IL-27 is expressed in chronic eczematous skin and stimulates keratinocytes

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Interleukin-27 (IL-27) is a heterodimeric cytokine belonging to the IL-12 family that is composed of two subunits:

- Epstein-Barr virus (EBV)-induced gene 3 (EBI3) (also known as IL-27B)
- IL27-p28 (known as IL-30)

IL-27 is produced by antigen-presenting cells early during immune responses. It supports T-cell polarization along the T(H)1 lineage and has anti-inflammatory effect in murine models.

IL-27 was expressed in chronic lesional allergic eczematous skin but not in the acute phase of eczema. It acts as a priming signal on keratinocytes - amplifies chemokine production and surface molecule expression.

IL-27 might act in an inflammatory, disease-maintaining manner in chronic (but not acute) eczema.

Type I cytokine receptors are mediated through JAK/STAT and bind: IL-2, 3, 4, 5, 6, 7, 9, 10, 12, 13, 15, GM-CSF.


Key steps of the JAK-STAT pathway. Image source: Wikpedia, public domain.


Cytokine Signaling. This video is from: Janeway's Immunobiology, 7th Edition Murphy, Travers, & Walport. Source: Garland Science.

References:
Wittmann M, Zeitvogel J, Wang D, Werfel T. IL-27 is expressed in chronic human eczematous skin lesions and stimulates human keratinocytes. J Allergy Clin Immunol. 2009 Jun 10.

Related:
Interleukin 27, from Wikipedia, the free encyclopedia.

Filaggrin (FLG) mutations increase risk of severe atopic dermatitis and asthma

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Filaggrins are filament-associated proteins which bind to keratin fibers in epithelial cells.

The discovery of filaggrin (FLG) null mutations as a major risk factor for eczema represents a milestone toward the understanding of this complex disease.

A meta-analysis of 24 studies on FLG mutations and eczema included 5,791 cases, as well as 17 studies on asthma involving 3,138 cases.

FLG haploinsufficiency strongly increases the eczema risk (odds ratio [OR]) and is associated with more severe and dermatologist-diagnosed disease. FLG mutations are also significantly associated with asthma (OR, 1.48). There appears to be no association with asthma in the absence of eczema.

The authors concluded that there is strong evidence for a high eczema risk conferred by FLG mutations suggesting an association with more severe and secondary care disease. FLG mutations are also a robust risk factor for asthma in patients with eczema.

Early food sensitization and FLG mutation in infants with early eczema increase the risk for later asthma (JACI, 2011).

References:

Meta-analysis of filaggrin polymorphisms in eczema and asthma: Robust risk factors in atopic disease. Elke Rodríguez et al. JACI, Volume 123, Issue 6, Pages 1361-1370.e7 (June 2009).
Early food sensitization and presence of FLG mutation in infants with eczema increase the risk for later asthma. JACI, 2011.
Early food sensitization and FLG mutation in infants with early eczema increase the risk for later asthma (JACI, 2011).

Treatment of Exacerbation of Moderately Severe Atopic Dermatitis
Atopic Dermatitis: A Short Review

Loss-of-function mutations in filaggrin gene are associated with atopic dermatitis, and now with peanut allergy too. JACI, 2011.

Gene defect can triple risk of peanut allergy - filaggrin has already been shown to be a factor in eczema and asthma. BBC, 2011.
Filaggrin gene mutations are associated with atopic asthma http://goo.gl/5mQlj
Blog articles from AllergyNotes
Image source: Wikipedia, public domain.

CNN video: How to find a job

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Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Breast feeding is associated with a lower asthma risk in children until 8 years of age http://bit.ly/RZxwn
  
  
• Low dietary intakes of vitamins A and C are associated with significant increased odds of asthma and wheeze http://bit.ly/C2MlP
  
  
• New Guidelines Issued for Asthma Assessment by ATS and ERS http://bit.ly/3FhpX
  
  
• Influenza but not pneumococcal vaccination was associated with a reduced risk of all-cause mortality in COPD. http://bit.ly/XsXm8
  
  
• Tennis player allergic to grass at the grass courts of Wimbledon 2009... http://bit.ly/J3A4G

Image source: OpenClipArt.org, public domain.

