Asthma Abstracts 2

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The role of food allergy in children's bronchial asthma
            (Basomba, 1967)  Download
There are a great many factors which play an important role in the etiology of infantile asthma. The bacterial and the inhalant factors are often taken into consideration, but the possibility that the process might be due to the action of certain foods is largely disregarded. Among the 200 cases studied, disregarding other allergenic factors such as the inhalant or bacterial type, 44 cases were found to have a positive food case history, i.e. 22%. Thirty of them could be confirmed by the skin tests, whereas in the 14 remaining cases the results obtained with foods other than those which suggested the case history were negative or positive. We have demonstrated the high percentage (45%) of intestinal parasitosis, which is to be found in asthmatic children, and the importance of this condition particularly with regard to food sensitizations, not only in skin al- lergies but also in infantile asthma. This has also been demonstrated by other authors .In some cases we could observe a complete remission of the bronchospasmodic symptomatology due to food allergy by simply treating the concomitantly existing parasitosis.

The Hypochlorhydria of Asthma in Childhood
            (Bray, 1931)  Download
From the earliest times ‘digestive upsets’ have been noted by all observers in association with the asthmatic habitude, and dietetics have proved one of the main strongholds of the therapeutists. Asthmatic children, in general, show a diminished power of secreting acid gastric juice in response to a test meal as compared with normal children. The author is applying acid therapy to all cases of allergy in which a hypochlorhydria is determined by gastric analysis.

Effect of parenteral magnesium on pulmonary function, plasma cAMP, and histamine in bronchial asthma.
            (Brunner et al., 1985)  Download
Ten mild to moderate asthmatic subjects were selected from the allergy clinic population of the Los Angeles County-University of Southern California Medical Center. All had an atopic background as evidenced by positive puncture tests to routine inhalant allergens. I.V. magnesium, 25 mg/kg in 100 ml normal saline, or normal saline was infused over 30 min.  Comparison with the best observed value showed an average 21% improvement in FEV, and 59% improvement in MMEF for both trials combined. Before epinephrine percent changes from baseline for FEV, were -4.4% with placebo and +2.2% with magnesium, which repre- sents a significant difference (p =0.04). For MMEF, the difference in percent change from baseline was 11.7% in favor of improvement with magnesium but this was not significant (p=0.11) because of greater scatter in the data. After epinephrine, MMEF again approached significance (p=0.08) with a 22% difference between percent improvement over baseline for the magnesium versus placebo.

Vitamin B12 and the growth of children: a review
            (Campbell and Mc, 1955) Download
Vitamin B12 is known to be specific for the treatment of pernicious anemia but its role in promoting growth in children has not been so firmly established. Nine reports on the oral administration of vitamin B12 to normal and underweight children and several reports on its use for chronically ill children have been reviewed. The reports are conflicting and demonstrate, above al, a need for critically controlled experiments before any definite conclusions can be reached regarding the possible effect of vitamin B12 on growth in children. To date, available evidence indicates that the effect is far from spectacular and that there is little, if any, justification for the widespread use of vitamin B12.

Upon therapy for asthma using vitamin B12 (Abstract)
            (Caruselli, 1952a)  Download
Vitamin B12 in Asthma. Good results were obtained with vitamin B12 in 10 of 12 patients with asthma to whom the vitamin was given daily in doses of 30 mg. for 15 to 20 days. In six of the patients, the disease was due to bacterial allergy. Symptoms improved, the asthmatic attacks ceased, and there was a pronounced improvement in general condition, with weight gains. This therapy also cured severe constipation in one patient and dyspepsia due to hyperacidity in another. An antiallergic action of the vitamin is suggested. A recurrence in two patients after three and eight months, respectively, subsided when the vitamin was given again. Two patients in whom asthma was associated with circulatory decompensation and whose condition was aggravated by strophanthin and digitalis improved with vitamin Biz. This result may be due to an improvement in hemodynamics and oxygénation of the blood or, more likely, to a direct action of the vitamin on the nutrition and function of the myocardium. The two patients in whom this therapy failed were old persons in whom asthma was associated with severe pulmonary emphysema and hypertensive arteriosclerosis. In these patients the disease may no longer have been due to active allergic factors but to irreversible anatomic and functional changes.


