Daily Archives: December 3, 2021

Eczema, asthma, and allergies sometimes occur together. Doctors call this the atopic triad. Eczema, common in babies and children, is a risk factor for later developing asthma and allergies.

All three conditions cause inflammation, which may help explain the link. Moreover, both eczema and allergies happen when the immune system secretes inflammatory chemicals.

In the case of allergies, the immune system overreacts to harmless substances, while eczema may cause a persons body to attack itself.

Doctors do not yet fully understand the atopic march, the tendency for eczema to develop into allergies and asthma. But the presence of one condition in the triad is a clear risk factor for another, which may help people with symptoms, their caregivers, and healthcare professionals anticipate symptoms and make treatment decisions.

In this article, we cover the link between eczema, asthma, and allergies and look at how to manage these conditions.

The atopic triad refers to the tendency of asthma, eczema, and allergies to occur together. The progression typically begins with eczema, followed by food allergies, and then the development of asthma and allergic rhinitis, which causes sneezing and a runny nose. Doctors also call this progression the atopic march.

Early research found that immunoglobulin E (IgE) plays a role in the triad. IgE is an antibody involved with the functions of the immune system, such as inflammation. While inflammation is important in these three conditions, we now know that IgE is not present in all cases of asthma, allergies, or eczema.

According to a 2018 paper, 20% of children with mild eczema develop asthma, while 60% with severe eczema develop asthma.

A 2021 study similarly linked eczema to the later development of peanut allergies, especially if the eczema is severe. The study included 321 babies. Peanut allergies developed in 18% of the babies with eczema, 19% with other food allergies, and 4% who had a relative with a peanut allergy. This suggests that eczema and other allergies better predict peanut allergies than genetics.

While people with one symptom in the triad are more likely to develop other symptoms, having one symptom does not guarantee the development of others. A 2014 cohort study of 9,801 children found that only about 7% of children with at least one symptom develop symptoms consistent with the atopic march.

Doctors do not fully understand the atopic march. Several underlying factors, such as genetic differences in immune response and inflammation, may help explain it.

Some evidence suggests that exposure to allergens through eczema-damaged skin may trigger immune system responses that lead to inflammation and allergies. Data from mice, for example, show that certain kinds of peanut exposure on the skin increase the risk of sensitivity to milk.

Environmental factors may also play a role. Children exposed to farm animals, for example, have a lower risk of atopic march, while antibiotics seem to increase the risk.

Because atopic march begins with eczema, doctors have focused on how eczema might influence the development of later symptoms. Some evidence suggests that early eczema treatment may help prevent subsequent allergies and asthma, perhaps by preventing exposure to allergens through a damaged skin barrier.

It is not possible to manage the three symptoms with a single treatment. Instead, treatment focuses on managing each symptom individually.

New research into biological therapies to treat these conditions is ongoing.

Keeping the skin well-moisturized is critical for people with eczema since the skins moisture barrier is damaged. This makes the skin dry out faster and more severely. Anti-inflammatory medication such as hydrocortisone can help. When itching is intense, a doctor may recommend antihistamines.

Identifying triggers can help reduce the frequency and severity of flares. This includes avoiding exposure to environmental allergens.

Learn more about treatment options for eczema here.

Avoiding allergens is critical for people with severe, life threatening allergies that cause anaphylaxis. For milder allergies, such as seasonal respiratory allergies, remaining indoors, using an air filter, and limiting contact with allergens may help.

Depending on the allergen, a person may undergo immunotherapy, or allergy shots, which helps desensitize the body. People with severe, life threatening allergies may need to carry an EpiPen for emergencies.

Learn more about allergy treatments here.

Treating asthma requires identifying and avoiding asthma triggers, which may include allergens. Some people have asthma attacks when they are stressed, so calming strategies like deep breathing and meditation can help.

During an asthma attack, a person may need to use an inhaler to take a corticosteroid. A person may need other medications for severe asthma. When an asthma attack does not relent, a person may need to go to the hospital.

Learn more about treatments for asthma here.

A different triad, Samters triad, suggests that people with asthma are more likely to develop nasal polyps and aspirin intolerance. Researchers do not know why this happens, but nonallergic hypersensitivity reactions may be to blame.

Samters triad involves inflammation like the atopic triad, but the inflammatory patterns are different. Samters triad does not involve IgE.

