Medical Review / Research

RESEARCH

Currently being funded by AFC

ASTHMA: A RISK FACTOR FOR ANAPHYLAXIS

Investigators - Dr. M. Gold, Dr. P. Vadas, Dr. C. Graham, Dr. A. Atkinson

The presence of certain risk factors may intensify the allergic response. Asthma in particular has been associated with more severe and fatal anaphylactic responses. The contention of the investigators is that those individuals who react to specific allergens are more likely to develop more severe anaphylactic responses if severe and / or uncontrolled asthma is also present. The benefits of examining for the asthmatic state in allergic patients may in turn enhance the outcome of an anaphylactic response if prior asthmatic symptoms are appropriately controlled.

 

A STUDY OF ALLERGENICITY OF PLANT PROTEIN HYDROLYSATES

Investigators - Dr. E. Tsai, J. Yeung PhD, Dr. M. Gold, Dr. G. Sussman, B. Perelman PhD, Dr. P. Vadas, St. Michael's Hospital, The Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada

Hydrolyzed plant proteins (HPP) are used as flavour enhancers in commercial foods. Source plant proteins are degraded by either enzymatic or acid hydrolysis to yield amino acids or small peptides. Incomplete hydrolysis of the source plant protein may leave antigenic epitopes intact, potentially causing reactions in allergic individuals. The purpose was to determine the allergenicity of plant protein hydrolysates in patients allergic to the non-hydrolyzed source plant proteins. Five commercially prepared HPP's were obtained from various companies. HPP's#3 were derived from soy, HPP#4 from peanut and HPP#5 from wheat. The antigenicity of these HPP's were determined by ELISA's using anti-peanut and anti-soy antibodies. No wheat ELISA was available. A cohort of 11 patients with an allergy to peanut, 5 to soy, 3 to wheat and 6 controls were recruited. Subjects (4 males, 15 females) ranged in age from 13-56 years. The allergenicity of the HPP's was assessed by skin prick testing with serial tenfold dilutions of the HPP's until either a definite positive (wheal.4mm) or negative response to the highest concentration (100mg/ml) of HPP was seen. All skin prick tests were done in duplicate. Western blots were done to correlate the results of the skin testing, and to determine the pattern of IgE binding. The ELISA results showed 14.4 ppm soy in the soy HPP#1, 7.6 ppm soy and 6 ppm peanut in the soy HPP #2 and no soy or peanut detected in the soy HPP #3 or the peanut HPP #4. All the skin prick tests were negative to the highest concentration of all the HPP's. There were no significant skin test responses to any of the hydrolyzed plant proteins. Oral challenges will be undertaken to determine whether HPP's would cause reactions in individuals sensitized to the source plant proteins.

 

Food Allergies and Families: Who and What Helps Families Cope with a Diagnosis of Anaphylaxis in a Child?

Investigators - Deena Mandell, PhD, Ruth Curtis, MSW Additional co-authors: S. Hardie, PhD candidate, M. Gold, MD.

There is very little in medical, mental health or social work literature about the psychosocial dimensions of living with anaphylaxis. Using qualitative methodology, parents representing 17 families were interviewed about their family's experiences in adjusting to a diagnosis of anaphylaxis in a child. The ages of the 17 diagnosed children ranged from toddler to 18. From the responses about the nature and sources of helpful information, useful support, parenting dilemmas, family activities, anxieties, challenges and coping strategies, the authors develop an understanding of some important patterns in the adaptation of children and their families to living with anaphylaxis. There are developmental and episodic points at which anxiety rises and additional information and support to families become necessary. Parents identify the need to maintain a balance that is just right (the Goldilocks principle) between protective and debilitating anxiety. Identification of gaps in crucial information and supports suggest recommendations to medical practitioners about how to realistically optimize the help given to families when a child has been diagnosed with anaphylaxis.

 

Life Threatening Allergies More Common Than Suspected

The Berger Monitor formerly Canada Health Monitor Survey #18, August, 1998

Anaphylactic reactions, or life-threatening allergic reactions, are much more common than previously suspected. A 1998 survey of 2532 Canadians 15 years of age and older, commissioned by the Anaphylaxis Foundation of Canada and conducted by The Berger Monitor formerly Canada Health Monitor, found that 37% of Canadians have been told by a medical doctor that they have one or more allergies and 6% have four or more allergies. Among those with allergies 8% have been prescribed epinephrine/adrenaline a life-saving drug used to treat anaphylaxis. About 9% of all respondents had required emergency treatment for allergic reactions over the previous year. Previous estimates had placed approximately 50,000 Canadians at risk of life-threatening allergic reactions. However, according to the results of this recent survey the number is closer to 800,000. These results confirm our impression that allergies in general, and life-threatening allergies in particular, are becoming increasingly common. (Graphs) For further information regarding this survey or Media inquiries contact AFC at (416) 438-1917 or email at: [email protected] Contact: Earl Berger, Managing Director "The Berger Monitor", HayGroup (416)815-6405 or email: [email protected]

 

EPIPENS -SOLD IN ONTARIO NOW DOWN REGULATED
TO BTC (BEHIND THE COUNTER) STATUS. EPIPENS ARE STILL COVERED ON ODB FORMULARY

Ontario Drug Benefit (ODB) still has EPIPENS listed in their formulary and will continue to cover all of the ODB claims if prescribed and accompanied by a SAA- 1A form. BTC down regulation has not changed the status of the current coverage. It is listed in the ODB formulary under PIN # 0059558 for EPIPEN adult and PIN # 00578657 for the junior. The SAA-1A form must accompany a prescription for ODB benefits. SAA-1A forms are available to all physicians for their ODB patients. For information or supplies contact: Director, Drug Programs Branch, 3rd floor, 5700 Yonge Street, North York ON M2M 4K5 or call: (416) 327-8109 or the Manager, Ontario Drug Benefit Claims, 49 Place d'Armes, P.O. Box 58, Kingston, ON K7L 5J1 (613) 548-6552

Early evidence in the Toronto area has shown an increase in price for the BTC EPIPEN . Check with your pharmacists regarding a difference between the prescribed price and the BTC price before purchasing. Further information will be posted when available.