Discovering the Connection Between Allergies and Asthma and Understanding the Importance of Allergy Testing
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you are listening to reach empty. Welcome to this week's medical industry feature sponsored by Quest Diagnostics. The following program is intended for health care professionals on Lee. Your host is Mario NASA Novich. On today's program, we will be discussing the connection between allergies and asthma and the importance of allergy testing and symptomatic patients. I'm your host Mario NASA novich and joining me today is Dr in Nepal, A. Randhawa, associate clinical Professor of Pediatrics, U. C. Irvine School of Medicine and Associate Clinical Professor of Medicine. You see L. A. David Geffen School of Medicine. Dr Randhawa, welcome to the program. We are looking forward to hearing your perspectives today. Thank you, Mario. I'm glad to hear first can give us some perspective on the burden of asthma in the U. S. Certainly Morio. The burden of disease from asthma is quite large. According to multiple sources, including the Centers for Disease Control and Prevention and the National Center of Health Statistics, asthma rates are increasing across the United States. It is currently estimated roughly one in 12 Americans suffer from asthma. The clinical and economic toll of the disease is also increasing. Patients with asthma account for approximately 1.9 million Yare visits and 407 9000 hospitalizations. That equates to $56 billion in direct health care costs annually. The economic burden on individual patients is also significant, and roughly 1/3 of the per patient annual direct costs of asthma are spent on medications alone. So clearly, asthma remains an increasingly critical challenge from the national level, down all the way to individual patients. Why is this happening, Doctor? Why does asthma continue to be a growing challenge? One of the main reasons is that asthma symptoms are usually not adamantly controlled, and there are two studies. We can point to one in adults Thea, the one in adolescence and Children that clearly demonstrate this. The first is a 2007 study called You React Study, which surveyed adults with moderate or severe persistent asthma. The results of the study were quite striking. Among the over 1800 adults, Assess assessed about 50%. 57% of the patients with uncontrolled asthma and about 30% of the patients with controlled asthma reported the need to take their asthma medications more frequently than prescribed. The second study presented in 2008 by Brito. It all assessed the percentage of Children and adolescents. Asthma patients who still experienced daily symptoms to study results demonstrated that 92% of Children and adolescents adolescence still experienced daily symptoms despite the use of inhalers. And once again, symptom control, according to asthma treatment guidelines, was inadequate. Why are the majority of patients with asthma unable to manage your illness? One of the primary reasons maybe the association between asthma and allergy or allergic triggers and one of the most direct methods to determine if an individual has an allergy is to measure their levels of immunoglobulin E for i G in their blood. The immune system reacts to allergens by producing I G antibodies, which then leads to an allergic reaction and the symptoms associated with the allergic reaction. So to determine if there is an association between asthma and allergies, one approaches to measure I G levels in asthma patients. The same substances that trigger hay fever symptoms such as Poland, dust mites and pet dander may also cause asthma Simpsons and sign in some people skin where food allergies can cause as the symptoms. This is called allergic or allergy induced asthma. So, based on these data, a connection between asthma and allergies Is it true that if asthma patients reduce their exposure to allergens triggers, it should help to manage your disease? Absolutely. And this strategy is related to the symptom rush hold of each patient. Consider this. Individuals are typically continually exposed multiple allergic triggers simultaneously, and 90% of patients suffering with allergies are sensitized to multiple allergies. Once exposure to these allergic figures exceeds a certain threshold, this can lead to the development of asthma symptoms. So, fortunately, the reverse is also true if exposure to allergic triggers is kept below a certain threshold. This should help prevent the development of asthma sentence. So, in short, reduced allergy exposure reduced asthma symptoms. This is known as target exposure reductions. Are there any data that demonstrate targeted exposure reduction helps reduce asthma symptoms? Yes, A study in the New England Journal of Medicine of Children with Asthma demonstrated that targeted exposure reduction with interventions restricted to the bedroom lead annually to 21.3 fewer symptom days, 4.4 fewer missed school days and 2.1 fewer your visits over two years, targeted explosion reduction was shown to be as effective as inhaled cortical steroids in reducing and was associated with 34 fewer days of weeding. So what can primary care and pediatric clinicians do to help asthma patients alleviate their allergy symptoms and ultimately control their asthma symptoms? The most effective method is to reduce the exposure to allergens before the near that threshold by utilizing allergy testing to identify and characterize the triggers and then implementing guidelines based care to manage symptoms. In fact, when a guideline basic care regimen is implemented, control problems and cost of care decrease you two fewer E R visits and hospitalizations. What types of tests or diagnostic tools should patients and physicians know about? First of all, the I H recommends a stepwise approach to managing asthma and for persistent asthma. The night recommends testing for allergic triggers to reduce allergen exposure. So you're saying there's a similar procedure in place for patients with asthma who may have an allergy trigger? Yes, it's almost exactly the same for patients with allergies. In this instance, the physician would order a specific I G blood panel, which could