Aspirin and some other anti-inflammatory drugs inhibit the expression of the enzyme cyclooxygenase-1. People with Samters triad who take these drugs develop respiratory symptoms similar to an allergic reaction. Most also develop respiratory symptoms after drinking alcohol.

Although the triad of asthma, allergies, and eczema are distinct from Samters triad, people with asthma have a higher risk of this triad. And because people with allergies and eczema have a higher risk of asthma, they may also have an elevated risk for Samters triad.

A doctor can help with treating any of these conditions. People should speak with a doctor about symptoms of eczema, allergies, or asthma. It is especially important to seek help if symptoms are severe, such as if eczema cracks open and bleeds, allergies cause breathing difficulties, or asthma attacks are severe or frequent.

People undergoing treatment for these conditions should also contact a doctor if:

Asthma, allergies, and eczema all correlate with high levels of inflammation and disproportionate reactions to harmless substances. While most people who have one condition will not develop all three, they are much more likely to develop another triad disorder than those who do not have one.

Though these conditions tend to occur together, doctors cannot treat them as a single diagnosis. Instead, the presence of one component of the triad merely predicts that a person might develop another.

A knowledgeable doctor can help with properly diagnosing asthma, eczema, and allergies and appropriately treating them.

Excerpt from:
The triad of asthma, eczema, and allergies explained - Medical News Today

Older age, male sex, and other medical conditions not associated with heightened risk .Unlike Asian ethnicity, obesity, overcrowding, socializing, and people-facing roles.

People with allergic conditions such as hay fever, rhinitis, and atopic eczema, may have a lower risk of COVID-19 infection, especially if they also have asthma, finds a large, population-based study of UK adults, published online in the respiratory journalThorax.

And contrary to the findings of recent studies, older age, male sex, and other underlying conditions arent linked to a heightened risk of infection, the research indicates.

But Asian ethnicity, obesity, household overcrowding, socializing indoors with other households, and holding down a people-facing role other than in health and social care are all independently associated with a heightened risk of developing COVID-19, the findings show.

A growing body of evidence suggests that at least some risk factors for developing COVID-19 may differ from those which predispose to severe disease and the need for intensive care, say the researchers.

To explore this further and glean what contribution demographic, socioeconomic, lifestyle, diet, medical treatment and underlying conditions might make to the risk of developing COVID-19, the researchers captured detailed information on potential risk factors for the infection among UK adults between May 2020 and February 2021.

All participants were asked to provide information on their age, household circumstances, job, lifestyle, weight, height, long-standing medical conditions, medication use, vaccination status, diet, and supplement intake when they joined the study and then again in subsequent months.

Out of 16,081 eligible people, 15,227 completed at least one subsequent monthly follow-up questionnaire 30 days or more after joining the study; and 14,348 completed the final questionnaire on or before 5 February 2021.

The average age of the participants was 59; 70% were women; and 95% identified their ethnic origin as white.

In all, 446 participants (almost 3%) had at least one episode of confirmed COVID-19 infection, as determined by swab (PCR or lateral flow) test during the study period, and 32 were admitted to hospital.

The researchers accounted for an array of potentially influential factors: age: sex: length of participation in the study: ethnicity: testing frequency: ethnicity; education; deprivation; household income; housing type; number of people per bedroom; schoolchildren at home; ownership of a pet dog; shielding; socialising with other households; visits to shops and other indoor public places; travel to work or study; frontline worker status; physical activity; alcohol intake; weight (BMI); asthma; allergies; use of immune suppressant drugs, inhaled corticosteroids, and bronchodilators; BCG vaccination status; fruit, vegetable, and salad intake; and use of nutritional supplements.

Certain factors consequently emerged as being independently associated with increased odds of developing COVID-19.

People of Asian/Asian British ethnicity were more than twice as likely to become infected as their white counterparts.

Similarly, household overcrowding; socializing with other households in the preceding week; number of visits to indoor public places; a people-facing role other than in health and social care; and overweight/obesity were all associated with a heightened risk.

And the greater the number of people sharing a household and the higher the number of visits made to indoor public places, the higher were the odds of becoming infected, the findings showed.

But atopic (triggered by allergens) disease, which includes eczema/dermatitis and hay fever/allergic rhinitis, was independently associated with 23% lower odds of developing the infection than it was in those without atopic disease or asthma.

