Tag Archives: Asthma

Marijuana use linked to increased asthma risk in youth, says study: ‘Worrisome’ health implications – Fox News

  1. Marijuana use linked to increased asthma risk in youth, says study: ‘Worrisome’ health implications Fox News
  2. Cannabis use may increase asthma risk, study finds Medical News Today
  3. Asthma More Common Among High School Students Who Use Cannabis AJMC.com Managed Markets Network
  4. Madison County Health Alert: Rising Asthma Rates in Teens Linked to Legal Cannabis. Doctor Explains Manchestertimes
  5. Study Reveals Link Between Cannabis Use and Current Asthma Prevalence in U.S. Adolescents and Adults Columbia University’s Mailman School of Public Health

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A US federal agency is considering a ban on gas stoves


New York
CNN
 — 

A federal agency is considering a ban on gas stoves as concerns about indoor pollution linked to childhood asthma rise, Bloomberg first reported.

A US Consumer Product Safety commissioner told Bloomberg gas stove usage is a “hidden hazard.”

“Any option is on the table. Products that can’t be made safe can be banned,” agency commissioner Richard Trumka Jr. said in a Bloomberg interview. The report said the agency plans “to take action” to address the indoor pollution caused by stoves. CNN has reached out to the CPSC for comment.

The CPSC has been considering action on gas stoves for months.Trumka recommended in October that the CPSC seek public comment on the hazards associated with gas stoves. The pollutants have been linked to asthma and worsening respiratory conditions.

A December 2022 study in the International Journal of Environmental Research and Public Health found that indoor gas stove usage is associated with an increased risk of current asthma among children. The study found that almost 13% of current childhood asthma in the US is attributable to gas stove use.

Trumka told Bloomberg the agency plans to open public comment on gas stove hazards. Options besides a ban include “setting standards on emissions from the appliances.”

Thirty-five percent of households in the United States use a gas stove, and the number approaches 70% in some states like California and New Jersey. Other studies have found these stoves emit significant levels of nitrogen dioxide, carbon monoxide and fine particulate matter – which without proper ventilation can raise the levels of indoor concentration levels to unsafe levels as deemed by the EPA.

“Short-term exposure to NO2 is linked to worsening asthma in children, and long-term exposure has been determined to likely cause the development of asthma,” a group of lawmakers said in a letter to chair Alexander Hoehn-Saric, adding it can also exacerbate cardiovascular illnesses.

The letter – Sen. Corey Booker and Sen. Elizabeth Warren among its signers – argued that Black, Latino and low-income households are more likely to be affected by these adverse reactions, because they are either more likely to live near a waste incinerator or coal ash site or are in a home with poor ventilation.

In a statement to CNN, the CPSC said the agency has not proposed any regulatory action on gas stoves at this time, and any regulatory action would “involve a lengthy process.”

“Agency staff plans to start gathering data and perspectives from the public on potential hazards associated with gas stoves, and proposed solutions to those hazards later this year,” the commission said in a statement. “Commission staff also continues to work with voluntary standards organizations to examine gas stove emissions and address potential hazards.”

Some cities across the US banned natural gas hookups in all new building construction to reduce greenhouse emissions – Berkeley in 2019, San Francisco in 2020, New York City in 2021. But as of last February, 20 states with GOP-controlled legislatures have passed so-called “preemption laws” that prohibit cities from banning natural gas.

“To me that’s what’s interesting about this new trend, it seems like states are trying to eliminate the possibility before cities try to catch onto this,” Sarah Fox, an associate law professor at Northern Illinois University School of Law, told CNN last year. “The natural gas industry… has been very aggressive in getting this passed.”

In a statement to CNN Business, the Association of Home Appliance Manufacturers said an improvement in ventilation is the solution to preventing indoor air pollution while cooking.

“A ban on gas cooking appliances would remove an affordable and preferred technology used in more than 40% of home across the country,” Jill Notini, industry spokesperson, said in a statement. ” A ban of gas cooking would fail to address the overall concern of indoor air quality while cooking, because all forms of cooking, regardless of heat source, generate air pollutants, especially at high temperatures.”

The American Gas Association pushed back against a natural gas ban in a blog post in December, saying it makes housing more expensive as “electric homes require expensive retrofits.”