Venom immunotherapy reduces large local reactions to insect stings

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Large local reactions to insect stings cause significant morbidity and impair quality of life. Venom immunotherapy is not recommended because of a low risk for future systemic reaction and unproven efficacy in preventing large local reactions.


Figure 1. Mind map of insect venom allergy (click to enlarge the image).

Reaction to Wasp	Reaction to Bee
More common	Rarer
After a single sting	After many stings
Typical narrow waist and little hair	Hairy "fuzzy" bee

Table 1. Comparison of allergic reactions to wasp and bee venom.


Figure 2. A yellow jacket wasp with a typical narrow waist (left) and a honey bee with a fat hairy "fuzzy" body (right). Image source: Wikipedia 1, 2, GNU Free Documentation License.

In this study, a sting challenge in 41 patients with previous large local reactions and positive venom skin tests caused large local reactions 16 cm or larger in 34 patients, and 29 consented to treatment. Venom immunotherapy was initiated in 19, and 10 were untreated controls. Sting challenge was repeated after 7 to 11 weeks, and annually for as long as 4 years.

After 7 to 11 weeks of treatment, the size and duration of large local reactions decreased 42% and 53%, respectively, in treated patients and 18% in controls (P lower than 0.01 for both). The response was similar after 1 year, and improved after 2 to 4 years to 60% and 70%, respectively.

The authors concluded that venom immunotherapy significantly reduced the size and duration of the large local reactions, and the efficacy improved over a period of 2 to 4 years of treatment.

References:

Venom immunotherapy reduces large local reactions to insect stings. David B.K. Golden et al. JACI, Volume 123, Issue 6, Pages 1371-1375 (June 2009).
Venom Allergy: A Short Review. V. Dimov, 08/2007.
Challenge sting: to bee or not to bee? Sting challenges don't add much to current diagnostic testing & increase risk http://goo.gl/F50dX
Image source: Wikipedia, GNU Free Documentation License.

Meat allergy is rare in adults and not readily recognized

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Meat allergy is rare in adults because it is normally outgrown during the first years of life.

Beef among mammals and chicken among birds are most frequently involved. The major allergens are serum albumins and immunoglobulins (from blood).

Meat allergenicity can be reduced by various treatments - heat, homogenization and freeze-drying.

Cross-reactivity has been described between different meats, between meat and milk or eggs and between meat and animal dander.

References:
Meat allergy. Restani, Patrizia; Ballabio, Cinzia; Tripodi, Salvatore; Fiocchi, Alessandro. Current Opinion in Allergy and Clinical Immunology. June 2009 - Volume 9 - Issue 3 - p 265-269.

Cross Reactions Among Foods (PDF).
A small number of people who are allergic to cat may also get allergic reactions when eating pork http://goo.gl/zVSaN
Image source: Varieties of meat, Wikipedia, public domain.

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Study: Partially hydrolyzed "hypoallergenic" formula not better than standard cow milk based formula http://bit.ly/jv0eT
  
  
• Obesity May Have Offered Edge Over Tuberculosis in Human Evolution, enhanced innate immunity http://bit.ly/xgTiD
  
  
• "Public should be cautious and wait for study findings before jumping on the bandwagon to take megadoses of vitamin D" http://bit.ly/BGsUO
  
  
• New series: WAO Clinical Allergy Tips http://bit.ly/dqK1j

Image source: OpenClipArt.org, public domain.

TNF-α blockade with golimumab fails in patients with severe asthma

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Several small studies of TNF-α antagonists in severe asthma have produced encouraging results which were not confirmed by later, large studies.


Tumor necrosis factor-alpha (TNF-alpha). Image source: Wikipedia, public domain.

A study of an antibody to TNF-α, golimumab, was conducted in 309 patients with severe asthma (Am J Respir Crit Care Med 2009;179:549-58).

Golimumab did not show improvement over placebo in FEV1 or severe exacerbations over the first 24 weeks of treatment. Treatment with golimumab was halted after a 24-week review, revealing not only no improvement but also an increase in infections and a nonsignificant increase in malignancies in those receiving golimumab.

