2010 Annual Scientific Meeting of the American College of Allergy, Asthma & Immunology

The 2010 Annual Meeting of the American College of Allergy, Asthma & Immunology, took place Nov. 11-16 in Phoenix, Arizona. The meeting offered an exciting array of educational sessions for physicians, allied health professionals, office managers and asthma educators.

Eye Allergies Often Overlooked, Undertreated
Millions of Americans unnecessarily experience itchy, gritty, watery eyes. The underdiagnosis, undertreatment, and self-treatment of eye allergies may seriously diminish quality of life.

“For every one eye allergy medicine prescribed, 40 people are treating themselves with over-the-counter eye medicine from their local pharmacy,” said allergist Leonard Bielory, MD, chair of the ACAAI Ocular Allergy Committee. “The over-the-counter product may relieve the symptoms for a short time, but long-term, these patients need to see an allergist who can develop a complete treatment plan to eliminate the disease.”

Eye allergy symptoms are regularly reported as one of the top three allergy complaints, according to the Allergies in America Survey. Forty percent of adults in the United States experience eye allergies, and more than 40 million bottles of eye allergy medicine are sold in the U.S. each year.

“The focus for people with allergies is usually their skin, lungs, and nasal symptoms,” said Dr. Bielory. “But what people don’t realize is that the burning, itching, watery, gritty, or sandy feeling they have in their eyes can and deserves to be treated. Anyone with these symptoms should see an allergist to have their allergies identified and resolved.”

Hate Taking Allergy Drugs? Get Better with Immunotherapy
Antihistamines and nasal steroids offer good short-term options for people with mild allergies, but allergy immunotherapy, better known as “allergy shots,” is a preferred method for achieving long-term remission of more bothersome allergy symptoms.

Beginning with the first published study on inoculation against grass pollen in 1911, allergy immunotherapy has been proven over the past century as a safe, effective treatment against allergens, and for allergic asthma. The treatment stops the source of the problem rather than just treating the symptoms.

The immunization procedure begins with injections of small amounts of purified “extracts” of the substances that cause the allergic reaction. They are approved for this use by the U.S. Food and Drug Administration.

Alternative methods of administration offer promising new treatments on the horizon, including sublingual immunotherapy (SLIT), the absorption of the allergens into the body by keeping drops or tablets in the mouth under the tongue.

Climate Change Grows More Allergen-Producing Plants and Fungi
Ragweed, fungal spores, and poison ivy are thriving due to rising carbon dioxide levels.

“Plant-based respiratory allergies are on the rise, and increased levels of ragweed pollen are in the air,” said ACAAI symposium presenter Lewis Ziska, PhD, a plant physiologist with the USDA Agricultural Research Service. “Climate change is affecting plants and human health, especially allergy sufferers.”

Additionally, leaves fed by heightened levels of carbon dioxide enable fungi to reproduce more rapidly and spread more allergenic spores, leading to higher rates of allergies and asthma.

Climate change also affects allergen levels in homes, schools, and offices. Not only are people allergic to outdoor allergies going to experience more symptoms, so are people with indoor allergies.

“Climate change causes indoor humidity levels to increase, which may contribute to the proliferation of dust mite and mold – allergy triggers for many people,” said allergist and ACAAI member Wanda Phipatanakul, MD. “Furthermore, people stay indoors with higher humidity levels, and allergic individuals then have more exposure to indoor allergens.”

Pumpkin Pie Not a Treat for Some Allergic Children
Your child may be allergic to your holiday pumpkin pie. Although pumpkin is not a food usually associated with allergic reactions, the Annals of Allergy, Asthma and Immunology, the scientific journal of the ACAAI, reported a case study of an eight-year-old boy with known asthma and food allergies who became sick after carving a pumpkin. His symptoms included itchy eyes, sneezing, eyelid swelling, and chest tightness. Allergists say these symptoms can occur after carving or eating pumpkin.

“An allergic reaction to pumpkin can occur even if your child has had no prior reactions,” said pediatric allergist John Kelso, MD, of the ACAAI Pediatrics and Literature Review Committees.

And although your little one may want to catch a caterpillar and see it become a butterfly, case studies show caterpillars can also cause allergic reactions in some children. Direct contact with caterpillars or breathing airborne caterpillar hairs can cause hives or respiratory symptoms. Extensive or prolonged exposure can cause life-threatening anaphylaxis.

Outgrowing Childhood Allergies
The life cycle of childhood allergies was examined to determine how children’s responses to airborne allergens changed over time. While it was known children can outgrow certain food allergies, airborne allergies were thought to only get worse with age. Researchers found that reactions to airborne allergies undergo tremendous changes throughout childhood; and mild allergies early in life frequently disappear as children grow.

Path of the Allergic March
It had been previously thought that allergic children “marched” predictably from eczema to asthma to allergic rhinitis. But recent research found while this is the most common path, it is not as predictable as once thought. Most children who develop one of these conditions will not develop the others. Those who do can start with any one of them and may develop the others in any order. Having eczema, asthma, or allergic rhinitis makes children more likely to have one or more of the others, but there is not a conventional march from one to the next.

Intimate Allergic Reactions Can Be Treated
Even brushing your teeth – or waiting hours after eating – may not prevent some partners of people with food and medicine allergies from triggering an allergic reaction through a kiss.

“If you have food allergies, having an allergic reaction immediately after kissing someone who has eaten the food or taken oral medication that you are allergic to isn’t highly unusual,” said allergist Sami Bahna, MD, ACAAI president. “But some patients react after their partner has brushed his or her teeth or several hours after eating. It turns out that their partners’ saliva is excreting the allergen hours after the food or medicine has been absorbed by their body.”

“Kissing” allergies are most commonly found in people who have food or medication allergies. Symptoms include swelling of the lips or throat, rash, hives, itching, and wheezing. So what are lovebirds to do? Allergists recommend that the nonallergic partner brush his or her teeth, rinse his or her mouth, and avoid the offending food for 16 to 24 hours before smooching with a person who is highly allergic to that food. But even these steps may not help in some cases.

When things turn more intimate, allergies can be disruptive as well. Allergists have seen cases of people experiencing allergies to chemicals in spermicides, lubricants, latex, or even a partner’s semen. Some people develop hives or wheezing from the natural chemicals released by their body by the emotional excitement or physical exertion during sexual interaction.

For people allergic to their partner’s semen, Dr. Bahna suggests the use of condoms or desensitization (immunotherapy). Preventative antihistamines may be helpful in mild cases.

Allergic To Bed Bugs?
Want another reason to fear bed bugs? They can sometimes set off allergic reactions, asthma attacks, and anaphylaxis.

Most individuals bitten by bed bugs get red bite marks that are mildly itchy. But those who are allergic can experience intense itching, swelling, redness, hives, and blisters. The bugs can trigger asthma if a large group of them becomes airborne. And, although rare, those who are highly allergic to the bites may experience anaphylaxis, a life-threatening reaction that can cause trouble breathing, hives or swelling, or tightness of the throat.