A L L E R G Y A N D A S T H M A M I S E R Y

1. A L L E R G Y A N D A S T H M A M I S E R Y END It’s worth a shot!

2. Allergies and asthma: if you have them, are you stuck with them? T H E L A T E S T R E S E A R C H S A Y S The American College of Allergy, Asthma and Immunology (ACAAI) wants to share with you somegood news about stopping allergic disease. NO.

3. T H I S P R E S E N T A T I O N I S F O R if you: • Have allergies or asthma • Have a child with allergies or asthma • Are a teacher, coach or school nurse • Just want the latest information on stopping allergic disease YOU

4. Here are the headlines: • Allergic disease is epidemic • If you have allergies, you also may have undiagnosed asthma or could develop it • Allergy shots (immunotherapy) can help control your allergies and asthma, or keep you from developing asthma

5. • Avoid the allergens, the things you’re allergic to • Treat the symptoms with medications• Stop the allergic reaction with allergy shots, also known as immunotherapy Allergies can be controlled three ways: Some of the most exciting and hopeful advances are taking place in immunotherapy.

6. This presentation focuses on how advances in immunotherapy, or allergy shots, can help you. I T A L S O W I L L : • • Tell you how to locate an allergistin your area • • Help you assess your risk for asthmawith a short quiz

7. VERY One in five Americans – 55 million people – have allergies to airborne triggers such as pollen, mold, dust mites or animal dander. Allergic Disease is Epidemic H O W C O M M O N A R E A L L E R G I E S ?

8. The epidemic is most serious in children. Asthma cases rose 160% between 1980 and 1998 in children ages 0-4. Another17 million have asthma –a serious allergic disease caused by inflammation of the lung airways. Between 1980 and 1998, reported cases of asthma doubled.

9. If you or your child have allergies, you also may have asthma or could develop it. We don’t completely understand what causes asthma, but we do know what puts you at risk.

10. There’s a provenlink between allergies and the development of asthma: • At least 90% of childhood asthmatics, and about half of all adult asthmatics, are allergic. • Studies also show that about 20% of children with hay fever will develop asthma. This knowledge led researchers to study allergy shots, a well-established and effective allergy treatment, as a possible treatment for asthma.

11. Experts analyzed 24 studies involving more than 900 asthmatics with documented allergies and found that allergy • shots were effective in • treating allergic asthma in a majority (71%) of the studies. The treatment resulted in: • reduced symptoms • reduced lung inflammation • reduced need for medications • improved lung function

12. Researchers began to seek a greater understanding of how allergy shots work. Studies showed that allergic symptoms are relieved because allergy shots alter the underlying disease process. Given as a series of regular injections, the shots gradually decrease sensitivity to particular allergy triggers. The treatment uses the body’s own natural defenses to reduce overreactions to otherwise harmless substances. No other available treatment does this.

13. The preventive effect of allergy shots was first recognized almost 40 years ago. One study followed children with allergies for 14 years and found that those who were treated with allergy shots were less likely to develop asthma, and less likely to develop additional allergies than those who did not receive allergy shots. Since this study was published, additional evidence has been building.

14. N E W R E S E A R C H published in February 2002 has provided further proof that allergy shots can prevent asthma. A three-year study, conducted in Europe with more than 200 children with seasonal allergies, found that those who got allergy shots were about half as likely to develop asthma as those who didn’t.

15. T H E S T U D Y A L S O T U R N E D U P A S U R P R I S E. More than 20% of the children with no reported history of asthma experienced asthma symptoms during pollen season. This finding indicates that many children with allergies also have unrecognized – and therefore untreated – asthma. It also suggests that those with allergies should have an asthma check up, even if they think they only have bad hay fever.

16. What does all this mean? If you have allergies or asthma, it means you can control your symptoms and possibly stop the progression of your disease.

17. Allergists — doctors who specialize in • treating allergies and asthma — • recommend youstrongly • consider allergy shots • if you have: • • allergic asthma • hay fever • sinusitis • Allergy shots also have been proved extremely effective in treating insect sting allergy, preventing potentially life-threatening reactions to insect sting venom.

18. If you or your child has allergies, take this short self-assessment quiz to learn if you are at risk for developing asthma, and if you are a candidate for asthma testing: 1.Do you have a family history of asthma?Children of one asthmatic parent have a 40% probability of developing asthma. The risk increases to 90% when both parents have asthma. Are you at risk?

19. self-assessment quiz 2.Are you exposed to tobacco smoke, dusty environments, cockroaches or pet dander? The greater the exposure to these environmental conditions, the greater the risk. 3.Do your allergies cause secondary symptoms such as recurring sinus or ear infections, frequent throat clearing or difficulty breathing? Are you at risk?

20. self-assessment quiz 4.Do you cough at night, particularly during peak pollen seasons? 5.Do you find yourself wheezing, experiencing shortness of breath or lingering colds, particularly during peak pollen seasons? 6.Do you experience wheezing, chest tightness, or difficulty breathing when exercising? Are you at risk?

21. If you answered “yes” to one or more of the preceding six questions, you might be a candidate for allergy shots to treat or prevent the development of allergic asthma. An allergist can provide a diagnosis and help you find the best way to control your allergic disease.

22. You can expect the allergist to: • Conduct a thorough medical history and physical exam • Test and determine what triggers your allergies • Prepare a treatment plan that helps alleviate your particular symptoms

23. YOU CAN TAKE CONTROL OF YOUR ALLERGIES and reduce the development of new allergies.No more sniffling, sneezing and wheezing. You also can prevent or reduce asthma symptoms. Visit the ACAAI Web site at http://allergy.mcg.edu to learn more or locate an allergist in your area. Take a shot at life without allergies.

24. BIBLIOGRAPHY Centers for Disease Control and Prevention, CDC Surveillance Summaries, Morbidity and Mortality Weekly Report 1998;47(SS-1). CDC, Forecasted state-specific estimates of self-reported asthma prevalence – United States, 1998; MMWR 1998;47(47):1022-1025. CDC, Vital and Health Statistics, Current estimates from the National Health Interview Survey, 1994 (U.S. Department of Health and Human Services, Public Health Service, National Center for Health Statistics) 1995;DHHS Pub. No. PHS 96-1521. Ebner C, Siemann U, Bohle B, et al. Immunological changes during specific immunotherapy of grass pollen allergy: reduced lymphoproliferative responses to allergen and shift from TH2 to TH1 in T-cell clones specific for Phl p 1, a major grass pollen allergen. Clin Exp Allergy 1997; 27:1007-1015. Gergen PJ, Turkeltaub PC, Kaovar MG. The prevalence of allergic skin reactivity to eight common allergens in the U.S. population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol 1987;800:669-79. Johnstone DE, Dutton A. The value of hyposensitization therapy for bronchial asthma in children – a 14-year study. Pediatrics 1968;42:793-802. Moller C, Dreborg S, Ferdousi HA, et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol 2002;109:251-6. National Heart, Lung, and Blood Institutes, U.S. Department of Health and Human Services, Public Health Service, and National Institutes of Health 1990:NIH Pub. No. 90-2339. Ross RN, et al. Effectiveness of specific immunotherapy in the treatment of Hymenoptera venom hypersensitivity. Clin Ther 2000;22 (Suppl):351-58. Ross RN, Nelson HS, Finegold I. Effectiveness of specific immunotherapy in the treatment of asthma: a meta-analysis of prospective, randomized, double-blind, placebo-controlled studies. Clin Ther 2000;22(Suppl):329-341. Weiss ST. Epidemiology and heterogeneity of asthma. Ann Allergy Asthma Immunol 2001;87(Suppl):5-8.