 

[Treatment of asthma with vitamin B12]
            (Caruselli, 1952b)  Download
For about a year we have been experimenting on the action of vitamin B12 on the course of illness in bronchial asthma. Vitamin B12 affects a beneficial influence on the course of asthmatic bronchitis, cutting down extreme symptoms and giving aid toward long period of remission even in cases where common treatment gave only a hazy result.

Pyridoxine treatment of childhood bronchial asthma
            (Collipp et al., 1975)  Download
Urinary xanthurenic and kynurenic acid levels were measured in five patients while they were receiving 50 mg and 100 mg of pyridoxine. The levels of tryptophane metabolite decreased progressively as the dose was increased but remained above basal levels. There was marked clinical improvement in these patients while receiving the higher dose only. The double-blind study with 76 asthmatic children followed for five months indicated significant improvement in asthma following pyridoxine therapy (200 mg daily) and reduction in dosage of bronchodilators and cortisone. The data suggest that these children with severe bronchial asthma had a metabolic block in tryptophane metabolism, which was benefitted by long-term treatment with large doses of pyridoxine.

Hypochlorhydria In Asthma: With Special Reference To The Age Incidence
            (Gillespie, 1935) Download
Fractional test meals were carried out on 109 asthmatic patients. Low free acidity was found in 51.5 per cent, and low total acid in 41.2 per per cent, of cases. Excess mucus and increased combined acidity were also present in many cases. Hypochlorhydria was found to be most common in asthmatic children under 15, and less so in young adults: it again became more common in those nearing middle age. It would appear that gastric acidity does not remain the same throughout life in allergic individuals, but tends to increase in a certain percentage of cases about puberty. Female asthmatics from 15 years of age upwards. showed a higher percentage of hypochlorhydria than males of the same age. Before 15 years of age there was practically no difference in the sex incidence. Sensitivity, as shown by skin tests, bore no apparent relationship to the hypochlorhydria. Repetition of the analyses after treatment showed definite change in 59 per cent, of cases. Improvement in gastric acidity in originally hypochlorhydric cases coincided with clinical improvement. The probable factors in the causation of hypochlorhydria have been discussed.


 

Erythrocyte aspartate amino transferase activity in asthmatic and non-asthmatic children and its enhancement by vitamin B6
            (Hall et al., 1981)  Download
Erythrocyte aspartate amino transferase activity with and without in vitro pyridoxine stimulation has been measured in asthmatic and non-asthmatic children. No significant differences were found which would support a suggestion of pyridoxine deficiency in the patients studied.

A double-blind controlled trial of elemental diet in severe, perennial asthma
            (Hoj et al., 1981)  Download
In a double-blind controlled trial 41 hospitalized adults with severe, perennial asthma of unknown aetiology were allocated to either an antigen-free elemental diet (Vivasorb) or control diet, i.e. blended ordinary hospital food, for 2 weeks. At the time of entry into the trial all patients were in an active but stable phase of the disease. Medical treatment was given throughout the study as clinically indicated. Peak expiratory flow was measured hourly during the daytime and patients noted their symptoms daily on an assessment form. Validation of variables according to a scoring system indicated that the elemental diet resulted in an improvement of the patients asthma (p less than 0.05). It is concluded that elemental diet may serve as a diagnostic tool for disclosing alimentary intolerance in patients with perennial asthma.

Effect of vitamin B12 in asthma
            (Kaufman, 1951) Download
Marked improvement in a patient with asthma was noted by Wetzel during administration of oral vitamin B12 in doses of 10 micrograms daily. Of the eight patients to whom vitamin B12 was administered, there was improvement in only one individual.

