Idea: Hypoallergenic Cat

What’s Involved: Genetically engineering a cat that doesn’t have the gene that makes Fel d 1 protein, which causes the majority of allergic reaction. Once a colony of hypoallergenic cats is established, kittens could be bred using “traditional” methods.

Where We Stand: In 2006 a company called Allerca Inc. claimed to have bred the world’s first hypoallergenic kittens and Time magazine hailed them as one of the best inventions of the year.

But the company and its founder have been the subject of controversy, with the media and a dedicated website questioning whether the firm, now called Lifestyle Pets, really has sneeze-free cats.

But this is not the only company in the hunt for the hypoallergenic kitty. Dr. David Avner, an emergency room physician in Denver, has been working with molecular biologists on silencing the Fel d 1 gene for years, and so far has come up empty-handed.

This past summer his team thought they had successfully knocked out the gene, which could lead to the breakthrough they’ve hoped for.

While Avner admits to being “optimistic” in predicting when his company, Felix Pets, will have cats on the market, he says there’s little doubt that in 10 years, a hypoallergenic cat will be in people’s homes.

“Without question, someone is going to do it. It’s too obvious an application of the technology, and the desire for people to have allergen-free cats is too high for it to go unrealized.”

Idea: Herbal Tablets for Asthma

What’s Involved: The Antiasthma Herbal Formula (ASHMI) is a tablet containing three traditional Chinese herbs. A study of patients in China shows it improves lung function and reduces use of bronchodilators.

Where We Stand: Dr. Xiu-Min Li at the Mount Sinai School of Medicine and her colleagues continue to study ASHMI in mice and people, comparing it to using corticosteroids. New, unpublished data show that eight weeks after mice stop taking the corticosteroids, their asthma symptoms return when they are exposed to triggers.

However, the mice on the herbal formula are still protected eight weeks later. Safety studies in humans have been completed, and Phase 2 efficacy studies are continuing.

One of the benefits to using ASHMI, instead of a steroid, is that there are fewer side effects, such as weight gain. However, Li says corticosteroids will be the standard treatment for asthma for years to come.

“The practical protocol will be to have a herbal remedy that will reduce the steroid’s side effects and help to maintain the protective effect,” she says.

Idea: Quick-Acting Allergy Shots

What’s Involved: Currently, immunotherapy to environmental allergies such as trees, grass, ragweed and cats, sometimes called allergy shots, requires numerous needles over several years. The shots also carry the risk of anaphylaxis in some individuals. Now, a few companies are developing therapies to make the treatment process far shorter and also safer.

Adrienne Smith has been battling with her asthma since she was diagnosed at the age of 13. For Smith, high school gym class was particulary difficult: she would often get a crushing feeling in her chest when she started to run, and it would take her 25 minutes to recover. “It was humiliating,” she says.

Now, at 30, Smith’s asthma is still a big part of her life. She doesn’t play competitive sports any more, something she used to enjoy. And when she works out, she tends to walk, rather than run. When her asthma is at its worst, it keeps her up at night. During these bouts, she finds ordinary household chores arduous, such as carrying laundry up the stairs.

Still, Smith, who lives in Victoria, B.C., feels she’s doing fairly well. “I haven’t been to the hospital this year,” she says. “So that’s a good sign.” While she finds her limitations frustrating, she accepts them as a part of who she is. “I don’t think I’m sickly. It’s just that sometimes I have these episodes.”

About three million Canadians have asthma – one of the highest incidences in the world – and the majority of those affected share Smith’s conception of the disease.

“They think it’s normal to be short of breath, waking up at night, or not being able to perform exercise,” says Dr. Louis-Philippe Boulet, a respirologist and asthma researcher at Laval University in Quebec City. “I saw a patient recently who had stopped exercising; he started playing chess. He almost couldn’t do anything. But it was normal for him.

“Research shows 28 per cent of Canadians with asthma have symptoms of their disease every day, while 67 per cent have symptoms every week. But the experts agree that this should not be the case; that asthma is completely controllable. In the right environment and with the right medications, even those with severe asthma should have relatively few symptoms.

That’s because the medications available today can prevent the inflammation of the lungs, and the resulting constriction of the bronchial tubes and mucus build-up.

It’s possible to develop an asthma action plan in which, by reducing bronchial inflammation with medication and avoiding asthma triggers, the patient should rarely have to stop to catch a breath. And that blue “rescue” inhaler that many asthmatics depend on to treat frequent symptoms? It should only be used occasionally.

However, this ideal is far from reality. Instead, the majority of Canadian asthmatics are living half-lives. They aren’t exercising, which can lead to a host of other health problems, like obesity, diabetes and heart disease. They are missing school and work, and giving up activities they enjoy.