Subgroup analyses suggested that there might be asthma phenotypes that would benefit from this treatment: those with lower FEV1, a 12% or greater bronchodilator response, a history of sinusitis, an emergency department visit or hospitalization in the previous year, or onset of asthma after age 12 years.

The authors suggested that TNF-α antagonism might still prove to be a viable option for selected phenotypes of severe asthma.


Cytokine-based treatments of asthma and allergic diseases.

References:
News Beyond Our Pages. JACI, Volume 123, Issue 6, Pages 1197-1198 (June 2009).

Related:
Severe asthma unresponsive to inhaled corticosteroids -- what treatment option is next?
Cytokine-based treatments of asthma and allergic diseases

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Early wheezing associated with cognitive deficit in 3-yr-old children? http://bit.ly/1JLEcb
  
  
• CNN: Mystery cough? 8 possible culprits http://bit.ly/nHMQo - Suggested mnemonic: BAD CAT TOM http://bit.ly/uFKjb
  
  
• Review of Meat Allergy: http://bit.ly/11LwDT
  
  
• Top 5 medical journals impact factor: 1) NEJM 50; 2) JAMA 31.718; 3) LANCET 28.409; 4) ANN INTERN MED 17.457; 5) BMJ 12.827
  
  
• 25 ways to teach with Twitter: http://bit.ly/VEOdM - Alternative title: 25 ways to spend your academic time producing nonacademic work.
  
  
• New Ph.D.s Look Abroad for Jobs - WSJ http://bit.ly/UYWPH

Image source: OpenClipArt.org, public domain.




Differential diagnosis of cough, a simple mnemonic is GREAT BAD CAT TOM. Click here to enlarge the image: (GERD (reflux), Laryngopharyngeal Reflux (LPR), Rhinitis (both allergic and non-allergic) with post-nasal drip (upper airway cough syndrome), Embolism, e.g. PE in adults, Asthma, TB (tuberculosis), Bronchitis, pneumonia, pertussis, Aspiration, e.g foreign body in children, Drugs, e.g. ACE inhibitor, CF in children, Cardiogenic, e.g. mitral stenosis in adults, Achalasia in adults, Thyroid enlargement, e.g. goiter, "Thoughts" (psychogenic), Other causes, Malignancy, e.g. lung cancer in adults).

Children explain asthma in their own words using imagery to make sense

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From Asthma UK:

Children use metaphors to explain or describe their asthma, say researchers.

One boy described his asthma as a jellyfish, saying that it ‘stings like a jellyfish’, whereas a 12 year old girl, whose asthma was described as not being severe, used the comparison of a troll that ‘sleeps all day in the dark… kind of hidden, until I wake him up with the activities I do.’

Another child described her asthma as dry crackers: ‘When you breath out, the crackers go out and when you breathe in the little pieces come back in.’ She adds that ‘If you take medicine, it kind of settles down the cracker pieces, so they don’t bother you.’

Children who explain asthma in their own terms will feel valued and invested in their own healthcare as they find that their voices make a difference in decisions about their care.

References:
Children use imagery to make sense of asthma. Asthma.org.uk.
Asthma. AllergyCases.org.
Image source: Wikipedia, public domain.

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Vitamin D one of oldest hormones on earth, you'll be surprised that many people are deficient of it! http://bit.ly/ZsiDz
  
  
• "First time in history that an independent Open Access journal takes the top spot in its discipline" http://bit.ly/SX7ct
  
  
• Just registered with the BMJ social network site Doc2Doc http://doc2doc.bmj.com - Give it a try.
  
  
• I believe we had the first ever Journal Club on Twitter on Dec 11, 2008 http://bit.ly/ZkDn0 - please reply @JRBtrip to expand the idea: "Imagine multiple contributions from the 'twitterverse' - a global perspective on a paper."
  
  
• For medical bloggers: Blogging is a public activity with no right to anonymity, the U.K. high court ruled http://bit.ly/uVDJA

Image source: OpenClipArt.org, public domain.

"Television allergy" - increased TV viewing associated with development of asthma

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One possible cause for the increased prevalence of asthma is that breathing patterns associated with sedentary behavior could lead to developmental changes in children lungs.