Nigella sativa Supplementation Improves Asthma Control and Biomarkers: A Randomized, Double-Blind, Placebo-Controlled Trial.
            (Koshak et al., 2017)  Download
Poor compliance with conventional asthma medications remains a major problem in achieving asthma control. Nigella sativa oil (NSO) is used traditionally for many inflammatory conditions such as asthma. We aimed to investigate the benefits of NSO supplementation on clinical and inflammatory parameters of asthma. NSO capsules 500 mg twice daily for 4 weeks were used as a supplementary treatment in a randomized, double-blind, placebo-controlled trial in asthmatics (clinicaltrials.gov: NCT02407262). The primary outcome was Asthma Control Test score. The secondary outcomes were pulmonary function test, blood eosinophils and total serum Immunoglobulin E. Between 1 June and 30 December 2015, 80 asthmatics were enrolled, with 40 patients in each treatment and placebo groups. After 4 weeks, ten patients had withdrawn from each group. Compared with placebo, NSO group showed a significant improvement in mean Asthma Control Test score 21.1 (standard deviation = 2.6) versus 19.6 (standard deviation = 3.7) (p = 0.044) and a significant reduction in blood eosinophils by -50 (-155 to -1) versus 15 (-60 to 87) cells/μL (p = 0.013). NSO improved forced expiratory volume in 1 second as percentage of predicted value by 4 (-1.25 to 8.75) versus 1 (-2 to 5) but non-significant (p = 0.170). This randomized, double-blind, placebo-controlled trial demonstrated that NSO supplementation improves asthma control with a trend in pulmonary function improvement. This was associated with a remarkable normalization of blood eosinophlia. Future studies should follow asthmatics for longer periods in a multicentre trial. Copyright © 2017 John Wiley & Sons, Ltd.

Gastric Secretion in Infants and Children
            (Neale, 1930) Download
An easy and accurate method of obtaining the gastric contents in the child is described. A 7% alcohol-water mixture is an adequate stimulus of gastric secretion in the child and may be used as a test for achlorhydria. The only adequate test for achylia gastrica is the absence of acid gastric secretion after the subcutaneous injection of histamine. The maximum acidity of the pure gastric juice varies considerably in any one age group in infants and children. This is similar to Ryle's results in adults using the fractional test meal. The volume of gastric secretion in infants during the milk feeding period is very small ; after this period of life the quantity is very greatly increased. It is suggested that the gastric secretion in the infant does not play so important a part in normal digestion as it does in the older child.

Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma.
            (Okayama et al., 1987)  Download
The bronchodilating effect of magnesium sulfate (MgSO4) was studied in ten asthmatic patients with mild attacks. In five patients, 0.5 mmol/min of MgSO4 was administered intravenously for 20 minutes, and the time courses of respiratory resistance, forced vital capacity, and forced expiratory volume at 1 s were studied. In another five patients, MgSO4 dose-response curves were obtained. Soon after administration began, MgSO4 relieved bronchoconstriction in a dose-dependent manner. Maximum responses (mean +/- SE) of respiratory resistance, forced vital capacity, and forced expiratory volume were 71% +/- 3%, 117% +/- 5%, and 118% +/- 1% of initial values, respectively, and were similar to the effects of additional albuterol inhalation. The infusion of MgSO4 also improved dyspnea and piping rales in three other asthmatic patients with a severe attack. We conclude that intravenous infusion of MgSO4 produces a rapid and marked bronchodilation in both mild and severe asthma and may be a unique bronchodilating agent.

Observations on the Treatment of Asthma
            (Pridham, 1860)  Download
I speak now of what is called dyspeptic asthma -a disease which I believe to be peculiarly hereditary; that is to say, when the disease has once made its appearance, those who inherit it will ever be liable to attacks from imprudent diet. Diet: Breakfast at eight o'clock - half a pint of green tea or coffee, with a litle cream, two ounces of dry stale bread; dinner at one o'clock-two ounces of fresh beef or mutton without fat or slain, two ounces of stale dry bread or well boiled rice; three hours after dinner, half a pint of weak brandy and water, or toast-water ad libitumn; supper at seven o'clock -two ounces of meat with two ounces of dry bread. In addition to this, I ordered him three grains of the extract of conium four times a day.

Depressed plasma pyridoxal phosphate concentrations in adult asthmatics.
            (Reynolds and Natta, 1985)  Download
In 15 adult patients with bronchial asthma, plasma and erythrocyte pyridoxal phosphate (PLP) concentrations were significantly lower than in 16 controls (P less than 0.0001 and P less than 0.005, respectively). Oral supplementation of seven asthmatics with 50 mg pyridoxine as pyridoxine X HC1 twice daily failed to produce a sustained elevation of PLP in either the plasma or erythrocytes. However, all subjects reported a dramatic decrease in frequency and severity of wheezing or asthmatic attacks while taking the supplement. The reasons for the failure of a uniform elevation in plasma and erythrocyte PLP concentration and for the apparent beneficial effects of pyridoxine supplementation on the asthmatic symptoms of the patients are unknown at present.

