There are many tools that can help suggest the presence of food allergies, but, in the end, the most reliable procedure to confirm or exclude a diagnosis of food allergy remains the oral challenge.  But how should allergists perform them?  In this month’s issue of JACI, Drs. Ballmer-Weber and Beyer provide their insights on how to effectively conduct a food challenge (J Allergy Clin Immunol 2018; 141(1): 69-71).   The majority of children with food allergies require such challenges to diagnose their condition, especially younger children with eczema who have skin prick or b ..read more

The rate of food allergies in the United States keeps on rising, but nobody really knows the exact reasons why.  In this month’s issue of the Journal of Allergy and Clinical Immunology, Du Toit and colleagues review the literature and focus on the ‘dual allergen’ hypothesis (J Allergy Clin Immunol 2018; 141(1): 30-40).  Briefly, they explain that allergic sensitization may occur when there is low-level skin exposure to food allergens, while tolerance is more likely to develop in children to have early exposures to food proteins.  The data are mounting from both animal and human ..read more

Asthma affects about 1 in 11 American children, making it one of the most common diseases of childhood.  It carries a huge burden on families, especially during exacerbations when disease activity suddenly flares, leading to breathlessness and even death.  In this month’s issue of JACI, Hoch and colleagues discuss their research in validating the Seasonal Asthma Exacerbation Predictive Index, the saEPI (J Allergy Clin Immunol 2017; 140(4): 1130-1137).  The saEPI is a score ranging from 0 to 16 that can help predict how likely a child is to have an asthma flare.  Using data ..read more

Wheezing is a common complaint among parents of infants.  About 1 in 5 children have acute wheezing illnesses in their first two years of life.  This is important because an overwhelming majority of these wheezing illnesses are related to viruses, and are linked to asthma development.  In this month’s issue of JACI, Jartti and Gern review the role of viral infections in the development of asthma in children (J Allergy Clin Immunol 2017; 140(4): 895-906).  They survey the viruses -rhinoviruses, respiratory syncytial viruses, and others – and how they impact the developing s ..read more

There are hundreds of viruses that cause respiratory tract infections.  While most of us think about them as nuisances causing cough and wheezing, they bear a huge toll on health, especially in people who have lung diseases like asthma and COPD, as well as an economic toll in lost workdays and inappropriate use of medical resources.  In this month’s issue of JACI, Papadopoulos and colleagues look at the treatment and prevention of these diseases (J Allergy Clin Immunol 2017; 140(4): 921-932).  They look at new medications that target the specific viruses in their reproductive p ..read more

Cough is an important reflex we need to remove irritants from the airways, but for many people, a hypersensitive cough reflex can negatively affect quality of life.  A major trigger of chronic cough is airway inflammation from immune cells including type 2 helper T-cells (TH2), but conventional tests required for diagnosis are technically challenging and often require specialist expertise.  Fortunately, measurement of the fractional exhaled nitric oxide (FENO), a potential marker of TH2 airway inflammation, has become much more common in allergy and pulmonary practices.  In this ..read more

Asthma is a complex disease of the airways characterized by inflammation and dynamic airway obstruction.  Despite the single, more recent evidence suggests that asthma is mediated by a set of distinct immune abnormalities.  In this month’s issue of JACI, Silkoff and colleagues report the results of the ADEPT (Airways Disease Endotyping for Personal Therapeutics) study, in which 83 patients with mild, moderate, and severe asthma as well as 25 healthy non-asthmatic subjects were examined for biomarkers of asthma (J Allergy Clin Immunol 2017; 140(3): 710-719).  They underwent bronc ..read more

Along with wheezing illnesses, allergic sensitization during infancy is a major risk factor for childhood asthma.  But how exactly this allergic sensitization occurs is not very well known.  In this month’s issue of JACI, Gern and colleagues look at cytokine responses in 467 inner-city children from the URECA study (Urban Environment and Childhood Asthma) at ages 1 and 3 years (J Allergy Clin Immunol 2017; 140(3): 836-844).  They then examined these cytokine responses in relation to environmental exposures to allergens and endotoxin as well as development of allergic sensitizati ..read more

Until a few years ago, it was thought that microbes don’t live in the lung’s passages.  But now we know that there is a diverse range of microbiota that lives there.  In this month’s issue of JACI, Sverrild and colleagues examine the relationship between these microbes and patterns of airway inflammation in healthy patients and in asthmatics who have not taken steroids (J Allergy Clin Immunol 2017; 140(2): 407-417).  In order to do so, they took 10 healthy participants and 23 nonsmoking steroid-free asthmatics and had them undergo bronchoscopy so that they could get fluid from t ..read more

Cockroaches are small, scurrying insects that we just don’t like to think about.  But as small as they are, they have a large impact on asthma and allergies.  In this month’s issue of JACI, Rabito and colleagues look at the effect of cockroach elimination on asthma outcomes (J Allergy Clin Immunol 2017; 140(2): 565-570).  They build on previous work showing that integrated pest management (IPM) reduces cockroach levels.  But because IPM is s costly and requires special expertise, it is generally not practical for low-income families.  Instead, the authors looked at the ..read more