Microbiome and Medicines

Microbiome and Medicines

Previous issues of the Allergic Reaction have had several articles about the human microbiome and its impact on health including its effects on the immune system and other systems.  Now, add an additional new finding to this list.   This research was recently published in Nature and it studied interactions of gut bacteria with oral drugs.  Among people who have the same disease a particular medicine can vary greatly in its effectiveness and side effects.  Much of this variability has been…

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C- Tips: (Christmas Tips)

C- Tips: (Christmas Tips)

-Nuts (especially walnuts & chestnuts), chocolate, cinnamon and “re-gifted” fruit cake can be non-allergic irritants to the mouth and tongue even to the point of causing canker sores, so tread lightly -Mistletoe can be a contact irritant similar to poison ivy so when kissing stand beneath it but don’t hold it -“Fresh” Christmas trees are often not so fresh but are often harvested weeks beforehand and kept damp.  This in turn can lead to mold contamination which can be both…

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Dear Dr. K;

Dear Dr. K;

My husband and I are pre-planning for our first pregnancy.  I’ve had asthma since I was 11years old, can I stay on my asthma medications while pregnant?  The short answer is yes.  The emphatic answer is yes, its vital.  The long answer comes next.  Asthma affects 5 to 8% of women of childbearing age and is one of the most common underlying health conditions that can complicate pregnancy.  Poorly controlled asthma is associated with increased risk of maternal morbidity, spontaneous…

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Bacteriophages

Bacteriophages

When intestinal bacteria that are part of the microbiome were first linked to obesity it seemed to be a scientific curiosity.  That was in 2007.  Now fast forward 14 years and the microbiome has become the subject of hundreds of thousands of research projects around the globe.  This research has led to the understanding of how our gut bacteria can influence the development of many human diseases including asthma and allergy.  Not to over simplify all this research but it…

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Acetaminophen

Acetaminophen

Acute liver injury caused by accidental or intentional acetaminophen overdose is well known.  If ingested all at once, 30 acetaminophens are lethal by causing acute liver failure.  One of the metabolites of acetaminophen is N-acctyl-p-benzoquinone imine (NAPQI) which is produced by the liver enzyme system P-450.  Glutathione stores in the liver detoxify this otherwise harmful metabolite.  Acute overdose can deplete the glutathione stores in the liver and this will cause the liver cells to die.  New research published in the…

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Covid Q-Tips:

Covid Q-Tips:

-Social isolation is still a good strategy and it works.  -Early Covid infection can be successfully treated with monoclonal antibodies casirivimab and imdevimab given as a one-time injection or IV infusion. -Post-exposure prophylaxis can also be given to high-risk individuals who have been exposed to someone with active Covid 19 infection before they develop the infection themselves.  The same monoclonal antibodies are used.

Dear Dr. K; I received BCG treatments for my bladder cancer. Now I hear it is being used for diabetes. Is that true?

Dear Dr. K; I received BCG treatments for my bladder cancer. Now I hear it is being used for diabetes. Is that true?

The one second answer is “yes”, but there is an over 100-year-old story behind that.  BCG, properly called Bacillus Calmette-Guerin is a live attenuated (weakened) form of tuberculosis.  The vaccine has been around for 100 years and is routinely given to children in nearly all non-Western countries to prevent TB.  Not long after the vaccine was developed in the 1920’s scientists noted a significant decrease in childhood death rates not only from TB but from many unrelated infections.  More recent…

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IgG Food Testing

IgG Food Testing

IgG food testing (also known as food sensitivity testing) was recently discussed in an editorial from Yale in the Annals of Allergy, Asthma and Immunology.   The physicians at Yale sited the American Academy of Allergy and Immunology and the European Academy of Allergy and Clinical Immunology in recommending strongly against the use of IgG food testing.  IgG (Immunoglobulin G) is one of the main immune proteins in humans.  It serves both “recognition” and “protection” functions.  Homeland Security might serve as…

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Covid-19 and Immunocompromised Patients

Covid-19 and Immunocompromised Patients

There is still much to learn about Corona virus.  One area that is particularly problematic is how to protect patients that are immunocompromised (roughly 5% of the US population) due to organ transplant, auto-immune/rheumatic diseases, cancer, and dialysis.  It has been long understood that the efficacy of many vaccines is attenuated in immunocompromised patients and this also seems to be the case for Covid-19 vaccines.  Timing of the vaccine is important and it should be administered between chemotherapy cycles.  For…

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Dear Dr. K; Any good news on Covid vaccines?

Dear Dr. K; Any good news on Covid vaccines?

The answer is yes: they are working well and luckily the foibles are generally mild.  Globally there are eleven different vaccines currently in use, but so far only 2% of the world’s population has been vaccinated.  We need to do better, including vaccines that don’t have elaborate requirements for transport or refrigeration.  Another 251 vaccines are at some stage of development including 60 that are entering human trials.  Let me tell you about some of the very promising ones.  Vaxxinity…

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