And among those who had atopic disease and asthma, the risk was even lower: 38%.This association held true even after factoring in the use of steroid inhalers.

Taking drugs to dampen down the immune system response (immunosuppressants) was also associated with 53% lower odds of COVID-19 infection, although this may reflect greater shielding from infection by these patients, say the researchers.

But age, sex, other medical conditions, diet, and supplement use werent associated with infection risk.

This is an observational study, and as such, cant establish cause. And the researchers acknowledge some limitations to their study.

These include no oversight of swab testing and reliance on the results of routine testing that will usually have been prompted by symptoms, so potentially missing those with symptomless infection.

Participants also volunteered themselves, so some ethnic minorities, particularly people of black, African, and Caribbean ethnicities, were underrepresented in the study.

Nevertheless, the researchers conclude: This large, population-based prospective study shows that there is limited overlap between risk factors for developing COVID-19 versus those for intensive care unit admission and death, as reported in hospitalized cohorts.

Reference: Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK) by Hayley Holt, Mohammad Talaei, Matthew Greenig, Dominik Zenner, Jane Symons, Clare Relton, Katherine S Young, Molly R Davies, Katherine N Thompson, Jed Ashman, Sultan Saeed Rajpoot, Ahmed Ali Kayyale, Sarah El Rifai, Philippa J Lloyd, David Jolliffe, Olivia Timmis, Sarah Finer, Stamatina Iliodromiti, Alec Miners, Nicholas S Hopkinson, Bodrul Alam, Graham Lloyd-Jones, Thomas Dietrich, Iain Chapple, Paul E Pfeffer, David McCoy, Gwyneth Davies, Ronan A Lyons, Christopher Griffiths, Frank Kee, Aziz Sheikh, Gerome Breen, Seif O Shaheen and Adrian R Martineau, 30 November 2021 2021, Thorax.DOI: 10.1136/thoraxjnl-2021-217487

See more here:
People With Allergic Conditions Such As Hay Fever and Eczema May Have a Lower Risk of COVID-19 Infection - SciTechDaily

Topical asivatrep, a transient receptor potential vanilloid subfamily V member 1 (TRPV1) antagonist, has been shown to be more effective than placebo in patients with mild to moderate atopic eczema. This was the finding from a Phase III trial by researchers from the Department of Dermatology, Hallym University, South Korea.

TRPVI is a non-selective cation channel which is expressed by keratinocytes, mast cells and sensory neurons related to itch, especially itch related to the release of histamine. Moreover, in vitro study data suggests that antagonism of TRPVI can suppress the atopic eczema-like symptoms by accelerating recovery of the skins barrier. More specifically, in animal models of atopic eczema-like dermatitis, topical asivatrep, has demonstrated improvements in eczema symptoms and the barrier function of the skin. In a dose ranging clinical study in adults with atopic eczema, topical asivatrep 1% was found to provide the greatest improvement in disease severity.

For the present study, the Korean team used a 1% formulation of asivatrep based on the results of the dose ranging study, for a Phase III, randomised, double-blind, placebo-controlled trial. Included patients were aged 12 years and older, with mild to moderate atopic eczema, defined by an investigators global assessment (IGA) score of 2 (mild) or 3 (moderate), and which affected between 5 and 30% of their body. The primary efficacy endpoint of the trial was the proportion of patients with an IGA score of 0 or 1 (i.e., clear or almost clear) after 8 weeks of treatment. Secondary endpoints included changes in EASI score, a pruritus visual analogue scale (VAS) score and a sleep disturbance score at several time points, including week 8.

Findings

A total of 240 patients with a mean age of 25.6 years (45.6% female) were included in the analysis with 157 assigned to topical asivatrep. Most (58.3%) had moderate severity atopic eczema. However, due to withdrawals and patient violations, the final analysis was based on a sample of 231 patients (153 asivatrep).

After 8 weeks of treatment, the proportion of patients achieving an IGA score of 0/1 was 36% in the asivatrep group and 12.8% in the placebo arm (p < 0.001). With respect to EASI scores, the greatest difference was observed at week 8 (44.3% vs 21.4%, asivatrep vs placebo, p < 0.001), with 9.8% of those receiving asivatrep achieving an EASI90 (i.e., 90% reduction in EASI score) compared to only 2.6% in the placebo group (p = 0.046).

