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… And now the cat story

… And now the cat story

“Spoiler” alert!

Between 5 and 10% of the human population has an allergy to cat. The major cat allergen is a protein called “Fel-D-1,” which is a protein in the cat’s saliva, sebaceous glands and genitourinary tract. Dried skin particles (dander) contain the protein, even though the protein is not part of the coat itself.

Female cats produce less Fel-D-1 than male cats. Light-colored cats make less than dark-colored cats. Long-haired cats give off less allergen into the environment than short-haired kitties because their long fur holds the protein against the skin.

The Fel-D-1 protein is a very tiny molecule which allows it to stay airborne for a very long time, which in turn makes it easy to inhale. The particles are also very sticky, making it easy for them to cling to furniture, carpet, drapes, bedding and walls — so sticky they can “hang around” six-to-eight months after a cat has left the premises. These particles can also be picked up by shoes and clothing and travel home to abodes that have never housed a cat.

Even “hairless” breeds groom themselves, so the protein ends up on their skin. The only allergic advantage of “hairless” cats is they don’t harbor other allergens such as pollen or dust mites. And even after washing cats, the levels of Fel-D-1 are back up to pre-bath levels within 24 hours.

Child in crisis — Epi-Hug more than affection

Child in crisis — Epi-Hug more than affection

Because of the burgeoning of allergic disorders, more and more children are requiring auto- injectors of epinephrine. These devices are used to stop severe allergic reactions or anaphylaxis.

If the device is required it is obviously at a time of crisis for both the child and the parent, which makes it more likely for mis-adventures to occur. Because it is life-critical that the medication be properly administered, it usually requires some form of child restraint.

Thus has evolved the concept of compassionate restraint known as “the epi-hug.”

The best site to administer the epinephrine is the top side of the child’s thigh. So, try to visualize this: one parent should sit and place the child on his or her lap, with the child sitting on one of that parent’s legs, while the parent’s other leg rests on top of the child’s knees, immobilizing the child’s legs.

The parent should use her non-dominant arm around the child’s back to hold and immobilize the child’s free arm. Have the child place his other arm in a “hug” around the back of the parent. The parent’s dominant arm is then free to use the auto-injector on the child’s thigh.

Trying to administer the epinephrine to a non-restrained or “bucking” child has led to countless episodes of partially administered doses, broken needles and even of the parent accidently being injected.

The advice of “practice makes perfect” applies. If you’ve rehearsed the epi-hug with the “trainer” injector before a true need, it will help ensure all goes well.

Not real common, or innocent

Not real common, or innocent

Food additives are often suspected as a possible culprit for allergic reactions. A recent study done at LSU proves otherwise; that is, they are rarely a cause.

Most food additives fall into one of seven categories: antioxidants, coloring, emulsifiers, flavorings, taste enhancers, preservatives or stabilizers. The three most common allergy troublemakers are two preservatives (sulfites and nitrites), and one taste enhancer (MSG – monosodium glutamate).

Next most common are the dyes: carmine (red) and tartrazine (yellow). Other culprits include the emulsifiers guar gum, the preservative Benzoates and the artificial sweetener aspartame.

Allergic manifestations of food additives can vary from asthmatic rhinitis, skin rash, gastro upset and headache. As there are no standardized skin or blood tests to diagnose food additive allergy, a more “seat-of-the-pants” approach is required, such as keeping a diet/adverse event diary, or doing an oral food challenge with the suspected culprit.

Quick Tips: Sjogren’s Syndrome

Quick Tips: Sjogren’s Syndrome

Another  recent study from that publication found that people with the chronic allergic “triad” of rhinitis, asthma and eczema have a much greater risk of developing Sjogren’s Syndrome (an auto-immune condition causing dry eyes and mouth) than the general population.

