“We conclude that a subset of severe asthmatics harbor infectious C. pneumoniae in their lungs, resulting in antibody production and increased asthma severity,” says Eduard Drizik of the University of Massachusetts, Amherst, who presented the study.

Asthma is a chronic respiratory disease, whose causes are not completely understood, affecting over 300 million people worldwide, including almost 24 million American children and adults. There is no cure for asthma and the disease is managed by controlling disease symptoms. The recognition that asthma pathogenesis involves chronic inflammation has led to a flurry of studies exploring the prevalence of various infectious organisms in the asthmatic condition.
Having previously demonstrated an increased prevalence of C. pneumoniae in the lungs of children and adults with asthma, the researchers conducted a study designed to determine if the presence of Chlamydia-specific antibodies could predict asthma severity and if these antibody-positive patients would benefit from treatment with antibiotics.

“The data revealed a statistically significant link between Chlamydia-specific IgE antibody production and the severity of asthma,” says Drizik. “Of the asthma patients analyzed, 55% had Chlamydia-specific IgE antibodies in their lungs compared to 12% of blood donor controls.”
Moreover, patients who were treated on the basis of asthma severity with antibiotics had significant improvements in asthma symptoms and some even experienced a complete abolition of these symptoms.

“Physicians should therefore fully explore the involvement of microbes in difficult to treat asthma cases, since there might be a cure for some types of asthma after all,” says Drizik.

http://www.dddmag.com/news-Bacteria-May-Have-Role-in-Asthma-52411.aspx

To test the hypothesis, they recruited 170 patients (113 female), aged 13 to 81 years, who had severe asthma that was uncontrolled at sea level in Holland. They were classified for sensitization for A fumigatus and then enrolled in a multidisciplinary, 12-week treatment program at the Dutch Asthma Centre Davos, in Switzerland.

“The Dutch Asthma Centre Davos is situated at 1600 meters (about 5250 feet) altitude, and the climate there is very dry and there is very little air pollution, so this was an ideal setting to study patients with severe asthma who have A fumagatus sensitivity,” said lead study author Lucia H. Rijssenbeek-Nouwens, MD, of the Dutch Asthma Centre Davos.

At the end of the 12-week treatment, patients who were and who were not sensitized to A fumigatus showed significant improvement in all parameters, including the Juniper asthma control questionnaire (Juniper ACQ), Juniper asthma-related quality of life questionnaire (Juniper AQLQ), postbronchodilator forced expiratory volume that was 1% of predicted, postbronchodilator residual volume/total lung capacity percentage predicted, fractional exhaled nitric oxide (FeNO), and daily dose of oral corticosteroids, related to changes in total IgE.

Patients in the A fumigatus–associated asthma group, however, showed more significant improvement in FeNO, total IgE, and total eosinophils.
Their changes from baseline in total IgE are correlated with changes in Juniper ACQ (r = 0.31, P = .35), Juniper AQLQ (r = −0.734, P = .01), and FeNO (r = 0.298, P = .04).

“After 12 weeks of treatment at the Davos center in Switzerland, we saw significant clinical improvement in both groups in terms of asthma control, quality of life, and lung function,” Dr. Rijssenbeek-Nouwens said.

“In the group with A fumigatus, we saw an even more important decline in the FeNO and blood eosinophils and the total IgE, and the decrease in total IgE correlated with improvement in asthma control and decreases in FeNO and eosinophils,” she noted.

Treatment of asthma patients with A fumigatus sensitivities can be a significant challenge, but the study demonstrates the potential relief that patients can find at higher altitudes, explained Anneke ten Brinke, MD, PhD, a chest physician with the Medical Centre Leeuwarden, in Leeuwarden, the Netherlands.
“Patients with severe asthma form a difficult-to-treat group of patients and a real challenge to doctors working in this field,” said Dr. Brinke, who moderated the poster session. Dr. Brinke was not associated with the study.

“In particular, patients with a sensitivity to Aspergillus seem to be at great risk for more severe disease, as has been shown in some previous studies.

“In this poster, Dr. Rijssenbeek-Nouwens compares severe asthma patients referred to their high-altitude hospital in Davos with and without this sensitization to Aspergillus, and although the study has some limitations, she clearly shows that even those severe patients with sensitization to Aspergillus do profit from a treatment at high altitude, probably due to the fact that the dry climate at high altitude is almost free of this fungus,” Dr. Brinke observed.

http://www.medscape.com/viewarticle/743185

“The chemicals in some of these products can trigger the nasal congestion, sneezing and the runny nose,” said Dr. Stanley Fineman, an allergist from Emory who helped gather data for the study. “With the asthmatics, there’s really good data showing their lung function changes when they’re exposed to these compounds.”