However, Biden’s landmark Inflation Reduction Act includes a rebate of up to $840 for an electric stove or other electric appliances, and up to an $500 to help cover the costs of converting to electric from gas.

– CNN’s Ella Nilsen contributed to this report.

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Study tries to see if child vaccines and asthma are linked

NEW YORK (AP) — A number of scientists have wondered if aluminum, a vaccine additive that has been used for decades, had a role in allergies and asthma in children.

A new federally funded study has found a possible link, but experts say the research has important shortcomings and is not a reason to change current vaccine recommendations. The study doesn’t claim aluminum causes the breathing condition, and officials say more work is needed to try to confirm any connection, which hadn’t been seen in earlier research.

Even if a link were ever found, the life-saving benefits of the vaccines are still likely to outweigh the asthma risk, said Dr. Matthew Daley, the study’s lead author. But it’s possible that if the results are confirmed, it could prompt new work to redesign vaccines, he added.

Dr. Paul Offit, of Children’s Hospital of Philadelphia, worried that the flawed study will needlessly scare some families away from proven vaccines.

“Making an extraordinary claim requires extraordinary evidence,” Offit said. This study does not offer that kind of evidence, he said.

He and other outside experts noted that Daley and his colleagues were unable to account for the effects of some potentially important ways children are exposed to aluminum — such as in the air or through their diet.

They also noted the findings include hard-to-explain inconsistencies, like why, in one subset of thousands of fully vaccinated kids, more aluminum exposure didn’t seem to result in a higher asthma risk.

CDC officials, in a statement, said it appears that aluminum-containing vaccines “do not account for the overall trends that we see.”

The study, released Tuesday, suggests that young children who were vaccinated with most or all of the recommended aluminum-containing vaccines had at least a 36% higher risk of being diagnosed with persistent asthma than kids who got fewer vaccines.

Aluminum has been used in some vaccines since the 1930s, as an ingredient — called an adjuvant — that provokes stronger immune protection.

By age 2, children should be vaccinated against 15 diseases, according to U.S. recommendations. Aluminum adjuvants are in vaccines for seven of them.

Aluminum adjuvants have long been considered safe and effective. Still, scientists noted a period of increased rates in allergies and asthma among U.S. children during a 30-year period starting in about 1980, and some wondered if there was a connection. (Those rates leveled off starting about a decade ago and have declined somewhat in recent years, for reasons not fully understood.)

Several previous studies didn’t find a link between aluminum-containing childhood vaccines and allergies and asthma. But other research has linked aluminum in industrial workplaces to asthma. And mice injected with aluminum suffer an immune system reaction that causes the kind of airway inflammation seen in childhood asthma.

“Based on what I consider limited animal data, there is a theoretical risk that the aluminum in vaccines could influence allergy risk,” said Daley, an associate professor of pediatrics at the University of Colorado School of Medicine.

In 2013, the Institute of Medicine — now known as the National Academy of Medicine — called for more federal research into the safety of childhood vaccines, including their use of aluminum.

The new study is part of the government response to that call, Daley said. It was funded by the CDC, and included current and former CDC staffers among its authors. It was published by the medical journal Academic Pediatrics.

The researchers focused on about 327,000 U.S. children born from 2008 to 2014, looking at whether they got vaccines containing aluminum before age 2 and whether they developed persistent asthma between ages 2 and 5.

Asthma, a condition that can cause spasms in the lungs, usually results from an allergic reaction. About 4% of U.S. children under 5 have persistent asthma.

The researchers took steps to try to account for different factors that might influence the results, including race and ethnicity, whether kids were born premature or whether children had food allergies or certain other conditions.

But there were many other factors they were unable to address. For example, aluminum can routinely be found in breastmilk, infant formula and food, but the researchers were unable to get data on how much aluminum the kids got from eating. They also had no information on aluminum exposures from the air and environment where the children lived.

The researchers split the study group into two. One was about 14,000 kids who developed eczema, a skin condition that is seen as an early indicator for the development of asthma or other allergic diseases. They wanted to see if kids with eczema were more or less sensitive to aluminum in vaccines, compared with children who did not have early eczema. The other 312,000 or so kids in the study did not have early eczema.

