EMH Reference Laboratory

Asthma and Allergies

Asthma is a progressive inflammatory disease in which allergies are a cause most of the time.^1-3 Medications are helpful and necessary but they do not always do enough.⁵ As a result, nearly all asthma patients experience a daily variability of asthma symptoms which go unreported or unrecognized. The National Institutes of Health recognize the need and recommend options for a more comprehensive management of asthma.⁴

One of these options is the utilization of in vitro specific IgE testing to reliably determine sensitivity to allergens to which the patient is exposed. ImmunoCAP ® (specific IgE blood test) results tell you exactly what patients are sensitive to and help guide a practical approach of targeting exposure reduction to specific sensitivities. Following simple and practical exposure reduction techniques (along with medications) allows for a much more comprehensive management of asthma and a better chance of symptom resolution.

Approximately 60% of adults and 90% of children with asthma have IgE-mediated sensitivities.^1-3 Allergic asthma consists of a complex and insidious allergic inflammatory process that results in symptoms and subsequent medications. The NIH recommends complete symptom management4 and studies indicate that medications are usually not able to achieve this lofty goal on their own.⁵

Most asthma patients have unreported and unrecognized symptoms. Well-designed studies show that:

• More than 2/3 of all asthma patients have unscheduled office visits.⁵
• Nearly half of asthma patients who seek primary care for non-respiratory reasons report asthma symptoms and exacerbations.⁶
• 92% of asthma patients have experienced symptoms in the past 2 weeks.⁷
• 56% of asthma patients experience at least 1 day of wheezing every 2 weeks.⁸

Learning what patients are sensitive to and taking a sensible and practical approach to reducing exposure to these sensitivities can produce dramatic results. Well-designed studies show that:

• Targeted exposure reduction can dramatically reduce hours of wheezing and doses of medication.⁹
• Targeted exposure reduction produces symptom improvement comparable to that achieved with pharmacotherapy.¹⁰
• Practical targeted exposure reduction techniques can produce dramatic results even in very difficult environments (e.g., inner city), and produce an effect similar to inhaled corticosteroid therapy.¹¹

EMH Reference Laboratory performs the ImmunoCAP ® specific IgE assay, a simple and easy to order blood test with a 95% positive predictive value. The results are easy to read and consist of specific individual sensitivities which allows the implementation of a practical and targeted approach to reducing exposure to these sensitivities.

References
1. Milgram H. AAAAI news release. Milwaukee, WI: American Academy of Allergy, Asthma and Immunology;June 18,2003. 2. Allen-Ramey F, et al. J Am Board Fam Pract. 2005;18(5):434-439. 3. Host A, et al. Allergy. 2000;55:600-608. 4. NIH. Guidelines for the Diagnosis and Management of Asthma, 2007. NIH publication 08-4051. 5. Peters SP, et al. J Allergy Clin Immunol. 2007;119:1454-1461. 6. Stanford RH, et al. Research findings abstract #4. Presented at: ACAAI 2008 Annual Meeting ; Seattle, WA; November 9, 2008. 7. Britto M, et al. Adolescent medicine abstract 4300.6. Presented at: PAS & ASPR Joint Meeting. Honolulu, HI; May 4, 2008. 8. Stingone JA, et al. J Allergy Clin Immunol. 2008;122(4):748-753. 9. Murray AB, et al. Pediatrics. 1983;71:418-422. 10. Eggleston PA, Immunol Allergy Clin North Am. 2003;23:533-547. 11. Morgan WJ, et al. N Engl J Med. 2004;351:1068-1080.