Asthma Watch

California Clinics Give Free Inhalers

Community health clinics throughout California began giving away environmentally friendly asthma inhalers to uninsured and low-income asthma patients who are facing a federal ban on older inhalers that use chlorofluorocarbons (CFCs), an ozone-depleting propellant. After 2008, pharmacies will no longer be allowed to dispense inhalers that use CFCs, which were found in 1985 to be contributing to a hole or thinning in the Earth's ozone layer (a band of gases that protects the planet from harmful radiation).

Schering-Plough, a marketer of albuterol asthma products, is donating 500,000 non-CFC inhalers to 850 clinics across the country, including more than 100 in California. These inhalers usually range in cost from $30 to $60, compared with $5 to $25 for the older CFC versions.

Barbara Pulley, executive vice president of QueensCare, which operates 6 clinics in the Los Angeles area, said, "For most of our patients, just to get a prescription to get their medication is enough of a challenge, without supply issues." She said the donation will help the clinics meet the expected demand for the new inhalers as the deadline for replacing them draws nearer.

Smoking Plus Genetics Raises Child's Asthma Risk

Smoking during pregnancy is already known to raise a child's risk of future asthma development, but a recent study has shown that children with a certain gene variation may be at an added risk.

The researchers found that, among children studied from birth to age 10, those with a particular variant of a gene called interleukin-1 receptor antagonist (IL1RN) seemed more susceptible to the effects of maternal smoking during pregnancy. These children were 4 times more likely to develop asthma before age 10 than their counterparts without the gene variant. The study was published in the March 2007 issue of the European Respiratory Journal.

The researchers looked at 921 children in the United Kingdom who were assessed for asthma at ages 1, 2, 4, and 10 and had blood samples taken to see which variant of IL1RN they carried. The researchers also gathered data on each child's family history of allergies and asthma, mother's smoking habits, and other health factors.

They found that those children with the least common form of IL1RN were more than 4 times likely to develop asthma than their peers with other variants of the gene. The variant alone was not a deciding factor, however; it was only a factor when the mother smoked during pregnancy.

Ulcer Bacteria May Help Lower Asthma Risk

A study from the department of medicine at New York University suggests that a bacterium that causes ulcers might have a beneficial effect in helping to reduce the risk of asthma and allergies. The researchers questioned 7663 patients about their history of asthma, allergic rhinitis, and allergy symptoms and tested them for antibodies to Helicobacter pylori, the main cause of peptic ulcer disease. The researchers also administered skin tests using 10 standardized allergens.

On the whole, no direct relation was found between the presence of H pylori and current asthma status, but patients under 43 years of age who were colonized with the most virulent strain of H pylori were 32% less likely to have asthma, 35% less likely to have allergic rhinitis, and 20% less likely to report allergy symptoms than those who did not carry the bacterium. These patients were also one third less likely to have skin sensitivity to 5 common pollen plants and the mold Alternaria alternata. The findings were published in the April 23, 2007, issue of the Archives of Internal Medicine.

Web-based Asthma Program Helps Younger Patients

A study conducted among low-income African American high school students with asthma showed that a specially designed, Web-based disease management program helped them experience fewer days and nights with symptoms, fewer missed school days and days of restricted activity, and fewer hospital visits for asthma during a 12-month follow-up period, compared with other asthmatic students who did not take part in the program.

The study was conducted by a group at the Henry Ford Health System in Detroit, Mich, and involved 314 mostly African American students in 6 high schools throughout the city. Of this group, 162 students took part in 4 tailored Web-based asthma intervention educational sessions. The remaining students had access to generic asthma Web sites. Those who accessed the tailored Web sites reported less than 1 night of symptoms every 2 weeks, compared with 1.5 nights in the control group. The treatment group also missed less than half a school day every 30 days. The findings were published in the May 2007 issue of the American Journal of Respiratory and Critical Care Medicine.