More briefs from AAAAI conference 2012

[CMdeux]

I'm just going to post a few things that I've run across that seem pertinent to our community.  There's LOTS more to be found directly at AAAAI's direct link to the annual meeting, and

www.medpagetoday.com is even having live press conference coverage at their FB page:  https://www.facebook.com/MedPageToday?sk=app_142371818162





Kids Beat Egg Allergy with Tolerance Tx


Well...  75% seem to improve tolerance, anyway.

But there's still no way to know who's who.

After 22 months of immunotherapy, 75% of children had been desensitized, meaning that the threshold dose that triggers a reaction has been raised, whereas no children who had received placebo became desensitized (P<0.001), according to Stacie M. Jones, MD, of the University of Arkansas in Little Rock, and colleagues.

In addition, 27.5% had become functionally tolerant, meaning that there had been long-term loss of allergic reactivity as demonstrated on an oral food challenge. Again, no children on placebo became tolerant (P=0.025), the researchers reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

After 22 months of immunotherapy, 75% of children had been desensitized, meaning that the threshold dose that triggers a reaction has been raised, whereas no children who had received placebo became desensitized (P<0.001), according to Stacie M. Jones, MD, of the University of Arkansas in Little Rock, and colleagues.

In addition, 27.5% had become functionally tolerant, meaning that there had been long-term loss of allergic reactivity as demonstrated on an oral food challenge. Again, no children on placebo became tolerant (P=0.025), the researchers reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Parents need more education on symptoms, risks of anaphylaxis in children with egg allergy


Howe LE. #122. Parental perceptions of anaphylaxis in children with egg Allergy. Presented at: The AAAAI 2012 Annual Meeting; March 2-6, 2012; Orlando, Fla.

The upshot is that parents don't recognize anaphylaxis FAR more often than they overestimate severity, and that epinephrine is WAY under-utilized.

That one isn't a big surprise, but what was is that parents don't necessarily focus on breathing as a marker. 

[CMdeux]

Many Asthmatics Do Well on Food-Allergy Tests, Study Finds


Ugh.... well, I am reporting it, since it's being presented at AAAAI's annual conference, but mostly I'm reporting it because this is the kind of "study" that drives me NUTS as a scientist. 

This is effectively a collection of anecdotes that the authors have cobbled together and decided to call data, from what I can tell.

In the study, researchers from the Medical College of Wisconsin and the Children's Hospital of Wisconsin reviewed the charts of 105 patients with food allergies who ranged in age from 9 months to 74 years old. About three-quarters of the patients had asthma.

About 21 percent of those who didn't have asthma failed food challenges, meaning they had a reaction such as hives, cough or wheezing after being exposed to the food. Less than 13 percent of the asthmatic patients failed the food challenge.

"A diagnosis of asthma was not associated with a higher food-challenge failure rate, which suggests that food challenges should be encouraged in this population," senior study author Dr. Monica Vasudev said in a news release from the American Academy of Allergy, Asthma and Immunology (AAAAI).

Dontcha think that just MAYBE clinicians use a different standard for those patients with asthma??  Maybe asthmatic patients are LESS likely to be offered IOFC when they are not extremely likely to pass those challenges...  Selection bias, much?

[CMdeux]

Food-specific IgE levels rise after positive food challenge but drop to baseline

Yiqun Hui, MD, PhD, from the division of allergy and clinical immunology at The Mt. Sinai School of Medicine in New York, and colleagues conducted the study to determine the impact of a positive (failed) oral food challenge (OFC) on serum IgE levels.

"With a child fails an OFC, there is always a question about the encounter of the allergy during the OFC and whether that will have any impact on later recovery from food allergy," Hui told Infectious Diseases in Children. "At this moment, we do not have that kind of data."

The researchers found that food specific IgE levels were transiently elevated in the year following a positive OFC, but fell toward baseline afterwards.

What this suggests is that exposure which causes a reaction doesn't seem to cause LONG-TERM damage to a child's chances of outgrowing...

and

that an IgE value may remain elevated for a LONG, LONG time after a reaction.  Very interesting!

[Macabre]

Any reason not to do this in the thread already created?  I do think it needs a different subject line.

[CMdeux]

Treatment for food allergies showing progress

Robert A. Wood, MD, director of Allergy & Immunology at Johns Hopkins Children's Center, presented new study results that indicated children with severe milk allergy who received a longer schedule of sublingual immunotherapy and then moved to oral immunotherapy had less respiratory reactions, along with less frequent use of certain medications.

