New Covid Strategies

New Covid Strategies

The FDA has recently approved (emergency use authorization) two oral antivirals and a monoclonal antibody for Covid.  The antivirals are designed for out patient use in mild to moderate Covid-19.  Both have proven to be active against the original Corona virus and its new variants.  Paxlovid uses two agents:  nirmatrelvir (a viral protease inhibitor) and ritonavir (a CYP3a inhibitor).  The treatment is for 5 days and can be used down to the age of 12.  Lagevrio contains molnupiravir a nucleoside…

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Dear Dr. K;

Dear Dr. K;

My sister is on a JACK medicine for her ulcerative colitis but she said it may soon be used for allergies.  Is that true? Well, kind of.  First of all, not to be too picky but there is a whole family of JAK drugs and the “JAK” refers to Janus kinase which is a pathway that transmits signals across cell membranes.  The JAK system plays important roles in embryonic development, stem cell development, blood cell production and inflammation signaling.  This…

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Irisin

Irisin

Patients who come to this office know well the exercise sermon both doctors preach.  Exercise is one of the key foundational elements of general health and also allergic/immunologic health.  New research is adding cognitive health to the list of benefits.   Recent journal articles in the Journal of Cellular Physiology and in Journal of Nature Metabolism contain new data on the fact that exercise leads to the production of a hormone irisin.  It has been known for some time that…

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Lions and tigers and bears, oh my! Or polyomavirus…

Lions and tigers and bears, oh my! Or polyomavirus…

It has been known for quite a while that certain viruses such as respiratory syncytial virus (RSV) and rhinovirus (the common cold) have been associated with the development and/or worsening of asthma.  Both of these viruses are RNA viruses.  This fact led researchers to wonder about certain DNA viruses.  The one most recently studied is polyomavirus.  This virus is widespread and consists of 117 species.  Once thought to be totally innocuous, it is now understood that these viruses can cause…

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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.