Both groups got roughly the same amount of vaccine-related aluminum. The researchers found that for each milligram of aluminum received through vaccines, the risk of persistent asthma rose 26% in the eczema kids and 19% in kids who did not have eczema.

Overall, kids who got 3 milligrams or more of vaccine-related aluminum had at least a 36% higher risk of developing persistent asthma than kids who got less than 3, Daley said.

Offit said the study’s limitations meant that the work has “added nothing to our understanding of vaccines and asthma.”

But other experts said the researchers drew from a respected set of patient data and worked carefully with the best information that was available.

“This is public health at its best. They are making every effort to find any possible signal that may be a concern,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “It’s our job to exhaustively examine that to see if that’s true.”

He acknowledged anti-vaccine activists will likely jump to conclusions that the evidence doesn’t support. But if CDC had the information and didn’t publish it, the agency might be seen as misleading the public, further eroding trust, he said.

Dr. Sarah Long, professor of pediatrics at the Drexel University College of Medicine, echoed that.

“I believe in complete transparency,” she said. “If you’ve asked a question and here spent our (taxpayer) money to (investigate) that question, I think the results should be aired in all of its warts and glory.”

___

The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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Third week of September is worst week of the year for asthma and allergy sufferers

It’s the worst week of the year for asthma and allergy sufferers! Expert warns that third week of September is ‘peak week’ for ER visits related to the conditions as illnesses like the flu surge and pollen counts reach seasonal highs

  • Experts warn that the third week of September is ‘peak week’ for asthma and allergy complications
  • A combination of high ragweed prevalence and the start of flu season leads to a surge in doctor visits
  • Around 15% of Americans suffer from ragweed pollen allergies, which exacerbate asthma symptoms
  • Dr Robert McDermott recommends allergy sufferers to seek out care that can alleviate their symptoms

A combination of ragweed pollen and the start of flu season may make this week the worst of the year for allergy and asthma sufferers in the U.S., an experts warns.

Dr Robert McDermott, a board-certified allergist and immunologist with AllerVie, told DailyMail.com that the third week of September – between the 18th and 24th this year – is often a time where doctors report a sharp increase of allergy and asthma related visits. The period has earned the title of ‘peak week’ among experts.

This is because ragweeds, one of the most common fall allergens, reaches one of its highest pollen counts of the year in parts of America, combined with the start of flu season and the return to school around the country jump-starting the spread of infectious disease.

McDermott recommends parents who have children that suffer from asthma or severe allergies to equip a school nurse with medication their child may need incase severe symptoms arise. Adults who suffer from asthma or severe allergies may want to consult a doctor as well, as there are effective treatments available for allergies that many are totally unaware of.

The third week of September, the 18th through the 24th this year, is considered allergy ‘peak week’ by experts because of the surge of complications caused by the flu and ragweed pollen in the air (file photo)

‘Peak allergy week is the third week in September where we see the largest increase in asthma exacerbations and increased allergy symptoms in sufferers across the U.S.’ McDermott said.

The Asthma and Allergy Foundation of America reports that asthma episodes and attacks will surge throughout the month of September as multiple factors combine to cause problems for sufferers.

Ragweeds, which are prevalent along the east coast and Midwest, start to become fully grown in late August.

Dr Robert McDermott (pictured), a board-certified allergist and immunologist with AllerVie, said that he expects the flu to rebound this year after quiet seasons in recent years

By mid-to-late September, the weeds have released pollen spores into the environment en masse, causing issue for the estimated 15 percent of Americans who suffer from the allergy.

For people with asthma this situation can get even worse, as their already restricted airways may tighten. This can cause shortness of breathe, and trigger an asthma attach in the most serious of cases.

The eruption of the flu will make things worse as well. Cases of the common respiratory illness will start to pick up in the coming weeks, with late-September usually when the uptick first begins.

Combine this with schools, which have entirely returned to in-person learning across the U.S., being breeding grounds for outbreaks of the flu.

While rarely deadly, the common flu is still often dangerous for people with asthma.

It can cause the airways to become inflamed, causing them to narrow or even close – triggering asthma symptoms.

Some fear that this could be an especially problematic flu season as well, as Australia – whose flu season is during the U.S. summer months – suffered its worse flu season in a half-decade this year, with peak case rates reaching heights three times higher than usual.

