Sensibilización cutánea a aero alérgenos en niños con rinitis y asma / Skin sensitization to aero-allergens in children with rhinitis and asthma

Introducción: Las enfermedades alérgicas son muy comunes en la población pediátrica. Entre las causas frecuentes se encuentran los aeroalérgenos del ambiente, y la identificación de estos es de gran ayuda tanto para el diagnóstico como para el tratamiento. Objetivos: Determinar la frecuencia de aeroalérgenos, por medio de la determinación de Inmunoglobulina E (IgE) específica a alérgenos comunes por la prueba de sensibilidad cutánea en pacientes pediátricos con síntomas de asma y rinitis alérgica. Materiales y Métodos: Diseño observacional, descriptivo, prospectivo, transversal, población de pacientes de 4 a 17 años con síntomas compatibles con asma y rinitis alérgica que acudieron a un centro asistencial pediátrico en el periodo de estudio. Se realizó por medio de las Pruebas de punción cutánea (PCP). Resultados: La edad media de los pacientes fue de 8 años, 57% pacientes de sexo masculino y 43% de sexo femenino. El 53% de los pacientes presenta rinitis y asma, 45% solo rinitis y el 2% solo asma. El 79% de los pacientes presentó reacción positiva de sensibilización alérgica por medio de la PCP. Teniendo en cuenta la sensibilización por tipo de aeroalérgenos se tuvo que el 64% de los pacientes tuvo reacción positiva a ácaros, 19% a animales 18% a cucarachas, 8% a pólenes y 6% a hongos. Conclusión: La gran mayoría de pacientes con asma padecía rinitis alérgica concomitante y los ácaros del polvo fueron los aeroalérgenos más frecuentemente determinados en las pruebas cutáneas de alergia en niños con asma y rinitis de nuestra población.

Introduction: Allergic diseases are very common in the pediatric population. Among the frequent causes are aeroallergens from the environment and the identification of these is a great help for diagnosis and treatment. Objectives: To determine the frequency of aeroallergens, through the determination of Immunoglobulin E (IgE) specific to common allergens by the skin sensitivity test in pediatric patients with symptoms of asthma and allergic rhinitis. Materials and Methods: Observational, descriptive, prospective, cross-sectional design, population of patients from 4 to 17 years old with symptoms compatible with asthma and allergic rhinitis who attended a pediatric care center during the study period. It was carried out by means of Skin Puncture Tests (PCP). Results: The mean age of the patients was 8 years, 57% male patients and 43% female. 53% of the patients presented Rhinitis and Asthma, 45% only Rhinitis and 2% only Asthma. 79% of the patients presented a positive allergic sensitization reaction through PCP. Taking into account the sensitization by type of aeroallergens, 64% of the patients had a positive reaction to mites, 19 % to animals 18% to cockroaches, 8% to pollens and 6% to fungi. Conclusion: The vast majority of patients with asthma suffered from concomitant allergic rhinitis and dust mites were the most frequently determined aeroallergens in allergic skin tests in children with asthma and rhinitis in our population.

SENSIBILIZACIÓN A AEROALERGENOS EN PACIENTES CON RINITIS Y ASMA

Las enfermedades alérgicas han aumentado en las últimas décadas en todo el mundo. El asma y la rinitis alérgica podrían representar un espectro de la misma enfermedad, cuya patogénesis puede explicarse, entre otros factores, por la sensibilización a aeroalergenos. Los aeroalergenos más frecuentemente involucrados como sensibilizantes se hallan en el polvo del interior del hogar o lugar de trabajo (indoor). Dentro de los aeroalergenos indoor, los dermatophagoides son los más prevalentes. Este estudio demuestra que la prevalencia de sensibilidad a aeroalergenos indoor, en pacientes con rinitis y asma, es coincidente con la bibliografía. Es un área a investigar en el futuro, la prevalencia de sensibilidad a aeroalergenos outdoor

Allergic diseases have increased in recent decades worldwide. Asthma and allergic rhinitis could represent a spectrum of the same disease, whose pathogenesis can be explained, among other factors, by sensitization to aeroallergens. The aeroallergens most frequently involved as sensitizers are found in the dust inside the home or workplace (indoor). Within indoor aeroallergens, dermatophagoides are the most prevalent. This study demonstrates that the prevalence of sensitivity to indoor Aeroallergens, in patients with rhinitis and asthma, is consistent with the literature. It is an area to investigate in the future, the prevalence of sensitivity to outdoor aeroallergens.