In a birth cohort of more than 3000 children there was a linear trend for increased television viewing at 3.5 years to be associated with the development of asthma at 11 years.

Children with more than 2 hours of viewing per day were almost twice as likely to have asthma as those with only 1 to 2 hours of viewing. The outcome was independent of body mass and sedentary behavior at age 11.5 years (Thorax 2009;64:321-5).

References:
News Beyond Our Pages. JACI, Volume 123, Issue 6, Pages 1197-1198 (June 2009).
Image source: Wikipedia, Creative Commons Attribution ShareAlike 2.5 License.

CNN video: FDA warns about loss of smell with Zicam

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Asthma is serious - 90 sec TV public service announcement

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CrowdEye search for Twitter makes interesting word clouds and associations

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CrowdEye search engine for Twitter makes interesting word clouds and associations. See the search results for:

- allergy http://bit.ly/LKL1T

- asthma http://bit.ly/OWlvt

New Immunodeficiency due to FCN3 gene mutation for Ficolin-3, a recognition molecule in lectin pathway of complement

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A NEJM report describes a man with repeated severe bacterial pulmonary infections, bronchiectasis, pulmonary fibrosis, warts, and a cerebral abscess.

He was homozygous for a variant of the FCN3 gene, which encodes ficolin-3. A lack of ficolin-3 may cause immunodeficiency disease.

Ficolin (collagen/fibrinogen domain containing lectin) 2 (hucolin). Image source: Wikipedia, public domain.



Overview of the innate immune system (a mind map).

There are 3 pathways for activation of complement:

CAM

Classical
Alternative
Mannose-binding lectin (MBL)


Mannose-binding lectin (MBL). Image source: Wikipedia.

The 3 pathways (CAM) converge at the point of cleavage of C3. Then C3b becomes an acceptor site for C5, and C5-9 form the membrane attacking complex (MAC). Thus, CAM leads to MAC:

CAM --> MAC

A complement protein attacking an invader. Image source: Wikipedia.

Classical and alternative complement pathways. Image source: Wikipedia.

References:
Immunodeficiency Associated with FCN3 Mutation and Ficolin-3 Deficiency. NEJM, 2009.
NEJM figure.
Complement System

Videos:


Classical Pathway Complement System


Alternative Pathway Compliment System


The Complement System.


Complement Proteins

Related:
Figure 1 - The complement system as a bridge between innate and adaptive immunity. Nature.
The three major complement activation pathways
Overview of the Complement System

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Biotech drugs to account for 50% of top 100 drugs by 2014 http://bit.ly/9ep9O
  
  
• New Immunodeficiency due to FCN3 gene mutation for Ficolin-3, a recognition molecule in lectin pathway of complement http://bit.ly/itsh2
  
  
• Understanding the Immune System: How It Works (PDF), by National Institute of Allergy and Infectious Diseases (NIAID) http://bit.ly/iWHGG
  
  
• Parenting advice: "Vaccinate Your Baby" website with actress Amanda Peet. http://bit.ly/NpLtS
  
  
• Children use imagery to make sense of asthma http://bit.ly/17RW6m

Image source: OpenClipArt.org, public domain.

YouTube Video Playlists: Immunology, Molecular Biology, Cell Biology

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Playlists by Garland Science:


Immunology Videos, 42 Videos.


Cell Biology Videos, 80 Videos.

Molecular Biology Videos, 47 Videos.

T-cell receptor excision circles (TRECs) as routine newborn screening protocol for severe combined immunodeficiency (SCID)

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Severe combined immunodeficiency (SCID) is characterized by the absence of functional T cells and B cells. Without early diagnosis and treatment, infants with SCID die from severe infections within the first year of life.

The researches tried to determined the feasibility of detecting SCID T(-)B(-)NK(+) in newborns by quantitating T-cell receptor excision circles (TRECs) from dried blood spots (DBSs) on newborn screening (NBS) cards (See what a TREC is here).

DNA was extracted from DBSs on deidentified NBS cards, and real-time quantitative PCR (RT-qPCR) was used to determine the number of TRECs.