Many scented air freshener products contain harmful volatile organic compounds (VOCs) like formaldehyde, petroleum distillates, benzene and limonene, which are known to trigger asthma and other respiratory symptoms, as well as eye irritation, bone damage and leukemia. They also contain various other toxic ingredients like benzyl alcohol, camphor, dichlorobenzene, ethanol, naphthalene, phenol and pinene (http://mcs-america.org/airfresh.pdf).

Even some scented products labeled “natural” contain harmful ingredients like phthalates that can build up in the liver and fatty tissue over time. Phthalate exposure is linked to low sperm counts and reproductive damage. This is why it is always a good idea, even with “natural” products, to verify all ingredients with product manufacturers prior to purchasing them.

http://www.naturalnews.com/034181_air_fresheners_allergies.html

In New York City, where the study was conducted, asthma among school-age children ranges from a low of 3% to a high of 19% depending on the neighborhood, and even children growing up within walking distance of each other can have 2- to 3-fold differences in risk for asthma. Helping explain these disparities, the researchers found that levels of airborne black carbon, which mostly comes from incomplete combustion sources like diesel trucks and oil furnaces, were high in homes of children with asthma. They also reported elevated levels of black carbon within homes in neighborhoods with high asthma prevalence and high densities of truck routes and homes burning low-grade or “dirty” heating oil.

“This study adds to the evidence that further public health interventions on oil and truck emissions standards and the use of dirty oil may be warranted. This is especially timely as New York City considers regulations to further reduce the burning of low-grade oil for domestic heating,” says the study’s senior author, Matthew Perzanowski, PhD, associate professor of Environmental Health Sciences.

The study may be the first to show an association between airborne black carbon in the home and proximity to buildings burning dirty oil (low-grade, types 4 and 6). “Because of its history as a shipping and oil refining center, New York City burns more dirty oil for residential and commercial heating than any other city in the country,” says study co-author Steven Chillrud, PhD, Lamont Research Professor at Columbia’s Lamont-Doherty Earth Observatory . “These fuels produce more byproducts of incomplete combustion than cleaner oil or natural gas and contribute substantially to air pollution. Buildings that burn dirty oil are unevenly distributed throughout the city, which could help explain disparities in health.”

The research team collected air samples from inside the homes of 240 7- and 8-year-old children from middle-income neighborhoods throughout New York City. These children also took breathing tests to measure exhaled nitric oxide, an indicator of lung inflammation.

“Airway inflammation plays an important role in the development of asthma and can contribute to more frequent symptoms among children with the disease,” says study lead author Alexandra Cornell, MD, assistant professor in pediatrics at Dartmouth Medical School and previously a pediatric pulmonology fellow at Columbia University Medical Center/NewYork-Presbyterian Hospital. “Children in this study with higher black carbon in the air of their homes had higher exhaled nitric oxide, suggesting that they were at greater risk for asthma exacerbations. That this increased risk comes from air pollution lends weight to New York City’s efforts to improve air quality, including phasing out the use of dirty oil, which is a large contributor to local air pollution. ”

http://www.sciencedaily.com/releases/2012/03/120327124806.htm

Corticosteroids reduce inflammation.

The findings illustrate the importance of rapidly identifying and treating children with asthma when they arrive at an emergency department, the researchers said.

The study was recently published online in the journal Annals of Emergency Medicine.

“We knew that corticosteroids could help avoid hospital admissions and relapses. However, just how delays between emergency department admission and administration of the treatment impacted outcomes remained unclear,” lead author Dr. Sanjit Bhogal said in a University of Montreal news release.

“Our study demonstrates that, to be effective in preventing hospital admission, treatment with corticosteroids should be administered within 75 minutes of triage, regardless of patient age,” senior author Dr. Francine Ducharme said in the news release.

“In fact, the earlier the treatment is given within this time frame, the more effective it is, hence the advantage of starting treatment right after triage,” she added. “Furthermore, beginning early treatment reduces emergency department stay by almost 45 minutes for patients who will be discharged from the emergency department.”

http://www.azma.com/Asthma-Article.aspx?type=news&aid=819

The government-funded study is one of the largest to delve into the biology of asthma.
Researchers collected data on nearly 1,000 people with asthma who were enrolled in nine clinical trials sponsored by the National Heart, Lung and Blood Institute.

Most of the studies followed patients over time and collected samples of mucus from the lower part of the lungs.
Researchers checked the samples for certain kinds of white blood cells, called eosinophils, that cause airway inflammation. Many asthma medications work by reducing inflammation.

Surprisingly, researchers found that nearly half (47%) of asthma sufferers did not have eosinophils in their mucus, indicating that something else was causing asthma in these patients.

They also found that people with this so-called non-eosinophilic asthma did not respond well to treatment with oral and inhaled corticosteroids, like prednisone, Aerobid, Azmacort, Flovent, and Symbicort, which fight inflammation.