McDermott says that parents should equip their child with allergy medicine and devices that can help manage their asthma if need be this week (file photo)

With the COVID-19 pandemic disrupting spread of the flu for the past two years, many do not have the necessary antibodies to fight it as easily as they did before – leading to surging cases and more serious infections.

McDermott expects the flu to roar back to usual levels in the U.S. this year as well, presenting more of a problem for asthma and allergy sufferers. 

Those at risk of more severe symptoms do not just have to accept their suffering, though.

McDermott recommends that people take active steps this week, and throughout the rest of fall to protect themselves.

For children, parents should make sure they have allergy medicine and devices like an inhaler that can treat asthma available to them at school. These can even be given to a school nurse for safe keeping.

He recommends adults to see a medical professional about treatment to manage their allergies, and make it so their immune system is less ‘hyperactive’ when exposed to inflammatory triggers like pollen.

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Psychological distress before COVID-19 infection associated with increased risk of long COVID

Psychological distress, including depression, anxiety, worry, perceived stress, and loneliness, before COVID-19 infection was associated with an increased risk of long COVID, according to researchers at Harvard T.H. Chan School of Public Health. The increased risk was independent of smoking, asthma, and other health behaviors or physical health conditions.

“We were surprised by how strongly psychological distress before a COVID-19 infection was associated with an increased risk of long COVID,” said Siwen Wang, a researcher in the Department of Nutrition at Harvard Chan School who led the study. “Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension.”

The study will be published online in JAMA Psychiatry on September 7, 2022.

According to the U.S. Centers for Disease Control, about 20% of American adults who have had COVID-19 have developed long COVID, which is defined as experiencing COVID-19-related symptoms, such as fatigue, brain fog, or respiratory, heart, neurological, or digestive symptoms, for longer than four weeks after infection. Severe COVID-19 illness increases the risk of long COVID, although people with milder COVID-19 cases can also develop long COVID. Symptoms, which can be debilitating, could last months or years, and little is known about which traits are linked to developing long COVID.

Mental health is known to affect the outcomes of some diseases. Depression and other mental illnesses have been associated with greater risk of more severe COVID-19 including the risk of hospitalization, which is a risk factor for long COVID. In other acute respiratory tract infections, such as flu or common cold, mental health conditions are associated with greater severity and longer duration of symptoms. Previous studies have also suggested that distress is associated with chronic symptoms following Lyme disease and in chronic fatigue syndrome and fibromyalgia, which have symptoms similar to those of long COVID.

To determine the effects of psychological distress before COVID-19 infection on developing long COVID, Wang and her colleagues enrolled more than 54,000 people in April 2020. At the beginning of the study, the researchers asked the participants about their psychological distress. Over the following year, more than 3,000 participants contracted COVID-19, and the researchers asked participants about their COVID-19 symptoms and symptom duration.

After analyzing the responses and comparing those who developed long COVID to those who did not, the researchers determined that distress before COVID-19 infection, including depression, anxiety, worry, perceived stress, and loneliness, was associated with a 32%-46% increased risk of long COVID. These types of psychological distress were also associated with 15%–51% greater risk of daily life impairment due to long COVID.

To the best of our knowledge, this is the first prospective study to show that a wide range of social and psychological factors are risk factors for long COVID and daily life impairment due to long COVID. We need to consider psychological health in addition to physical health as risk factors of long COVID-19. These results also reinforce the need to increase public awareness of the importance of mental health and to get mental health care for people who need it, including increasing the supply of mental health clinicians and improving access to care.”

Andrea Roberts, senior research scientist in the Department of Environmental Health at Harvard Chan School and senior author of the JAMA Psychiatry paper

Source:

Harvard T.H. Chan School of Public Health

Journal reference:

Wang, S., et al. (2022) Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post COVID-19 Conditions. JAMA Psychiatry. doi.org/10.1001/jamapsychiatry.2022.2640.

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Common steroids used for asthma, allergies linked to brain decline, study finds

“This new study is particularly interesting in showing the extent to which white matter, which is required for neurons to connect with each other, is affected by medication use,” said Thomas Ritz, a professor of psychology at Southern Methodist University who has researched the impact of steroids on people with asthma. He was not involved in the study.

