Principales aeroalérgenos en rinoconjuntivitis alérgica en la ciudad de Temuco, Chile / Aeroallergens causing rhinoconjunctivitis

Background: Allergic rhinoconjunctivitis (ARC) has a prevalence of 30% in industrialized countries. For an accurate diagnosis and treatment, it is crucial to identify the causative aeroallergen. Aim: To evaluate aeroallergen sensitization in adults with ARC in the city of Temuco, Chile. Patients and Methods: A skin test against the main aeroallergens present in Temuco was carried out in patients aged 15 to 64 years with ARC diagnosed by medical examination and the Score For Allergic Rhinitis. Results: At least one aeroallergen sensitization was present in 234 (62.4%) out of 375 patients. Pollen-sensitized patients were positive mainly for Grasses (44.4%), Plantago (27.8%), Cynodon (26.1%), Sorrel (23.5%), Birch (14.9%), Nothofagus obliqua (13.3%) and Alder (11.1%). Dust mites were the most common non-pollinic sensitizing aeroallergens, including Dermatophagoides pteronyssinus (70.1%) and Dermatophagoides farinae (62.8%). Conclusions: According to our results, skin tests in the city of Temuco should include at least dust mites, pollens of Grasses, Plantago, Cynodon, Sorrel, Birch, Nothofagus obliqua and Alder, because these allergens account for 93% of ARC cases in this city.

Fatores de risco para atopia no nascimento e na idade adulta / Atopy risk factors at birth and in adulthood

OBJETIVO: Estudar a associação entre atopia e variáveis como peso, comprimento e nível socioeconômico no nascimento e na idade adulta jovem. MÉTODOS: Foram investigados 2.063 indivíduos em um estudo prospectivo de coorte de nascimento com indivíduos nascidos em Ribeirão Preto (SP), em 1978/1979, e examinados aos 23-25 anos de idade. Realizaram-se testes cutâneos de puntura (TCP) para oito alérgenos comuns no Brasil. Foram considerados atópicos os indivíduos que apresentaram reação papular > 3 mm para um ou mais dos oito alérgenos testados. A fim de avaliar a associação entre atopia e variáveis no nascimento e na idade adulta, utilizamos o modelo log-binomial (modelo linear generalizado). RESULTADOS: A prevalência de TCP positivo foi de 47,6 por cento. O gênero masculino esteve associado a aumento do risco de atopia [risco relativo (RR) = 1,18; intervalo de confiança de 95 por cento (IC95 por cento) 1,07-1,30]. O baixo nível de escolaridade foi um fator de proteção contra atopia, com um RR = 0,74; IC95 por cento 0,62-0,89. A convivência com um fumante na infância também esteve associada a um menor risco de atopia (RR = 0,87; IC95 por cento 0,79-0,96). Peso e comprimento ao nascer, ordem de nascimento, idade materna e restrição de crescimento intrauterino não estiveram associados a TPC positivo. CONCLUSÕES: Este estudo demonstrou que o gênero masculino esteve associado a um aumento do risco de atopia. O baixo nível socioeconômico, estabelecido pelo baixo nível de escolaridade, foi um fator de proteção contra a atopia. Esses dados estão de acordo com a teoria da higiene.

OBJECTIVE: To study the association between atopy and variables such as weight, length, and socioeconomic level at birth and in young adulthood. METHODS: A total of 2,063 subjects were investigated in a prospective birth cohort study of individuals born in Ribeirão Preto, Brazil, in 1978/1979, and examined at the age of 23-25 years. Skin prick tests (SPT) for eight common allergens in Brazil were performed. Subjects with a wheal reaction > 3 mm to one or more of the eight allergens tested were considered to be atopic. We used the log-binomial model (generalized linear model) in order to assess the association between atopy and birth or adult variables. RESULTS: The prevalence of positive SPT was 47.6 percent. Male gender was associated with an increased risk of atopy (relative risk [RR] = 1.18; 95 percent confidence interval [95 percentCI] 1.07-1.30). Low level of schooling was a protective factor against atopy, with a RR = 0.74; 95 percentCI 0.62-0.89. Living with a smoker in childhood was also associated with lower risk of atopy (RR = 0.87; 95 percentCI 0.79-0.96). Birth weight, length and order, maternal age, and intrauterine growth restriction were not associated with positive SPT. CONCLUSIONS: This study showed that male gender was associated with an increased risk of atopy. Low socioeconomic status, assessed by low level of schooling, was a protective factor against atopy. These data agree with the hygiene hypothesis.

Common allergens of atopic dermatitis in dogs: comparative findings based on intradermal tests

Intradermal tests were performed on 58 dogs diagnosed with atopic dermatitis from 2004~2008 at the Veterinary Medical Teaching Hospital of Konkuk University, Korea. To compare the allergen distribution observed in the present investigation to the results from other studies conducted in Korea and elsewhere, the allergens were grouped according to their kinds. There was no significant difference in gender distribution among the dogs. The most common breeds among the 58 dogs were Maltese (n = 11) and Shih-tzu (n = 11). The average age was 4.8 years. The most frequently produced a positive reaction on the intradermal tests was mold (67.3%) followed by house dust (54.5%) and house dust mites (49.1%). The present study found a low distribution of dogs allergic to various outdoor allergens compared to studies performed in other countries; this may reflect differences in living conditions for dogs living in Korea.

pattern of sensitisation to inhalant allergens in Omani patients with asthma, allergic rhinitis and rhinoconjunctivitis

