Research Database -
International Updates

Allergies

Issue 77

DE LA TORRE and colleagues, Hospital Nuestra Senora de la Candelaria, Tenerife, Canary Islands, Spain, ftorre@comtf.es, investigated possible cross-reactivity in vivo between the known allergens Artemisia vulgaris (a common weed in Tenerife, Canary Islands, Spain) and Matricaria chamomilla – i.e. whether exposure to one allergen can lead to an allergic reaction on exposure to the other – in individuals with asthma and/or rhinitis (‘hayfever’).
Background: There have been indications that there may be cross-reactivity between common subtropical weed A. vulgaris and several other plant allergens including those derived from hazelnut, kiwi, birch, several Compositae (Ambrosia, Chrysanthemum, Matricaria and Solidago) and grass allergens. Existing data on in vivo cross-reactivity between A. vulgaris and M. chamomilla are limited. The researchers sought to investigate this phenomenon in sufferers of asthma and/or hayfever.
Methods: Subjects were 24 individuals with asthma and/or rhinitis sensitized primarily to A. vulgaris. [However, skin prick tests with M. chamomilla were positive in 21 subjects.] Subjects received conjunctival challenges (by drops into the eye) and bronchial challenges (by inhaling) with A. vulgaris and M. chamomilla pollen extracts, and oral challenge with chamomile (by oral administration of a commercial chamomile infusion).
Results: In the conjunctival tests, 18 subjects had a positive response to A. vulgaris and 13 had a positive response to M. chamomilla. In the bronchial tests, 15 had a positive response to A. vulgaris and 16 had a positive response to M. chamomilla. With the oral test, 13 subjects had a positive response to the chamomile infusion. 9 subjects were also found to have positive skin prick tests to food allergens and 17 had positive skin prick tests to other pollens of the Compositae family.
Conclusion: The authors concluded that there is a high degree of in vivo cross-reactivity between A. vulgaris and M. chamomilla. Individuals sensitized to A. vulgaris are likely to be at risk of experiencing allergic symptoms if they ingest chamomile infusions. The results of the study also indicate that M. chamomilla may be an important respiratory allergen.
de la Torre MF et al. Clinical cross-reactivity between Artemisia vulgaris and Matricaria chamomilla (chamomile). Journal of Investigative Allergology and Clinical Immunology 11 (2): 118-22. 2001.

LEWITH and colleagues, Medical Specialities, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK, GL3@soton.ac.uk, evaluated the effects of homeopathic immunotherapy on lung function and respiratory symptoms in people with asthma and allergy to house dust mites.
Methods: This was a double-blind, randomized, controlled trial involving 38 GP surgeries in Hampshire and Dorset, UK. The participants were 242 asthmatics who had a positive response to a skin prick test for house dust mite allergy. The subjects entered a 4-week baseline assessment period, after which they were given oral homeopathic immunotherapy or a placebo treatment. They were assessed over 16 weeks, During which they were assessed in the clinic (3 visits) on lung function (measurements of forced expiratory volume in 1 second [FEV1]), quality of life and mood. They also assessed themselves on morning and evening lung function (measurements of peak expiratory flow [PEF], using a portable PEF meter) and on severity of asthma (using a visual analogue scale [VAS]), quality of life and daily mood; and they recorded their findings in a diary. 202 of the subjects completed the clinic-based assessments and 186 completed the diary-based assessments.
Results: For most of the outcome measures, there were no differences between homeopathic immunotherapy and placebo treatment. Three of the diary assessments showed a different pattern of change between the 2 groups over the period of the trial: morning PEF; severity of asthma; and mood. The researchers were unable to explain the reasons for or the significance of these differing patterns of change. With homeopathic immunotherapy, severity of asthma increased significantly and mood deteriorated compared with placebo treatment. Participants’ belief in complementary medicine was unrelated to any improvement in asthma.
Conclusion: The oral homeopathic immunotherapy used in this study was ineffective for treating patients with asthma and house dust mite allergy.
Lewith GT et al. Use of ultramolecular potencies of allergen to treat asthmatic people allergic to house dust mite: a double blind randomised controlled clinical trial. British Medical Journal 324 (7336): 520. Mar 2002.

