clair088

Until a few years ago, it was thought that microbes don’t live in the lung’s passages.  But now we know that there is a diverse range of microbiota that lives there.  In this month’s issue of JACI, Sverrild and colleagues examine the relationship between these microbes and patterns of airway inflammation in healthy patients and in asthmatics who have not taken steroids ( J Allergy Clin Immunol 2017; 140(2): 407-417 ).  In order to do so, they took 10 healthy participants and 23 nonsmoking steroid-free asthmatics and had them undergo bronchoscopy so that they could get fluid from the lower passageways.  They then sequenced bacterial DNA and looked at the number and type of immune cells.  The 33 participants also had their asthma better characterized through other standardized measures of disease severity like airway hyperresponsiveness to mannitol and fraction of exhaled nitric oxide. They found that patients with eosinophilic asthma and those with hyperresponsiv...

Cockroaches are small, scurrying insects that we just don’t like to think about.  But as small as they are, they have a large impact on asthma and allergies.  In this month’s issue of JACI, Rabito and colleagues look at the effect of cockroach elimination on asthma outcomes ( J Allergy Clin Immunol 2017; 140(2): 565-570 ).  They build on previous work showing that integrated pest management (IPM) reduces cockroach levels.  But because IPM is s costly and requires special expertise, it is generally not practical for low-income families.  Instead, the authors looked at the efficacy of insecticidal bait, which is much cheaper and can be done by almost anybody.  They followed 102 children (between the ages of 5 and 17) who live in New Orleans. At the beginning of the study, field technicians laid traps for cockroaches.  Over the next 12 months, 53 of the children’s houses were visited six times to place the bait, and asthma was evaluated every 2 months by ...

Food allergies are seen in up to 1 in 12 school-age children in the United States today, and peanut is one of the most common allergens.  In response, many schools have started to have peanut-free policies, but the effect of these policies has not yet been rigorously assessed.  In this month’s issue of JACI, Bartnikas and colleagues examine how peanut-free policies affect the rate of potentially fatal allergic reactions to peanut ( J Allergy Clin Immunol 2017; 140(2): 465-473 ).  They looked at 2,223 public schools in Massachusetts during a five-year period, of which 6.3-10.3% banned peanuts from being brought from home, 56.6-59.1% banned peanuts from being served in school, 90.1-91.1% had peanut-free tables and 65.6-67.4% had peanut-free classrooms.  Among these schools, 46 (1.5-2.9%) self-designated as being a “peanut-free school,” but there was considerable variability in how these schools defined a self-designated “peanut-free school,” with 28.9% still allowing p...