Airborne Weed Pollen in Relation to Allergic Rhinitis in Riyadh, Saudi Arabia.

Aims: The study was conducted to investigate the frequently encountered allergenic pollen grains in the environment of Riyadh, Saudi Arabia as well as to determine their seasonal and annual growth pattern in the region. Study Design: Volumetric air sampling of two City sites with qualitative and quantitative comparison of data on seasonal and diurnal concentrations of weed pollen aeroallergens. Place and Duration of Study: The work was conducted in the capital City of Riyadh, Saudi Arabia and the sampling was conducted for a continuous 12 month period from January to December 2012. Methodology: Using two Burkard 7-Day Volumetric Air Sampler, airborne pollen grain for two sites in Riyadh City (City Center site in the middle of City) and Riyadh airport site (40 km away from the city) was studied. The data were collected for at least 12 months period in both sites. Results: The pollen grains from grasses, weeds and trees were identified. However, the weeds pollen dominated the pollen flora by a ratio of 70% followed by trees 20%, and grasses 10%. The major weeds pollen identified were: Amaranthus viridis, Artemisia monosperma, Atriplex nummularia, Chenopodium murale, Plantago boissieri, Ricinus communis, Rumex vesicarius and Salsola imbricata. Riyadh City Center site constituted higher percentage of total weeds (69%) compared to Riyadh airport site (31%). Conclusion: Seasonal periodicities of major allergens, reveal a trend that would help allergists and allergic patients for diagnosis and prevention.

Pattern of Aeroallergen Sensitization in Atopic Dermatitis Patients at University Clinic in Jeddah-Saudi.

Aims: To evaluate the pattern of skin prick test results of atopic dermatitis patients. Study: This was a retrospective study. Data were collected for the results of skin prick tests for atopic dermatitis patients who attended the King AbdulAziz University Medical Services Dermatology clinic in Jeddah Saudi Arabia between October 2010 and November 2012 Results: A total of 63 cases were collected. The rate of sensitization was 85.7% (54 out of 63). Most of them had been sensitized to more than one allergen (77.8%). Most of the patients were sensitized to Dermatophagoides pteronyssinus and Dermatophagoides farina (80% and 74% respectively). Less commonly they were sensitized to cat fur (44%) and to cockroaches (37%). Conclusion: House dust mite, cats and cockroaches allergens appear to be the most prevalent sensitizers in atopic dermatitis patients in Jeddah region.

Aeroallergen Sensitization in Childhood Asthmatics in Northern India.

Objective: To determine the prevalence of sensitization to common aeroallergens in asthmatic children and study the differences in characteristics of atopics and non atopics. Design: Analysis of data from a prospective cohort study. Setting: Pediatric Chest Clinic of tertiary care center in Northern India Patients: Asthmatic children from 5-18 year of age. Main outcome measures: Prevalence of sensitization to common aeroallergens. Results: Skin prick testing (SPT) was performed on 180 children above 5 years of age, with a mean (SD) age of 111.4 (34.2) months. 100 children (55.6%) were sensitized to at least one aeroallergen, suggesting atopy; 68 (37.8%) were sensitized to more than one allergen. 36.7% children were sensitized to housefly antigen; 31.1% to rice grain dust, 18.3% to cockroach, and 7.8% to house dust mite antigens. Atopic children had significantly higher median FENO during follow up than nonatopic children (17.5 ppb vs 13 ppb, P=0.002). There was a positive correlation between age and the number of allergens that an individual was sensitized to (r= 0.21; P=0.0049). Conclusions: More than half of asthmatic children in our cohort had sensitization to one or more aeroallergens suggesting atopy; sensitization was most commonly seen to housefly antigen and rice grain dust. Atopic children had significantly higher FENO measurements during follow up as compared to non-atopic children.