However, “there’s no reason for alarm,” said neuroimmunologist Dr. Avindra Nath, the clinical director of the National Institute of Neurological Disorders and Stroke, who was also not involved in the study. Doctors have long known that, if you give patients steroids, “the brain does shrink, but when you take them off the steroids, it comes back,” Nath said.

Due to brain plasticity — the ability of the brain to reorganize its structure, functions or connections — “these could be temporary effects,” he said. “They don’t necessarily have to be permanent. White matter can repair itself.”

Widespread use

Glucocorticoids are some of the most frequently prescribed anti-inflammatory medications due to their widespread use in a number of conditions, experts say.

In addition to asthma, both oral and inhaled glucocorticoids can be used to treat allergies, chronic obstructive pulmonary disease (COPD), Crohn’s disease and other types of inflammatory bowel disease, eczema and other skin conditions, lupus, tendinitis, multiple sclerosis, osteoarthritis, and rheumatoid arthritis.

However, glucocorticoid inhalers should not be confused with quick-relief inhalers used to stop an asthma attack. Quick-relief inhalers contain non-steroid medications that relax the muscles in the lungs, such as albuterol, levalbuterol and pirbuterol, which can open airways in minutes. Inhaled corticosteroids do not work in emergencies — they are prescribed for longer-term control of inflammatory conditions.
Prior research has linked the long-term use of oral glucocorticoids to structural brain abnormalities and shrinkage of certain areas of the brain, as well as mental health issues such as anxiety, depression, confusion and disorientation. Studies have also shown that people who have lived with asthma have higher rates of cognitive and memory impairment later in life than people without the condition.

But much prior research has been small in scale, and at times, inconclusive, experts say.

The new study used data from the UK BioBank, a large biomedical research center that followed 500,000 residents of the United Kingdom from 2006 to 2010. From that database, the researchers were able to find 222 oral glucocorticoid users and 557 users of inhaled glucocorticoids who did not have a previous diagnosis of any neurological, hormonal or mental health disorder.

Those people underwent cognitive and mental health testing and received a diffusion MRI of the brain. Researchers pulled that data and compared those MRI and cognitive findings to over 24,000 people in the database who did not use steroids.

“To the best of our knowledge, this is the largest study to date assessing the association between glucocorticoid use and brain structure, and the first to investigate these associations in inhaled glucocorticoid users,” wrote the study authors.

Inhalers had smallest impact

The study found the greatest amount of white matter damage in people who use oral steroids regularly over long periods of time. The mental processing speed of chronic oral steroid users tested lower than non-users. People on oral steroids also had more apathy, depression, fatigue and restlessness than non-users of steroids.

The smallest impact on white matter occurred in people who use inhaled steroids, the study found.

That fits with what doctors see in clinical practice, said pulmonologist Dr. Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California. He was not involved in the study.

“We don’t see side effects as often with the inhaled form of glucocorticoids,” he said. “And of course, mainstay of therapy for allergies and asthma is always going to be avoiding the triggers and making lifestyle modifications.”

Pulmonologists and rheumatologists are cautious about prescribing the smallest dose of steroids needed to control symptoms, Dasgupta said, due to the large number of side effects from steroid use that can also impact health, including brain health.

“As a clinician, the minute you start a person on these medications, you’re immediately thinking, ‘How do I safely take that person off in a timely fashion?’ Steroids cause weight gain, and weight gain is always going to be a risk for developing diabetes and high blood pressure,d” Dasgupta said.

“When you give steroids to people with diabetes, their blood sugar can go up,” he added. “When you take steroids acutely, you could definitely have insomnia and trouble sleeping, and when you’re on long-term steroids, it puts you at a high risk for infections because they are an immunosuppressant.”

More research needed

The new study had limitations. For one, it was not able to determine steroid dose or track adherence, Ritz said.

“We know that only about 50% of patients with asthma take their medication as prescribed, and potential overreporting of intake is also an issue,” Ritz said. “You should take your inhaled corticosteroids, which reduce the inflammation locally, as regularly as possible, albeit at the lowest possible dose that allows you to control you asthma.

“This study gives us another reason to keep the dosages low,” he added.

