 |
|
News
|
|
|
Allergic Rhinitis: a significant issue
The clocks have gone forward announcing the start of summer. It doesn’t feel like it yet although we know this heralds a period of the year when those with pollen allergies start to experience symptoms.
The lengthening days and the increase in temperature lead initially to tree pollination and then later grass pollination. The earliest trees to flower are hazel and alder, followed by others such as birch, oak and ash. As they flower pollen is disseminated in to the air and when it settles on the moist mucus membranes of the eyes, nose and throats or is breathed down into the airways of those with pollen allergy, symptoms arise.
Typically these symptoms represent some or all of the following: itchy, watery red eyes (conjunctivitis), itchy nose, sneezing, runny nose and nasal stuffiness (rhinitis), itchy throat or itchy inside the ears and wheeze, breathlessness, chest tightness and cough (asthma). For those sensitised to tree, grass and weed pollens (weed pollination arises after the grasses in late summer and early autumn) the symptoms may last from February through to September/October. Thus although pollen allergies are often referred to as seasonal disease and thus not considered to last for more than 4-6 weeks at the most, those with many allergies experience problems for many months.
The same symptoms can arise all year round in those sensitised to indoor allergens, typically those linked to house dust mites or pets (usually cats and dogs). With such all year round allergy, itching is less noticeable and, within the nose, blockage is often more problematic.
In all instances allergic rhinitis impacts significantly on an individual’s quality of life and has more of an impact than those without rhinitis could appreciate. Although we often focus on the symptoms referable to the eyes, nose or chest, those with rhinitis feel generally unwell, often have headache, sleep poorly and have impaired concentration.
Studies have shown that with untreated rhinitis school performance is impaired and allergic rhinitis (especially summer seasonal allergic rhinitis at times of high pollen counts) is recognised as an important cause of reduced productivity or absenteeism from work.
Last summer we were involved in an international trial to see if four injections of a modified grass pollen extract, given before the grass pollen season, could protect against the development of symptoms. Intuitively this may seem strange. It is, however, recognised that the administration of high doses of an allergen to someone who is allergic can lead to immunological tolerance, such that the body ceases to respond to that allergen.
Usually we build this up over many months to years, as the injections may themselves induce a very serious allergic reaction, and the standard treatment course is three years. The potential availability of just four injections that have the same effect would make this much simpler and more acceptable, providing it was both effective and safe.
We are awaiting the results of this trial but the allergy and asthma clinical trials unit in Southampton was a major contributor to this study, having entered the most patients to this study from all the sites within the UK. We are about to start a trial of a new orally administered treatment for house dust mite sensitive allergic rhinitis.
See Our Story for more details.
|
|
|
Biomedical
Research Units
Southampton University Hospitals NHS Trust and the University of Southampton are delighted to announce the award of a NIHR Biomedical Research Units worth over £4million.
The unit will specialise in respiratory disease including asthma.
The NHS/University partnership will foster growth, driving innovation in the prevention, diagnosis and treatment of ill health. The BRUs will focus on "translational research" that takes advances in basic medical research out of the laboratory and into the hospital clinic, delivering the maximum benefits to our patients.
Research in the Respiratory BRU aims to help develop medicines that prevent onset of airways disease in adults and children and ameliorate control where disease is established. Five specific programmes of investigation are planned in immune response, novel therapies, epithelial repair mechanisms, antibiotic resistance, and imaging in lung disease.
“This is the greatest vote of confidence that we could get as a centre of excellence in translational research and a sign of how we are perceived nationally and internationally”, said Professor of Respiratory Medicine and BRU Director, Ratko Djukanovic. “It is also recognition of what Southampton has achieved in respiratory medicine since the Medical School was established. The BRU will be a platform for more excellent work and an opportunity to develop new areas, such as adult intensive care and ILD, as well as to broaden our existing strengths.”
The selection process took six months, ending with a rigorous panel interview for the applicants, and NHS and University senior management.
Southampton is the only centre to have been awarded two BRUs – another ten will be established across the country. Second of which will focus on nutrition, diet and lifestyle
“The awards are excellent news”, confirmed NHS Chief Executive, Mark Hackett,
“helping us turn the 2020 vision into reality and achieving our objective of becoming a comprehensive Biomedical Research Centre within five years.”
The AAIR Charity is delighted with this unit as the charity is based in the Southampton General Hospital and raises funds to support the world-acclaimed asthma and allergy research team based there. This team will be at the heart of this prestigious new bio medical research unit.
|
|
|
Is
Asthma Preventable?