No TRECs were detected in either the SCID or naive T-cell-depleted samples.

The authors concluded that the use of RT-qPCR to quantitate TRECs from DNA extracted from newborn DBSs is a highly sensitive and specific screening test for SCID. This assay is currently being used in Wisconsin for routine screening infants for SCID.


Severe combined immunodeficiency (SCID) - 4 groups according to T/B/NK cells (click to enlarge the image).

References:

Development of a routine newborn screening protocol for severe combined immunodeficiency. Baker MW, Grossman WJ, Laessig RH, Hoffman GL, Brokopp CD, Kurtycz DF, Cogley MF, Litsheim TJ, Katcher ML, Routes JM. J Allergy Clin Immunol. 2009 May 29. [Epub ahead of print]
Mind Maps: Primary Immunodeficiency (PID)
Video: Universal Newborn Screening for Severe Combined Immunodeficiency (SCID) by Quantitating T Cell Receptor Excision Circles (TRECs). University of Wisconsin.

TRECs are the most accurate noninvasive tool to detect T-cell SCID http://goo.gl/B680e
Screening for T-cell lymphopenia and SCID recommended as an addition to the newborn screening programs in all states. Expert Rev Clin Immunol. 2011 Nov;7(6):761-8.
The state of Wisconsin approach to newborn screening for SCID: 5 infants with SCID detected in 3 years. JACI, 2012.

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Study: Sinus infections may cause more than 20 percent of all cases of toxic shock syndrome in children http://bit.ly/OpIzl
  
  
• FDA: Neuropsychiatric events reported with montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo). Insomnia reported more frequently with all 3 meds (Singulair, Accolate, Zyflo) compared to placebo http://bit.ly/1aoBK6
  
  
• Asthma Improvements Do Not Persist When Long-Term Therapy with budesonide or nedocromil Is Stopped http://bit.ly/uBC7a
  
  
• CNN Reveals Secret allergy triggers http://bit.ly/NhdB3
  
  
• An interactive map aggregating people tweeting about allergies: http://allergytweets.com - @AllergyTweets
  
  
• Headline of the Day: Eosinophilic Esophagitis: From Rookie of the Year to Household Name http://bit.ly/H7Tcy
  
  
• Pollen maps http://bit.ly/aG7K -- http://bit.ly/B2l6k -- http://bit.ly/4DEfcb
  
  
• Hunch.com tries to be your doctor: check this question "Which OTC allergy remedy should I use?" http://bit.ly/WLXBS
  
  
• Photo: "Allergy medicine at night" http://bit.ly/10tZMy
  
  

Image source: OpenClipArt.org, public domain.

Peanut oral immunotherapy in peanut allergy: symptoms more likely during initial escalation day

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Oral immunotherapy (OIT) offers a promising therapeutic option for peanut allergy. Given that during OIT an allergic patient ingests an allergen that could potentially cause a serious reaction, the safety of OIT is of particular concern.

In this study of 20 patients, most symptoms were noted during the initial escalation day:

- upper respiratory tract symptoms (79%)
- abdominal symptoms (68%)

The risk of mild wheezing during the initial escalation day was 18%. The probability of having any symptoms after a buildup phase dose was 46%.

The risk of reaction with any home dose was 3.5%. Upper respiratory tract (1.2%) and skin (1.1%) symptoms were the most likely after home doses. Two subjects received epinephrine after 1 home dose each.

The authors concluded that subjects were more likely to have significant allergic symptoms during the initial escalation day when they were (and must be) in a closely monitored setting.

Allergic reactions with home doses were rare but yet, 2 out of 20 patients needed to use EpiPen.


Eight top allergens account for 90 percent of all food allergies. See more Allergy and Immunology mind maps here.

References:
Safety of a peanut oral immunotherapy protocol in children with peanut allergy. Hofmann AM, Scurlock AM, Jones SM, Palmer KP, Lokhnygina Y, Steele PH, Kamilaris J, Burks AW. J Allergy Clin Immunol. 2009 May 26. [Epub ahead of print]
Oral tolerance induction in peanut allergy
Food Allergy

Adverse reactions during peanut oral immunotherapy home dosing. JACI, Volume 124, Issue 6, Pages 1351-1352 (December 2009).

