Asthma

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=110 BGCOLOR="#666699" TEXT="#080000" bgproperties="fixed" background="0b500840erlcjm.gif"> <div> <FONT SIZE="5" COLOR="#FFFFCC" FACE="Arial" ><B>Asthma</B></FONT><B>   |     </B><A HREF="index.htm" TARGET="_top" TITLE="Allergy Centre"><U><B>home</B></U></A></div> <div> <A HREF="id172.htm" TARGET="_top" TITLE="Allergy Centre"><U><B>Location of the Allergy Centre</B></U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=190 BGCOLOR="#CCCCFF" TEXT="#080000" background="0af11c00egdysm.gif"> <div> <A HREF="id177.htm" TARGET="_top" TITLE="For Journalists"><U><B>Return to Journalists  page</B></U></A></div> <div> <B>________________</B><FONT SIZE="2" COLOR="#3333CC" FACE="Arial" ><A HREF="id27.htm" TARGET="_top" TITLE="Check Your Allergies"><U><B> </B></U></A></FONT></div> <div> <I><B>Phone</B></I></div> <div> <B>03 9874 4144</B></div> <div> <B>       ________________</B><FONT SIZE="2" COLOR="#3333CC" FACE="Arial" ><A HREF="id27.htm" TARGET="_top" TITLE="Check Your Allergies"><U><B> </B></U></A></FONT></div> <div> <B> </B></div> </td> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> Asthma</div> <bR> <div> DATA FOR YOUR ARTICLE</div> <div>  </div> <div> An asthmatic experiences coughing, wheezing, tight chest and difficultly in breathing, particularly breathing out. It has been described by one sufferer as trying to breath with a sock stuffed down your throat'. </div> <bR> <div> People who have allergic asthma will react to allergy triggers in their environment. About one in ten of allergic asthmatics show a delayed asthmatic response to  airborne allergens. The reaction occurring one or two days after exposure.</div> <div> Asthma may be particularly active after rain, due to rain water causing the bursting of pollen grains.</div> <bR> <div>  If you also have asthma, this can also be caused by the same allergens that cause your hayfever. If your asthma is due to pollen it tends to begin later in the pollen season than hayfever.</div> <bR> <div> WHAT IS AIRBORNE ALLERGY?</div> <bR> <div> Airborne allergy is allergy to particles in the air we breath and includes grass, flower and tree pollens, animal fur, dust mite and moulds. It is the most common form of allergy and a cause of bronchial asthma. Once symptoms of asthma have emerged they tend to persist for a long time. However if the allergen is seasonal as with pollen, then the asthma may also be only seasonal. Pollen can induce asthma from the nose, and does not have to actually enter the bronchial tubes to cause an asthmatic attack. It does this by a learned reflex action. On the other hand perennial allergens such as moulds and mites cause persistent year long asthma.</div> <bR> <div> WHY DO WE HAVE ASTHMA?</div> <bR> <div> The reason a person becomes sensitised to allergens is unknown, but appears to be</div> <div> related to continued exposure. There is some evidence that chronic exposure to smoke, particularly tobacco smoke, may sensitise the bronchial mucosa (lining) to protein particles in the air over a one or two year period. This can produce allergic asthma to those same inhaled proteins. For example, soya bean dust.</div> <bR> <div> Triggers are any substance that precipitates an allergic reaction in a person sensitised to a particular allergen. House dust mite is one of many triggers. The critical threshold of mite contact likely to lead to sensitisation of the bronchial mucosa is around 2mcg of allergen/g of house dust. The level of dust mite in the residences of asthmatics who are allergic to dust mite is usually around 10mcg/g dust.</div> <bR> <div> There are factors that are known to disrupt the proper working of the immune system. These include illness, microorganisms, chemicals, hormones and stress. In asthmatics, attacks can be brought about by exposure to these triggers.</div> <bR> <div> Executives, office and factory workers are exposed to many different chemicals in the workplaces which may precipitate bronchial asthma.  They can work with air-conditioning which may recycle moulds, chemicals, bacteria, viruses, tobacco smoke, perfumes and toiletries around the building, all of which may affect sensitive asthmatics. There are approximately 6 million chemicals in day to day use, and no one could guess how many may trigger asthma.