Another limitation was that it was unable to differentiate between people who take steroid tablets and those who use infusions, according to study authors.

“The study mainly confirms what we know for a long time in asthma management: Take as few systemic (oral) corticosteroids as possible, as long as you are not a patient with severe asthma. Stick to inhaled steroids and discuss with your treating physician plans to step down medication regimens during good times,” Ritz said.

“It’s a very well done study,” Nath said. “But the findings demand another study to be done to see how long these effects last and how they can be reversed.”

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How to Know If Your Symptoms Are Bad Enough to See an Allergist

Photo: Budimir Jevtic (Shutterstock)

So you’re sneezing and rubbing your eyes this allergy season. Who isn’t? Allergies are common enough that many of us can manage our symptoms with over-the-counter medications and avoidance strategies like spending less time outdoors on days with a high pollen count. But when are allergies bad enough that you should visit a specialist?

First of all, if you’re seeing a primary care provider for regular checkups, you can always ask them about your allergies. Let them know how bad your symptoms are and how much they affect your life, and they’ll help you figure out whether a referral to an allergist makes sense. (They may also recommend a specific person to see.)

But if you’re trying to decide on your own, here are some of the signs you could benefit from seeing a professional.

You don’t know what you’re allergic to

One of the biggest things an allergist can do that you can’t do on your own is test your reaction to dozens of common allergens at the same time. This is not the same as one of those mail-order blood tests, which are pretty much useless. Instead, allergy testing is usually done with a skin prick test. The provider will draw a little grid on your arm or back, and in each spot they will apply a small amount of a substance and prick your skin. There are sets of tests for pollens, pet dander, and other common allergens. If you’re allergic to one of the items in the test, you’ll have a skin reaction.

Other types of legit allergy testing, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI), include challenge tests, where you ingest a small amount of a suspect food under supervision, and IgE blood tests (no relation to the mail-order IgG tests).

For skin tests, you’ll get the results right away (the test takes about 20 minutes). The allergist can then advise you about what you should do for the allergies that have been identified—if you need to carry an Epi-Pen, for example, or if you should use certain prescription or over-the-counter drugs, they will discuss this with you.

They can also provide other strategies that will help you avoid and deal with the allergens in your life. For example, my allergist recommended pillow and mattress covers as part of a strategy for managing my dust mite allergy. I had never thought those covers were likely to be all that useful, but I finally shelled out for them based on her recommendation, and my symptoms got much better.

You have asthma too, and it’s getting bad

Allergists also specialize in asthma. Both conditions involve the immune system, and people who have asthma often tend to have allergies. Consider visiting a specialist if you experience signs of severe asthma, whether they occur together with allergies or not. The American College of Allergy, Asthma, and Immunology (ACAAI) identifies these as:

  • Wheezing or coughing, especially at night or after exercise
  • Struggling to catch your breath
  • Feeling tightness in your chest or shortness of breath

Trouble breathing is bad for you no matter the cause, and symptoms of asthma may overlap with those of other heart and lung conditions. If you can’t get in to see the allergist anytime soon, bring up these concerns with whatever doctor you can get in to see.

Your allergies or asthma seriously affect your day-to-day life

If you sniffle occasionally when it’s pollen season, you probably don’t need a specialist’s help. But the ACAAI recommends seeing someone about your allergies if:

  • Your seasonal allergies last for months out of the year
  • Over-the-counter medications aren’t enough to control your allergies
  • Over-the-counter medications control your allergies, but only when you take enough that you’re feeling drowsy all the time or otherwise having unacceptable side effects
  • Your allergies are causing chronic sinus infections, congestion, or difficulty breathing
  • Your asthma or allergies are seriously affecting your day-to-day life.

If you’ve seen an allergist before, but your symptoms have gotten worse since then, it’s worth going back. For example, if you’re already taking asthma medication but you have frequent asthma attacks, that’s a sign you need to see somebody.

  

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COVID worsens asthma in children; booster after infection not as beneficial vs Omicron

By Nancy Lapid

(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

COVID-19 worsens asthma in children

Asthma in children may worsen after an infection with the coronavirus, doctors warn.