AAIR’s Dr Hasan Arshad is currently studying a generation from birth through to adulthood hoping to help answer the question ‘Is asthma preventable?’ This study is now in its 18th year and is probably the best known asthma prevention study in the world.
“Asthma is the most common chronic disease in children. Asthma and allergic diseases affect millions of people in the UK and some reports suggest that their prevalence is still increasing. Asthma and rhinitis adversely affect quality of life and some people with severe asthma live in a constant fear of another attack. Although, a number of questions regarding the causes of asthma and allergy remain unanswered, this lack of knowledge should not deter us from the important task of investigating new and effective ways to prevent the development of asthma and allergy.
It is well known that both genetic and environmental factors contribute to the development of asthma and allergy. Thus, children with a family history of allergy are at higher risk. Exposure to allergens in early childhood may be one of the most important environmental factors. Lack of infection in early childhood, exposure to pollution and dietary changes may be others.
In 1990 we embarked on a study to test the effectiveness of strict dietary avoidance of food allergens combined with reduced exposure to house dust-mite allergen to prevent asthma. Infants, at higher risk of asthma and allergy, due to family predisposition, were recruited before birth and assigned to intervention (that is allergen avoidance) and control groups. This study was carried out in the Isle of Wight. The intervention group infants were either strictly breast-fed with mothers on a low allergen diet or they were given a special milk formula with reduced allergen content (hypoallergenic milk formula). We also cleaned infants’ homes with special chemicals to kill house-dust mites. Control group children followed standard recommendation by midwives and health visitors. This reduction in exposure to allergens was only carried out during the first year.
We followed up these children as they grew up to see how many from the intervention and how many from the control group would develop asthma and allergy. All 120 children have been seen at ages 1, 2, 4 and 8 years. Throughout this period, children who avoided high allergen exposure during infancy did develop less asthma (about 50%), and eczema (about 50%) and they were less often allergic to foods and house dust mite allergens on skin prick test.
|
|
These children have now grown up in to young adults, age 18 years. The important question is to establish if the effect of allergen avoidance during infancy, which was seen up to 8 years of age, continues into adolescence and early adult life.
We are delighted to have been awarded a 2 year funding from the National Institute of Health Research to do that. This is probably the best known asthma prevention study in the world and results up to the age of 8 years are very encouraging. If we can demonstrate that this type of intervention in children of parents (or sibling) with allergic disease is effective, we can then make appropriate recommendations.
|
|
|
|
Genes, Mums,
Environment and Asthma
|
Matthew Rose-Zerilli using the robot
to handle all the DNA samples from
mothers and children in the study.
|
Researchers in the Asthma Genetics Group at the University of Southampton are working on a project to understand how the environment a mother is exposed to during pregnancy might increase the risk of her child developing asthma. We already know tobacco smoke exposure before and after birth is a risk factor for respiratory problems in children, and our collaborators at the University of Bristol and Imperial College recently found very frequent use of paracetamol in pregnancy may also increase the risk of asthma in the
child.
However, we still needed to understand several things. Firstly did exposure to these factors have the same effect in everyone, and secondly, by what mechanism might they be altering lung development to increase the risk of asthma?
|
The lungs are continually exposed to potential injury from some forms of oxygen found in pollutants and tobacco smoke. The lungs in early childhood, which are growing rapidly, may be particularly vulnerable. There are clues that consumption of antioxidants, such as vitamin E and selenium, may protect against such damage, and hence improve lung health. As genetic differences in the mother and her child might cause differences in the level of responses to oxidant injury, we looked at genetic variation in genes that encode proteins that help protect the body from this type of injury. Susceptibility to the detrimental effects of tobacco smoke and paracetamol, and the extent to which antioxidants may be beneficial, is likely to vary between individuals, depending which genetic variants are present in the mother and/or child.
These genetic differences were measured in over 10,000 mothers and their children participating in the Avon Longitudinal Study of Parents And Children. The ALSPAC project began in 1991, with the recruitment of some 14 000 expectant mothers by a team led by Professor Jean Golding at the University of Bristol. The Children have been followed since then for a wide range of health related outcomes including allergy and asthma.
We have now found several genetic variations in both the mothers and children that appear to modify the risk of exposure to tobacco smoke and paracetemol intake on asthma in the children. This tells us several things, firstly, if an individual is more susceptible to these exposures when they have gene variants which make these exposures more toxic, this would provide strong evidence to suggest that the exposures are really causing lung problems later in life. At present we cannot be sure that apparent effects of paracetamol on asthma risk are really causal or just a marker of some other environmental exposure. Secondly, identification of gene variants which influence susceptibility may help to clarify the mechanisms by which paracetamol and tobacco smoke cause damage to the developing lung. For example, at present we do not know whether nicotine is responsible for the harmful effects of tobacco smoke or some other component. In the same way, we hope to clarify whether exposure to antioxidants in the diet in early life is beneficial for lung growth and development. By gaining further understanding of the early life influences on lung development we hope to devise new strategies to prevent lung disease in children and improve their respiratory health.
