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Monday, December 20, 2010

Anti-TNF-alpha in asthma: Myth or reality

TNF-alpha has been widely studied in asthma and proposed as a possible target for the treatment of severe asthma. Unfortunately, toxic effects of monoclonal antibodies against TNF-alpha have precluded their use in patients with severe disease. Moreover, the clinical benefits have always been very small.

A new trial assessed the efficacy and safety of ethanercept, a biologic against TNF-apha (fusion protein of TNF-alpha receptor), in moderate-to-severe persistent asthma. In a 12-week, randomized, double-blind, placebo-controlled, phase 2 trial, 132 subjects with asthma received subcutaneous injections of etanercept or placebo twice weekly.

Clinical efficacy of etanercept was not shown in any of the outcomes studied over 12 weeks. However, etanercept treatment was well-tolerated.

The authors propose that studies in specific subsets of patients with asthma with longer-term follow-up may be needed to fully evaluate the clinical efficacy of etanercept in asthma.

Friday, December 10, 2010

Is Bisphenol A a risk factor for allergy in children?

Exposure to environmental toxicants is associated with numerous disease outcomes, many of which involve underlying immune and inflammatory dysfunction. The U.S. government declared Bisphenol A (BPA) a hazardous substance in October 2008 and has since placed it on its list of toxic substances. Triclosan (2,4,4’ –trichloro-2’-hydroxydiphenyl ether) is a chlorinated aromatic anti-microbial agent under review by the U.S. Environmental Protection Agency (EPA) using the new National Health and Nutrition Examination Survey (NHANES) 2003-2006 data.

Using data from the 2003-2006 NHANES, a study in the journal Environmental Health Perspectives compared urinary BPA and triclosan with diagnoses of allergies or hayfever in U.S. adults and children age ≥ 6 years.

Triclosan, but not BPA, showed a positive association with allergy/hayfever diagnosis. In the under-18 age group, higher levels of triclosan were associated with greater odds of having been diagnosed with allergies or hayfever (p<0.01).

Although additional studies should be done to investigate these interesting findings, shall we further restrict the use of BPA ?