annually for 3 years.
Psychotropic drugs with sedative effects (appointed, if it's necessary):
alimemazine - 2,5-5mg 2 times a day or night courses within 1 month;
tioridazin (sonapax) - 10 mg 2-3 times daily rates for 1 month;
oxazepam (tazepam) - 10 mg at night;
fenazepam - 0.0005 g per night.
Antihystamine medications are appoint with rates for 7-10 days, as well as preventive purpose:
Suprastin per one pill for 2-3 times a day;
Tavegyl per 1 pill 2 times a day;
Claritin per 1 pill 1 times a day;
Stabilizers fat cell membranes:
ketotifen per one pill for 2 times a day rate of not less than 3 months to 6 - 12 - 24 months;
bisodium salt chrom glicerine acid (nalcrom) per 1 capsule 3 times a day for 10-15 minutes before eating, course per 1-2 months.
In the case of aggravation pyodermia should undertake a course of antibacterial therapy (against the background of antihystamine medications).
Absolutely contraindicated medications penicillin series!
In low treatment of purulent processes to antibacterial therapy should be combined with immunologically drugs.
Patients with respiratory manifestations of atopic need to make corrigent therapy.
Correction of associated diseases
Dysbacteriosis:
Piobacteriophage (combined or polivalent) eubiotics depending on the expression violations Intestinal microflora (bificol, bifidumbacterius, acylact, primadofilus, floradofilus, normadofilus, linecs) in combination with enzyme preparations: pankreatin (festal, espumisan, maalox) .
Terms of skin care:
1. The daily shower gels with non-soap.
2. Extenuating, nourishing cream, cream with olive oil with the addition of steroid creams or ointments in the proportion of 1:1 (advantan). At perioral area zaeds - a combination of drugs: triderm, travochort etc.
3. With escalating piodermia: leather 3% solution of hydrogen peroxide to remove purulent content and korochek, after which - 0.2% chlorhexidine solution or a solution furatsillina, then - fukocin or green diamond, and as the final stage - the local antibacterial drugs ( baneocin, oxyciclozol, levavinizol, etc.). Sports hold 1-2 times a day.
In the course of treatment is necessary to educate patients and their families the rules of care, compliance with hygiene measures, especially in the presence of domestic and epidermology of sensibilization (Appendix N2), prevention of exacerbations.
Recommended physiotherapy mud, MSS, selective phototherapy, PUVA therapy, climatic therapy at sea.
Length of hospital
Hospitalization, if necessary, be divided into 2 stages:
Step 1 - stopping worsening, a survey and correction of associated diseases, duration of phase from 20 to 35 days.
Step 2 - take SIT allergens; phase duration 14-20 days.
Requirements for the results of treatment
The disappearance of itching, reducing the size and intensity of skin lesions to the clinical remission, normalization of sleep, the improvement of psycho-emotional and general condition of patients, stabilization of respiratory manifestations atopic and associated diseases. Patients with AD are subject to a dispensary observation allergist for timely treatment and preventive measures to reduce temporary disability.
Patients with a limited form of blood to be outpatient treatment for patients with generalized form of AD is shown hospitalization period of 20-35 days.
Atopic dermatitis - chronic allergic inflammation of the skin surface, accompanied by itch, often combined with the presence of respiratory manifestations of immediate allergy: allergic rinoconjuctivitis's, atopic bronchial asthma.
The degree of severity of AD is determined by the prevalence of skin, location, availability of respiratory manifestations of atopic and the availability of secondary purulent infection.
To assess the severity of the skin, as well as to the effectiveness of therapy should be used Semiquantitative method - scale SCORAD (Scoring of Atopic Dermatitis), a score of six of objective and subjective symptoms, which are recorded in the grade sheet.
AD is characterized by a high content of total serum IgE and sensitization to multiple allergens atopic (domestic, epidermal, fungi, pollen, food).
At AD there are violation of blood of T-cell regulation (the predominance of Th2-response), which may determine the presence of IgE-indirect reactions. For the AD is characterized by a high degree of colonization of Staph. aureus; viral infection caused by Herpes simplex, Varicella, by virus of warts and molluscum contagiosa, as well as fungal infections (dermatomycosis caused by Trichophyton, high procent of colonization conditionally pathogenic mushroom genus Candida albicans, parapsilosis, Rhizopus spp., Spegazzinia tessarthra, Pitirosporum ovale). Of the opportunistic diseases most frequent is range pathology of the gastrointestinal tract: stomach ulcer and a duodenum, a violation of Intestinal microflora, as well as pockets of chronic infection, disease of ENT organs,of mental disturbances and of cataracts.
Survey
1. Mandatory laboratory and instrumental studies:
Clinical analysis of blood (in deviation from the norm, 1 time every 10 days);
Biochemical analysis of blood (total protein, bilirubin, ALT, AST, urea, creatinine, fibrinogen, C-reactive protein, glucose) once, in the case of plasmapheresis - control of total protein before each session;
Determination of blood group, Rh-factor;
RW, HIV;
An overall analysis of urine, if necessary - an analysis of urine on Nechiporenko once;
Immunological examination (level of total serum IgE, subpopulations of lymphocytes);
Bacteriological study of faeces (stool analysis on dysbacteriosis) upon receipt and check in 2 weeks after the end of corrigent treatment;
Esophagogastroduodenofiberscopy - when you are admission;
ECG (electrocardiogram);
X-ray research of accessory sinuses of nose - when you receive.