We are particularly grateful to the British Lung Foundation who funded this work and also to the AAIR charity that provided funding to purchase a multi-channel pipette that helped us handle the tens of thousands of DNA samples from the mothers and children in the laboratory.
|
|
|
ALLERGY EPEDEMIC
AAIR’s allergy experts were once again in the public eye as a House of Lords Report highlighting the growing allergy epidemic in the UK featured heavily in all the national media.
The investigation by the House of Lords Science and Technology committee, published September 26th, found that serious and immediate action were required to combat what has become known as the ‘modern epidemic’
The Report identified the ‘severe shortage of allergy specialists in the UK’ and that ‘clinical services lag far behind’ most of Europe. The Report confirms the huge rise in allergy and inadequate provision across the NHS at all levels – including a lack of training in allergy in medical school undergraduate training programs, in primary care and in hospital-based secondary care resulting in inadequate patient care.
As President of the NASG (National Allergy Strategy Group) and one of the world’s top allergy experts AAIR’s Prof Stephen Holgate, was in high demand to comment on the report from both the media and medical bodies including the Medical Research Council.
Prof Holgate said: “The Report on allergy highlights Southampton as one of the lead hospitals in the UK for allergy and asthma research. Since we receive strong support for our work (including my professorship) from the Medical Research Council, the MRC wanted to seek our advice when the Report was published.”
Prof Holgate welcomed the report and its key recommendations which included:
- The Department of Health to set up regional allergy centres nationwide through the ten Strategic Health Authorities. These should be headed by full-time specialists in allergy. They would act as ‘clusters’ of expertise that include a partnership among allergists, paediatric allergists, clinical immunologists, chest physicians, dermatologists, ENT specialists, gastro-intestinal specialists and occupational health physicians.
- Each Allergy Centre should have facilities for diagnosis of complex cases and provide training in allergy for specialist trainees, organ-based specialists, GPs, nurses, pharmacists and school personnel.
As Professor of Clinical Pharmacology at The University of Southampton Prof. Holgate went on to explain how Southampton’s world acclaimed allergy department, backed by AAIR, is leading the way. Professor Holgate said: “What is unique about our research and clinical allergy team is that they are fully engaged in tackling some of the difficult questions about allergy mechanisms and treatment that has also been so strongly supported by AAIR. Indeed it is the synergy between our AAIR charity and the MRC that has helped drive forward our new PhD research training programme that Professor Donna Davies now runs as well as supporting both the basic and clinical science that underpins our success. Without this fantastic local support we would not be in such a strong position to push forward the frontiers that will lead to new treatments. We are grateful to all those who continue to support us especially when the going gets tough.”
This is the 4th national Report on allergy. All say much the same on services and patient need, despite this the Department of Health have not acted to bring about change. Professor Holgate urged Health Ministers to act now as failure to diagnose and treat allergy is resulting in continuing illness and cost to the NHS and patients.
The facts behind the allergy epidemic.
- 1 in 5 of the UK population suffers from
hayfever
- Reduces quality of life and work performance
- Impairs results in school examinations.
- 1 in 10 have asthma
- That’s 3-4 children with a ‘blue’ inhaler per classroom
- Allergies are a major trigger factor for asthma
- Asthma may be severe and even life threatening
- 1 in 50 children suffer from peanut allergy
- That’s one child in every 2nd classroom
- May cause life-threatening anaphylaxis
- Asthma accounts for 70,000 admissions and anaphylaxis for 30,000
admissions to hospital each year within UK
- Medications for allergies cost £0.9 billion/yr, 11% the total NHS drug budget
- There are only about 30 specialist allergists and GPs are poorly informed and most have received no formal training.
- There are only 8 trainee doctors in allergy for the whole country: not enough to replace consultants soon to retire.
- The recommendation to abandon the DH advice on ‘peanut avoidance in pregnancy /early childhood’ identifies the lack of evidence. But the lack of research is in part a result of lack of allergy specialists. More clinical research is needed. Prevention of allergy will be important in the future.
|
|
|
|
Professors Stephen Holgate and Martin Church
Book Award
|
|
AAIR professors Stephen Holgate and Martin Church were recently awarded top prize in the most prestigious medical book competition in the United Kingdom.