POTHMANN and colleagues, Kinderneurologisches Zentrum Oberhausen, Essen, Germany, assessed the diagnostic value of applied kinesiology (AK) in the area of food intolerance.
Background: Applied kinesiology (AK) is popular among individuals who are thought to have a nutritional intolerance. Many individuals utilize complementary/alternative medicine (CAM) due to the difficulty of diagnosis and treatment of these ailments by conventional methods. The scientific basis or validity of AK remains uncertain. The investigators sought to assess the diagnostic validity of AK by comparing it with established laboratory tests for food sensitivities.
Methods: The study involved 315 children and adolescents (0-17 years of age) with chronic ailments such as headache, abdominal pain, eczema, hyperactivity and bronchial asthma. The participants were assessed using AK for a period of 2 years. AK diagnoses were compared with those obtained from laboratory tests such as RAST, the lactose breath hydrogen test and a specific immunoglobulin G (IgG) test (Cytolisa).
Results: AK methods showed moderate test-retest reliability, but showed no reliability between different testers. There was no statistically significant agreement between diagnoses made by AK and those made using either RAST or Cytolisa or using the lactose breath hydrogen test.
Conclusion: The researchers concluded that AK could not, in general, be recommended for diagnosing nutritional intolerance. However, it did show high sensitivity and therefore might be valuable for providing preliminary diagnostic findings.
Pothmann R et al. (Evaluation of applied kinesiology in nutritional intolerance of childhood.) Forschende Komplementaermedizin und Klassische Naturheilkunde 8 (6): 336-44. Dec 2001.

Issue 67

KAIL, Naturopathic Family Care, Phoenix, AZ, USA, kkail@home.com, used a diagnostic and treatment protocol of electrodermal screening in allergy patients.
Methods: 90 patients with a diagnosis of allergy or sensitivity were treated with electrodermal screening. Treatment was continued to an endpoint chosen as normalisation of electrodermal conductivity at specific acupuncture points. An Allergy Symptom Severity Index was developed to measure outcome.
Results: A statistically significant change in pre- and post treatment measurements was observed. 87.2% of patients rated the efficacy of the treatment as good or excellent. Evaluation at up to three years post treatment still showed excellent results, suggesting excellent longevity of the treatment. 48% of patients experienced an initial exacerbation of symptoms lasting on average 10 hours. No serious long-term adverse effects could be detected.
Conclusions: Electrodermal screening appears to be an effective, long-lasting, and economical treatment for allergy across all gender and age groups.
Kail K. Clinical outcomes of a diagnostic and treatment protocol in allergy/sensitivity patients. Alternative Medicine Review 6 (2): 188-202, Apr 2001.
Comments: Electrodermal screening for allergy diagnosis and treatment is often criticized by the medical profession. The above clinical results are exceptionally positive, lasting even up to the 3-year follow-up. Greater respect by the medical community for such methods for allergy treatment is genuinely warranted.

OGAWA and colleagues, Research Institute for Food Science, Kyoto University, Uji, Japan, reviewed what is known about the allergenic constituents of soy bean, and how these allergens can be removed from soy bean products, thus making them safe for consumption by soy bean-sensitive patients.
Background: Three main proteins contained in soybean show an immune reaction with the blood of soy bean-sensitive patients. They are known as Gly m Bd 60k, Gly m Bd 30k, and Gly m Bd 28k.
Methods: The literature on these three proteins was reviewed (46 references), and methods of inactivation that can be industrially applied were reviewed.
Results: By a combination of chemical breeding, which eliminated two of the proteins, and a salting-out technique (or alternatively enzymatic digestion), all three proteins were removed from soy bean products such as soy milk, cooked soy bean grains, tofu, and fermented soy paste (Miso). In a preliminary trial, about 80% of soy bean-sensitive patients were able to ingest these products without any adverse reactions.
Conclusions: It appears to be possible to breed and chemically modify soybean products in such a way that they are safe to eat for even soybean-sensitive persons.
Ogawa A, Samoto M, Takahashi K. Soybean allergens and hypoallergenic soybean products. Journal of Nutritional Science and Vitaminology 46 (6) : 271-9. Dec 2000.

