Asthma - Twitter summary from EAACI-WAO Congress 2013

This summary was compiled from the tweets posted by allergists/immunologists who attended the EAACI-WAO Congress 2013. The tweets were labeled #eaaciwao2013. The text was edited and modified by me.

Obesity and asthma

Dr. Moreira presented dramatic (and horrifying) data on the rising prevalence of obesity in the USA.

High birth weight and high weight in childhood may increase risk of asthma by 50%. Each additional unit increase in BMI is associated with an increase in asthma risk of 7-10%.

Increased BMI is associated with decreased beclomethasone responsiveness.

Proinflammatory cytokines

Visceral adiposity is associated with circulating levels of proinflammatory cytokines. Increases in leptin exacerbated allergic airway response. Asthmatic premenopausal women have higher leptin levels.

However, obesity in asthma is inversely associated with airway inflammation. If not inflammation, is airway restriction (due to body habitus) to blame? Occasional deep inspirations are bronchodilatory in nature. However such breathing is reduced in both asthma and obesity.

Diet

Adherence to Mediterranean diet is associated with improved asthma control.

Diagnosis and treatment of asthma in athletes
This summary is from a presentation by Kai-Hakon Carlsen (Norway), Mariana Couto (Portugal).

"Those who do not make time for exercise will eventually have to make time for illness."

Does chlorine exposure when swimming in children cause an increased risk of asthma?

Chlorine exposure in young children may increase asthma risk. Competitive swimmers also have a higher asthma risk.

In professional athletes, there is a higher prevalence of developing asthma in triathletes and swimmers than other sports.

Asthma treatments used to be classified as doping by Anti-Doping Agency. Thanks to the work of asthma specialists, this is no more. IOC and World Anti Doping Agency (WADA) rules are frequently revised, and should be monitored.

In a 7 year study, 23% of studied athletic-related deaths were asthma-related.

Is it EIB or VCD?

Cold, dry air can trigger EIA/EIB. Vocal cord dysfunction (VCD) can be a confounder. EIA and VCD present differently. EIA shortly after exercise, VCD during maximal exertion.

Treatment of EIB and EIA

Cromolyn (not in the U.S.), LTRA, inhaled steroids (esp. ciclesonide), ipratropium bromide, and beta-agonists comprise building blocks of therapy.

Lifestyle interventions in allergy and asthma - by Andre Moreira (Portugal), Matteo Bonini (Italy):

The major risk factor for all major chronic diseases is physical inactivity. "Those who do not make time for exercise will eventually have to make time for illness."

Exercise does NOT increase allergic inflammation in asthmatic children. Prevalence of allergy and asthma is significantly higher in elite athletes.

Allergists are on Twitter - follow them

Allergists increased use of Twitter by 470% between 2011 and 2012. The service is very efficient in spreading the news from the annual scientific meetings, for example, 25 allergists reached 250,000 individuals from the 2012 #AAAAI meeting (see the references here).

This summary was compiled from some of the tweets posted by the following allergists:

Allergy Nurse ‏@AllergyNurseUK
Sakina Bajowala, M.D ‏@allergistmommy

This is a list of the allergists who used Twitter to post updates from the 2013 #AAAAI meeting. The list is open for edit, please feel free to add your own info.

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