Breastfeeding Might Have Protective Effects on Atopy in Children With the CD14C-159T CT/CC Genotype

Breastfeeding is widely recommended to reduce risk of sensitization, eczema and asthma. However, the role of breastfeeding in prevention of allergic diseases is uncertain. We aimed to investigate whether the relationship between breastfeeding and sensitization to aeroallergens is modified by cluster of differentiation 14 (CD14) genotype. This study included 1,828 school children aged 9-12. We administered a detailed questionnaire and genotyped the CD14C-159T polymorphism. Skin prick tests for 12 aeroallergens were performed. School children who had been breastfed were less likely sensitized to aeroallergens (adjusted odds ratio [aOR] 0.712, 95% confidence interval [CI]: 0.555-0.914). There was no significant association between CD14C-159T genotype and atopy. Breastfeeding was associated with a decreased risk of atopic sensitization in children with CT/CC genotype (aOR 0.667, 95% CI: 0.463-0.960). Our data might identify the gene-environment interaction between the CD14C-159T polymorphism and breastfeeding in relation to aeroallergen sensitization.

Seasonal Variation in Skin Sensitivity to Aeroallergens

PURPOSE: We previously demonstrated seasonal variation in sensitization to aeroallergens in a small group of patients with exercise-induced asthma. This study was performed to confirm the relationship in a much larger population. METHODS: The charts of 1,891 patients who received allergy skin prick tests were reviewed retrospectively. The test results from subjects aged < or =60 years were compared between the groups classified according to the season when the patients received the tests (spring: March-May, summer: June-August, fall: September-November, winter: December-February). The data from 25 respiratory allergy patients who received the tests two or more times and showed a positive response at least once were analyzed longitudinally. RESULTS: The most prevalent among 29 tested aeroallergens were house dust mites (HDMs) Dermatophagoides pteronyssinus and D. farinae. The skin sensitization rates to D. pteronyssinus (23.2% vs. 32.1%, P=0.004) and D. farinae (22.2% vs. 30.2%, P=0.009) were significantly lower in the summer and higher in the fall (38.3% vs. 26.6% and 35.6% vs. 25.3%; P=0.001 respectively) than those in other seasons in patients with a respiratory allergy (n=1,102). The sensitization rates to weed pollens in the fall (13.9% vs. 8.3%, P=0.006) and to Aspergillus fumigatus in the winter (2.9% vs. 0.7%, P=0.005) were significantly higher. In patients with non-respiratory allergy such as urticaria/anaphylaxis (n=340), the D. farinae sensitization rate was significantly lower in the summer also but higher in the spring. The trend of the HDM sensitization rate being lower in the summer and higher in the fall was observed in the longitudinal study. CONCLUSIONS: Skin sensitivity to aeroallergens such as HDMs, pollens, and molds demonstrates seasonal variation in respiratory allergy patients. Non-respiratory allergy patients also showed seasonal variation in sensitivity to aeroallergens, which might be related to the "priming" effect of allergens.

Analysis of allergens in 5 473 patients with allergic diseases in Harbin, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To analyze the allergic status to common inhalant allergens and food allergens in clinical patients in Harbin in northeastern China and provide evidence to develop the prevention strategy of allergic disease.</p><p><b>METHODS</b>The data were collected from 5 473 patients with clinical suspected allergic diseases seeking medical care in the Second Affiliated Hospital of Harbin Medical University. Among these patients, 2 530 (46.2%) were males aged 0-86 years, the youngest was only 1 month old and 2 579 (47.1%) were young children and teenagers. The serum specific Immunoglobulin E (sIgE) to 14 kinds of common allergens and serum total IgE were detected by using AllergyScreen test (Mediwiss Analytic GmbH, Moers, Germany).</p><p><b>RESULTS</b>In 5 473 subjects the positive rate of sIgE was 33.1% (n=1 813). Cow milk (6.9%) and wheat (3.1%) were the most common food allergens, followed by house dust mite mix (12.5%) and mould mix (9.4%) and the age and gender specific differences in the positive rate were significant. For the children aged <7 years the positive rates to cow milk, beef-mutton, and egg white/egg yolk were high, but the positive rates to house dust mite mix, ragweed estragon, and mould mix were low (P<0.05). For the adults the positive rates to aeroallergens were high while the rates to food allergens were low.</p><p><b>CONCLUSION</b>The results from this study showed that the food allergens in Harbin had geographic characteristics, which support the viewpoint that the environment factors play an important role in the incidence of allergic diseases. Also, the detection of sIgE and total IgE are essential to identify relevant allergens for the purpose of early diagnosis, management and prevention of allergic disease.</p>

Impacts of climate change on aeroallergens

Climactic changes are key environmental issues affecting allergic diseases. Temperature and CO2 content have been found to be increasing together with climate changes, which could increase pollen production, extend the pollination period, and augment the allergenic components of major pollens. Changes in the distribution of major trees and weeds have been noted. Severe weather events such as thunderstorm winds and precipitation could increasingly cause pollen grains to burst, releasing allergenic particles and leading to extensive mold growth. Air pollutants can increase the concentration of allergen released from pollen grains and allow for easier penetration into airway mucosa. Future studies will be essential to investigate the mechanisms by which allergenic contents can be changed in response to climate change. A better understanding of how aeroallergens interact with air pollutants is needed. Climate change has a significant impact on aeroallergen levels and content in ways which may accelerate the development of allergic diseases. Future strategies will be crucial in preventing the allergic diseases associated with climate changes.