Issue 47

KROUSE and KROUSE, Department of Otolaryngology, College of Nursing, University of Florida, Gainesville USA write that an estimated 50 million Americans are bothered with symptoms of allergic disease and sinusitis. The authors studied the use of complementary therapies for allergic disease by patients prior to consulting an otolaryngologist.
Methods: The authors conducted a prospective clinical survey with 120 adult patients from a community-based otolaryngology practice, presenting with sinusitis and rhinitis complaints. Patients complete a set of questionnaires assessing the types of traditional and complementary therapies they had used, as well as a questionnaire evaluating their presenting symptoms. All the data were analysed statistically.
Results: Patients had been symptomatic for a mean length of 3.5 years prior to seeking therapy from the otolaryngologist. 87% of patients had previously seen a primary care provider, and 42% had previously consulted an otolaryngologist. In addition to conventional medications, many patients had also used a variety of complementary treatment, including diet and nutritional management, herbal therapy, exercise and chiropractic. Patients who had previously seen an otolaryngologist were commonly treated with surgery.
Conclusions: These data demonstrate that patients use conventional and complementary therapies prior to seeking medical help from an otolaryngologist. The data also show that despite aggressive medical and surgical therapy, many patients persist with symptoms.
Krouse JH and Krouse HJ. Patient use of traditional and complementary therapies in treating rhinosinusitis before consulting an otolaryngologist. The Laryngoscope 109(8): 1223-7. Aug 1999.

Comments: The above studied show, not only that allergic conditions are a significant health problems affecting 50 million of people in the US alone, but also that a range complementary therapies, including diet, homoeopathy and Chinese massage can be effective. Conventional treatment by otolaryngologist for sinusitis and allergic disease is often surgery.

WEISER and colleagues, Institut fur Antihomotoxische Medizin und Grundregulationsforschung, Baden-Baden, Mannhein, Germany compared the efficacy and tolerance of a homoeopathic nasal spray for hay fever (seasonal allergic rhinitis) with conventional intranasal cromolyn sodium therapy.
Methods: 146 patients with hay fever symptoms were recruited into the randomised, double-blind trial of 42 days. The homoeopathic remedy (Luffa comp. –Heel trade mark Nasal Spray), 0.14 ml per application, 4 times per day consisted of a fixed combination comprised of Luffa operculata, Galphimia glauca, histamine and sulfur. Quality of life, as measured using the Rhinoconjunctivitis quality of Life Questionnaire (RQLQ) was the principal outcome measure. The trial medication tolerance was measured using global assessment, rhinoscopy, recording of adverse events and the use of vital and laboratory parameters.
Results: The treatment showed quick and lasting effects. This effect was independent from the medication applied and produced an almost complete remission of hay fever symptoms. RQLQ global scores changed significantly during the course of the treatment, demonstrating therapeutic equivalence between the 2 forms of treatment. There were no adverse systemic effects, although local adverse events appeared in 3 patients.
Conclusions: The homoeopathic nasal spray is as efficient and well tolerated as conventional therapy with cromolyn sodium for the treatment of hay fever.
Weiser M et al. A randomized equivalence trial comparing the efficacy and safety of Luffa comp .-Heel nasal spray with cromolyn sodium spray in the treatment of seasonal allergic rhinitis. Forschende Komplementaermedizin 6(3): 142-8 Jun 1999.

