Uso de probióticos na rinite alérgica / Probiotics in allergic rhinitis

Probióticos são microrganismos viáveis, usados como suplemento alimentar, normalmente bactérias ácidas lácticas, que podem modificar a composição e/ou a atividade metabólica da microbiota intestinal, modulando o sistema imune de forma que beneficie a saúde do indivíduo. OBJETIVO: Fazer uma revisão sobre o uso de Probióticos (Lactobacillus e Bifidobacterium) na rinite alérgica. MATERIAL E MÉTODO: Foram pesquisados artigos originais no Pubmed. RESULTADOS: Os resultados encontrados indicam que os probióticos, Lactobacillus e Bifidobacterium parecem prevenir as recorrências alérgicas, aliviar a severidade dos sintomas e promover melhora da qualidade de vida dos pacientes com rinite alérgica. Estes efeitos ocorrem devido à modulação do sistema imunológico através da indução da produção de citocinas que promovem uma resposta TH1 dominante em alérgicos, através do efeito da modulação no balanço TH1/TH2. CONCLUSÃO: O uso de bactérias probióticas pode ser uma forma efetiva e segura de prevenção e/ou tratamento de rinite alérgica, mas seu mecanismo exato de ação permanece desconhecido. No entanto, estudos clínicos usando probióticos e intervenção dietética deverão ser o foco de futuras investigações, para permitir um uso mais amplo.

Probiotics are live microorganisms used as supplementary food, usually lactic acid bacteria that can change either the composition and/or the metabolic activities of the gut microbiota modulating the immune system in a way that benefits the person's health. AIM: To review the use of Probiotics (Lactobacillus and Bifidobacterium) in allergic rhinitis patients. MATERIALS AND METHODS: Pubmed original articles were used as data source. RESULTS: Results indicate that probiotics, Lactobacillus and Bifidobacterium appear to prevent allergy recurrences, alleviate the severity of symptoms and improve the quality of life of patients with allergic rhinitis. This happens because of the immune system modulation through the induction of cytokine production which cause a dominant TH1 response in allergic patients by modulating the TH1/TH2 balance effect. CONCLUSION: The use of probiotic bacteria could be an effective and safe way to prevent and/or treat allergic rhinitis, but its underlying mechanisms remain unclear. Therefore, clinical studies using probiotics and dietary intervention should be the focus of future research to enable a more widespread use.

Pet exposure and the symptoms of asthma, allergic rhinitis and eczema in 6-7 years old children

Allergic diseases are frequent in children and their prevalence and severity differ in the different regions of the world. The association between pet ownership in childhood and subsequent asthma and sensitization is very controversial. In our survey conducted with standardized method [International Study of Asthma and Allergies in Childhood], 3200 children 6-7 years old were questioned regarding asthma, allergic rhinitis and eczema. The prevalence of Attacks and shortness of breath with wheezing during last 12 months in the children who had exposure to pets in the first year of life was 34.3% that was less than children who had not exposure [OR=3.06, 95% confidence interval [CI] 1.14-8.21, P=0.021]. Also during the past 12 months the prevalence of night dry coughs, allergic rhinitis symptoms and eczema symptoms in those who had pet exposure in the first year of their life was lower than the children did not have it. However there was no significant difference in some other symptoms of asthma in two groups. Our findings suggest that pet exposure in the first year of life can have a protective effect on asthma, allergic rhinitis and eczema

Rinitis alérgica como causa de obstrucción de las vías áereas superiores / Allergic rhinitis caused by upper airway obstruction

La rinitis es una patología muy frecuente, siendo la rinitis alérgica la de mayor prevalencia. Esta constituye una de las causas de obstrucción de las vías aéreas superiores.

Doenças das vias aéreas superiores / Diseases of the upper respiratory tract

Um grande número de agentes presentes no ar inalado, ambiental ou ocupacionalmente, pode causar sintomas e doenças das vias aéreas superiores. Infelizmente o estabelecimento do nexo causal entre os mais diversos tipos de exposições que podem desencadear essas doenças não faz parte da rotina dos profissionais da saúde afeitos a essa questão. Uma extensa lista desses agentes e suas relações com as atividades e o desencadeamento dessas enfermidades estão disponíveis na literatura. Destacamos as rinossinusopatias, as disfonias, as ulcerações e perfurações do septo nasal e o elevado número de neoplasias da cavidade nasal e dos seios paranasais, que podem estar associados às atividades laborativas. Os procedimentos diagnósticos para investigação da etiologia ocupacional, apesar de disponíveis, ainda são pouco utilizados rotineiramente. Geralmente o reconhecimento precoce do agente causal e o afastamento da exposição podem resolver o problema evitando sua cronificação, pois, como nas demais doenças respiratórias ocupacionais, os programas de prevenção e o controle são elementos imprescindíveis para o equacionamento dessas enfermidades.