</div> <bR> <div> Housewives and family members are similarly exposed to chemical fumes that come from furnishings around the home as well as exposure to cleaning substances.  Even clothes may have chemical smells that can trigger an asthmatic attack.  Asthma can also come from things of animal origin such as hairs of household pets. Gas fumes from heaters are known to cause asthmatic illness in children as well as adults.</div> <bR> <div> Additives and preservatives in foods can cause allergy or hypersensitivity problems with certain people. Episodic asthma attacks are an example. The reaction usually occurs in the first two hours of ingestion. Common reactive foods are prawn, egg, nuts, fish, wheat, corn, pork and cow's milk. Food additives such as preservatives and food dyes may also cause an allergic response in certain individuals.</div> <div>  </div> <div> To find the cause of an allergy needs considerable diagnostic skills, otherwise a lot of money and time can be spent looking at the wrong answer before you get to the correct answer. This is where allergy testing resources are able to save money. </div> <bR> <div> TESTING FOR ALLERGY TO ASTHMA?</div> <bR> <div> RAST: A RAST test is a laboratory blood serum test. Even in the presence of airborne allergy it will not always show positive. </div> <bR> <div> Skin testing: This is the more reliable test. Specific allergens for asthma are used to detect reactions to specific proteins present, by applying these allergens to the skin. These skin reactions are carefully read and tested against control substances from the laboratory.</div> <bR> <div> WHAT CAN BE DONE ABOUT AIRBORNE ALLERGY?</div> <bR> <div> Sometimes, asthma is merely a minor inconvenience and can be controlled by avoiding areas where the allergens are present that may precipitate an attack. However, if the symptoms become severe, they can become an important problem to the health and lifestyle. In this case, treatment may be needed. Immunotherapy will build up your tolerance and can often provide good relief from asthma. There must however be a positive skin reaction to the allergen. </div> <bR> <div> If avoidance of asthma triggers is impossible, then provided you have a positive skin reaction, a clinical trial of immunotherapy should be considered. Sometimes the beneficial response to immunotherapy can be quite dramatic.</div> <bR> <div> HOW CAN I GET TREATED FOR ALLERGIC ASTHMA?</div> <bR> <div> If you know or suspect which allergens causes your asthmatic symptoms, you can be tested for sensitivity to those allergens and be provided with suitable vaccines.  </div> <bR> <div> VACCINES AND IMMUNOTHERAPY.</div> <bR> <div> A course of immunotherapy (called desensitisation) should help.  This removes the cause of your allergy, unlike medications, which provide only temporary relief.</div> <bR> <div> Once the cause of your allergy has been ascertained, and a positive skin test obtained, then a specific vaccine can be created to desensitise you against the allergen that is triggering your symptoms. In this case, the specific airborne protein producing your allergic response.</div> <bR> <div> They contain small amounts of the allergens to which you are allergic.  The body will defend itself by making antibodies to the allergens injected. This helps build up your defences against further reaction.  Also, injections "switch on" a part of your immune system which acts to reduce allergic responses.</div> <bR> <div> WILL IMMUNOTHERAPY CURE MY ALLERGY?</div> <bR> <div> No treatment can guarantee complete success, but 8 out of 10 patients get almost complete relief of their symptoms, provided two important things are done.  First, the allergens used for treatment must be correctly identified and matched with your allergy.  Second, treatment should be given for a sufficient period of time, which may be extended, depending on your response.</div> <bR> <div> WHAT IS INVOLVED IN A COURSE OF TREATMENT ?</div> <bR> <div> Injections contain increasing doses of vaccine given one-a-week for about 11 weeks.  The injections are usually given in the upper part of the arm and are virtually painless. </div> <bR> <div> Why are injections given weekly?  After each injection small amounts of allergen is released slowly into the bloodstream from the site of injection.  