Specific oral tolerance (SOTI) cannot be recommended for routine clinical practice for food allergy treatment yet - JACI http://goo.gl/AKBy

Peanut oral immunotherapy is not ready for clinical use - From the experts in the field. JACI, 2010 http://goo.gl/YipT

Office-based oral immunotherapy for food allergy is safe and effective - according to Texas allergist group that use it http://goo.gl/S4N8W

Therapies for peanut allergy: Sustained oral tolerance over desensitization is the goal, we are not there yet. http://goo.gl/mXsyt

Peanut oral immunotherapy (20 peanuts) induces desensitization, however questions about long-term tolerance remain. JACI, 2011.

Oral immunotherapy for peanut allergy - interview with Dr. Wesley Burks: clearly 15-20% will not tolerate the treatment http://goo.gl/U45UB
Sublingual and oral immunotherapy for milk allergy. Desensitization was lost in some cases within 1 week off therapy. JACI, 2011.

Image source: Roasted peanuts as snack food, Wikipedia, public domain.

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Talking Points on SLIT for Physicians Practicing in the US by the ACAAI: http://bit.ly/SF2Ip
  
  
• Study: Adenoidectomy Does Not Increase Risk of Asthma or Allergy. Chronic respiratory infections in early childhood appear to promote bronchial hyperreactivity http://bit.ly/bM8OY
  
  
• T-cell receptor excision circles (TRECs) as routine newborn screening protocol for severe combined immunodeficiency http://bit.ly/FNJnE
  
  
• Metformin may help make vaccines work better (in mice) http://bit.ly/TCoep
  
  
• "The Itch: Its mysterious power may be a clue to a new theory about brains and bodies." http://bit.ly/KwFPS
  
  
• "Scratching makes the neurons completely stop for five to 10 seconds and blocks itch" http://is.gd/Nton
  
  
• Blog power: Our blog is #1 search result for "allergic rhinitis guidelines" easily beating NEJM, AAFP and guideline.gov http://bit.ly/8d7dm

Image source: OpenClipArt.org, public domain.

Leukotriene B(4)-BLT1 axis may contribute to airway remodeling in asthma

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Leukotriene B(4) (LTB(4)) increases in induced sputum and exhaled breath condensate in people with asthma. However, the direct effects of LTB(4) on human airway smooth muscle (ASM) have not been studied.

A recent study suggested a role for a LTB(4)-BLT1 signaling axis in ASM responses that may contribute to airway remodeling in asthma.

LTB(4) induced cyclin D1 expression, proliferation, and chemokinesis of human ASM cells. LTB(4) also induced phosphorylation of both p42/p44 mitogen-activated protein kinase (MAPK) and downstream PI3 kinase effector, Akt1 (hyperlinks from Wikipedia).


Mast cells (mind map).


Eicosanoid synthesis. Image source: Wikipedia.

Arachidonic acid. Image source: Wikipedia.


LTC4 is a cysteinyl leukotriene, as are D4 and E4. Image source: Wikipedia.

LTB4. Note the four double bonds, three of them conjugated. This is a common property of A4, B4, C4, D4, and E4. Image source: Wikipedia.

Leukotriene receptors mnemonic

Leukotriene
B4
BLT 1, 2 receptors

Leukotriene
C4, D4, E4
CysLT 1, 2 receptors

What is the most potent bronchoconstrictor?

(A) LTB4

(B) LTC4

(C) acetylcholine

(D) histamine

(E) thromboxane A2 (TXA2)

(F) methacholine

Answer: B

CysLTs are the most potent bronchoconstrictor agents yet discovered, about 100-1000 times more potent than histamine. The second most potent bronchoconstrictor is thromboxane A2 (TXA2).

Cysteinyl‐LTs and LTB4 are, respectively, the most potent bronchoconstrictor agents and one of the most effective leukocyte chemotaxins yet.