They studied nearly 62,000 U.S. children with asthma who had PCR tests for the virus in the first year of the pandemic, including more than 7,700 who tested positive. Infected children had significantly more asthma visits, hospitalizations, emergency inhaler use, and steroid treatments during the six months after their illness compared to children who tested negative and to their own prior history, researchers reported in the Journal of Allergy and Clinical Immunology: In Practice https://www.jaci-inpractice.org/article/S2213-2198(22)00360-9/fulltext. Children who tested negative for the virus “had improved asthma control for the next six months, meaning fewer emergency department visits and hospitalizations for asthma, and less asthma treatment,” said Dr. Christine Chou of Children’s Health of Orange County, in California.

Results of earlier studies showing improvement in asthma control in the early part of the pandemic were likely due to public health measures like staying home and masking, which curbed exposure to asthma triggers, she said. Despite the overall impression that children with asthma did well during the first year of the pandemic, Chou added, the new study shows “longer lasting harm of COVID on children’s asthma control.”

Booster after infection adds little extra benefit vs Omicron

Among people who were previously infected with the coronavirus, a third dose of an mRNA vaccine from Pfizer/BioNTech or Moderna may not boost their protection against the Omicron variant of the virus, according to new data.

Researchers studied nearly 130,000 people tested for COVID in Connecticut from November 2021 through January 2022, including 10,676 with Omicron infections. Roughly 6% to 8% had been infected with previous versions of the coronavirus, according to a report posted on medRxiv https://www.medrxiv.org/content/10.1101/2022.04.19.22274056v3 ahead of peer review. Two doses of an mRNA vaccine did help protect against Omicron among people with prior infections, but “we did not detect an additional benefit of receiving a third booster dose among this population,” said Margaret Lind of Yale University.

A separate study from Canada, also posted on medRxiv https://www.medrxiv.org/content/10.1101/2022.04.29.22274455v1 ahead of peer review, similarly found that more than two vaccine doses “may be of marginal incremental value” for protecting previously-infected individuals against Omicron. The message, Lind said, “should be that (1) people should get two doses of mRNA vaccine regardless of if they have had a prior infection or not, that (2) people without prior infections should get a booster dose and that (3) people with prior infections should consider a booster dose, especially if they are in a high risk group for life threatening complications, but recognize that it may not provide significant additional protection against infection above two doses.”

Click for a Reuters graphic https://tmsnrt.rs/3c7R3Bl on vaccines in development.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

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Asthma Drug Montelukast (Singulair) Can Block Crucial COVID Protein, Reducing Viral Replication

Targeting Nsp1 with montelukast (Singulair) helps prevent shutdown of host protein synthesis. Credit: Mohammad Afsar

An oral medication used to treat asthma and allergies can bind to and block a crucial protein produced by the

Montelukast is a drug used in the maintenance treatment of asthma that is marketed under the trade name Singulair and others. In general, it is less favored for this application than inhaled corticosteroids. It is ineffective in treating acute asthma attacks. Other applications include allergic rhinitis and long-lasting hives. It is a second-line therapy for allergic rhinitis.

“The mutation rate in this protein, especially the C-terminal region, is very low compared to the rest of the viral proteins,” explains Tanweer Hussain, Assistant Professor in the Department of Molecular Reproduction, Development and Genetics (MRDG), IISc, and senior author of the study. Since Nsp1 is likely to remain largely unchanged in any variants of the virus that emerge, drugs targeting this region are expected to work against all such variants, he adds.

Hussain and his team first used computational modeling to screen more than 1,600 FDA-approved drugs in order to find the ones that bound strongly to Nsp1. From these, they were able to shortlist a dozen drugs including montelukast and saquinavir, an anti-HIV drug. “The molecular dynamic simulations generate a lot of data, in the range of terabytes, and help to figure out the stability of the drug-bound protein molecule. To analyze these and identify which drugs may work inside the cell was a challenge,” says Mohammad Afsar, former Project Scientist at MRDG, currently a postdoc at the University of Texas at Austin, and first author of the study.

Working with the group of Sandeep Eswarappa, Associate Professor in the Department of Biochemistry, Hussain’s team then cultured human cells in the lab that specifically produced Nsp1, treated them with montelukast and saquinavir separately, and found that only montelukast was able to rescue the inhibition of protein synthesis by Nsp1.