Celiac disease needs two genes and virus to switch on

Celiac disease needs two genes and virus to switch on

It has been known for some time that two HLA genes (DQ2, DQ8) predispose to celiac disease. What was recently discovered, and reported in The New England Journal of Medicine, is that is seems to take a virus to activate these genes that leads to the disease.  The research focused on the interplay between viruses and genes causing celiac disease, with its gluten sensitivity. The genes alone don’t cause celiac disease.

The virus that appears to be the culprit is a Reovirus that infects the intestines, but is otherwise innocuous, in that is doesn’t cause any symptoms or illness. But in people who inherited HLA-DQ2 or DQ8, the genes are “switched on” and the auto-immune gluten sensitivity develops.

This is very compelling research because development of a viral vaccine could prevent millions of cases of celiac disease.

Mighty mites proven peskier

Mighty mites proven peskier

Dust mites have long been known as the No. 1 cause for allergic asthma around the world. They are the “perfect respirable particle” – at only seven microns in size – and thus, easily inhaled into the lungs.

Based on this information it has long been assumed that the development of dust-mite allergy must occur via breathing in the particles.

Well, new research at the Pasteur Institute in Paris has found otherwise. It seems that the early development of dust-mite sensitivity occurs through the skin. This finding helps explain why many infants have eczema caused by dust-mite allergy, and then later develop allergic asthma.

The researchers in Paris found that dust mites are able to initiate this allergic immune response even in children with normal intact skin. Of course, once eczema develops, there is more ready penetration of the skin layers.

Based on this research it seems reasonable to work harder to minimize dust-mite exposure to infants. Good moves: use mite-barrier sheets, avoid stuffed animals and frequently wash sheets.

Pets in home: many allergy studies, mixed results

Pets in home: many allergy studies, mixed results

By Sasha Klemawesch, MD

Finally, scientific proof of dogs’ superiority! Research studies have reported a variety of health benefits provided to owners by their dogs; perhaps most pertinent to this newsletter being those related to allergies.

A trio of studies in 2003, ’04 and ‘05 in various allergy journals (Current Opinions in Allergy and Clinical Immunology, Journal of Allergy and Clinical Immunology, and Current Allergy Asthma Reports) all reported that children who had dogs in their homes as infants were less likely to develop a variety of allergic maladies, including atopic dermatitis and wheezing, compared with pet-free households.

Many doctors will tell you the key core foundations of good health are regular exercise and a balanced diet. Now dogs won’t cook your dinner, but a Journal of Preventative Medicine study showed that dog owners were much more likely to meet the recommended 30 minutes a day goal of moderate physical activity. Dogs also help with your mental health. A University of Portsmouth study showed dog owners were less likely to suffer a depressive episode, and that overall, they had a better sense of well-being, social connection, and less loneliness. And dogs’ psychological benefits can extend beyond the home-front. The International Journal of Healthy Workplaces (yes, that is an actual thing) conducted a study on dogs and workplace productivity, finding that workers who could have their canine companions with them at the office had decreased job stress, increased productivity and job satisfaction.

But don’t worry cat people, you guys aren’t totally wrong. Turns out cats have benefits for their owners too. Cat and dog owners both tend to reap the benefits of a statistically significant decrease in the number of times they get sick each year, and many of the psychosocial benefits apply to cat owners as well.

The one place dogs really seem to display a potentially scientifically founded superiority is the arena of asthma and allergy. And I say potential, because there are a lot of conflicting study results out there, some of which cite no change in asthma among kids who had cats or dogs in their house as an infant, but many which do.

For example, the European study which found an increased risk of asthma in children with feline or farm animal exposure early in life vs decrease risk with canine contact. To date there have been a plethora of studies evaluating various aspects of atopy (a genetic tendency to develop heightened immune responses, even allergic diseases, to common allergens – especially to inhaled and food allergens, and animal exposures. The results have been varied.

A large meta-analysis of them, however, reported that among all the animals studied, dogs are the most consistently proven to have positive effect on the immune system. Cats, birds, reptiles, et al, all tended to have neutral or negative effects.