Atopy in children with eczema.

Objective. To explore the prevalence of common food and aeroallergens sensitization in early childhood skin diseases and to compare the pattern of common food and aeroallergens sensitization before and after 6 months among infants with atopic dermatitis (AD). Methods. All skin prick tests (SPTs) performed on children =< 18 months of age managed at the pediatric dermatology clinic of an university-affiliated teaching hospital over a 16-month period were examined. Results. There was generally no difference in the pattern of sensitization to common food and aeroallergens between AD patients and non-AD young children with miscellaneous dermatological or gastrointestinal conditions. Dust mites were the only common aeroallergens in these patients; whereas egg and peanuts were the common sensitizing food allergens. Cat and dog fur as aeroallergens, soy bean, orange and beef as food allergens were relatively uncommon among the studied subjects. In AD, infants =< 6 months were generally naive to aeroallergens but became sensitized to the D. Pteronyssinus in the next 12 months of age. 80% of these infants were not sensitized to cow’s milk and none sensitized to soybean. Conclusions. Atopic sensitization to common allergens was common in early childhood with or without AD. Majority of young infants were not sensitized to milk, and develop eczema before they show atopy to the milk or soy allergens.

Produção de IL-10 em resposta a aeroalérgenos em crianças e adolescentes de zona urbana com geohelmintíases / IL-10 production in response to aeroallergens by children and teenage from urban areas with geohelminthiasis

Objetivos: A IL-10 pode imunomodular as respostas alérgicas no hospedeiro. A respeito dos geohelmintos, trabalhos divergem quanto à alteração do quadro clínico e/ou testes cutâneos de hipersensibilidade. Pouco é conhecido sobre a produção de IL-10 frente a aeroalérgenos durante as geohelmintíases. Neste estudo, verificamos a produção de IL-10 por células mononucleares de sangue periférico de pacientes com ou sem geohelmíntiases, de zona urbana, em resposta ao Dermatophagoides pteronyssinus ou Blomia tropicalis. Métodos: Estudo experimental, com 21 pacientes de zona urbana, em que foram realizadas 84 determinações de IL-10. Após exames coprológicos, em triplicata, dois grupos foram formados, crianças enteroparasitadas e não-parasitadas. Amostras de sangue foram coleta das para purificação de células mononucleares e cultivo com antígenos de Ascaris sp (Asc), mitógeno concanavalina A (Con A), O. pteronyssinus (Dep) e B. tropicalis (Bt). A IL-10 do sobrenadante celular foi dosada (ELISA). Resultados: Idade dos pacientes variou de 9-12 anos e sem diferença quanto ao sexo. Nos indivíduos parasitados a carga parasitária foi baixa. Frente ao Asc, Con A ou Dep não houve diferença na síntese de IL-10 pelas células do grupo parasitado e não parasitado. Contudo, uma produção significativamente maior de IL-10, frente ao estímulo com Bt, nos não-parasitados foi observada. Conclusões: Pacientes de zona urbana parasitados produzem menos IL-10 frente à B. tropicalis, alérgeno mais prevalente em Recife, podendo levar a predisposição às manifestações alérgicas. Estes dados corroboram a hipótese que baixa carga parasitária de geohelmintos, principalmente Ascaris lumbricoides, pode predispor à asma/sibilância.

