Environmental exposure and allergy - 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.


Dr. Ege: Farm exposure and number of siblings: both are protective against the development of allergy.

A NEJM 2011 article suggested that diversity of microbial exposures is responsible for protective farm effect on asthma. There is an inverse association between presence of asthma and diversity of microbial exposures in asthma. Not for hay fever.

Mothers with farm exposure in pregnancy have kids with decreased risk of IgE in cord blood to grass. Hay and animal contact together seemed the most protective combination to diminish grass IgE levels in cord blood.

Hopefully, we will get more answers from the EAT Study in the UK: http://www.eatstudy.co.uk

Airway colonization

Dr. Bisgaard: 20% of children showed colonization of the airway of by 4 weeks old. Children colonized with bacteria at 4 weeks old showed higher risk of asthma (NEJM 2007).

Moraxella catarrhalis seemed to be highly associated with development of asthma.

Antibiotic use in pregnancy is associated with increased asthma incidence and hospitalization in children.

Planned C-section had the highest risk for asthma development (higher than vaginal delivery and acute C-section).

Summary of Bisgaard’s Risk of childhood asthma with method of delivery: Planned C-section -- Acute C-section -- Spontaneous Vaginal Delivery

Dust mite

Dr. Wahn: Children sensitized to dust mite have a higher risk of asthma development at an early age. Indoor allergen levels of house dust mite will vary throughout the year depending on which country you're in.

HDM immunotherapy

Dr. Holgate: Who are the best candidates for HDM immunotherapy?

The age of 5 appears to be a cut-off point between sensitization and long-term asthma/allergy.

The kids with earliest sensitization had the lowest FEV1, earlier PC20 reaction and risk of hospitalization.

Allergic asthmatic epithelium in adults predisposes for development of viral exacerbations.

HDM has 22 different proteins that have biological/immunogenic properties that can affect humans.

Dr. Calderon reviewed the PRACTALL review of HDM showing efficacy for both SLIT and SCIT. There are studies showing efficacy for rhinitis for SLIT and SCIT with SCIT more efficacious than SLIT.

HDM SLIT tablet

HDM SLIT tablets in allergic rhinitis study showed improvement in the first year - at the 4 month mark. HDM SLIT tablet study VO67 used Environmental Challenge Chamber showed efficacy vs placebo in rhinitis. Study V071 of HDM SLIT tabs for asthma tested with various doses for safety with no serious side effects.

HDM SLIT tablets are moving on to Phase II and Phase III studies in rhinitis and asthma in adults and children.

Humans show all the hallmarks of animals living in captivity - vulnerability is expressed as allergy

Dr. Prescott: Humans show all the hallmarks of animals living in captivity and early vulnerability to this environment shows as allergy.

Elevated CRP in pregnancy is not only associated with increased risk of allergy, but CVS disease and metabolic syndrome. High microbial environments are associated with lower CRP levels so this may help explain increased allergy risk.

Epigenetic studies of high folate levels in pregnancy suggested as link to higher allergy risk (http://www.ncbi.nlm.nih.gov/pubmed/21923665).

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:

David Fischer, MD ‏@IgECPD

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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