Their book Allergy, 3rd edition was named the British Medical Association (BMA) Book of the Year. This is made to the publication which is deemed to best fulfil the criteria of clinical accuracy and currency which maintains a high standard of design and production. It was also triumphant in the Respiratory Medicine category
A record 632 titles competed for 20 top awards across a variety of categories in the competition, which has been held annually since 1994.
The book, co-authored with Professor Lawrence Lichtenstein from Johns Hopkins University in Baltimore, USA, was praised by its reviewer as offering "a wealth of detailed information on the diagnosis, treatment, and management of allergic diseases - from asthma to
urticaria."
|
Professor Martin Church, co-author of Allergy, said: 'All the authors are thrilled by the recognition that this BMA Award gives us for our book. The current book is the third edition and contains more clinical information than previous editions. We have always endeavoured to use illustrations to replace rather than repeat information in the text and this latest update contains a CD Rom with slides suitable for presentation.
'We are indebted to our publishers who have been brilliant in helping us achieve our objective of producing a really accessible book at a time when allergic disease has reached epidemic proportions.'
|
|
|
A
Bright Future For Research at Southampton
Southampton’s reputation as one of the leading respiratory centres in the UK with a bright future has again being recognised
The department has won 4 MRC-funded Capacity Building Studentships in Respiratory Medicine from 21 awarded nationwide – more than any other UK academic institution. The research awards address the need to increase the number of researchers in respiratory medicine and were created in response to the growing number of people in the UK who suffer from respiratory disease. Various medical research charities joined forces with the Medical Research Council to fund the studentships. They hope that by encouraging young scientists to study conditions affecting the respiratory system, there will be a greater capacity to develop treatments and knowledge of these illnesses in the future.
The four talented young scientists will begin their 4yr PhD research projects is Southampton in October 2007 . Southampton’s Professor Donna Davies, who led the team applying for the awards, explained that Southampton was likely to have been so favourably received not just because of its world-class reputation. “We applied for four studentships and were awarded all four for several reasons. For these four-year MRC awards, we designed a specific ‘Respiratory Pathway’ to fit into the School of Medicine’s Four Year PhD Programme in Biomedical Sciences . We will spend the first year teaching the students about respiratory disease and the associated problems and we will help them to develop their research skills so they are much more able to focus on key question relevant to respiratory diseases. After this training year, the students will engage in an in-depth research project studying a specific aspect of lung disease”
Professor Davies went on to explain: “These awards are good for the future of department because we are now in a position to train excellent students to fill the gap where there has previously been a lack of research expertise in the area of respiratory medicine. Eventually we will have better trained post doctoral fellows and hopefully, as the programme develops well get more and more students to join the programme so strengthening research into respiratory disease across the UK.”
Nicole Bedke, a current MRC Capacity Building student said: “It’s a privilege to carry out research at the cutting edge of respiratory medicine learning from so many eminent scientists”
Professor Stephen Holgate, Chair of the UK Respiratory Research Strategy Committee, said: “More people in the UK are becoming ill as a result of respiratory conditions. Two major disease areas, lung cancer and lung fibrosis, were still under-represented in the research applications but this simply highlights why it is so important that we encourage young scientists to begin their careers in respiratory research, build their knowledge and find out more about how and why these conditions are on the rise so that we can offer effective treatments in the future. All of the funding partners believe the collaboration is a fantastic opportunity to strengthen respiratory research.’’
AAIR is proud to be providing funding of £120,000 towards these Studentships.
Facts and figures
- 5.2m people in the UK are currently receiving treatment for asthma, that’s one in twelve people. 4.1 million of the people who have asthma are adults, 1.1m are children,
- An estimated 3 million people in the UK have Chronic Obstructive Pulmonary Disease (COPD), 24,160 died from the condition in 2005.
|
|
|
|
The Pollen Season is Round the Corner. Are you Ready for Hay Fever Again?
|
|
Are you one of those millions of people for whom early summer is a misery rather than a pleasure? Are you worried that allergic rhinitis will ruin your examination results? Allergic rhinitis tends to be considered a trivial disease by many people and even by some doctors. However, you know different! All the time your nose is running and then it gets blocked. Your eyes are itchy and watery and you can't see clearly. You can't stop sneezing and you can't breathe properly. Your sleep is disturbed, you have headaches and you feel tired all the time. It is a warm sunny day and everyone around you is happy and enjoying the release from the cold dark days of winter. And yet to you, even the simplest of daily activities appears like a large mountain to be climbed and the thought of going out with friends or enjoying a leisure day with your family seems like a distant dream.
