Exposure and allergic sensitization to cockroach was associated with a significantly greater risk of asthma hospitalization and greater healthcare utilization among 476 children aged 4 to 9 years who participated in the National Cooperative Inner-City Asthma Study. Allergic sensitization to the mold Alternaria has been identified as a significant allergen in terms of increasing airway hyperresponsiveness and was associated with a nearly 200-fold increased risk of respiratory arrest due to asthma, emphasizing the importance of determining underlying allergic sensitivities in patients with asthma and providing patients with accurate and practical advice on allergen avoidance techniques. (more…)

More severe asthma can persist from childhood into adulthood without remission. Another important tendency in the natural history is for symptoms to remit in adolescence only to return again in adulthood. In general, the amount of wheezing in early adolescence seems to be a guide for severity in early adult years, with 73% of those with few symptoms at age 14 years continuing to have little or no asthma progression at age 28 years. Similarly 68% of those with frequent wheezing at 14 years still suffered from recurrent asthma at age 28 years. Most subjects with frequent wheezing at 21 years continued to have comparable asthma at 28 years. In addition to the importance of symptoms in childhood, childhood degree of bronchial responsiveness in combination with a low FEV-1 were also related to the outcome of asthma in adulthood. (more…)

Maintenance of asthma control by once-daily inhaled ciclesonide nasal spray in adults with persistent asthma. Ciclesonide is an inhaled corticosteroid that is converted to an active metabolite, desisobutyryl ciclesonide, in the lungs, thereby minimizing effects on endogenous cortisol inflammation. The goal of finding newer, safer corticosteroids for the management of asthma has led to the development of this inhaled corticosteroid.

This 12-week, double-blind, randomized, parallel-group, placebo-controlled study evaluated the efficacy and safety of ciclesonide in adults with persistent asthma. Efficacy was monitored with asthma symptom scores, rescue medication use, morning and evening peak expiratory flow rate (PEF) measurements, spirometry, and the probability of study completion without experiencing lack of efficacy. It was concluded that ciclesonide (160 or 640 µg) once daily in the morning maintains asthma control effectively, does not affect cortisol levels, and has an adverse event profile comparable with that of placebo in adults with primarily mild to moderate asthma.

It has been reported previously that, compared with fluticasone, ciclesonide possesses equivalent anti-inflammatory efficacy, through pulmonary activation, with a significantly improved safety profile. Since it has low bioavailability because it is metabolized by the lung, it is believed to cause minimal systemic adverse effects. It was found that the morning peak expiratory flow rate (PEF) and FEV 1 values from patient diaries decreased significantly in patients switched from their usual inhaled corticosteroids therapy to placebo but remained stable in patients switched to either dose of ciclesonide (160 or 640 µg). Furthermore, in patients switched to placebo there were significant increases in daily asthma symptoms and the use of rescue medication, with no significant changes from baseline in patients switched to either dose of ciclesonide. Mean changes from baseline in serum and urinary cortisol levels were not statistically significant in any of the treatment groups. Adverse effects were mild, with no reported cases of oral candidiasis.

In conclusion, once-daily inhaled ciclesonide nasal spray (160 or 640 µg) was superior to placebo in the maintenance of asthma control in adult patients previously treated with moderate doses of inhaled corticosteroids, without any significant adverse effects.

Classification of bronchial asthma can be based on age, etiology, associated characteristics, or severity. Classifications based on severity have been primarily designed as an approach to asthma treatment. Thus, management of mild intermittent disease may require only bronchodilator treatment, but frequent attacks with or without persistent mild symptoms require a comprehensive approach to controlling inflammation as well as bronchodilator treatment. Severe asthma can become a major clinical problem that requires specialist care and many different approaches to asthma attack treatment. (more…)

In theory, any kind of food is having the capability to trigger food allergic reaction in our body. All foods contain molecules capable of triggering a response of the immune system. However, for many reasons—including both the structure of the food molecules and our body’s immunological responses—the foods that cause the majority of allergic reactions tend to be few in number. (more…)