Fungal infections can trigger and exacerbate asthma

A common fungal infection can trigger asthma and make it much worse by way of a route not targeted by existing asthma drugs, report researchers at Boston Children’s Hospital. Their findings, published online by Nature Medicine on September 1, have implications for some patients with severe asthma who may be chronically exposed to fungi and can become highly sensitized.

The findings from this mouse study explain why existing asthma drugs don’t work well in fungal-associated asthma. “As we understand the different pathways to asthma, we can develop better therapies,” says senior investigator Dale Umetsu, MD, PhD , of Boston Children’s Division of Immunology and also a professor at Harvard Medical School. “Most existing therapies are good for allergic asthma, but they’re not effective in many patients, whose asthma may involve non-classical pathways.”

When Umetsu and colleagues exposed the mice to the fungus Aspergillus fumigatus, a mold common in the indoor and outdoor environment, they developed airway hyperreactivity, the cardinal feature of asthma, within just a few days. Since allergic responses in mice typically take 10 to 14 days to develop, this finding suggested that the fungus triggers an immediate, innate immune response.

Traditional asthma-control drugs, such as inhaled corticosteroids, act on pathways involving Th2 cells, a type of T cell in the adaptive immune system that is important in allergy. However, the new study shows, in mice and in human cell cultures, that Aspergillus directly activates a recently discovered group of T cells, known as natural killer T cells (NKT cells), via a lipid molecule on its surface, asperamide B. In live mice, asperamide B alone was enough to induce airway hyperreactivity.

Umetsu and colleagues first showed in 2006 that NKT cells can trigger asthma in people in the absence of Th2 cells. The cells have been shown to be activated by various bacteria, but this is the first demonstration of their activation by a fungus.

Although Aspergillus and NKT cells initiate asthma through non-allergic means, patients can become sensitized to the fungus and develop chronic allergic reactions that make their respiratory disease more severe. Previous studies indicate that 28 percent of patients with asthma and 45 percent of patients with severe asthma become sensitized to Aspergillus.

Umetsu’s investigations support the growing idea that asthma is a collection of different disease processes that all cause airways to become twitchy and constricted.  In 2011, for example, his lab showed that influenza infection—which often requires asthmatic children to be hospitalized—exacerbates asthma by activating not Th2 cells or NKT cells, but yet another group of immune cells called natural helper cells or innate lymphoid cells.

“We need to understand the specific asthma pathways present in each individual with asthma and when they are triggered, so we can give the right treatment at the right time,” Umetsu says.

Some academic research groups are using antifungal agents in asthma, with some success, Umetsu notes. In the future, he would like to target NKT cells in patients with severe asthma if a successful targeting method could be found.

Tips to Make Your Next Pharmacy Visit the Best Ever

Going to your local pharmacy does not have to give you or the pharmacy staff a headache. There are many things that you can do and remember to make these trips productive and less time consuming.

Know something about your prescription

By knowing the prescription number or the name of your medication it provides the pharmacy with less chances of making a mistake. On the front of your bottle you will find your prescription number and the name of your medication. Even if you can only give a generic name or spell the beginning of the medicine name this will give the staff a better clue has to how to help you the best.

Use one pharmacy

With competitive pricing it can be tempting to go to many different pharmacies for different medicines. This can be a deadly mistake. If the pharmacy staff does not know all the medicine that you are taking then they will not be aware of possible interactions. Most pharmacies are equipped with computer software that will electronically check your current medication with the new ones you turn in. By going to different pharmacies the chances of catching a potentially serious interaction are lessened. There is really no price on your health so please pick one pharmacy and stick to them.

Research your state’s privacy laws

In some states it is illegal to release any information to other family members if the patient is over 18 years old. If you need a printout for tax purposes you may not be able to pick up your spouse’s information with them. You may not be able to be told the name of a medication that is waiting for someone else in the family. Every state is different so researching your own states privacy practices will avoid lots of unexpected surprises and conflict. Along with the privacy practices of each state, it would be good to know the return policy of your pharmacy. Some pharmacies can not take a medication back once it has left the store, so you want to check while your there that it is what you wanted.

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New Survey Reveals the Impact of Nasal Allergies on Sleep, Relationships and Productivity

LANDOVER, Md., April 23, 2013 /PRNewswire/ – The Asthma and Allergy Foundation of America (AAFA) and Teva Respiratory released results today from a new survey which showed that more than half (59 percent) of nasal allergy sufferers polled reported sleep issues as a result of their allergy symptoms, yet only 35 percent proactively treat their nasal allergy symptoms.  Furthermore, nearly half of those surveyed (48 percent) said their nasal allergy symptoms, such as nasal congestion and sneezing, also interrupted their partner’s sleep.

The survey is part of Ditch the Drip: Get Serious about Nasal Allergies , an educational program that features Misty May-Treanor, three-time Olympic beach volleyball gold medalist and nasal allergy sufferer. May-Treanor has teamed up with the program for the second year to elevate the seriousness of nasal allergies and educate the 60 million Americans suffering from nasal allergies about the need for proactive preparation in advance of peak allergy seasons. For more information on the survey findings and resources for those suffering from seasonal or year-round nasal allergies, visit www.DitchtheDrip.com.

“I made the difficult decision to retire from international beach volleyball after the 2012 Olympic Games, but I still lead an incredibly active lifestyle,” said Misty May-Treanor, Olympic athlete and Ditch the Drip spokesperson. “As I move into this next chapter of my life, I’m focused on spending quality time with my husband and pursuing both professional and educational goals, so suffering from bothersome nasal allergy symptoms just doesn’t fit into my plans. By continuing my partnership with Ditch the Drip, I hope to show others that they don’t have to miss out on doing the things they love just because they’re suffering from nasal allergies. By being proactive about scheduling appointments with their doctors in advance of peak allergy seasons, people with allergies can avoid being sidelined by their pesky symptoms.”

Beyond survey results related to sleep quality, additional findings include:

  • 57 percent of survey respondents noted they’ve experienced difficulty concentrating at work
  • 61 percent said they cannot enjoy the outdoors with their children as much as they would like due to their nasal allergies
  • 71 percent indicated they typically only treat their nasal allergies when they are experiencing symptoms or a flare-up

“This survey further reinforces that although many people are significantly impacted by their nasal allergies, they are doing very little to avoid the onset of their burdensome symptoms,” said Bill McLin, President and CEO of AAFA. “As such, we are thrilled to continue our partnership with Misty and Teva Respiratory on the Ditch the Drip program to help provide people with nasal allergies with tools and resources they can use to better prepare for peak allergy seasons and nip their symptoms in the bud.”

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