|
It was with someone exactly like you in mind that Dr Diana Arion, Dr De Yun Wang and I wrote "Simply Allergic Rhinitis". This book explains with easy text and pictures what allergy is and what is happening in your nose during the hay fever season. It also explains minimising the effects of hay fever is not simply a matter of taking a tablet on a `bad day', but involves a co-ordinated management plan. For example, reduce pollen exposure by keeping you windows shut at home, particularly in your bedroom at night. Decide which treatment you are going to take, antihistamine tablets or corticosteroid nasal sprays. Remember that both tablets and sprays are much more effective when taken regularly than taken occasionally. Finally, consider starting your drugs before the pollen season really gets underway because it is much easier to prevent symptoms developing than it is to reverse them once they are establish.
AAIR and Prof Church are giving away 15 Simply Allergic Rhinitis books to the first 15 people who write or small The AAIR Charity with their full name and address.
By Prof Martin Church.
|
|
How much do you know about hay fever triggers?
Question 1.
Where are your hay fever symptoms more likely to be worse:
A: A field of yellow rapeseed flowers
B: A grassy meadow
Question 2.
During the hay fever season, is it better to sleep with your bedroom windows:
A: Closed B: Open
Question 3. Where would be best to go on holiday during the hay fever season:
A: The Norfolk Broads B: The Costa del Sol
Question 4.
If on one day during the hay fever season your symptoms are particularly bad, would you get more rapid relief by:
A: Taking an antihistamine tablet
B: Using a steroid nasal spray
Q1 B
Q2 A Q3
B Q4 A
|
|
|
AAIR`s top asthma expert warns that we must change the way, asthma 's managed
Co-chairing the European Summit for Change in Asthma Management, Professor Stephen Holgate said the current trend of asthma therapy is
not reflective of current medical knowledge and needed to be changed.
The summit, which took place at the European Parliament in Brussels, heard asthma is a systemic inflammatory disease affecting more than just the lungs and so the need to control inflammation is essential. Professor Holgate said current guidelines and practice are based on a historical view of diagnosis and treatment of asthma - which only measure airflow in the lungs and may not truly capture whether the inflammation is under control or if other parts of the body are affected by the same type of inflammation. Furthermore, patents respond differently to treatments and one option may not suit all and therefore treatment should be individualised to meet the needs of each patient.
|
|
Unfortunately, current methods of assessing therapies that influence the wider aspects of allergic inflammation are not reflected in guidelines, which currently are restrictive in their recommendations and limit the choice of treatments available for clinicians to choose from.
Conclusions from the summit, which saw leading asthma experts and EU policy makers join together, form part of the draft Brussels Declaration stating that Clinical and Regulatory changes must be made to asthma management to ensure it reflects current scientific understanding of the disease and the needs of patients.
Professor Holgate said the Summit and the resulting draft Declaration was a great step forward: "This meeting has been extremely valuable as A has allowed health care professionals, scientists and patient groups to work directly with regulators and policymakers to establish where and how improvements need to be made in order for asthma patients to receive optimum treatment. However,
our work does not end here. It is vital that all of the actions agreed upon are also acted upon to ensure asthma
patients benefit fully".
|
|
It is estimated that over 30 million people in Europe have asthma and the number is rising. In addition, deaths from asthma have reached 180,000 annually and the economic costs of asthma in Europe is thought to be in the region of
€17 billion per year with an annual productivity loss estimated at
€9.8bn.
|
|
|
Food Allergy or Food Intolerance?
As January 22nd - 26th was Food Allergy and Intolerance Week we asked Diana Arion, MD consultant in allergy and clinical immunology to answer some common questions.
Q. What is the difference between food allergy and food intolerance?
Intolerance is generally when you cannot digest a specific food, this can be caused by
a genetic deficiency of the enzyme which is involved in digesting that food (the person is born with a lacking enzyme) or it can occur in people who had long lasting diarrhoea and whose normal structure and function of the lining of the digestive tract has been impaired. Because the body cannot digest the food, the digestive tract is irritated and becomes inflamed.
An allergy is a deficiency in the immune system, which causes it to wrongly perceive a harmless food as a potentially dangerous enemy. The immune system then triggers a defence to eliminate it. The marker of allergy is the presence of antibodies from the IgE class.
In both cases the food should be avoided.
|
|
Q. Can any food cause an allergy?
Any food with proteins can cause a reaction. However, 90 per cent of food allergies are caused by a limited number of foods. For example in infants the foods are more often milk, eggs and wheat. As we get into childhood and diet is more diverse, peanut and tree nut allergies become more common, in adulthood we often see fish and shellfish allergies.
