Asthma and allergy
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SUMMARY OF PRACTICE POINTS
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| Inhalant allergens are a major trigger for asthma and wheezing in allergic individuals. In sensitised individuals, exposure to house dust mite, pollen, domestic pets, moulds or cockroaches can trigger asthma attacks or worsen symptoms. |
II |
| There is no definitive evidence that strategies to reduce exposure to house dust mites are effective in controlling asthma. However, some patients may benefit from these strategies. |
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| Food allergens are uncommon triggers for asthma. |
II |
| Acute food allergen-induced respiratory symptoms may be due to anaphylaxis, not asthma – particularly if associated with urticaria or angioedema. |
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| Ensure responsible food allergens are accurately identified and appropriate avoidance strategies are instituted. This will usually entail referral to a specialist with experience in allergy and clinical immunology. |
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| Intranasal corticosteroids are the most effective medications for controlling symptoms of allergic rhinitis. |
I |
| Specific allergen immunotherapy might reduce the risk of childhood rhinitis progressing to asthma. |
II |
| Specific immunotherapy (SIT) has clear therapeutic benefits in asthma. |
I |
| Pre-treatment with less-sedating H1-antihistamines can significantly reduce local and systemic adverse reactions to immunotherapy. |
II |
| Immunotherapy is contraindicated in patients with severe or unstable asthma. |
IV |
There is a strong association between allergy (sensitisation to allergens) and asthma, although these processes appear to develop independently.1
- Asthma is regarded as one of the final stages of the ‘atopic march', which frequently begins in infancy as food allergy and atopic dermatitis. As many as 80% of infants with early evidence of allergic disease will go on to develop asthma or allergic rhinitis.2
- Early allergic sensitisation is a major risk factor for persistent wheezing and airway hyperreactivity.3,4
- Allergic individuals are over three times more likely to develop asthma5 and airway hyperresponsiveness.6 Around 70-90% of individuals with established asthma show hypersensitivity to one or more allergens,6,7 and this proportion is higher among children than adults.
Content Created (Thursday, 16 November 2006)
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Last Updated ( Thursday, 31 May 2007 )
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Asthma and allergy 
