Challenging Environments
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Med News markets land on AAFA’s Fall Allergy Capitals list

LANDOVER, MD — In the Asthma and Allergy Foundation of America (AAFA) 2012 Fall Allergy Capitals rankings of the 100 most challenging places to live with allergies, all Medical News markets were included.

The rankings were based on pollen scores and the numbers of allergy medications and allergy specialists per patient:

  • Louisville, Ky. (1)
  • Knoxville, Tenn. (3)
  • Jackson, Miss. (4)
  • Memphis, Tenn. (8)
  • Baton Rouge, La. (10)
  • Chattanooga, Tenn. (11)
  • New Orleans, La. (13)
  • Little Rock, Ark. (16)
  • Birmingham, Ala. (17)
  • St. Louis, Mo. (27)
  • Nashville, Tenn. (36)
  • Charlotte, NC (51)
  • Tampa, Fla. (73)
  • Orlando, Fla. (76)
  • Raleigh, NC (88)
  • Sarasota, Fla. (92)

“All 100 cities are bad,” said AAFA’s Mike Tringale, vice president of external affairs. “We don’t make a claim that if you live in the No.1 city that you should move to No. 100.”

Tringale pointed out the pollen scores alone aren’t “a perfectly appropriate measure.”

 “Data is measured by pollen grains per cubic measure,” he explained. “Then a comparison of pollens is tracked over time to get an idea of how much pollen matter is in the air. But not all pollen is allergenic. Flower pollen, for example, isn’t that allergenic. Different species of trees have different allergenics. Pine or conifers may be less allergenic, so not only is the number of pollen important, but also the type of pollen to make statistical analysis for total pollen score.”

The National Institutes of Health (NIH) is focusing additional efforts on collaborative research via grants and clinical trials governing allergies and asthma. For example, researchers at Washington University School of Medicine in St. Louis received an $8 million NIH grant last December to study the role of the barrier functions of the skin, gut and airway in asthma and allergic diseases, particularly to better understand the role of the epithelial cells in these tissues that may help prevent and treat respiratory illnesses.

“The epithelial cells are critical for forming a barrier between the organism and its environment,” said principal investigator Michael J. Holtzman, MD, the Selma and Herman Seldin Professor of Medicine at Washington University. “The reaction of these cells to the environment can determine whether the host develops a normal immune response or an inflammatory disease process. We want to figure out how these reactions might move in a helpful direction and provide protection against the environment or in a harmful direction, leading to inflammatory diseases such as asthma.”

Tringale said much of the research in allergies and asthma involves understanding the root causes of the diseases.

“Researchers know allergy is a disease of the immune system,” he explained, “and that asthma is a disease of the airways that lead to the lungs. They could possibly call it a lung disease; it’s an interesting distinction. Three decades ago, researchers realized the allergy and asthma link and called it allergic asthma. Later on, they realized that some asthma was brought on by heavy exercise, so they called it exercise-induced asthma. Then there’s a fourth one that creates mucus and may require a different kind of attention. It’s not about airways getting smaller; it’s about mucus clogging up the airways. Progress is being made – it’s much better than the prescribed allergy cigarettes in the 1930s – but also it’s turning up additional questions. The scientific community is recognizing stratified diseases require different attention. It may take longer to find a cure because there are so many variations.”


All Market Box: The American Academy of Allergy, Asthma and Immunology (AAAAI) will host the 2013 AAAAI Annual Meeting Feb. 22-26 in San Antonio, Texas. Five days of educational topics will include the Presidential Plenary on sensitization and tolerance in allergic disease, immunotherapy, food allergy and GI disease, skin disease, PIDD, practice management, new technologies and healthcare reform. For more information, visit


AAAAI., AAFA, American Academy of Allergy, Asthma and Allergy Foundation of America, Asthma and Immunology, Mike Tringale

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