Q. Is it possible to know by the symptoms which food is to blame?
The body expresses an illness through quite a limited range of symptoms. Usually any food can result in any of the characteristic symptoms of allergy or food intolerance and therefore you cannot identify the culprit food based only on the symptoms that it elicits.
|
Q. What are the likely reactions?
The symptoms of food allergy can be limited to the organs of the digestive tract or they can involve other organs e.g. skin,
respiratory organs, the heart and blood vessels.
Symptoms of the digestive tract can start in the mouth and throat with
redness, itching and/or swelling which can cause severe breathing difficulties or even asphyxia. Further down the digestive tract we see nausea, vomiting, abdominal cramps and
diarrhoea.
Food allergy is frequently a cause of eczema it is also the primary cause of anaphylaxis in which in addition to all or any of the symptoms described above the person can also present asthma attacks (not only in people suffering from asthma), heart racing and severe decrease in the blood pressure which can lead to the loss of
consciousness.
Food intolerance manifests first with digestive symptoms such as nausea, vomiting, abdominal cramps and
diarrhoea. If the problem is not treated in time growth and nutrition problems can occur, manifesting as
anaemia, chronic tiredness, and/or bones, muscle and skin disorders.
Q. What advice can you offer someone who thinks they have a food allergy or intolerance?
I would underline the need to see doctor. In allergy there are commercial tests used to check if allergies to substances, including foods. However, these tests, even when accurate, have no value if not interpreted in a clinical context (there are people who have positive tests and no symptoms and therefore are considered ill and vice versa, persons who have the disease but caused by another allergen that has been tested). Based on the history of the disease the doctor will know which allergens are more suggested to be involved and will test them; also he is the only one that can make the correlation between the test results and the clinical symptoms (simply showing a reaction to a skin prick test does not necessarily mean that your symptoms are caused by the allergen). The final accurate diagnosis may involve other test and also a differential diagnosis with other diseases that may present with similar symptoms.
The same is valid for food intolerance. As more diseases can manifest with similar digestive symptoms the involvement of the doctor in choosing the right tests, making the correct interpretation of the results and making the right diagnosis is crucial.
Q. Should you take any steps prior to visiting a doctor?
Keeping a food diary is very important to provide a good history. Record all foods eaten (even those not swallowed e.g. chewing gum), if the symptoms occur every time when you ate that food, how was it cooked. Also record the times you eat and the times the symptoms develop.
For food allergy The Gold standard of tests is an Oral Challenge, which means the suspected food is given in increasing quantities at 20-30 minute intervals (during which the occurrence of symptoms is evaluated). However this test can, potentially be very dangerous so should only be carried out by a doctor at a hospital.
|
|
|
UNIQUE OPPORTUNITY FOR AAIR SCIENTISTS
Once again AAIR scientists are involved in a pioneer project, joining forces with eight other countries to discover more about childhood food allergies.
|
|
In the
biggest ever study of its kind, more than 10,000
babies and their families are being recruited in
Greece, Germany, Spain, Poland, Lithuania,
Netherlands, Iceland and the United Kingdom as part of
a large European project called EuroPrevall.
The study known as PIFA (Prevalence of Infant Food
Allergy), aims to identify the prevalence, cost and
cause of food allergy across Europe. Pregnant mothers
are being recruited before delivery then keep a diary
of everything their infants eat in the first year of
life.
|
Children
are being reviewed at their first and second birthdays
and infants with symptoms suggestive of food allergy
are also being seen.
The UK cohort is being recruited in Winchester, Eastleigh and Andover and represents a partnership between The Royal Hampshire County Hospital and the University of Southampton.
AAIR’s Graham Roberts, a Clinical Senior Lecturer and Consultant Paediatrician, said: “This is the first time that such a large number of infants have been recruited and followed-up within Europe. This will give us a unique opportunity to work out why some young children develop food allergies. This may provide novel treatments to prevent food allergy. Additionally important information is being collected about asthma and other allergic diseases. This will allow us to gain a better understanding of these conditions and how they interrelate with food allergy in childhood.”
The importance of this study (which is being supported by the Foods Standards Agency) is clear as around 11-26 million people in Europe suffer from food allergies. This figure is thought to be increasing, as are the variety of foods that cause allergies and the frequency of severe reactions.
The first baby in the study was born at the end of December 2005. The study will follow all the infants until they are 2 years old, results are expected Autumn 2009.
|
|
|
John Warner - 16 Years Dedication
AAIR sends its very best wishes to one of our leading professors who has moved to a new position at St Mary’s Imperial College London after 16 years dedication.