Objectives: IL-10 can immunomodulate allergic reactions in the host. Concerning of the geohelminths, the studies diverge about the alteration of clinical allergic disease and/or skin prick test reactivity. IL-10 production in response to aeroallergens during the geohelminths infection is poorly known. In this study, we verified the IL-10 syntheses by peripheral blood mononuclear cells from low parasitic load infected or non-infected patients coming from urban areas, when stimulated with Dermatophagoides pteronyssinus (Dep) or Blomia tropicalis (Bt). Methods: Experimental analysis of 21 patients from urban areas, which was performed 84 IL-10 determinations. After the parasitological exams (Hofmann/Kato-Katz), in triplicate, two groups were obtained, geohelminths infected and non-infected children. Blood sample were harvested for purification of mononuclear cells and culture with Ascaris sp antigen (Asc), concanavalina A mitogen (Con A), Dep and Bt. IL-10 content in cellular supernatant was measured (ELISA). Results: Patients age was among 9-12 years old and without difference in gender. In parasite infected individual the parasite load was low. In response to Asc, Con A or Dep there was not difference in the IL-10 synthesis. However, in response to Bt stimulus, high production of IL-10 by non-parasite infected group was observed. Conclusions: Parasite infected patients from urban areas product less IL-10 to Bt, allergen more prevalent in Recife, could lead to predisposition to allergic manifestation. These finding corroborate the hypotheses that low parasite load of geohelminths, especially Ascaris lumbricoides, can predispose to asth ma/wheezing.

Effectiveness of education for control of house dust mites and cockroaches in Seoul, Korea

We evaluated the efficacy of health education in reducing indoor arthropod allergens in Seoul. The mite control measures comprised the use of mite-proof mattress and pillow coverings, regular washing of potentially infested materials, maintenance of a low humidity, removal of carpets, and frequent vacuum cleaning. Cockroach control measures included trapping, application of insecticides, and protecting food. Of 201 homes enrolled in October 1999, 63 volunteers were included in a 2-year follow-up survey between April 2000 and January 2002. Before intervention, the density of mites/g of dust varied greatly; 27.1/g in children's bedding, 20/g in adult bedding, 7.2/g on the floors of children's bedrooms, 6.8/g in sofas, 5.9/g on the floors of adult's bedrooms, 3.9/g on living room floors, 3.7/g in carpets, and 1.9 mites/g on kitchen floors. The predominant mite species and house percentages infested were; Dermatophagoides farinae 93%, D. pteronyssinus 9%, and Tyrophagus putrescentiae 8%. Comparing 1999 and 2001 infestations, before and after 25 mo of education, mite abundance was reduced by 98%, from 23.7 to 0.57 mites/g of dust. In 1999, cockroaches were detected in 62% homes: 36% Blattella germanica and 35% Periplaneta spp., including 9% double infestations of B. germanica and P. americana. Following intervention, cockroach infestation rates decreased to 22% of houses in 2000 and 23% in 2001. We conclude that continuous and repetitive health education resulted in the effective control of domestic arthropods.

Aeroallergens survey in nakornsawan province.

An aeroallergen survey in Nakornswan province, was done prospectively in 1991 using a rotorod sampler. The most common pollen types and mold spores were Cyperaceae and Cladosporium, in order. There were definite differences in the amount and frequency of occurrences of aeroallergens between seasons. Mold spores were found frequently in rainy season.

Aeroallergens in Nakornnayok Hospital.

An all year survey of atmospheric pollens and molds was made in Nakornnayok Province, Thailand by Durham’s standard gravity method from 1st September 1988 to 31st August 1988. Most aeroallergens found were mold spores, with Cladaosporium (Hormodendrum) on top of the first, and Alternaria, Curvularia, Helminthosporium, Leptosporium, Rust, Tetraploa, Ascospore, Smut, Fusarium, Stemphylium were found to be less common in that order. Grass pollens were found 11 percent of total pollen count. Pine pollens were found in winter and weed pollens were found very low count. Unidenfiable pollens were found in high count with the peak between October to March.

Aeroallergens in songkla province.

An all year round survey of atmospheric pollens and molds was made in Hat Yai, Songkla Province in the south of Thailand by Durham’s standard gravity method from 1st January 1984 to 31st December 1984. Most aeroallergens found were mold spores, with Cladosporium (Hormodendrum) on top of the list, and Helminthosporium, Alternaria, Ascospore, Fusarium, Curvalaria, Torula, Rust, Stemphylium Smut, Tetraploa, and Ledtosporium were found to be less common in that order. Grass pollens were found in low counts, as well as weed pollens, which most of them belong to the group of Chenopod-Amaranthus. Unidentifiable pollens were found in high counts, and were probably the pollens of para rubber, cashew, corn, oil palm or wattle. The atmospheric pollens and mold spores were found throughout the year with highest peak in summer and lowest in November and December when there was heavy rain.