“There are two aspects [to consider]: one is affinity and the other is stability,” explains Afsar. This means that the drug needs to not only bind to the viral protein strongly, but also stay bound for a sufficiently long time to prevent the protein from affecting the host cell, he adds. “The anti-HIV drug (saquinavir) showed good affinity, but not good stability.” Montelukast, on the other hand, was found to bind strongly and stably to Nsp1, allowing the host cells to resume normal protein synthesis.

Hussain’s lab then tested the effect of the drug on live viruses, in the Bio-Safety Level 3 (BSL-3) facility at the Centre for Infectious Disease Research (CIDR), IISc, in collaboration with Shashank Tripathi, Assistant Professor at CIDR, and his team. They found that the drug was able to reduce viral numbers in infected cells in the culture.

“Clinicians have tried using the drug … and there are reports that said that montelukast reduced hospitalization in

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Asthma drug can block crucial SARS-CoV-2 prot

image: Targeting Nsp1 with montelukast helps prevent shutdown of host protein synthesis
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Credit: Mohammad Afsar

A drug used to treat asthma and allergies can bind to and block a crucial protein produced by the virus SARS-CoV-2, and reduce viral replication in human immune cells, according to a new study by researchers at the Indian Institute of Science (IISc).  

Approved by the US Food and Drug Administration (FDA), the drug, called montelukast, has been around for more than 20 years and is usually prescribed to reduce inflammation caused by conditions like asthma, hay fever and hives. 

In the study published in eLifethe researchers show that the drug binds strongly to one end (‘C-terminal’) of a SARS-CoV-2 protein called Nsp1, which is one of the first viral proteins unleashed inside the human cells. This protein can bind to ribosomes – the protein-making machinery – inside our immune cells and shut down the synthesis of vital proteins required by the immune system, thereby weakening it. Targeting Nsp1 could therefore reduce the damage inflicted by the virus. 

“The mutation rate in this protein, especially the C-terminal region, is very low compared to the rest of the viral proteins,” explains Tanweer Hussain, Assistant Professor in the Department of Molecular Reproduction, Development and Genetics (MRDG), IISc, and senior author of the study. Since Nsp1 is likely to remain largely unchanged in any variants of the virus that emerge, drugs targeting this region are expected to work against all such variants, he adds.   

Hussain and his team first used computational modelling to screen more than 1,600 FDA-approved drugs in order to find the ones that bound strongly to Nsp1. From these, they were able to shortlist a dozen drugs including montelukast and saquinavir, an anti-HIV drug. “The molecular dynamic simulations generate a lot of data, in the range of terabytes, and help to figure out the stability of the drug-bound protein molecule. To analyse these and identify which drugs may work inside the cell was a challenge,” says Mohammad Afsar, former Project Scientist at MRDG, currently a postdoc at the University of Texas at Austin, and first author of the study. 

Working with the group of Sandeep Eswarappa, Associate Professor in the Department of Biochemistry, Hussain’s team then cultured human cells in the lab that specifically produced Nsp1, treated them with montelukast and saquinavir separately, and found that only montelukast was able to rescue the inhibition of protein synthesis by Nsp1. 

“There are two aspects [to consider]: one is affinity and the other is stability,” explains Afsar. This means that the drug needs to not only bind to the viral protein strongly, but also stay bound for a sufficiently long time to prevent the protein from affecting the host cell, he adds. “The anti-HIV drug (saquinavir) showed good affinity, but not good stability.” Montelukast, on the other hand, was found to bind strongly and stably to Nsp1, allowing the host cells to resume normal protein synthesis. 

Hussain’s lab then tested the effect of the drug on live viruses, in the Bio-Safety Level 3 (BSL-3) facility at the Centre for Infectious Disease Research (CIDR), IISc, in collaboration with Shashank Tripathi, Assistant Professor at CIDR, and his team. They found that the drug was able to reduce viral numbers in infected cells in the culture.

“Clinicians have tried using the drug … and there are reports that said that montelukast reduced hospitalisation in COVID-19 patients,” says Hussain, adding that the exact mechanisms by which it works still need to be fully understood. His team plans to work with chemists to see if they can modify the structure of the drug to make it more potent against SARS-CoV-2. They also plan to continue hunting for similar drugs with strong antiviral activity.  


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