“The currently used anti-inflammatories didn’t seem to be that effective, at least over a two-week period, in a subgroup of patients who had non-eosinophilic disease,” says researcher John V. Fahy, MD, a professor of medicine and director of the Airway Clinical Research Center at the University of California at San Francisco.

Patients with non-eosinophilic asthma also did respond to the drug albuterol. Albuterol works by relaxing the muscles around the airways, which helps them open up so the person can breathe easier. It’s usually prescribed as a rescue medication.
The study is published in the American Journal of Respiratory and Critical Care Medicine.

Search for Answers in Asthma Is Urgent

Asthma experts who were not involved in the study said it was “impressive and comprehensive.”

“It just confirms what a lot of us have felt,” that there are different kinds of asthma, says Erwin W. Gelfand, MD, chairman of the department of pediatrics at National Jewish Health, a hospital in Denver that specializes in lung diseases.

“It points out how desperate we are for additional asthma medications,” Gelfand says.

The search for a better understanding of asthma is an urgent one.

Twenty-five million people have asthma in the U.S., and that number is rising, according to the CDC, though researchers don’t know why.

A Link to Obesity?

One theory is that obesity is behind the steady increase.

This study lends some support to that theory.

When researchers tried to tease out differences between the groups with eosinophilic asthma vs. non-eosinophilic asthma, they discovered that people with eosinphilic asthma, which is associated with more severe disease, tended to be much leaner than people with the non-eosinophilic kind of asthma.

People with non-eosinophilic asthma were generally older when their asthma was diagnosed, had less severe disease, and were more likely to be overweight.

“You can’t tell in a … study like this, but it is known that obesity is associated with asthma, and it seems like the obesity comes first,” Fahy says.

Advice to Patients

While the biology behind asthma is a hot area of research, experts say the findings really haven’t found a way into the doctor’s office.
There’s still no test that can easily distinguish one kind of asthma from another, for example.

“What patients should take away is if they’re taking a medication, and they’re not benefiting from it, then they should question it,” Gelfand says. They should ask whether they might not need to try a different drug.

http://www.webmd.com/asthma/news/20120106/why-dont-some-people-with-asthma-respond-medication

Results appear online in the Journal of Exposure Science and Environmental Epidemiology.
In New York City, where the study was conducted, asthma among school-age children ranges from a low of 3% to a high of 19% depending on the neighborhood, and even children growing up within walking distance of each other can have 2- to 3-fold differences in risk for asthma. Helping explain these disparities, the researchers found that levels of airborne black carbon, which mostly comes from incomplete combustion sources like diesel trucks and oil furnaces, were high in homes of children with asthma. They also reported elevated levels of black carbon within homes in neighborhoods with high asthma prevalence and high densities of truck routes and homes burning low-grade or “dirty” heating oil.

“This study adds to the evidence that further public health interventions on oil and truck emissions standards and the use of dirty oil may be warranted. This is especially timely as New York City considers regulations to further reduce the burning of low-grade oil for domestic heating,” says the study’s senior author, Matthew Perzanowski, PhD, associate professor of Environmental Health Sciences.
The study may be the first to show an association between airborne black carbon in the home and proximity to buildings burning dirty oil (low-grade, types 4 and 6). “Because of its history as a shipping and oil refining center, New York City burns more dirty oil for residential and commercial heating than any other city in the country,” says study co-author Steven Chillrud, PhD, Lamont Research Professor at Columbia’s Lamont-Doherty Earth Observatory . “These fuels produce more byproducts of incomplete combustion than cleaner oil or natural gas and contribute substantially to air pollution. Buildings that burn dirty oil are unevenly distributed throughout the city, which could help explain disparities in health.”

The research team collected air samples from inside the homes of 240 7- and 8-year-old children from middle-income neighborhoods throughout New York City. These children also took breathing tests to measure exhaled nitric oxide, an indicator of lung inflammation.
“Airway inflammation plays an important role in the development of asthma and can contribute to more frequent symptoms among children with the disease,” says study lead author Alexandra Cornell, MD, assistant professor in pediatrics at Dartmouth Medical School and previously a pediatric pulmonology fellow at Columbia University Medical Center/NewYork-Presbyterian Hospital. “Children in this study with higher black carbon in the air of their homes had higher exhaled nitric oxide, suggesting that they were at greater risk for asthma exacerbations. That this increased risk comes from air pollution lends weight to New York City’s efforts to improve air quality, including phasing out the use of dirty oil, which is a large contributor to local air pollution. ”

http://www.sciencedaily.com/releases/2012/03/120327124806.htm

For people suffering with asthma, smoking is the worst thing you can do. Below, Linda Ford, MD, FAAAAI, AE-C, of the AAAAI’s Quality of Care for Asthma Committee, answers common questions about smoking and its effects on asthma. Dr. Linda Ford is an allergist/immunologist in Papillion, Nebraska and a former president of the American Lung Association.