John Warner was Professor of Child Health and honorary consultant paediatrician at Southampton General Hospital.
AAIR's Frank Anderson said: “John is a clinical scientist of international reputation who has rolled back the frontiers in relation to the development of allergies in childhood that result in a range of conditions including asthma, eczema and life threatening allergies to nuts and other food substances.
|
|
“Having established the Department of Child Health in Southampton as in international centre for allergy research, we wish him the greatest success in his new adventure of creating a great department at Imperial College.
Professor Warner said: “We have contributed uniquely to world understanding of the early events of foetal life which constituted to allergy and asthma. I will remember an immensely friendly department, where the staff are very kind and work together. They are all so incredibly nice people, good friends and super scientists.”
|
|
|
|
The Thrasher Research Fund
|
|
AAIR’s Dr Andrew Walls and
Dr Jo Zhou with Thrasher President
Dr Dean Byrd and Mr Aaron Pontsler
|
The Thrasher Research Fund, a USA-based charity which provides funding for research projects benefiting children, recently paid a visit to Southampton General Hospital. They gave a presentation on their work and checked on the progress of the research being conducted by AAIR’s Dr Andrew Walls and Dr Jo Zhou.
Dr Walls said of their project that is being funded by the Thrasher Research Fund: “The work has led to the development of a new test that can allow the more effective diagnosis of anaphylactic shock. We are currently applying this new test to investigate the potential role of allergic disease in sudden unexpected deaths in infants.”
The Thrasher Research Fund has since approved a further installment of funding.
|
|
|
State of the art controlled time-lapse microscope.
AAIR is currently raising £80,000 to help make one of our biggest ever, single purchases – a state of the art controlled time-lapse microscope.
This will be a powerful tool for studying a wide variety of dynamic events, which normally happen too slowly to appreciate. The microscope will provide a window into cells so structures can be visualized and monitored as they assemble or change enabling the behavior of living cells and tissues to be studied over intervals ranging from minutes to days.
Department professor Donna Davies said: “ We are incredibly excited by the capabilities of ‘live cell imaging’. It really does open up a new window onto cell behavior giving us much more detailed insight into those processes that are likely to be involved in the changes that occur in asthmatic airways that lead to the development or worsening of asthma
Professor Davies is currently directing studies to understand how the asthma gene, ADAM33, affects the airways in asthma and why asthma sufferers appear to be more prone to virus infections, especially the common cold, that lead to worsening of asthma symptoms. Her group has already found that there are several different types of ADAM33 that occur in different parts of the cell, so they plan to use the microscope to study how ADAM33 moves or ‘traffics’ within a cell, as this seems to be important for its function. They have also found that ADAM33 markedly affects cell behaviour and they plan to use the microscope to help pinpoint exactly what ADAM33 is doing, bringing much greater understanding of its function in asthma.
Several other projects will also benefit from the microscope, including those looking at the role of ADAM33 during lung development, the effects of virus infection on asthmatic airway cells and studies examining interactions between airway cells and the different types of inflammatory cells that accumulate in asthmatic airways.
|
|
|
New Statistics.
British Children now top the international league table for allergies according to a study recently published in the medical journal The Lancelot.
The international study of asthma and allergies showed 47% of UK children (3.5 million) now suffer from allergies such as asthma and eczema. The study covered 193,000 children aged 6 – 7 and 305,000 aged 13 – 14 across the world. Britain had one of the biggest increases in allergy rates making it the worst affected country with cases of asthma doubling over the past two decades and cases of hay fever and eczema trebling.
Another study also showed potentially life-threatening allergies had increased dramatically during the past decade with a 700% rise in hospital admissions for anaphylaxis or sever reactions and a 500% rise in admissions due to food allergies.
AAIR’s Dr Peter Howarth said: “We cannot identify what is causing the problem but one of the main problems is that we live in too clean an environment.”
|
|
|
Research by the Southampton Respiratory Group highlighted at Major International Lung Conference.
Two pieces of research undertaken by Professors Donna Davies and Stephen Holgate have been highlighted in the ‘Clinical Year in Review’ at the American Thoracic Society International Conference, which took place in San Diego earlier this year.
The purpose of the Clinical Year in Review is to update clinicians on newly published studies and to identify recent advances in pulmonary medicine.
|
|
These studies are the culmination of several years’ work and have been selected from thousands world-wide. For the Southampton group to have two papers out of the total of just thirteen cited in the asthma section demonstrates that their work is recognized internationally to be at the cutting edge of asthma research.
