Bring on the Bugs?

Think that keeping your children’s hands and mouths clean is helping them stay healthy?  Think again!  New research from Johns Hopkins Children’s Center reveals that exposure to common antibacterials found in soap, toothpaste, mouthwash and other personal-care products may make children more prone to a wide range of food and environmental allergies.

Using existing data from a national health survey of 860 children aged 6-18, the researchers examined the relationship between the children’s urinary levels of antibacterials and preservatives found in many personal-hygiene products and the presence of IgE antibodies in the child’s blood. IgE are markedly elevated in people with allergies.

We saw a link between level of exposure, measured by the amount of antimicrobial agents in the urine, and allergy risk, indicated by circulating antibodies to specific allergens,” said lead investigator Jessica Savage, M.D., M.H.S., an allergy and immunology fellow at Hopkins.

While antibacterials and preservatives themselves don’t cause allergies, that these agents appear to play a role in immune system development.

The link between allergy risk and antimicrobial exposure suggests that these agents may disrupt the delicate balance between beneficial and bad bacteria in the body and lead to immune system dysregulation, which in turn raises the risk of allergies,” Savage added.

In the study, those with the highest urine levels of triclosan – an antibacterial agent used in soaps, mouthwash and toothpaste – had the highest levels of IgE antibodies and their risk for food allergy risk was twice that of children with the lowest triclosan levels. Similarly, children with the highest urinary levels of parabens – preservatives with antimicrobial properties used in cosmetics, food and medications – were more likely to have detectable levels of IgE antibodies and twice the risk of environmental allergens such as pollen and pet dander.

These findings are consistent with the so-called hygiene hypothesis, which has recently gained traction as one possible explanation behind the growing rates of food and environmental allergies in the developed world. The hypothesis suggests that early childhood exposure to common pathogens is essential in building healthy immune responses. Lack of such exposure, can lead to an overactive immune system that misfires against harmless substances such as food proteins, pollen or pet dander.

Just  this week, other new research from the University of California, San Francisco has provided some answers to why children who grow up in homes with pets are less likely to develop allergies.

All of which suggests that parents should put away the hand sanitizer and let their kids play in the dirt with a dog!

Survey Reveals Unmet Needs Among Patients with Allergic Rhinitis

SRxA’s Word on Health team spent the last week attending the American Academy of Allergy Asthma & Immunology Annual Meeting in San Francisco. In addition to spending quality time with many of our KOL Allergy Advisors and pharmaceutical clients, we were able to catch up with some of the latest research on allergic rhinitis (AR).

Allergic rhinitis is an allergic reaction that happens when the immune system overreacts to inhaled, such as pollen. This causes release of a type of antibody, known as IgE, into the nasal passages, along with inflammatory chemicals such as histamines. The two types of allergic rhinitis are seasonal allergic rhinitis (hay fever) and perennial allergic rhinitis, which occurs year-round. Hay fever is caused by outdoor allergens. Perennial allergic rhinitis is caused by indoor allergens such as dust mites, pet dander, and mold.

Results from a recent pivotal AR satisfaction survey assessing patient and healthcare provider perspectives on AR reveal that symptoms like nasal congestion and post-nasal drip continue to impact patients’ daily activities.

Findings from the Nasal Allergy Survey Assessing Limitations (NASL) 2010, highlight the continued unmet need for more effective treatment options to help reduce symptoms and overall disease burden of AR.

The prevalence of AR in the U.S. has increased during the past three decades.  It is now estimated that 20% of the general adult population and almost 40% of children have the condition.  Of the estimated 60 million Americans affected with AR, approximately 20% have seasonal allergic rhinitis (SAR), 40% have perennial allergic rhinitis (PAR), and 40% have a combination of the two (i.e., PAR with seasonal exacerbations) depending on the allergen sensitivity.

In other words, one in 5 adults and almost half of children suffer from symptoms including:

  • Stuffy, runny nose
  • Sneezing
  • Post-nasal drip
  • Red, itchy, and watery eyes
  • Swollen eyelids
  • Itchy mouth, throat, ears, and face
  • Sore throat
  • Dry cough
  • Headaches, facial pain or pressure
  • Partial loss of hearing, smell, and taste
  • Fatigue
  • Dark circles under the eyes

According to NASL 2010, nasal congestion, post-nasal drip and repeated sneezing continue to be the most frequently reported nasal allergy symptoms among patients. Beyond physical symptoms, AR patients experience emotional burdens, like feeling tired and miserable. When assessing the impact nasal allergies have on productivity, the survey revealed that patients are less productive when their nasal allergies are at their worst, limiting them from doing well at work.

It’s clear from the NASL 2010 findings that the estimated 60 million people living with allergic rhinitis in the U.S. are still significantly affected, both physically and emotionally, by symptoms,” said Gary Gross, M.D. FAAAAI, Dallas Allergy & Asthma Center, Dallas, Texas. “This is a continuing trend we’re seeing in patients having allergic rhinitis as these findings are similar to those released in a past survey evaluating disease burden on patients. The NASL survey results further support the need for more effective treatment options that address these specific issues for patients living with allergic rhinitis.”

Nasal allergies can make it difficult for people to take part in both indoor and outdoor activities if their symptoms are not well controlled. According to NASL 2010, less than 20% of surveyed patients felt their nasal allergies were completely controlled over a one week time period. The vast majority of allergists, otolaryngologists and primary care providers interviewed in the survey stated intranasal corticosteroid sprays as their preferred treatment of choice for adults with moderate to severe persistent nasal allergies.

Because of its prevalence and health effects, AR is associated with considerable direct and indirect costs.  Latest estimates suggest that AR alone results in a staggering  $11.2 billion in healthcare costs, 12 million physician office visits, 2 million days of school absences and 3.5 million lost work days per year. In addition, the presence of co-morbidities such as asthma and sinusitis further increase AR-related treatment costs.

Word on Health will be bringing you more from AAAAI in the coming days, including some exciting new treatment options being developed for allergic rhinitis.

New Way to Eliminate Source of Asthma?

U.S. researchers say they’ve found a way to eliminate the source of immune system molecules that cause asthma and other allergic diseases.

These soluble IgE moleclues are produced by immune cells called B cells. While targeting IgE in the blood is an effective treatment for moderate-to-severe allergic asthma, this approach doesn’t stop IgE production and patients require repeated treatments.

According to the May 10 edition of the Journal of Clinical Investigation, scientists from Genentech say they’ve developed a way to eliminate IgE-producing B cells.  This finding could potentially lead to new long-lasting treatments for asthma and other allergic diseases.  So far the method has only been tested in mice, where it proved highly effective.

Word on Health awaits the results of future studies in humans.