Pediatrician
June 13, 2013

Needle-Free Relief for Allergies 

Allergy shots are commonly used to treat children with severe environmental allergies and asthma, but under-the-tongue drops may offer yet another beneficial—and stickfree—option for pediatric allergy sufferers, according to a Johns Hopkins Children's Center review of existing scientific evidence. The new research, which comes on the heels of another Hopkins study showing that oral drops provide a safe and effective alternative for adult allergy sufferers, is an analysis of 34 previously published clinical trials and suggests that both drops and injections work well in alleviating the bothersome symptoms of allergic rhinitis and asthma in children (Pediatrics, May 6, 2013). However, underthe-tongue drops are not approved for use by the U.S. Food and Drug Administration and are only offered off label by some physicians.

Estrogen Fuels Autoimmune Liver Damage

A life-threatening condition that often requires transplantation and accounts for half of all acute liver failures, autoimmune hepatitis is often precipitated by certain anesthetics and antibiotics. Researchers say these drugs contain tiny molecules called haptens that ever so slightly change normal liver proteins, causing the body to mistake its own liver cells for foreign invaders and to attack them. The phenomenon disproportionately occurs in women, even when they take the same drugs at the same doses as men. Results of a new Hopkins Children’s Center study in mice, described in the April issue of the journal PLoS One, reveal that estrogen and a signaling molecule called interleukin-6 collude to form a powerful duo that leads to immune cell misconduct and fuels autoimmune liver damage. The findings, the research team says, also suggest therapeutic strategies to curb damage in people who develop druginduced liver inflammation.  “Our study,” says pediatric anesthesiologist and critical care expert Dolores Njoku, “shows that estrogen is not alone in its mischief but is working with an accomplice to set off a cascade of events that leads to immune cell dysregulation and culminates in liver damage.”