Q: What is asthma?
A: Asthma is a chronic inflammatory lung disease that blocks air flow of the tubes (airways) that leads air to the lungs. By squeezing the muscles around the airways and causing swelling, inflammation of the inside of the air tubes, and producing excess mucus, the airways become narrower and therefore more difficult for air to move in and out of the lungs.

Q: How does smoking affect a person’s asthma?
A: Smoking can harm your body in many ways, but it is very harmful to the lungs. The airways in a person with asthma are very sensitive and “twitchy” and therefore can easily be squeezed down by the smooth muscle that surrounds these tubes. Many things can trigger symptoms such as coughing, wheezing, experiencing chest tightness and shortness of breath. When a person inhales tobacco smoke whether for personal smoking or passive smoke, these irritating substances can set off an asthma attack.

Q: How does smoking affect pregnancy?
A: Children born to mothers who smoke when pregnant have an increased risk for reduced lung function and asthma. Other risks include decreased birth weight and size as well as an increased risk for eczema and hay fever. Once you quit smoking, your baby will be healthier, get more oxygen and have fewer infections and colds. It is also important to stay away from places that allow smoking when you are pregnant, since secondhand smoke can contribute to these risks.

Q: What is the danger of secondhand smoke exposure?
A: Children are more susceptible than adults to the effects of secondhand smoke because their lungs are still developing. After infancy, exposure to tobacco smoke may continue to cause abnormal breathing. Smoking leads to decreased lung function, making the lungs more susceptible to asthma triggers. Fifteen million children are regularly exposed to secondhand smoke and up to one million children with asthma become more severe after exposure to secondhand smoke. Children who inhale environmental tobacco smoke are also at increased risk for a variety of problems including cough, wheeze, ear infections, bronchitis, pneumonia, allergic diseases, and hospital admissions for asthma.

Q: What changes will I see if I quit smoking?
A: Quitting smoking decreases the chance of triggering asthma attacks and improves your lung function whether you have asthma or not. Everyone should be smoke free. While you are stopping, at least you can stop smoking in the house and the car to decrease exposure to secondhand smoke for your family members. Within minutes of quitting smoking, you will begin a series of changes in your body such as having more energy, breathing easier, smelling, tasting food better, and decreasing your body’s carbon monoxide level. Some long-term benefits of quitting smoking are the decreasing chance of heart attack, improving your circulation, decreasing sinus congestion and cough, and reducing the risk of a stroke.

Q: How can my allergist/immunologist help me manage my asthma?
A: An allergist/immunologist is a physician specially trained to manage and treat allergies and asthma. To help prevent symptoms, he or she will work with you to figure out your asthma triggers and develop an appropriate management plan, including developing environmental controls and prescribing medication if needed.

http://www.healtharticles.org/smoking_worsens_asthma_070804.html

“The chemicals in some of these products can trigger the nasal congestion, sneezing and the runny nose,” said Dr. Stanley Fineman, an allergist from Emory who helped gather data for the study. “With the asthmatics, there’s really good data showing their lung function changes when they’re exposed to these compounds.”

Many scented air freshener products contain harmful volatile organic compounds (VOCs) like formaldehyde, petroleum distillates, benzene and limonene, which are known to trigger asthma and other respiratory symptoms, as well as eye irritation, bone damage and leukemia. They also contain various other toxic ingredients like .

Even some scented products labeled “natural” contain harmful ingredients like phthalates that can build up in the liver and fatty tissue over time. Phthalate exposure is linked to low sperm counts and reproductive damage. This is why it is always a good idea, even with “natural” products, to verify all ingredients with product manufacturers prior to purchasing them.

In 2007, the Natural Resources Defense Council (NRDC) tested 14 different brands of popular household air freshener products and found that most of them, even those labeled “all natural” or “unscented,” contained dangerous chemicals linked to hormone disruption and reproductive problems

The worst offender in the test was Walgreens Scented Bouquet Air Freshener, which contained 7,300 parts per million (ppm) of di-ethyl phthalate (DEP), a chemical linked to damaging hormones and impairing genital development, followed by Walgreens Air Freshener Spray with 1,100 ppm of DEP.

“Consumers have a right to know what is put into air fresheners and other everyday products they bring into their homes,” said Dr. Gina Solomon back in 2007. “There are too many products on the shelves that we assume are safe, but have never even been tested. The government should be keeping a watchful eye on these household items and the manufacturers who produce them.”

http://www.naturalnews.com/034181_air_fresheners_allergies.html#ixzz1qRf287Zq