2. Additional studies:
Ultrasound of the abdominal cavity, pelvic, kidney - on medical testimony;
X-ray of the chest - on medical testimony.
3. Allergological survey:
Allergologic histories;
Skin tests with atopic allergens (scarifications, prick);
Determination of specific IgE antibodies to atopic allergens (using the methods of MAST, RAST);
Provocative tests if necessary (nasal, conjunctival).
4. Mandatory consultation:
Allergist;
Dermatologist;
Therapist;
Gastroenterologist;
ENT;
Endocrinologist;
Neuropsychiatrist.
In diffuse AD staging of skin tests can be conducted only after a remission / relative remission of the skin.
Characteristics of treatment
We recommend that you stick gipoallergennoy diet.
Treatment.
Step 1 - blocking of worsening (in the case of expressed aggravation of skin process with the phenomen of partial erythrodermatitis, eczema, lymphadenopathy, hypothermia) shall take place within 3 -7 days, in some cases - for 10 days:
intravenously(i.v.) drop-by-drop introduction: hemodez-n 200 ml per day - every day;
Clemastin (tavegil) 2.0 ml per 100 ml of 0.9% solution, sodium chloride 1-2 times a day;
Dexamethasone (dexone) 4-8 mg per 100 ml of 0.9% solution, sodium chloride 1-2 times per day (total dose of dexone course are 8-64 mg depending on the severity and incidence of skin).
Therapeutic plasmapheresis in the blood or intermittent fraktsionatore method: 3-4 session with removal for 1 session 1000 ml of plasma. Replacement is done protein solution is equivalent in terms of protein and saline. Plasmapheresis is contraindicated in case of aggravation of pyodermia and other pockets of chronic infection. Multiplicity sessions, 2 times a week.
Step 2 - correction of associated diseases, and rehabilitation centers of chronic infection.
3rd stage - per achievement of clinical remission, a specific immunotherapy (SIT) causallymarking allergens expedited basis, if necessary - against the backdrop of antihistamine medications or ketotifen. SIT should be conducted annually for 3 years.
Psychotropic drugs with sedative effects (appointed, if it's necessary):
alimemazine - 2,5-5mg 2 times a day or night courses within 1 month;
tioridazin (sonapax) - 10 mg 2-3 times daily rates for 1 month;
oxazepam (tazepam) - 10 mg at night;
fenazepam - 0.0005 g per night.
Antihystamine medications are appoint with rates for 7-10 days, as well as preventive purpose:
Suprastin per one pill for 2-3 times a day;
Tavegyl per 1 pill 2 times a day;
Claritin per 1 pill 1 times a day;
Stabilizers fat cell membranes:
ketotifen per one pill for 2 times a day rate of not less than 3 months to 6 - 12 - 24 months;
bisodium salt chrom glicerine acid (nalcrom) per 1 capsule 3 times a day for 10-15 minutes before eating, course per 1-2 months.
In the case of aggravation pyodermia should undertake a course of antibacterial therapy (against the background of antihystamine medications).
Absolutely contraindicated medications penicillin series!
In low treatment of purulent processes to antibacterial therapy should be combined with immunologically drugs.
Patients with respiratory manifestations of atopic need to make corrigent therapy.
Correction of associated diseases
Dysbacteriosis:
Piobacteriophage (combined or polivalent) eubiotics depending on the expression violations Intestinal microflora (bificol, bifidumbacterius, acylact, primadofilus, floradofilus, normadofilus, linecs) in combination with enzyme preparations: pankreatin (festal, espumisan, maalox) .
Terms of skin care:
1. The daily shower gels with non-soap.
2. Extenuating, nourishing cream, cream with olive oil with the addition of steroid creams or ointments in the proportion of 1:1 (advantan). At perioral area zaeds - a combination of drugs: triderm, travochort etc.
3. With escalating piodermia: leather 3% solution of hydrogen peroxide to remove purulent content and korochek, after which - 0.2% chlorhexidine solution or a solution furatsillina, then - fukocin or green diamond, and as the final stage - the local antibacterial drugs ( baneocin, oxyciclozol, levavinizol, etc.). Sports hold 1-2 times a day.
In the course of treatment is necessary to educate patients and their families the rules of care, compliance with hygiene measures, especially in the presence of domestic and epidermology of sensibilization (Appendix N2), prevention of exacerbations.
Recommended physiotherapy mud, MSS, selective phototherapy, PUVA therapy, climatic therapy at sea.
Length of hospital
Hospitalization, if necessary, be divided into 2 stages:
Step 1 - stopping worsening, a survey and correction of associated diseases, duration of phase from 20 to 35 days.
Step 2 - take SIT allergens; phase duration 14-20 days.
Requirements for the results of treatment
The disappearance of itching, reducing the size and intensity of skin lesions to the clinical remission, normalization of sleep, the improvement of psycho-emotional and general condition of patients, stabilization of respiratory manifestations atopic and associated diseases. Patients with AD are subject to a dispensary observation allergist for timely treatment and preventive measures to reduce temporary disability.
Patients with a limited form of blood to be outpatient treatment for patients with generalized form of AD is shown hospitalization period of 20-35 days.
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