JONES and ROBBINS, Section of Pulmonary and Critical Care Medicine, Louisiana State University Medical Center at Shreveport, USA review the literature (29 references) regarding alternative therapies for chronic bronchitis.
Results and Discussion: Therapies for chronic bronchitis can be broadly divided into expectorants, mucolytics, mucokinetics, antiproteases, antioxidants, and immunostimulants. The data which support these therapies may be present in disorders clinically similar to chronic bronchitis, such as cystic fibrosis, or may be based on clinical observations or in vitro studies suggesting a potential therapeutic benefit. The establishment of these therapies will require more extensive investigation prior to the recommendation for their routine use.
Conclusions: Until such substantiating data is available, the clinician must use his or her clinical judgement regarding the likely risk-benefit ratio.
Jones KL and Robbinss RA. Alternative therapies for chronic bronchitis. The American Journal of the Medical Sciences. 318(2): 96-8. Aug 1999.

Issue 44

KATSAROU and colleagues, Department of Dermatology, University of Athens, A. Sygros Hospital, Greece write that the most common reaction to fragrances is contact dermatitis, a delayed hypersensitivity reaction; other reactions include immediate contact reactions such as contact urticaria and photo-allergic reactions. The authors used fragrance mix (FM) and balsam of Peru (BP) to screen for fragrance allergy, in order to study different types of allergic skin reactions to fragrance compounds.
Methods: The authors studied delayed hypersensitivity reactions to FM and BP in 4,975 patients with suspected contact dermatitis using routine patch testing. Results were interpreted at 48 and 96 hours. In 664 of the patients, the patch tests were read at 30 minutes in order to evaluate for immediate contact reactions, and again at 48 and 96 hours. In 111 patients suspected of having photo-allergic dermatitis, photopatch tests to FM were performed.
Results: There were delayed contact reactions to FM in 6.6% of females and 5.4% of males; to BP in 3.9% of females and 4.1% of males. Over 12 study years, there was an increased trend for reactions to fragrances, particularly in males. In 62% of patients, there was sensitivity to other contact allergens (polysensitivity), which presented more often with generalised contact dermatitis. The most sensitising components of the fragrance mix tested in 38 patients were cinnamic alcohol, oak moss, and cinnamic aldehyde. There were 112 immediate patch test reactions to FM and 113 to BP in 664 patients. Delayed contact reactions followed immediate contact reactions in 13.4% of patients for FM and 8.8% for BP. This represented a significant increase in the frequency of delayed contact reactions. However, patients with immediate contact reactions to fragrances did not have a higher incidence of atopy (25.9%). There were no cases seen of positive photopatch test reactions to FM.
Conclusions: Fragrances commonly cause both delayed and immediate patch test reactions. Patients with immediate contact reactions have an increase in delayed contact reactions to the same allergen.
Katsarou A et al. Contact reactions to fragrances. Annals of Allergy, Asthma, and Immunology 82(5): 449-55. May 1999.

ZHOU and ZHANG, Department of Epidemiology, Suzhou Medical College, Jiangsu, China researched effective therapy to treat allergic rhinitis accompanying asthma.
Methods: The authors treated 419 cases of allergic rhinitis accompanying asthma caused by allergens using a combined desensitising therapy, with acupoint of the head and upper back with the extract of positive allergen(s).
Results: Following 3 treatment courses, the extract of allergens was taken again to make intradermal injections. The diameter of redness and swelling on the skin was significantly reduced in comparison with that before treatment. There was a significant difference between lymphocyte transformation incorporation rate of a combined desensitising acupoints group and A or B control groups. Also significant was the difference of acidophil cell direct count, IgA, IgG and E-rosette formative rates compared with A or B control groups. Of the 419 cases followed up for 3 years, 68.73% of the patients demonstrated a markedly curative effect and 29.12% turned better. Compared with the other 2 control groups, the differences of the treatment group were significant.
Conclusions: This research demonstrated that this combined desensitising method of therapy is promising and worthwhile in the treatment of allergic rhinitis accompanying allergic asthma.
Zhou RL and Zhang JC. An analysis of combined desensitizing acupoints therapy in 419 cases of allergic rhinitis accompanying asthma. Chung Kuo Chung His I Chieh Ho Tsa Chih 17(10): 587-9 Oct 1997.