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Causes and risk factors for anaphylaxis.

J Dtsch Dermatol Ges. 2013 Jan;11(1):44-50

Authors: Worm M, Babina M, Hompes S

Abstract
Anaphylaxis is in most cases an IgE-dependent immunologic reaction. Mast cells are activated and release several mediators. Recent data about possible triggers of anaphylaxis indicate a clear age-dependency. The most frequent triggers of anaphylaxis in children are foods; in adults venom and drugs predominate. In 2006 an anaphylaxis registry was established in German-speaking countries. In the registry the triggers, circumstances, and treatment measures are collected from patients with anaphylaxis. However, the registry cannot supply epidemiological data like prevalence or incidence rates since the registration of cases is based on collaboration with allergy centers only. Similarly, other approaches to obtain data on the epidemiology of anaphylaxis are problematic given that allergic reactions of varying severity are covered by a number of codes in the ICD-10. Research in the field of anaphylaxis is focused on the identification of risk factors. Several data indicate the relevance of co-factors and augmentation factors in well-defined patient groups. Among these factors physical activity, infection, alcohol and additives are relevant. In the future a unique coding system with a subtype analysis regarding the triggers and severity should help to provide data on the epidemiology of anaphylaxis. Furthermore the mechanisms of co-factors and identification of biomarkers for risk assessment are important research areas for the future.

PMID: 23181736 [PubMed - in process]

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Impact of Sleep as a Specific Marker of Quality of Life in Allergic Rhinitis.

Curr Allergy Asthma Rep. 2012 Dec 18;

Authors: González-Núñez V, Valero AL, Mullol J

Abstract
Allergic rhinitis (AR) is a common disorder, which represents a considerable burden both on individual patients and society. It is associated with bothersome symptoms, which may impair usual daily activities, sleep quality, and productivity. Associated with impaired sleep, quality of life is significantly impaired in AR patients. AR significantly contributes to sleep-disordered breathing through multiple mechanisms, with the greatest impact mediated through nasal obstruction. Sleep impairment is very common in AR patients and has a significant impact on disease-specific measures of general health and quality of life. The degree of sleep disturbance is directly related to the severity of the disease. Nasal congestion also demonstrates circadian rhythm and positional variability, worsening during nighttime hours and in supine position. Increased sleep disordered events lead to poor sleep with fatigue and daytime somnolence, impaired performance, productivity and social functioning, and an increased risk of associated diseases.

PMID: 23247762 [PubMed - as supplied by publisher]

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Airway dimensions in asthma and COPD in high resolution computed tomography: can we see the difference?

Respir Care. 2013 Jan 9;

Authors: Kosciuch J, Krenke R, Gorska K, Zukowska M, Maskey-Warzechowska M, Chazan R

Abstract
Background:Airway remodeling in asthma and COPD results in bronchial wall thickening. The thickness of the bronchial wall can be measured in high resolution computed tomography (HRCT). The objectives of the study were: 1) to assess the bronchial luminal and wall dimensions in asthma and COPD patients in relation to the disease severity, and 2) to compare the airway dimensions in patients with asthma and COPD.Material and Methods:10 asthma patients and 12 COPD patients with stable, mild to moderate disease were investigated. All patients underwent chest HRCT (window level - 450 HU, window width 1500 HU). Cross-sections of bronchi (external diameter 1.0-5.0 mm) were identified on enlarged images; the following variables were measured: external (D) and internal diameter (L), wall area (WA), lumen area (A(L)), total airway area (AO), WA% - the percentage of airway wall area, wall thickness (WT) and WT/D ratio. Separate sub-analyses were performed for airways with D ≤ 2.0 mm and D > 2.0 mm.Results:261 and 348 cross-sections of small airways were measured in patients with asthma and COPD, respectively. There was a significant difference in WT and WA which were both greater in asthmatics than in COPD patients. In bronchi with D > 2.0 mm all measured parameters were significantly higher in asthma than COPD. In individual asthmatics the airway wall thickness was similar in all the assessed bronchi, while in COPD it was related to the external airway diameter.Conclusions:Our results indicate that bronchial walls are thicker in asthmatics than in patients with COPD. It seems that airway wall thickness and the luminal diameter in patients with asthma are related to disease severity. There is no such a relationship in COPD patients.HRCT may be a useful tool in the assessment of airway structure in obstructive lung disease.

PMID: 23307823 [PubMed - as supplied by publisher]

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Role of selenium and zinc in the pathogenesis of food allergy in infants and young children.

Arch Med Sci. 2012 Dec 20;8(6):1083-8

Authors: Kamer B, Wąsowicz W, Pyziak K, Kamer-Bartosińska A, Gromadzińska J, Pasowska R

Abstract
INTRODUCTION: Selenium and zinc are indispensable microelements for normal functioning and development of the human body. They are cofactors of many enzymes of the antioxidative barrier (selenium - glutathione peroxidase; zinc - superoxide dismutase). The aim of the study was to evaluate the importance of selenium and zinc in the pathogenesis of food allergy in small children.
MATERIAL AND METHODS: The study was performed in 134 children with food allergy, aged 1 to 36 months. The control group was composed of 36 children at the same age, without clinical symptoms of food intolerance. Each child had estimated serum levels of zinc and selenium. Furthermore, the authors evaluated activity of glutathione peroxidase (GSH-Px) in erythrocyte lysates and serum. Tests were performed twice, before and after 6-month administration of elimination diet.
RESULTS: The obtained results showed that children with food allergy had significantly lower concentrations of selenium, zinc and examined enzymes in comparison to children from the control group. Concentration of selenium and zinc as well as activity of examined enzymes increased after application of eliminative diet.
CONCLUSIONS: In children with allergy decreased concentrations of selenium and zinc, and lower values of glutathione peroxidase and superoxide dismutase which increased after elimination diet were affirmed. These observations suggest their role in pathogenesis of food allergy. Conducted observations indicate the need to monitor trace elements content in the diet in children with food allergy. The results showed that children with food allergy had a weakened antioxidative barrier.

PMID: 23319985 [PubMed]