Bronchial asthma due to food allergy alone in ninety-five patients.
            (Rowe et al., 1959)  Download
The assumption that bronchial asthma is due to inhaled allergens, such as the pollens, has sometimes resulted in overlooking aller- gens in food. Food allergy has too often been ignored or inadequately controlled when it was the sole cause of bronchial asthma or contributed to the effects of inhaled allergens. Recognition of the importance of food allergy in a given patient is usually impossible unless one begins with a cereal-free elimination diet which assumes allergy to cereal grains as well as to milk, eggs, and other less common allergenic foods. This was clearly demonstrated in 50 children and 45 adults, whose bronchial asthma was relieved without use of antigens, vaccines, corticosteroids, or ACTH. Strict adherence to the diet was necessary at first, especially in the winter, but in many cases it was found that tolerance to some foods developed in one to four years and that a more liberal diet could be allowed in the summer.

Vitamin B12 therapy in allergy and chronic dermatoses.
            (Simon, 1951)  Download
Vitamin B12 therapy using 1,000 pg. doses intramuscularly at weekly inter- vals was tried on 20 patients with asthma and 28 patients with chronic dermatoses. The number of patients treated with each type of chronic dermatitis is too small to draw any definite conclusions. However, it is felt that further trial of this therapy in chronic contact dermatitis and chronic urticaria is indicated. The response to B12 by the patients with asthma was equivocal and in no case was spectacular.

Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department.
            (Skobeloff et al., 1989)  Download
Conventional nebulized beta-agonist therapy has met with disappointing results in an increasing number of moderate to severe asthmatics who may be characterized as "poor responders." Thirty-eight patients suffering from acute exacerbations of moderate to severe asthma were treated in an emergency department with an intravenous infusion of saline placebo or 1.2 g of magnesium sulfate after conventional beta-agonist therapy failed to produce significant improvement in peak expiratory flow rate. Nineteen patients were randomized into each of two groups in a placebo-controlled, double-blind clinical trial. The treatment group demonstrated an increase in peak expiratory flow rate from 225 to 297 L/min as compared with 208 to 216 L/min seen in the placebo group. In addition, the number admitted vs discharged was significantly better for the treatment group (7 vs 12) than the placebo group (15 vs 4). Intravenous magnesium sulfate may represent a beneficial adjunct therapy in patients with moderate to severe asthma who show little improvement with beta-agonists.

Growth failure in school children as associated with vitamin B12 deficiency; response to oral therapy.
            (Wetzel and Fargo, 1949)  Download
In August 1949 we began to administer 10 µg of crystalline vitamin B12 orally to I1 children ( 6 boys, 5 girls; ages 5-12 years) 3 of whom were selected on account of slow progress, the remaining 8 at random from a group of 76 under regular care for varying degrees of malnutrition and in varying states of recovery from simple growth failure. Takcn togcther, the foregoing results speak, and they speak with measurable statistical certainty, of what may be termed B12 functional deficiency, that was definitely benefited by oral therapy. As a final mcasure of effects it may be remarkcd that the growth responses werc equivalent to another 100-240 days of rcgular institutional care without the help of B12.

 

Growth failure in school children; further studies of vitamin B12 dietary supplements.
            (Wetzel et al., 1952)  Download
In continuation of studies reported previously (Abst. 5424, Vol. 19), the grid technique of assessing growth was used to select children suitable for studying the effect of vitamin B12 on growth. A study of simple growth failure had been in progress in the Shaker Heights Schools since 1941 and 4500 long-term-records were available for comparison. An initial test was made with 60 children and a more extensive one with 236. In each test some normal children were included; some who showed growth failure received 10 µg. vitamin B12 daily by mouth for 16 weeks, some for 6 weeks, and some had no supplement. A significant growth response to the oral dose of vitamin B12 was recorded in the children who had previously shown retarded growth. The treatment with vitamin B12 produced also a general sense of wellbeing and an improvement in interest and attention in school work. No definite correlation was found between the growth response to vitamin B12 and physical performance as measured by change in grip or in back or leg strength. In an addendum the report of Benjamin and Pirrie (Abst. 2856, Vol. 22) is discussed, and it is considered that the results are not incompatible with those reported in Abst. 5424, Vol. 19. A. M. Copping.