A great number of agents found in inhaled air, whether in the environment or in the workplace, can cause symptoms and diseases of the upper respiratory tract. Unfortunately, establishing the cause-and-effect relationship between exposure to one of the various types of agents that can provoke such diseases and the diseases themselves is not routine practice among the health professionals involved. A comprehensive list of these agents and their relationships with the effects and onset of such illnesses is available in the literature. Chief among these ills are rhinosinusitis, dysphonia and ulceration/perforation of the nasal septum, as well as tumors in the nasal cavity or paranasal sinuses, all of which can be work related. Although widely available, diagnostic procedures for the investigation of occupational etiology are not yet routinely employed. In general, early identification of, and discontinuation of the contact with, the causal agent can resolve the problem, thereby averting the development of the chronic form of the disease. As with other types of occupational respiratory diseases, prevention and control programs are indispensable in the fight against these illnesses.

Allergy to house dust mites and asthma

House dust mites have been shown to be important sources of indoor allergens associated with asthma and other allergic conditions. Asthma is a chronic respiratory disease that affects millions of people worldwide, and numerous scientific studies have shown that the prevalence of asthma is increasing. The most common dust mite species around the world include Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Euroglyphus maynei (Em) and Blomia tropicalis (Bt). Over the past three decades, many important allergens from these species have been identified and characterized at the molecular level. The biological function of several house dust mite allergens has been elucidated, with many of them showing enzymatic activity. However, Bt allergens remain the least studied, even though this mite is very common in tropical and subtropical regions of the world, including Puerto Rico. Therefore, it is very important to include Bt in diagnostic and therapeutic strategies for house dust mite induced allergy and asthma, particularly in areas where Bt exposure and sensitization is high. Recombinant DNA technology, as well as other molecular biology and immunological techniques, have played a fundamental role in advances towards a better understanding of the biology of house dust mites and their role in allergic diseases. This kind of study also contributes to the understanding of the complex immunologic mechanisms involved in allergic reactions. The development of effective diagnostic and therapeutic approaches depends on the continuity of research of house dust mite allergens. The objectives of this review are to describe the most important aspects of house dust mite allergy and to acquaint the scientific community with the latest findings pertaining to house dust mite allergens, particularly those derived from Bt.

Rinite alérgica: tratamento e perspectivas / Allergic rhinitis: treatment and perspectives

A autora estabelece o conceito de rinite alérgica, destacando sua frequência na infância e a importância de uma correta abordagem terapêutica. Estuda o diagnóstico clínico, laboratorial e diferencial, a prática fundamental do controle ambiental, o tratamento farmacológico com anti-histamínicos de 1ª 2ª e 3ª geraçöes e do uso tópico, estabilizadores de mastócitos, descongestionantes, anticolinergéticos, corticosteróides tópicos e sistêmicos. Finaliza abordando a imunoterapia e a cirurgia nasal, como recursos terapêuticos em alguns casos

Tratamento da rinite alérgica em crianças: prescriçäo leiga de medicamentos e intoxicaçöes / Allergic rhinitis in children: over-the-counter medication and intoxication

Os autores realizaram pesquisa em 40 farmácias da cidade de Säo Paulo apresentando um caso fictício de rinite alérgica em uma criança de 4 anos. Apenas 14 (35 por cento) dos balconistas consultados orientaram a encaminha-lo ao medico, enquanto 26 (65 por cento) instituiram algum tipo de tratamento. Os medicamentos mais utilizados foram: anti-histaminicos (34,61 por cento), gotas nasais (30,77 por cento) e descongestionantes sistemicos (19,23 por cento). Foram encontrados erros de posologia e duraçäo do tratamento em todos os casos. Apenas 7,7 por cento dos balconistas ressaltaram os possíveis efeitos adversos das medicaçöes prescritas...