There were also significant reductions in pruritus VAS scores and measures of sleep disturbance with asivatrep. In terms of safety, topical asivatrep was well tolerated and while the incidence of treatment-emergent adverse effects was slightly higher with asivatrep compared to placebo, the difference was non-significant.

The authors concluded that treatment with asivatrep cream, as a first-in-class topical agent, may be a novel treatment for patients with atopic eczema.

Citation

Park CW et al. Asivatrep, a TRPV1 antagonist, for the topical treatment of atopic dermatitis: Phase 3, randomized, vehicle-controlled study (CAPTAIN-AD). J. Allergy Clin Immunol 2021

More here:
Topical asivatrep, a TRPVI antagonist, effective for adults with atopic eczema - Hospital Healthcare Europe

New research will delve further into the benefits of superfine Merino wool when it comes to skin conditions such as eczema.

Research has previously shown that wearing superfine Merino wool significantly improves the severity and symptoms of eczema.

Now Australian Wool Innovation is aiming to validate the successful Australian and US-based skin health studies that already exist by assessing wool's impact on childhood eczema sufferers across different climates throughout the world, teaming up with researchers in Chicago, USA and Trondheim, Norway.

How different skin types might be affected by wool will also come under scrutiny.

Associate Professor John Su is coordinating the international studies, having previously led a study through the Murdoch Children's Research Institute that proved wearing superfine Merino wool next to the skin reduced the severity of childhood eczema compared to cotton clothing.

He said that even with a small sample size of 40 children, the results showed that the effect was significant.

"In Australia we can say with some certainty that amongst the cohort that we dealt with that there were apparent benefits there," he said.

"The problem with that is you can't really generalise to all populations, so having different climates and different groups and also having a larger population to analyses just means that you can get clarification if we can reduplicate those findings across different countries and narrow down on how much potential benefit there could be."

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A/Prof Su said variables such as medication and weather conditions also played a role in how eczema presents in individual children, so having more data was essential.

While there has been research showing that wearing superfine Merino wool can benefit adult eczema sufferers, these studies will specifically babies and young children as they have the highest prevalence of eczema.

"In Melbourne about 30 per cent of infants have some eczema, in children as a whole it's somewhere around 15 to 20pc and then in adults around 7 to 10pc," A/Prof said.

"We're hoping if we can show wool's effect in the young age group we would be dealing with a lot of eczema sufferers and early intervention may have benefits as well."

The effort it will take to change public mindsets around wool's role in treating sensitive skin is also something scientists are keenly aware of.

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"The problem is we're dealing with decades of fixed ideas and what we had seen when we did our literature review is a lot of the general public feelings have been based on data from the mid 1900s as well as people's experience with the old kind of coarser wools and no one has really treated fabrics with much seriousness in eczema," A/Prof Su said.

Both international studies have been significantly delayed by COVID shutdowns with the Chicago research about a quarter of the way through and work in Norway still suspended but planned to start in early 2022.

The two studies, which will each recruit about 50 children, are expected to be complete by December 2022.

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The story Wool benefits for childhood eczema probed in further studies first appeared on Farm Online.

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Treating eczema with wool: international studies underway - The Land Newspaper

I caught Omicron variant in LONDON around the same time it was discovered in South Africa, doctor claims

A doctor who was one of the worlds first people to be infected with the Omicron Covid variant believes he caught it in London, it was reported.

Elad Maorwas in the UK for a conference for three days until November 23, around the time the more virulent strain was detected by researchers in South Africa.

The 45-year-old Israeli cardiologist stayed for four nights at a hotel in Islington and experienced symptoms after returning home, then tested positive on November 27.

I got the Omicron in London, for sure, he toldThe Guardian.

That is interesting because that was 10 days ago in London really, really early.

The father-of-three explained he took a PCR test on November 20 after arriving in the UK and again the next day, in accordance with Israeli travel regulations, with both results negative.

When he arrived back inTel Aviv on November 24, he had a third PCR test, which also came back negative.

He said the only reasonable explanation is that he got infected on the last day of the meeting or possibly at the airport because the third PCR was too early to detect the infection.

Continued here:
Omicron variant news Having asthma, hay fever or eczema REDUCES risk of covid infection by a massive 4... - The Sun