They see their doctors, but these visits are often marked by poor communication. They end up in the hospital after days of worsening symptoms. They are Canada’s “walking wounded,” and they’re slipping through the cracks of our health-care system. Amazingly, most of them don’t even realize they have a problem.

The statistics show just how bad it is. Six years ago, the Asthma Society of Canada announced that 57 per cent of Canadians with asthma did not have their disease under control. The society’s latest research, released in September 2006, shows no sign of improvement; more than half of asthmatics are still living with symptoms above what are considered acceptable levels.

Earlier findings showed 10 per cent of them had landed in the emergency room at least once in the previous year because of an asthma attack, and 12 per cent reported missing school or work.

In Ontario alone, hospital statistics show that asthmatics made more than 73,000 emergency room visits in the past year. National statistics are not available, but the numbers are known to be uniformly high.

“Certainly for children, we know that it is one of the most common reasons for emergency visits,” says Jan Haffner, vice-president of health initiatives for the Lung Association of Saskatchewan.

Next page: How asthma medication works

Why should Canadians care about banning smoking in cars carrying children? Because second-hand smoke is more concentrated in a confined space. Within a vehicle, poisons found in smoke can reach high levels in a short amount of time.

A 2006 study in the American Journal of Preventive Medicine found that breathing in smoke from a single cigarette for only five minutes in a car exposes a person to the same amount of smoke as spending the equivalent time in a smoky bar. Babies and children are most vulnerable because they breathe more rapidly and take in more harmful chemicals for their size than adults do. Second-hand smoke affects their developing respiratory, immune and nervous systems.

In the United States, the Surgeon General recently released a report on the profound impact of second-hand smoke on children, revealing that kids exposed to second-hand smoke have an increased risk of sudden infant death syndrome (SIDS), acute respiratory infections such as bronchitis and pneumonia, middle ear infections, more severe asthma, respiratory symptoms and slowed growth of the lungs. The report concludes that there simply is no safe level of exposure to second-hand smoke; even brief exposures can prove harmful.

There is growing evidence as well that kids who are exposed to second-hand smoke in the womb and as infants have more behavioural problems, shorter attention spans, and lower marks than peers who aren’t exposed to smoke.

Since babies and children are powerless to protect themselves from this risk, The Canadian Lung Association is asking Canadians to take a stand with the “Clean Air for Kids” lobby. “This campaign is about protecting Canada’s children from the harmful effects of second-hand smoke,” said Nora Sobolov, president of The Lung Association. “Working together with Canadians, we are confident that action can be taken to ensure kids are not subjected to smoking in cars.”

What can you do? If you want to send a message directly to your provincial or territorial representative, visit The Lung Association.

Related:
• Discussion: Smoking outside “still harms kids”
• The dangers of third-hand smoke
• 15 ways to clean up your home’s air

First published in Breathing Space, a supplement of Allergic Living magazine.

However, a leading Canadian pediatric allergist says acetaminophen – which is the active ingredient in these popular fever-reducing drugs – is safe for children if used properly. “There’s no proof that acetaminophen causes asthma,” says Dr. Allan Becker, a researcher with the Manitoba Institute of Child Health. Even the study authors say acetaminophen remains the medicine of choice for babies with high fevers. But they stress the importance of following the guideline that its use be limited to those cases, and not used casually.

The study reported that children who had been given acetaminophen once a year or more in their first year of life showed a 46 per cent higher risk of asthma symptoms by 6 or 7 years of age compared to those who hadn’t had the drug. The findings also indicate that the asthma risk increased threefold in 6-year-olds and 7-year-olds taking the tablets one or more times a month.

Researchers gathered the data from children in 73 countries, including Canada, as part of third phase of the International Study of Asthma and Allergies in Children (ISAAC) program. The findings were published in The Lancet, the well-known British medical journal.

This study shows an association between the use of acetaminophen and the definition of asthma in the survey, explains Dr. Becker. In a questionnaire, parents were asked whether their child had experienced wheeze – a whistling noise in the chest – in the past 12 months. “In the two participating Canadian centres, Hamilton and Saskatoon, 20 per cent and 17 per cent respectively answered yes to that question,” says Dr. Becker.

However, a sub-group of these parents was shown a video of a child with asthma wheezing, instead of getting the questionnaire. Only 12 and 10 per cent of this group answered that they had seen ‘wheezing’. “This tells us that many parents who said their child was wheezing really don’t understand what we mean when we say ‘wheezing’,” said Dr. Becker.

Stay tuned. Researchers have called for a large randomized trial to settle the acetaminophen debate once and for all.

First published in Breathing Space, a supplement of Allergic Living magazine.