 


References

Basomba, A. (1967), ‘The role of food allergy in children’s bronchial asthma’, J Asthma Res, 5 (2), 129-32. PubMed: 6079835
Bray, GW (1931), ‘The Hypochlorhydria of Asthma in Childhood’, QJM, 24 (94), 181-97. PubMed:
Brunner, EH, AM Delabroise, and ZH Haddad (1985), ‘Effect of parenteral magnesium on pulmonary function, plasma cAMP, and histamine in bronchial asthma.’, J Asthma, 22 (1), 3-11. PubMed: 2991184
Campbell, J. A. and Laughlan Jm Mc (1955), ‘Vitamin B12 and the growth of children: a review’, Can Med Assoc J, 72 (4), 259-63. PubMed: 14352080
Caruselli, M. (1952a), ‘Upon therapy for asthma using vitamin B12 (Abstract)’, JAMA, 150 (17), 1731. PubMed:
——— (1952b), ‘[Treatment of asthma with vitamin B12]’, Riforma Med, 66 (31), 849-51. PubMed: 13004705
Collipp, P. J., et al. (1975), ‘Pyridoxine treatment of childhood bronchial asthma’, Ann Allergy, 35 (2), 93-97. PubMed: 1096686
Gillespie, M. (1935), ‘Hypochlorhydria In Asthma: With Special Reference To The Age Incidence’, QJM, 4 (4), 397-405. PubMed:
Hall, M. A., H. Thom, and G. Russell (1981), ‘Erythrocyte aspartate amino transferase activity in asthmatic and non-asthmatic children and its enhancement by vitamin B6’, Ann Allergy, 47 (6), 464-66. PubMed: 7325421
Hoj, L., et al. (1981), ‘A double-blind controlled trial of elemental diet in severe, perennial asthma’, Allergy, 36 (4), 257-62. PubMed: 7032340
Kaufman, R. E. (1951), ‘Effect of vitamin B12 in asthma’, Ann Allergy, 9 (4), 517-18. PubMed: 14847439
Koshak, A, et al. (2017), ‘Nigella sativa Supplementation Improves Asthma Control and Biomarkers: A Randomized, Double-Blind, Placebo-Controlled Trial.’, Phytother Res, 31 (3), 403-9. PubMed: 28093815
Neale, A. V. (1930), ‘Gastric Secretion in Infants and Children’, Arch Dis Child, 5 (26), 137-45. PubMed: 21031802
Okayama, H, et al. (1987), ‘Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma.’, JAMA, 257 (8), 1076-78. PubMed: 3806898
Pridham, T. L. (1860), ‘Observations on the Treatment of Asthma’, Br Med J., 1 (180), 434-35. PubMed:
Reynolds, RD and CL Natta (1985), ‘Depressed plasma pyridoxal phosphate concentrations in adult asthmatics.’, Am J Clin Nutr, 41 (4), 684-88. PubMed: 3984921
Rowe, AH, A Rowe, and EJ Young (1959), ‘Bronchial asthma due to food allergy alone in ninety-five patients.’, J Am Med Assoc, 169 (11), 1158-62. PubMed: 13630736
Simon, S. W. (1951), ‘Vitamin B12 therapy in allergy and chronic dermatoses’, J Allergy, 22 (2), 183-85. PubMed: 14823832
Skobeloff, EM, et al. (1989), ‘Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department.’, JAMA, 262 (9), 1210-13. PubMed: 2761061
Wetzel, NC and WC Fargo (1949), ‘Growth failure in school children as associated with vitamin B12 deficiency; response to oral therapy.’, Science, 110 (2868), 651-53. PubMed: 15396016
Wetzel, NC, et al. (1952), ‘Growth failure in school children; further studies of vitamin B12 dietary supplements.’, J Clin Nutr, 1 17-31. PubMed: 12990680