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airAlert
A pilot scheme run by local authorities– called airAlert – has been launched as new research reveals air quality in some areas exceeds Government limits.
airAlert is a FREE service that sends text messages to your mobile or home telephone, informing you if poor air quality is predicted in your area. So far only Hertfordshire & Bedfordshire, Southampton & Sussex are offering the service.
The scheme is targeted at people with respiratory problems who may be affected by air pollution and gives warnings the day before or on the day that elevated air pollution is expected (probably around 20 times per year).
Dr Graham Roberts, a paediatric consultant and AAIR trustee, commenting on the scheme said: “Pollution is an important cause of exacerbations of asthma. We get many parents who feel that their child’s asthma is worse around pollution.”
Southampton’s public health director Andrew Mortimore said: “We believe the airAlert service will make a real difference to those people in the city with conditions such as asthma.” Register for free at www.airalert.info. |
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Drug for severely asthmatic children 'available in Scotland but not England'
A drug which can dramatically reduce the number of attacks suffered by severely asthmatic children will not be available on the NHS in England after the Government’s drug rationing body ruled it was too expensive.
The draft guidance by the National Institute for Health and Clinical Excellence (Nice) concluded that, at £256 per injection, Omalizumab is not cost-effective for under-12s, although it will be available to patients in Scotland.
Omalizumab (also know as Xoliar) has been available to adults on the NHS since 2008, ‘transforming’ many lives. AAIR trustee and Consultant in Paediatric Allergy and Respiratory Medicine Dr Graham Roberts described the decision as disappointing: “The European Medicines Agency extended the licence for omalizumab in June 2009 on the basis of clinical study data. It is disappointing to see that NICE have not also extended their recommendations for the use of omalizumab down to this age group. NICE focus on clinical trial data. Unfortunately in this age group there are few studies and these do not focus on the very severe patients. omalizumab is not an appropriate treatment for most young children with asthma, but for those with severe uncontrolled symptoms it has the potential to be very beneficial. We have seen dramatic improvements in the quality of life of teenagers with went we have started omalizumab therapy.”
Asthma affects around 1.1 million children in the UK with more than 30,000 aged 14 or younger being admitted to hospital between 2008 & ‘09 following an asthma attack. Xolair costs around £12,000 per patient a year although research shows that taking it for a year can cut in half the number of asthma attacks children suffer. While Nice accepted that the drug could reduce attacks, it said that the drug made no difference to the number of times that children were hospitalised and other key markers.
Xoliar is the first in a generation of drugs for severe, allergic asthma, where patients have high levels of the antibody IgE in the blood, resulting in an oversensitive immune system. The drug prevents IgE from starting the reaction that leads to asthma symptoms, effectively blocking the allergic triggers responsible for attacks. It has been found to greatly help those for whom regular drugs - such as inhalers and oral steroids which suppress the symptoms rather than tackling the causes - are ineffective.
Nice is not expected to publish its final guidance on the use of Xolair, which is made by Novartis, until October. |
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ALLERGY CARE SHOULD BE TAKEN MORE SERIOUSLY
Progress of allergy care has been slow or non-existent, while cost-effective solutions are still not being implemented, according to the report from the Royal College of Physicians and Royal College of Pathologists.
The report follows recommendations from the House of Lords Science and Technology Committee inquiry into allergy in 2007, which urged practical steps to improve allergy services. GPs surveyed as part of the report said they believed there had been no improvement in access to specialist service provision.
In 2003 the Royal College of Physicians, under the chairmanship of AAIR trustee Professor Holgate, issued a report concluding that Allergy services in the UK were totally inadequate. Prof Holgate was again involved in this new report and told AAIR: "It seems that the same situation exists despite at least 3 additional Government Reports. Allergy is being trivialised in the UK at a time when levels are at epidemic proportions and the complexity and severity continues to increase. Allergic diseases that include life-threatening anaphylaxis, food allergy, asthma, rhinitis, conjunctivitis, hives, eczema and drug and insect reactions often occurring together in different combinations requires specialist diagnosis and treatment as well as a greater awareness in primary care. It is time to treat allergy as a real public health problem and to drive forward its prevention and treatment. To do this requires the whole subject of allergy to be taken much more seriously and for a more joined-up approach to its management". |
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Managing Asthma.