References:
Expression of functional leukotriene B(4) receptors on human airway smooth muscle cells.
Watanabe S, Yamasaki A, Hashimoto K, Shigeoka Y, Chikumi H, Hasegawa Y, Sumikawa T, Takata M, Okazaki R, Watanabe M, Yokogawa T, Yamamura M, Hayabuchi T, Gerthoffer WT, Halayko AJ, Shimizu E. J Allergy Clin Immunol. 2009 May 26. [Epub ahead of print]
Mast Cells and Basophils
Mnemonics: Mast Cells and Basophils

Smoking increases the risk of asthma onset in men

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Although smoking is a well-known risk factor for the onset of airway diseases, the associations between smoking and asthma are inconsistent.

A total of 6,674 men and 8,301 women from a population-based cohort in Takayama, Japan, participated in this prospective study. Information on smoking was collected via a baseline questionnaire in 1992. Ten years later, development of asthma was reported.

During 10-year follow-up, 105 men and 92 women reported the onset of physician-diagnosed asthma. Among men, current smokers at baseline had a significantly increased risk of asthma (hazard ratio [HR], 2.79), whereas women with a current or former history of smoking were at an increased but not significant risk of asthma (HR, 1.18).

A 2-5-fold increased risk of asthma was observed in men who smoked for more than 30 years or more than 21 cigarettes daily. These data suggest that smoking increases the risk of asthma onset in men.

References:
Cigarette smoking and the adult onset of bronchial asthma in Japanese men and women. Nakamura K, Nagata C, Fujii K, Kawachi T, Takatsuka N, Oba S, Shimizu H. Ann Allergy Asthma Immunol. 2009 Apr;102(4):288-93.

Smoke-free laws reduce asthmatic symptoms http://goo.gl/K1U5h
Image source: Wikipedia, Tomasz Sienicki, Creative Commons Attribution ShareAlike 2.0 License.

Triamcinolone nasal spray safe in children aged 2 to 5 years with allergic rhinitis for up to 6 months

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Intranasal corticosteroids (INSs) are the most effective treatment for allergic rhinitis (AR), especially in terms of relieving nasal congestion. However, INS safety and efficacy data in children younger than 6 years are limited.

In a 4-week, multicenter, double-blind, parallel-group study, 474 patients were randomized to receive triamcinolone acetonide (chemical formula on the right) aqueous nasal spray (TAA AQ), 110 microg once daily, or placebo.

Safety measures included reports of adverse events, morning serum cortisol levels before and after cosyntropin infusion, and growth as measured using office stadiometry.

Adverse event rates were comparable between treatment groups. There was no significant change in serum cortisol levels after cosyntropin infusion.

The authors concluded that the use of TAA AQ, 110 microg once daily, for up to 6 months offers a favorable efficacy to safety ratio in children aged 2 to 5 years with perennial AR.


Medications for Allergic Rhinitis. See more Mind Maps of Allergic Rhinitis.

References:
Efficacy and safety of triamcinolone acetonide aqueous nasal spray in children aged 2 to 5 years with perennial allergic rhinitis: a randomized, double-blind, placebo-controlled study with an open-label extension. Weinstein S, Qaqundah P, Georges G, Nayak A. Ann Allergy Asthma Immunol. 2009 Apr;102(4):339-47.
Allergic Rhinitis: A Short Review
Mind Maps: Allergic Rhinitis
Mnemonics: Allergic Rhinitis
Image source: Triamcinolone, Wikipedia, the free encyclopedia, public domain.

Allergy and Immunology News of the Day

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Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

• Asthma Induced by a Point-of-sale Thermal Printer - NEJM http://bit.ly/yAGcz and Yahoo News http://bit.ly/1Rv1hB
  
  
• Yoga Helps Those With Asthma? http://bit.ly/EDAQ4
  
  
• Contrary to the opinion that "food allergies are a figment of our imaginations," a parent shares her experience. http://bit.ly/kRHjH
  
  
• Lancet review (seminar) on cystic fibrosis - the most common lethal genetic disease in white populations. http://bit.ly/u4HVt
  
  
• Lancet review: Glucocorticoid resistance in inflammatory diseases http://bit.ly/d4WG8
  
  
• WSJ Brutal Gallery: A World of Cigarette Warning Pictures by the WHO: http://bit.ly/19Cu5w

Image source: OpenClipArt.org, public domain.