Acid-suppressive medications, such as H2-receptor antagonists (H2RA) and proton pump inhibitors (PPI), are the main treatment options for dyspepsia and gastroesophageal reflux disease. These are common problems in pregnancy.1 Recently, concerns have been raised that prenatal exposure to these medications may increase the risk of allergic disease in the offspring.1 Dehlink et al1 were the first to report these associations, proposing that use of acid-suppressive medications in pregnancy may increase the risk of allergic disease in the offspring through interference with maternal digestion of labile antigens, thereby increasing the amount of allergen to which the fetus is exposed.

Capsule summary: We demonstrate that extra-fine particles are not associated with an appreciably higher exhaled fraction, hence explaining their efficacy profile in asthma.

Understanding factors that influence immune development in early life have the potential to offer new preventive strategies for allergic sensitization and recurrent wheeze, two important risk factors for childhood asthma.

Exposure to cockroaches is an important asthma trigger, particularly for children with asthma living in inner cities. Integrated pest management is the recommended approach to cockroach abatement; however, it is costly and difficult to implement. The impact of reducing cockroach exposure on asthma outcomes is not known.