AAIR Chairman and leading asthma expert Professor Stephen Holgate was interviewed on BBC Radio 4’s You & Yours programme discussing new treatments for asthma. This is now available to listen to on BBC iPlayer. To listen Click here and select ‘Chapter 5’. |
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Hay Fever Sufferers Wanted NOW.
Volunteers are needed for a new multinational 4-year study investigating a new hay fever treatment.
Allergen Immunotherapy involves the injection of allergens to which an individual is sensitized to induce a tolerance to these allergens, so reducing symptoms. The study, organised by AAIR trustee Dr Howarth, is directed against grass pollen allergens and thus aimed at helping those with troublesome hay fever.
Hay fever symptoms will be recorded in Year 1 (rescue treatment will be provided for symptom relief during this year and subsequent years). Following this, injection immunotherapy will be given for Years 2 & 3 and the hay fever severity compared to Year 1. Not all injections will be the proper allergen immunotherapy, some will be placebos. None of the subjects or investigators will know which is which to allow comparison and ensure any benefit is due to the proper injections and not just changes due to alterations in the levels of grass pollen from year to year. Finally participants will be observed for one final hay fever season as the allergen immunotherapy would be anticipated to have a long-lasting benefit, acting even when injections have stopped.
Potential participants should be aged 8 to 65, suffering symptoms predominantly in May, June, July and have a history of at least 2 years of seasonal symptoms such as itch eyes, runny nose and sneezing that have required therapy.
Deadline for entry is mid-May.
For more details & to check eligibility phone 02380795108. |
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Eczema and allergy
Dr M Ardern-Jones Senior lecturer in Dermatology
January 2010
Eczema is a disorder of inflammation in the skin and is strongly associated with other allergic conditions: asthma, hay fever and food allergy. Eczema incidence from 2001-5 has risen by 40% and now affects 20-30% of UK school age population and 3-10% of adults. Eczema has been found to impair quality of life as much as asthma and diabetes. It is well recognised that children frequently progress from one allergic condition to another: eczema usually arises first, most frequently in the absence of allergy, and is a major risk factor for the development of severe asthma and food allergy. The development of allergy to environmental allergens is thought to be due to the eczema and the severity of eczema has been shown to predict children with more severe forms of asthma. As well as inflammation in the skin and allergic responses, the characteristic features of eczema are reduced effectiveness of the skin as a barrier and impaired defence against infection. We propose that the leaky skin barrier and impaired defence against infection are responsible for the development of allergic responses in eczema. |
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We propose to test this hypothesis by designing a model of human skin in the test tube. We will do this by using cells donated from the skin of those with eczema and those without. Using this system we will be able to control the exact environment in which the skin grows to prevent differences arising from factors other than the cells making up the skin barrier. We can then challenge the models with the same allergen and determine if the immune response generated in the model from eczema skin promotes allergic responses as we suspect. If so, this will stimulate further work to address which components of eczema skin are most important for the allergic drive and these findings will become ideal targets for new therapies.
Investigation into the mechanisms responsible for eczema in humans has been limited to clinical tests (skin and blood tests) and laboratory examination of skin biopsies and blood samples. Although advances have been made with these limited approaches, investigators have sought to reproduce the more complex interactions in eczema by using models. Whilst gene manipulated models allow detailed analysis of single pathways, it is unclear whether these truly represent human eczema. Indeed, forty such models have been described for eczema, but none completely reproduce all the complex features of human eczema as described above. There is a clear unmet need for a human model system which encompasses both skin and immune system interactions to recreate the complexity of eczema. If successful, this model system will not only allow us to test our hypotheses but could also allow a platform for testing new therapies aimed at modifying the components of eczema.
We are very grateful to AAIR charity for making a grant to fund the cost of undertaking this important research in the field of skin allergy. |
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The AAIR Charity,
AIR, Mailpoint 810, Level F, Southampton General Hospital, Tremona Road, Southampton,
Hampshire SO16 6YD.
Tel: 023 8077 1234 Fax: 023 8079 6866 |
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