help the physician make suggestions towards lifestyle modification like targeted reduction of allergen exposure or even moving on to form of the therapy. Regarding I G specific testing, can you speak more about the importance of determining an I G panel? Simply put, I g e specific testing, such as with a test called a cab, helps identify allergic triggers. And that helps physicians recommend a targeted exposure reduction program specific to the patient that will help the patient reduce symptoms and manage their disease. Ultimately, this improves the patient's quality of life and productivity. In the case of allergic triggers, I d. Specific testing with Immuno Cab is a logical addition to the Physicians Testing Array because it fits into the work up in the same manner as the essays you regularly order for managing other diseases, such as diabetes or hypercholesterolemia. Doctor Randhawa, Can you please summarize the importance of testing for allergies triggers? Sure, Mario appropriate testing helps guide targeted exposure reduction. And when a guideline based care regimen is implemented, it can reduce healthcare costs associated with uncontrolled asthma while improving productivity and patient care. That's huge. If you're just tuning in, you are listening to this week's medical industry feature on reach MD. Sponsored by Quest Diagnostics. I'm your host, Mario Nasa Novich and was speaking with Dr Interpol Randhawa, associate clinical professor of pediatrics, UC Irvine School of Medicine and associate clinical professor of medicine. You see L. A. David Geffen School of Medicine. We talk a lot about the value of testing. You specifically mentioned a test called Immuno Cap. Please tell me about testing for I G with immuno cap. How would you describe it to primary care and pediatric clinicians? Simply put, immuno cap is a laboratory test to determine the sensitization of specific I G. In patients who present with allergy like symptoms is also the most extensively studied and widely used. I G blood test available for a position. Who is trying to determine whether a patient is suffering from allergies or an upper respiratory disease? Immuno cap is an easily performed test that is a means to eight positions and confirming or excluding a diagnosis. Is that really an issue for physicians differentiating between allergies and an upper respiratory illness? Yes, allergy like symptoms can be very difficult to differentiate from an upper respiratory disease. That is why amino cap is such an important tool immuno cap allows physicians toe accurately identify specific allergen sensitivities. It is a direct means to confirming patient allergies. If you would please describe what a Quest Diagnostics immuno cap panel is a quest. Diagnostics in Munich at panel includes category panels like respiratory and food. A respiratory allergy profile will include key indoor and outdoor allergens that have been selected according to geographic Poland patterns and cross reactivity of allergens that elicit patient sensitivity similar to certain other allergens within the same class. Individual allergens in the panel can also be ordered separately. So how did immuno cap results compare with results from a skin protest? Immuno cap is interchangeable with the skin ***** test. It is also a reliable and easy to interpret test allergy medications. Don't interview with the results, and the blood draw can be taken at any time of the day. Aside from what you said here today, are there any guidelines on the use of immuno cap? Yes, the N I H has guidelines that highlight, you know, cap for asthma care. And how has Amino Captain highlighted in the N. I. H. Guidelines. The guidelines for the diagnosis and management of allergic diseases state. That serum I G levels were originally measured using the radio Aller Joe's Corbin's test, otherwise known as Rash. But this test has been replaced by more sensitive fluorescent enzyme labeling passes. They also stated that the predictive values associated with clinical evidence of allergy for immuno cap cannot be applied to other test methods. Let me be clear about this. Um, you know, Cap is not wrapped The sensitivity, specificity, positive and negative predictive value that some of our listeners may be familiar with do not apply. The immuno cap is the only blood test comparable to what are the other advantages of the new cap that primary care and pediatric clinicians should know about? It's one blood draw any time of the day. There is no interference from allergy medications, and it is reliable, easy to interpret and simple to order. As we begin to wrap up this interview, are there any last statements you'd like to share about allergies and asthma? I want to stress that most asthma patients suffered daily and unnecessarily from this costly illness, and that reducing exposure to allergic triggers reduces symptoms and costs. This supports the importance of testing for allergic triggers so we can make specific recommendations to control the patient's symptoms and in regards to the role and importance of immune a cap, any final thoughts. Simply put, immuno Cap is the most widely used in vitro allergy blood tests, and its results can help clinicians implement a personalized targeted exposure plan to manage airway inflammation and symptoms, optimized effectiveness of medications and minimize associative healthcare costs. Finally, by using a Munich, our physicians are following an eye guidelines for Asthma care, which recommend specific I G testing four persistent asthma patients. Well, this has been a great discussion with a lot of information covered, but since only so much can be reviewed during this interview, I want to thank you, Dr Randolph for your time and insights and helping us understand more about the importance of asthma, allergens and amino cap. You've been listening to this week's medical industry Feature on reach Empty sponsored by Quest Diagnostics Toe Learn more about Quest Diagnostics Enemy No cap. Please visit Quest diagnostics dot com, And if you missed any part of this discussion, please visit. Reach MD dot com slash allergy testing To download this segment that's reach mt dot com slash allergy testing