J ALLERGY CLIN IMMUNOL

FEBRUARY 2013

AB48 AbstractsSATURDAY

173 Lung Resident Cells Are Independently Capable ofMaintaining Chronic Asthma in Mice After Immune Ablation

Christina Christianson, PhD, Chaoyu Chen, MS, Magdalena

Gorska, MD, PhD, Rafeul Alam, MD, PhD, FAAAAI; National Jewish

Health, Denver, CO.

RATIONALE:Wedeveloped amousemodel of chronic asthmawhere the

asthma features persist for longer than 3 months after cessation of allergen

exposure. The objective of this study was to assess the contribution of lung

resident cells to the maintenance of asthma phenotype and to examine the

signaling mechanisms.

METHODS: Chronic asthma is induced through twice weekly intranasal

exposure to a combination of allergens (D. Farinae, ragweed, and

aspergillus) for six weeks. Two weeks after cessation of allergen exposure

immune ablation was accomplished by lethal irradiation and irradiated

mice underwent transplantation of na€ıve bone marrow. Airway hyperre-

activity (airway resistance to inhaled methacholine by Flexivent) and

immunohistological features were measured at weeks 2, 4 and 6 after

irradiation.

RESULTS: Mice from the chronic model maintained the typical features

of chronic asthma—airway hyperreactivity and epithelial remodeling at all

observation points following immune ablation. They also mounted de novo

inflammation that was characteristically localized to the peribronchial and

perivascular space. Control mice did not manifest any features of asthma.

Persistence of asthma in the chronicmodel following immune ablation was

associated with sustained activation of ERK1/2 and AKT signaling,

especially in airway epithelium. To examine the importance of lung cell

ERK1 for asthma we adoptive transferred immunized ERK1+/+ CD4

T cells to ERK1-/- and ERK1+/+ littermate control mice. Only ERK1+/+

but not ERK1-/- recipient mice developed asthma.

CONCLUSIONS: Lung resident cells can sustain chronic asthma in the

absence of sensitized immune cells. Lung cell ERK1 plays a non-

redundant role in the development of asthma

174 Infant Feeding Practices Changed Following Publication of2000 American Academy of Pediatrics Guidelines

Shannon Seopaul, BS1, Corinne Keet, MD, MS2; 1Johns Hopkins Univer-

sity School of Medicine, 2Pediatrics, Johns Hopkins University School of

Medicine, Baltimore, MD.

RATIONALE: This analysis sought to determine if infant feeding

practices in the U.S. changed following publication of the 2000

American Academy of Pediatrics (AAP) guidelines for prevention of

food allergy in high risk infants.

METHODS: The Food and Drug Administration conducted two Infant

Feeding Practices Surveys in 1993-94 (IFPS1) and 2005-7 (IFPS2).

Questionnaires (1 prenatal, 10 postnatal) were sent to households with a

pregnant woman (3155 in 1993; 4900 in 2005). Differences in maternal

food avoidance between the two surveys were evaluated by the chi-squared

test, and differences in breastfeeding and food introduction were evaluated

by Cox proportional hazards using STATA 11/SE.

RESULTS: 1617 (IFPS1) and 2552 (IFPS2) mothers completed at least

the 2 month infant questionnaire. Duration of any and exclusive

breastfeeding were both longer in IFPS2 than IFP1 (p50.01 and 0.001,

respectively). More women in IFPS2 avoided nuts while breastfeeding to

prevent food allergy (3.7% vs 0.8%, p50.001), but not egg (p50.15) or

milk (p50.16). Introduction of solids, milk, peanut and eggs was delayed

in IFPS2 (p<0.001 for all). In IFPS2, mothers of high risk infants were

more likely to avoid peanut (p50.008) and milk (p50.001), but not egg

(p50.23), while breastfeeding and to exclusively breastfeed longer

(p50.003). Timing of introduction of milk and solids, but not peanut

and egg, varied by high risk status (p50.004, 0.001, 0.35 and 0.06,

respectively).

CONCLUSIONS: Breastfeeding and food introduction practices changes

following publication of the 2000 AAP allergy prevention guidelines. The

impact of the 2008 revision to these guidelines remains to be seen.

