The annual meeting of the American College of Allergy, Asthma & Immunology was held from Nov. 7 to 11 in Baltimore and attracted approximately 3,500 participants from around the world, including allergy and immunology specialists as well as other health care professionals. The conference featured presentations focusing on the latest advances in the prevention and treatment of asthma, food and medication allergies, immune dysfunction, and sleep apnea.

In one study, Marc Braunstein, M.D., of the State University of New York-Downstate Medical Center in Brooklyn, and colleagues found that climate factors influence the U.S. and statewide prevalence of hay fever, likely by triggering or exacerbating disease in predisposed individuals.

“We found that the overall hay fever prevalence in children in the United States is 18 percent based on the 2007 to 2008 National Survey of Children’s Health, and that there is significant statewide variation in hay fever prevalence,” said Braunstein. “Further, climate factors such as higher temperature, higher ultraviolet index, and increased precipitation are associated with higher hay fever prevalence, whereas higher humidity and a higher drought index (areas of wetter conditions) are associated with lower hay fever prevalence.”

In another study, Renata Engler, M.D., of the Walter Reed Army Medical Center in Washington, D.C., and colleagues performed a published literature review and found increasing evidence about both the physiological and immunologic differences between men and women.

“These differences are quite dramatic and should be taken into consideration in terms of research efforts, diagnosis, and treatment. Failure to recognize these differences could lead to delays in diagnosis, exacerbation of symptoms, and different responses to therapy,” said Engler. “Autoimmune and allergic inflammatory diseases in adult women represent a significant disease burden. Yet these diseases also occur in men, so personalized medicine demands individualized care of patients in the context of age and race as well environmental factors.”

According to Engler, not only can sex and gender have a complex impact on the physiology of the heart and lung as well as immune responses, these differences impact differently in childhood versus adult years.

“For example, male children have asthma more frequently than females. However, asthma is more prevalent in adult women compared to adult men,” said Engler. “We need to recognize that there are physiological differences between men and women and they need to be understood for proper diagnosis and management.”

Sami Bahna, M.D., of the Louisiana State University Health Sciences Center in Shreveport, and colleagues found that individuals with food allergies may not have to avoid the offending food completely, as some parts of food may be safe for allergy suffers to consume. In addition, there are substitutes that may be safe for food allergy suffers as well.

“A thorough allergy evaluation by an allergy/immunology specialist often allows food-allergic patients to tolerate other less cross-reacting members of the same food family, such as eggs of another avian species, another mammalian milk, another fish species, different types of tree nuts, different members of a certain fruit family, or molluscs (oysters, clams, abalone, scallop, octopus) instead of crustaceans (shrimp, lobster, crab, prawn),” said Bahna. “A different part of the food, such as egg yolk instead of egg white, fish dark muscles instead of its white muscles, fish but not its roe (caviar), or fruit pulp without its seeds, may be tolerated by food-allergic patients.”

In addition, the way foods are processed may change their allergenicity. According to Bahna, there may be a difference in response to eating cooked milk or eggs and consuming boiled instead of roasted peanuts. The food, if devoid of an allergenic contaminant such as another food, additives, antibiotics, toxins, insects or parasites, may be tolerable for allergy suffers. Lastly, the food may be safe if an enhancing co-factor is not present, such as physical exercise within a few hours of eating a certain food, alcohol, a combination of foods, or hormonal changes.


November 14, 2013