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Author: Stephen J. Klemawesch, MD

Nanoparticle technology fights peanut allergy

Nanoparticle technology fights peanut allergy

The much-anticipated arrival of a vaccine for severe peanut allergy is still unfulfilled. There seem to be too many unresolved issues with the vaccines currently being tested — whether they be injectable or oral vaccines.

Safety concerns and avoidance of unwanted reactions are instrumental in this delay.

Enter nanoparticle technology. Perhaps because the amount of peanut protein used in nanoparticle vaccines is so small, there have been no severe reactions to the vaccine. Also, early studies show that the nano-vaccine provides as good protection from peanut allergy as the traditional mega-protein vaccine.

Hard water known to cause infant eczema

Hard water known to cause infant eczema

Although it’s been suspected that hard water contributes to the development of eczema in infants, the premise had never been scientifically researched until investigators at St. George’s University in Canada have now proven it is so.

Hard water (water with high calcium content) and water with higher chlorine content were both found to increase the likelihood of eczema in infants by 46%.

The investigators also found the installation of a water softener removed this increased risk.

Tiniest cells causing big misery in young and old

Tiniest cells causing big misery in young and old

An infection that previously was mostly seen in children, over the past 15 years has been showing up more frequently in older adults. With its extended incubation period (2-4 weeks), it is difficult to diagnose, and capable of emerging as bronchitis or pneumonia.

And it is caused by the smallest free-living organisms — Mycoplasma pneumoniae — that were originally thought to be viruses, but have been shown to be bacteria. Unlike most bacteria they lack a cell wall and are bounded by only a thin plasma membrane.

These unique properties extend to their clinical features. Hence, the individual patient can have an extended period of “feeling like they are getting sick, but not really being sure.” Then the steamroller hits, often presenting as bronchitis or pneumonia, along with symptoms in other areas: headache, muscle aches, arthritis and GI symptoms. It can also cause a very painful type of ear infection with blisters on the ear drum.

Because of its lack of a cell wall it’s very difficult to grow in a culture and can be “missed” by this test; a fairly accurate blood test exists. It may be best recognized by its slow onset with attendant non-respiratory symptoms. It does respond to a few specific antibiotics: tetracyclines, macrolides and fluoroquinolones.

New shingles vaccine? Not quite yet

New shingles vaccine? Not quite yet

The lead article in the New England Journal of Medicine last month was on a new shingles vaccine. The study involved 15,000 people over age 70 in 18 different countries.

Unlike the currently used shingles vaccine which uses a live virus, the new vaccine uses a single protein from the virus, along with an immune stimulator.

The new vaccine, which is called HZ/su (Herpes Zoster subunit) prevented shingles in 92% of the patients, and prevented the dreaded complication of shingles post-herpetic neuralgia in 88% of the patients. This compares to the prevention values of the current vaccine of 52% for shingles and 66% for neuralgia.

In addition to its better protection, it can be given to people who are immune-compromised by their illness or by chemotherapy. The current live virus vaccine cannot be used in these patients.

Disadvantages of the new vaccine are that it requires two shots given two months apart. Also, there is a high incidence (30% of recipients) of local and systemic reactions. Finally, although the vaccine looks very promising, it is not yet approved by the FDA. One issue the FDA is studying is if and when it should be given to people who have already received the currently available vaccine.

Q – Tips: Asthma and fracking

Q – Tips: Asthma and fracking

John Hopkins Epidemiologists have found that asthmatics who live in areas of the country where fracking is done have an increased incidence of hospital/ER-requiring flare-ups — that is four times greater than their counterparts not exposed to the environmental leak of natural gas.

Allergic clock might tick in our favor

Allergic clock might tick in our favor

Research scientists in Tokyo have been working on resetting the allergic clock in mice to lessen their tendency to allergy.

Our daily circadian clock, which is critical for many of our biological systems, is located in a special area in the hypothalamus of our brain called the light-sensitive central oscillator. It is programmed by the varying exposure to light and dark. In turn, it signals all the peripheral oscillators (clocks) found in individual cells throughout the body. This includes the allergy-causing mast cells.

This nerve signaling is done via the release of “clock” proteins that can activate or suppress the cell function. As it turns out, most mammals, including humans, are least likely to have allergy symptoms the first four hours of the new day, and more likely to have symptoms overnight. In fact, asthma is sometimes called the “nocturnal predator” because of this circadian tendency to flare at night.

The Tokyo researchers used small amounts of one of these “clock” proteins (called casein kinase) to keep the mouse mast cells in the low-reactive mode. It worked amazingly well to lessen both the severity and frequency of their allergic reactions. The next step in this research is to extend these findings to humans.

Caring for childhood eczema clearer

Caring for childhood eczema clearer

Just-published research of eczema in children – and the accompanying sleep interruption it causes the kids and their parents – has led to a recommended treatment.

University of Nevada researchers compared the benefit of antihistamines versus topical steroids to control the itch/scratching in children with eczema.

They found that both forms of therapy were effective. In fact, they were equally good in preventing sleep disturbance from nocturnal itch – a particularly vexing symptom for families because it causes significant loss of sleep.

And, because the children are unattended in bed, their scratching often causes significant trauma to their skin.  All but five percent of the Nevada study group responded positively to the use of antihistamines.

This led the researchers to recommend their use in all children with eczema