"While the overall result of the study, which was recently published in The Journal of Allergy and Clinical Immunology, found that oral was far more effective than sublingual immunotherapy, it was also clear that oral was associated with more significant allergic reactions to the treatment," Wood, who is the senior study author, said in a press release.

The difference between sublingual and oral immunotherapy is that the allergen is held under the tongue with sublingual, where the allergen is simply swallowed with oral immunotherapy.

Previous research by Wood and colleagues compared sublingual therapy (allergen is held under the tongue) with oral immunotherapy (allergen is swallowed) after a short period of increasing sublingual doses. In the current study, the same researchers from Johns Hopkins and Duke University tested patients to determine if a longer period on sublingual and then oral immunotherapy would improve the safety of the treatment.

(This hypothesis seems to have been validated by the study, btw.)


•Wood RA. #478. Prolonged exposure to sublingual immunotherapy improves safety of oral immunotherapy. Presented at: The AAAAI 2012 Annual Meeting; March 2-6, 2012; Orlando, Fla.

[CMdeux]

Any reason not to do this in the thread already created?  I do think it needs a different subject line.

<shrug>

I just figured that this includes abstract numbers and such, rather than physician notes on the fly-- might be a good idea to LINK the two threads, though, even if we don't merge them.  I know some people don't like the Twitter format, too, and it necessarily includes a LOT of abbreviations and acronyms.  There is bound to be some repeated info. 

[CMdeux]

Peanut OIT improved food-related quality of life


LOL... I know, I know.... they needed a study to show this??!! 

"It has been demonstrated that patients who have food allergies have significant impairment in their quality of life," Factor told Infectious Diseases in Children. "What we have begun to do with our specific treatment is to desensitize children — as well as some adolescents and young adults — by oral desensitization to peanut, and measure the changes in the quality of life they experience from the outset until they reach their maintenance dose."

---------------------------------------------------------------------

Parents' surveyed assessment of children's quality of life demonstrated clinically significant improvement in 7/8 (87.5%) questions in the domain of food-related anxiety, 8/13 (61.5%) in emotional impact and 8/9 (88.9%) in social and dietary limitations.

"What we have observed is a significantly improved quality of life in terms of parent's perception of the children's experiences, adolescents and the children themselves," Factor said. "The data is quite robust, and of course, it is very rewarding to see families less anxious and less concerned about peanut allergy from the process of desensitization."

•Factor JM. #112. Presented at: the 2012 AAAAI Annual Meeting; March 2-6, 2012; Orlando, Fla.

[Macabre]

Well, you have more time than I do I guess!

[CMdeux]

Oh, I just think that both things have value independently.   

[Mezzo]

I find Twitter really hard to read (no offense intended).  So this is easier for me to absorb.

[suevv]

Thanks CMDeux.  This is a great summary (and I do find twitter to be annoying).

Non sequitur:  By the way - love your sig quote.  And you'll like this one from my son.  Whenever he is wondering something he asks me - "Mommy who does ...."  If I hesitate at all in answering (sometimes he asks hard ones), he says, "Mommy, I'm asking you because scientists know how to figure things out."

[CMdeux]

LOL. Not to worry, at some point down the road, he'll awaken to the notion that parents are inherently dumb and know nothing...  ask me how I know??      I hear that my IQ stands to recover somewhat in a few years, though. 


I like Twitter myself... so I definitely wasn't trying to suggest that Mac's thread wasn't a good idea.  I really enjoyed reading it.  Maybe even more because I find actually "following" feeds on Twitter to be a little more than my senses can take most of the time.   

[Macabre]

Well, it was eragon's actually. No, I was just confused about having two threads for the same thing. I have always been anal about that. Lol  Since we moved to our second location in 2007.

I can totally appreciate how folks may not like to wander through twitter conventions. But I thought it was enough to put more info here---really interesting and helpful stuff that we as a community do not normally have access to. But it's not like I have time to clean it up.

Heck, there's an awful lot of stuff I have had to wade through over the years to learn about this allergy, about all the legal stuff for a 504, etc., where I didn't particularly like the formatting, but it was the info I was after, yk? That's just an aside.

But I was worried about having content in two different places. I tend not to click on links when threads are related.

[CMdeux]

Nice thing here is that we have the merge, so we can temporarily keep the two things here, and when they drop off the front page, just merge them together and tag them so that they are easy to find in a search later.     LOVE that about here.

[suevv]

Ladies - including Eragon - thanks to you all for these postings, twitter and otherwise.  I surely didn't mean to suggest the twitter summaries were not appreciated.  Just the opposite - because you are right Macabre, I just can't filter well enough on Twitter and inevitably get lost looking for content I want.  This was just perfect.

Sue