This happens slowly so that your body receives a constant dose of allergen for about one week. If injections are given weekly there is an overlap between injections and the body becomes accustomed to the allergen and tolerance builds up.  The dose of vaccine can be increased each time.</div> <bR> <div> What happens if I miss a week?  Although it is best to have the injections once a week, there may be interruptions.  A gap of two weeks will still allow an increase in the injection dose on the next visit, but there will be more chance of you getting side effects.  A gap of more than two weeks means you cannot increase the dose of the next injection in case of an adverse reaction and the whole process will be slightly delayed.</div> <bR> <div> Will I get side effects from the treatment?  The injections are virtually painless.  You may get a slight swelling at the injection site which is a bit itchy. This is minor and should last no more than a day or so. An antihistamine tablet can be taken an hour before your injection to prevent this side-effect.  Very rarely, some patients experience larger reactions.  You may then have to consider reducing the dose for a time to prevent an asthmatic attack.</div> <bR> <div> How long will the benefit last? Immunotherapy (vaccines),  give relief for many years following a successful full course of treatment. Symptomatic, over-the-counter medications for allergy, on the other hand, need to be taken continuously to obtain relief.</div> <bR> <div> . . . more about allergies and your immune system.</div> <bR> <div> Your body has an immune system which identifies what belongs to your body (self) and what does not belong to your body (non-self). It detects and fights invading organisms (non-self) by attacking the protein of the invader. Without the immune system we would fall helpless to infection. However, for reasons largely unknown, the immune system may become sensitised to a foreign protein and create an allergy with all the resultant discomfort. </div> <bR> <div> The allergens causing asthma may lurk in house dust. While the house may be very clean, nevertheless small allergen particles will continue to be present in the house even though you may not see the particles.</div> <bR> <div> References:</div> <bR> <div> Dr Robert McEvoy, Allergies and other Environmental Illnesses: A Practice Handbook for Doctors, 1992.</div> <div> Platts-Mills T, De Week AL., Dust mite allergens and asthma  a worldwide problem. J</div> <div> Allergy Clin Immunol. 1989;83:416427.</div> <div> Middleton E, Jr, Reed CE, Ellis EF, Allergy Principles and Practice, Mosby St Louis, 1978</div> <bR> <div> Comment</div> <bR> <div> Increasing evidence suggests inhalant allergy plays an important role in the cause of</div> <div> asthma. These studies, carried out in central Virginia and northern California, showed a highly increased reaction to inhaled allergens among asthmatic patients.  In the fall, dust mite was the predominant cause, whereas in northern California, in May-June, most asthmatic patients (greater thin 90 percent) were allergic to rye grass.</div> <bR> <div> Extract</div> <div> Increasing evidence from case control surveys, population studies and allergen avoidance  studies suggest inhalant allergy plays an important role in the etiology of asthma according to Chapman and others. These  studies, carried out in central Virginia and northern California, showed a highly increased prevalence of IgE antibodies to inhaled allergens among asthmatic patients.  In the fall, dust mite was the predominant allergy, whereas in northern California, in May-June, most asthmatic patients (greater thin 90 percent) were allergic to rye grass.</div> <bR> <div> <I><B>TO PRINT</B></I><I> this page, </I><I><B>FIRST</B></I><I> </I>click anywhere<I> on this paragraph you are now reading and </I><I><B>THEN </B></I><I>just press the print button on you browser.</I></div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <I><B>Courtesy of The Allergy Centre 03 9874 4144</B></I></div> <div> Ref</div> <div> Chapman MD. Pollart SM. Luczvnska CM. Platts-Mills TA. Hidden allergic factors in the etiology of asthma. [Review]  Chest. 94(1):185-90, 1988 Jul.</div> <bR> <div> Brostoff J Gamlin L Hayfever, How To Cope With Hayfever, Asthma And Related Problems. Bloomsbury Publishing Ltd, London, 1994</div> <bR> </td> </tr></table></body>