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Posts for tag: Allergies

By Diji Vaughan, MD
October 28, 2012

Image credits, Pfizerpro.com and A.D.A.M

Image credits: Pfizerpro.com and A.D.A.M. October 2012

 

Is it conceivable to believe that an individual can be too clean for their own good? Maybe.

We know that the immune system in all mammals- a group that includes humans too, has an adaptive capability that matures and becomes more savvy as the challenges mounted by invading germs are responded to over a lifetime. Basically, “the troops remain battle ready when they are continually fighting and winning”. This has been cast as a potential mutually beneficial relationship for the body and the invading germs in a theory proposed to explain the rising trend of allergy and immune system mediated diseases called the ‘hygiene hypothesis’. This theory maintains that living in very clean and hygienic environments robs one of the exposure to microbial organisms which are beneficial for the maturation and ability to distinguish invaders from what belongs to the body. An abnormal maturation process involving the immune system’s cells and antibodies may then arise and predispose individuals to varying levels of abnormal immune responses which manifest in various disease forms.

Needless to say, this is still a theory and not validated as a scientific fact yet. Researchers from the University of Michigan School of Public Health observed a pattern  corroborating another aspect of this theory, more amenable to scientific scrutiny. They examined data from the National Health and Nutrition Survey (NHANES) for the period 2003-2006. Two common environmental toxins, Triclosan and Bisphenol A  both of which have known effects on the delicate balance of the immune and hormonal systems respectively in the body were looked for in patients aged 6 and older who also had diseases attributable to immune dysfunction for example, Hay fever. Their findings published online in November 2010, showed a relationship between having high levels of this Triclosan in the body and immune dysfunction associated disease. Triclosan, is an antimicrobial agent and is ubiquitous in the home environment. Diapers, antibacterial soaps, and toothpaste are some household items that contain this product. The higher levels of Triclosan seen in these patients may have sufficiently altered the population and type of microbes that these individuals would have been normally exposed to and therefore led to abnormal maturation of their immune system over time and subsequently modified their overall immune response and foster the development of allergy related disease states. This writer has observed trends not subjected to scientific testing at any level yet, in children of first generation West African immigrants born in the USA (Bronx NY) who go on to develop varying levels of allergy symptoms which are mediated at many levels by immune dysregulation. The parents of these patients demonstrate no such problems and a cautious assumption may be to say their earlier childhood exposures in the developing world to different microbial agents in childhood may have fostered a proper maturation and development of their immune systems, i.e the troops (immune cells) remained battle ready and matured as anticipated. This perhaps fostered the innate ability of the immune system to distinguish self from non-self and keep the focus on the invading germs.

As we push the frontiers of medicine daily in the 21st century, some of these basic questions remain unanswered and beg for more research and elucidation of the facts. Until then, we will keep the hygiene hypothesis in the realm of hypotheses and continue to take all necessary precautions for clean, safe healthy skies, water, air, soil, food and above all planet. Louis Armstrong’s timeless classic, still chimes, “what a wonderful world”.

The information here is for patient health education purposes only and is not intended to serve as or replace the advice of a physician, please consult your healthcare provider as appropriate.

By Dr. Diji Vaughan
July 22, 2012
Category: Newborn
Tags: Allergies  

 

Allergies are on the rise! No one has quite figured out all the answers at this point. There’s the “hygiene hypothesis”, which we spoke about previously and other areas of intense on-going research beyond the scope of this post.

A parent wondered aloud recently and asked if her 13-month old son could be having nasal allergies? My answer was, Yes. This surprised her and this is why. This parent realized and correctly so that you can only respond with allergy-type symptoms to something you’ve been exposed to and subsequently sensitized to. The baby at 13-months old has barely gone through his first allergy season and presumably his very first exposure to the annual tide of environmental allergens (trees, weeds, grasses) and really unlikely to be reacting now, let alone mount an allergic response barely after the first year of exposure.