175 Shift in Aeroallergen Indices, Allergy and Asthma Cases andan AHPCO Air Purifier to Reduce Indoor Airborne Pathogensand VOCs

Nabarun K. Ghosh, PhD1, Jeff Bennert, PhD CTN2, Constantine K.

Saadeh, MD, FAAAAI3, Griselda Estrada, BS1; 1West Texas A&M Uni-

versity, Canyon, TX, 2AIR OASIS, Amarillo, TX, 3Allergy ARTS

ACCR, Amarillo, TX.

RATIONALE: Aeroallergen data of Texas Panhandle for 12 years

revealed a gradual shift in aeroallergen index with the warmer climate

and shift in flowering seasons. We assessed an air purifier that uses

Advanced Hydrated Photocatalytic Oxidation Technology.

METHODS: AHPCO Technology was used with Air Oasis air purifiers to

improve the indoor air quality. They were assessed for net reduction of

bacteria, fungi,VOCs ina negative pressure laboratorywith the specific effect

on Methicillin resistant Staphylococcus aureus, MRSA. A fiber glass cham-

ber (AOchamber)was built to assess and evaluate the performance and safety

of the air purifiers. Blood, Human cell culture and plant cells were exposed to

the AO chamber and the UV chambers to compare the exposures. Images

were capturedwith FITC,TRITCFilterswith aBX40OlympusMicroscope.

RESULTS: Since 2007, Asthma cases doubled in Amarillo compared to the

state of Texas. The AHPCO air purifier improved the indoor air quality by

reducing the aeroallergens andVOCs.Humanbloodsamples andcell cultures

were exposed to the AO chamber and UV chamber with same duration we

found no anomalies with the AO chamber. With UV ray, RBCs and WBCs

exhibited cytological instability. With a short exposure to UV rays the cells

lysed in culture leaving residues that could be detected with TRITC imaging.

CONCLUSIONS: Early Flowering and shift in aeroallergen indices pos-

sibly causedan icrease in asthmacases.Experimental data showed that theAir

Oasis air purifiers reduced the symptoms of allergy and they are safe to use.

176 Epinephrine (E) for Self-Administration: Autoinjectors andAlternatives

Dona Shearer, RN1, Richard F. Lockey, MD2; 1University of South Flor-

ida, Tampa, FL, 2James A. Haley Veterans’ Hospital, Tampa, FL; Univer-

sity of South Florida Morsani College of Medicine, Tampa, FL.

RATIONALE: ‘‘Demand for E autoinjectors has increased throughout the

world as the indications for their use have expanded. Costs have simul-

taneously increased, resulting in a significant economic burden for some

patients and families who require such therapy’’.3 Information about the

pros and cons for autoinjectors and alternatives of E follow.

METHODS: Literature search and Micromedex Red Book

RESULTS:

1. a. One cc vials or ampules E 1:1000 (1 mg/mL); one cc syringe and

needle; training.

b. Pros: Cost trivial (approximately $6.00 USA, $2.90 Canada);

doses can be weight and risk adjusted.

c. Cons: Light sensitive/store in light-free case or aluminum foil.

Added time to deliver.

2. a. 30 cc vial 1:1000 (1 mg/mL) prefill one cc syringe with needle;

dose and weight adjusted; training.

b. Pros: 1 b

c. Cons: 1c; stability 2 months (arid climates), 3 months (humid

climates). versus

3. a. Autoinjectors E 0.15 and 0.3 mg as Adrenaclick (Amedra, Mid-

dlesex, NJ); Auvi-Q (Sanofi, Paris, France); EpiPen (Dey Pharma,

Basking Ridge, NJ); Jext (ALK-Abello, Horsholm, Denmark);

Twinject (Amedra, Middlesex, NJ). Training tools provided.

b. Pros: Ease of administration, storage, expiration date; Auvi-Q

incorporates audio/visual guide.

c. Cons: 2011, average cost for one dose $87.92 (USA).3CONCLUSIONS: Low cost alternatives to E autoinjectors exist which

can provide the recommended E dose. Autoinjectors are desirable for time

and convenience of self-administration. 3 Westerman-Clark E, Fitzhugh

D, Lockey RF: Increasing cost of epinephrine autoinjectors. JACI 2012;

1303:822-823.