Constrictive Bronchiolitis

Constrictive Bronchiolitis

Many smokers consider electronic cigarettes (vaping) to be a safer alternative to traditional cigarettes.  In some respect they are correct.  However, a newly described condition: constrictive bronchiolitis is appearing in some people who vape.  Bronchioles are the smaller arborations in the “bronchial tree”.  The trachea branches into bronchi which in turn branch into bronchioles.  The people who develop this condition have significant narrowing of these smaller airways that is caused by tissue thickening called fibrosis.  The pathophysiology of this condition…

Read More Read More

Long Haulers

Long Haulers

The plodding nature of scientific research is a source of frustration to many of us, especially with reference to this Covid pandemic and the long haulers.  But recent research at Stanford University seems to provide new insight.  In their studies of long haulers, they discovered that the majority of them continue to shed live virus in their stool.  Moreover, some of the long haulers who were “stool negative” did show live virus in biopsies of the intestinal lining.  And yet…

Read More Read More

Dear Dr. K –

Dear Dr. K –

My husband has intrinsic asthma and I have extrinsic asthma.  Despite having our COVID vaccines he caught COVID and I didn’t.  What’s up? Well, first of all I’m impressed that you know the difference between intrinsic and extrinsic asthma phenotypes.  To try and simplify what is a complex science most asthma can be categorized as high TH2 (extrinsic) or low TH2 (intrinsic).  TH2 is a type of lymphocyte that can cause inflammation.  In high TH2 asthma the main mediators of…

Read More Read More

RSV Vaccine

RSV Vaccine

Many Americans “have reached their limit” with vaccines due to the ongoing Covid pandemic.  But sadly, Covid isn’t the only game in town.  RSV (Respiratory Syncytial Virus) hasn’t gone away and continues to cause illness, hospitalization and death.  It is a single stranded RNA virus that can infect people at all ages.  It is the leading cause of respiratory hospitalizations in infants.  It is also problematic for people over 65, also causing hospitalization and death.  RSV vaccine research has been…

Read More Read More

Ticks Bite!

Ticks Bite!

By:  Sasha Klemawesch, MD It used to be that you only had to worry about ticks in certain parts of the country and during certain times of the year. However (at the risk of mentioning any potentially “politically charged” content), climate change has not only prolonged tick season, but has also changed the geographic distribution of various bites. Depending where you live in the country, a variety of ticks abound, leading to various infections endemic to each area. For the…

Read More Read More

Bacteriophages

Bacteriophages

Bacteriophages are viruses that infect bacteria.  Phage is a Greek word meaning “to eat”.  Bacteriophages invade bacteria, replicate themselves and then destroy the host cell.  There are many types of viruses in the world.  Some infect only certain animals.  Some infect only humans.  But bacteriophages are by far and away the most numerous viruses.  They number 10 to the 31st power on the planet and this number is greater than all of the other organisms on earth added together (including…

Read More Read More

Dear Dr. K;

Dear Dr. K;

Any new information on peanut vaccines? Actually yes; and it seems to be very promising news.  As you may recall from previous articles in this newsletter, the one FDA approved oral peanut vaccine is less than ideal:  it causes a lot of side effects including occasional anaphylaxis and it confers very modest protection.  But, a breath of fresh air came to peanut vaccine research based on astute observation by immunologists at Boston Children’s Hospital.  They discovered a major difference in…

Read More Read More

New Treatment for HAE (HANE)

New Treatment for HAE (HANE)

The New England Journal of Medicine recently published research done at the University of California on a new treatment for hereditary angioneurotic edema (HANE) also called hereditary angioedema (HAE).  HANE or HAE is a rare genetic disorder that leads to unpredictable, disabling and occasionally fatal episodes of swelling.  The swelling can occur in any part(s) of the body.  It is caused by uncontrolled activity of the contact system components factor X11a and plasma Kallikrein which leads to excessive release of…

Read More Read More

EILO not EIEIO

EILO not EIEIO

EILO stands for exercise induced laryngeal obstruction and it is a newly understood reason for DOE (dyspnea on exertion) especially in children and adolescents. Dyspnea (breathlessness) on exertion can occur for very diverse reasons including anemia, cardiovascular problems, neuro muscular problems and respiratory issues.  The most common respiratory cause for DOE is exercise induced bronchospasm (EIB) due to underlying asthma.  But asthma is an exhalation disease; that is, the main issue is getting air back out of the lungs.  EILO…

Read More Read More

Global Warming

Global Warming

The Journal of Allergy and Clinical Immunology had a recent article on global warming and the allergy epidemic.  Allergic diseases have reached epidemic proportions globally affecting 30% of the people on earth.  Just 20 years ago statistics in the US showed allergy affecting roughly 15 to 18% of Americans.  Despite new therapies allergic conditions are increasing in spectrum, frequency and severity.  Since 1970 average temperatures have increased by 2 degrees Fahrenheit and green house gases have increased dramatically (primarily carbon…

Read More Read More