This parent is factually correct. The development of allergy symptoms often has many factors and is seldom a singular reason. Features of seasonal allergic rhinitis usually do not occur until the fourth or fifth year of life on the average. A number of exposure cycles are sometimes required before the cascade of bodily changes which eventually manifest as allergy peak. This 13-month old however was having nasal allergy type symptoms with sneezing, clear runny nose and frequent eye-rubbing not from seasonal “outdoor” allergens - but from perennial “indoor” allergens!

Perennial allergic rhinitis sufferers go through an accelerated cycle of exposure and subsequent sensitization easily due to the ubiquitous nature of the offending allergen in their immediate environment at home usually. The body’s allergy cascade could be sufficiently primed and put in effect within the first year of life. House dust mite, pet/ animal dander, mould, cockroach infested environments are common causes. Airway irritants like cigarette smoke are also harmful to the airway structures and can directly cause injury that may manifest with allergy type symptoms in the early stages. My patient referenced above lives in an environment where cigarette smoke is present and a number of pet animals are also present in the home. These factors together present poor air quality around this child and have inevitably led to the evolution of allergic rhinitis at a young age. 

There is a direct relationship between allergic rhinitis and asthma symptoms. Both conditions tend to reinforce each other and early control with an “all-of-the-above” approach to controlling symptoms with medications and improving the quality of air in the home are often very helpful.

Smoking cessation is an important component of the treatment plan. Smoking away outdoors as we often see is welcome. We realize in addition that the cigarette smoke irritants stay on the clothing, hair etc and can still be inhaled by the infant. Smoking cessation helplines are available nationwide and we encourage parents who smoke desirous of stopping to avail themselves of the opportunity. It's shockingly more of a challenge when the trigger is the pet animal. I’ve heard of a case though where the family decided to get rid of the Pediatrician rather than the offending pet! - we hope that won’t be the case this time.                    

'Diji Vaughan, MD

By Am I too Clean
April 19, 2012
Category: Symptoms
Tags: Allergies  

 

Am I Too Clean?

Is it conceivable to believe that an individual can be too clean for their own good?

Maybe. We know that immune system has an adaptive capability that matures and becomes more savvy as the challenges mounted by invading germs continue over a lifetime and the body prevails. This has been cast as a potential mutually beneficial relationship for the body and thankfully the invading germs in a theory proposed to explain the rising trend of allergy and immune system mediated diseases called the ‘hygiene hypothesis’. This theory maintains that living in very clean and hygienic environments robs one of the ample exposure to microbial organisms which are beneficial for the maturation and cutting edge ability to distinguish invaders from what belongs to the body. A disorderly maturation may then arise and predispose individuals to varying levels of abnormal immune responses which manifest in various  allergy mediated disease forms.

What explanations exist?

Needless to say, this is still a theory and not validated as a scientific fact yet. Researchers from the University of Michigan School of Public Health observed a pattern  corroborating another aspect of this theory, more amenable to scientific scrutiny. They examined data from the National Health and Nutrition Survey (NHANES) for the period 2003-2006. Two common environmental toxins, Triclosan and Bisphenol A  both of which have known effects on the delicate balance of the immune and hormonal systems respectively in the body were looked for in patients aged 6 and older who also had diseases attributable to immune dysregulation e.g, Hay fever. Their findings published online in November 2010, showed a relationship between having high levels of this Triclosan in the body and immune dysfunction associated disease. Triclosan, is an antimicrobial agent and is ubiquitous in the home environment. Diapers, antibacterial soaps, and toothpaste are some household items that contain this product. The higher levels of Triclosan seen in this patients may have sufficiently altered the population and type of microbes that these individuals would have been normally exposed to and therefore led to maldevelopment of the immune system and allergy related disease states.

Does this apply?

This writer has personally observed trends not subjected to scientific testing at any level yet and not valid for general application, in children of first generation West African immigrants born in the USA who go on to develop varying levels of allergy symptoms which are mediated at some level by immune dysregulation. The parents demonstrate no such problems and  a cautious assumption may be to say their earlier childhood exposures in the developing world to different microbial agents in childhood may have fostered a proper maturation and development of their immune systems. This perhaps fostered the innate ability of the immune system to distinguish self from non-self and keep the focus on the invading germs.