The first highlighted study was the group’s demonstration that airway cells from asthmatic volunteers do not mount a normal antiviral response to the common cold virus, which is a major cause of worsening asthma symptoms. The researchers also showed that addition of interferon beta, the antiviral protein that was found to be deficient in asthmatic cells, protected against infection. This may pave the way for a novel treatment for viral-induced asthma attacks.
|
The second study that was highlighted was the group’s clinical trial studying for the first time the effect of blocking a mediator called TNFá in steroid refractory asthma. Although this therapy needs to be tested in larger asthma trials, the improvements seen in the initial study and a second study performed in Leicester are very encouraging.
Donna E. Davies
Professor of Respiratory Cell and Molecular Biology
Allergy and Inflammation Research
|
|
|
It's official! AAIR researcher Lynn Andrews has made classroom science exciting
Lynn has won a Science Communicator's Award after inspiring pupils at Poole Grammar School with imaginative lessons in science.
The award came after Lynn took part in the nationwide 'Researcher in Residence' scheme, which asks science researchers to work with teachers in making school science, technology, engineering and maths more relevant and exciting for young people.
The scheme's project manager Marilyn Brodie said: "We were impressed by Lynn's efforts to engage the pupils. Her willingness to host laboratory visits made a real difference to the pupils' experience of science and so was invaluable."
Lynn said: "The children particularly enjoyed the live experiments. We have such fantastic scientific equipment they could see microscopic pictures, which they found fascinating. It was very rewarding and good to show the children that a career in science does not necessarily mean just working in a laboratory."
|
|
|
|
BREAKTHROUGH BY AAIR RESEARCHER
|
|
AAIR scientist Dr Andrew Walls and his team have come up with a new test, which may eventually help prevent potentially life-threatening anaphylactic shocks.
Anaphylactic shock is an extreme form of allergic reaction where the body's immune system decides that something harmless, such as peanuts or wasp stings, poses a great danger, and launches a massive overreaction.
It is thought this new test could help in the reliable diagnosis of anaphylactic shock. Dr Walls said: 'A reliable diagnosis is important reduce the risk of suffering a further life-threatening reaction. This could involve avoiding the allergen that provoked the reaction and carrying an Epipen that will allow rapid injection of adrenalin at an early stage of anaphylaxis.”
The team found the enzyme carboxypeptidase, released by mast cells in tissue, can be used to identify an anaphylactic reaction. Tests so far have proved successful; levels of this enzyme have been considerably higher in people who had an anaphylactic reaction compared to those who had not.
|
Dr Wall added: 'It's early days yet but we're hoping that the research will lead to a simple and rapid test for anaphylaxis becoming available. It is more that five years since our laboratory first started work on the new test. It is satisfying to see the potential in laboratory diagnosis becoming apparent. It will be important for the test to become more widely available.
“The support of AAIR and other medical charities including Thrasher Research Fund, Sir Jules Thorne Charitable Trust, Action Research has been crucial for the work of our research group. We are grateful to them’.
|
|
|
|
EXCITING NEW DISCOVERY
|
|
Microscopy image of embryonic lung
showing a section of an airway tube
surrounded with smooth muscle (green)
and ADAM33 positive cells (red)
and the nuclei of the cells (blue).
|
AAIR scientists have again attracted worldwide attention following pioneering research, which suggests a known rogue asthma gene plays a key role in the developing lungs of embryos.
The exciting discovery, made by Hans Michael Haitchi and the University of Southampton team, opens up important new research horizons. It could, in time, lead to new treatments or even better prevention of disease by blocking the harmful reactions between the gene and the environment early in life at the origin of the disease.
The research, partly funded by AAIR, follows on from the major breakthrough in 2002 when the gene, Adam33 was discovered through joint research, again involving a Southampton team. This gene was associated with the inheritance of asthma and airway twitchiness and recent studies of young children from parents with asthma or allergy have shown these children with breathing problems have small changes in the Adam33 gene – suggesting it may have effects in early life.
|
Hans and his colleagues concentrated on whether the asthma gene Adam33 was found in the foetus, what role it played in during the earliest stages of airway development and how it might react with an allergic or smoking environment during the embryo’s development
Hans said: “Adam33’s expression in embryonic lung tissue and its interaction with allergy mediators suggest that it plays a key role in airway formation. It could contribute to the development, later in life, of chronic respiratory conditions such as asthma or COPD”
*COPD (chronic obstructive pulmonary disease) is an umbrella term covering chronic bronchitis and emphysema - the top two lung diseases.
|
|
|
|
|
|
|