Identification of relevant allergens that are prevalent in each environment which may have diagnostic and therapeutic implications in allergic diseases. This study aimed to identify the pattern of sensitisation to inhalant allergens in Omani patients with asthma, allergic rhinitis and rhinoconjunctivitis. The study was carried out during three consecutive years [2004-2006] at the allergy skin test laboratory of Sultan Qaboos University Hospital, Oman. Records of patients who had undergone an allergy skin prick test with a referring diagnosis of asthma, allergic rhinitis or rhinoconjunctivitis were reviewed. Two panels were used during the 3 years period. The frequencies of positive skin tests were analysed. Results: 689 patients were tested, 384 for the first panel and 305 for the second panel. In the first panel, the commonest positive allergens were: house dust mites [37.8%], hay dust [35.4%], feathers [33.3%], sheep wool [26.6%], mixed threshing dust [25.8%], cat fur [24.2%], cockroach [22.7%], straw dust [22.7%], horse hair [17.4%], maize [16.?%], grasses [11.5%], cotton flock [10.7%], trees [10.4%], cow hair [7.8%], Alternaria alternata [3.6%], Aspergillus Niger [3.4%], and Aspergillus fumigatus [?.3%]. In the second panel, the commonest positive allergens were also house dust mites: Dermatophagoides pteronyssinus [50.8%], Dermatophagoides farinae [47.9%]; Mesquite [Prosopis glandulosa] [35.7%], Russian thistle [Salsola kali] [34.4%], cockroach [32.1%], Bermuda grass [Cynodon dactylon] [19.7%], grass mix-five standard [18.0%], wheat cultivate [14.1%], cats [13.8%], Penicillium notatum [4.3%], Alternaria tenius [3.9%], Aspergillus Niger [3.3%], feather mix [3.0%], dog [2.6%], horse hair and dander [2.6%], and Aspergillus fumigatus [1.6%]. The pattern of sensitisation to environmental allergens in Oman seems to be similar to other reports from the Arabian Peninsula. Methods to identify and characterise environment specific allergens like a pollen survey may help in the management of patients with allergic asthma, allergic rhinitis and rhinoconjunctivitis

Result of standard patch test in patients suspected of having allergic contact dermatitis.

Contact dermatitis is a common skin disease. Disease was diagnosed by a history of contact substance together with geographic distribution of lesion. Up till now, standard patch test is one of the most reliable test to identify and confirm causative agent of allergic contact dermatitis. To determine the rate of positive standard patch test and to identify the common allergen of contact dermatitis in Thailand, we performed the standard patch test in 129 patients, suspected having allergic contact dermatitis at Department of Dermatology, King Chulalongkorn Memorial Hospital, Thailand from June 1, 2003 to September 1, 2004. The rate of positive standard patch test is 59.7% (n = 77/129). The most 3 common positive allergens were nickel sulfate (18.60%), cobalt chloride (17.05%) and fragrance mix (14.73%), respectively. The chance of positive standard patch test significantly correlated with sex (woman), initial diagnosis as contact dermatitis and history of house-worker (p = 0.017, p = 0.005 and p = 0.023, respectively). Whereas, there were no significant correlation between the chance of positive standard patch test and age of patient, location of lesion, history of recurrence, history of atopy, history of drug and food allergy. In addition, history of metal allergy significantly correlated with the chance of positive nickel sulfate or cobalt chloride in standard patch test (p = 0.017). In conclusion, this study demonstrated the prevalence of causative allergen of contact dermatitis in Thai patients using that standard patch test. Moreover, our data shown that the chance positive standard patch test was greater in patient, who were women or initial diagnosed as contact dermatitis or had history of houseworker or history of metal allergy.

Pruebas cutáneas de hipersensibilidad inmediata en una población pediátrica seleccionada / Skin prick test of immediate hipersensitivity in a selected Chilean pediatric population sample

Background: Skin prick test (SPT) of immediate hypersensitivity is a main instrument in the diagnosis of allergy. Aim: To demonstrate the applicability of skin prick test in different age groups. Patients and Methods: We studied children and adolescents with the diagnosis of allergy in the Pediatric Respiratory Laboratory of the Catholic University of Chile, from January 2001 to March 2002. The SPT was performed using a standardized technique. The allergens were applied on the volar surface of the forearm in children older than 4 years of age and in younger children it was applied on their back. For study purposes we separated them into three age groups: GI ¡2 years and 11 months, GII from 3 to 4 years and 11 months, GIII ×5 years. Results: We studied 408 children, aged between 8 months and 15 years. The SPT was applied to all patients with no adverse effects of any kind. There was a positive reaction in 57.7percent of children. The reaction was positive in 37percent in G1, 39percent in GII and 65percent in GIII (p <0.001). The predominant allergens for each group were dust mites (Dermatophagoides pteronissinus and farinae). Conclusions: SPT was useful when used on a selected pediatric population. The frequency of sensitization increased significantly with age. However, more than one third of children between 2 and 4 years of age tested positive to one or more allergen, demonstrating its applicability in this age group.

relation between HLA [Class I] and bronchial asthma

This study included forty eight patients suffering from allergic bronchial asthma in addition to 24 normal persons as a control group who were completely chest free. All individuals were subjected to full history taking, prick and intradermal skin tests for common allergens [house dust mites, mixed fungi, mixed pollens, hay dust, wool, cat hair and dog hair] and HLA [class I] typing by Micro lympnocyto-toxicity. It was found that the most prevalent allergens causing bronchial asthma were house dust mites [45.8%] and mixed fungi [20.8%]. The most common HLA [class I] associated with allergic asthma were HLA-A[1], B[8], Cw[4] and these results were statistically significant [P = < 0.01]. The asthmatic patients with house dust mites were mostly associated with HLA-A[1], B[8], Cw[6] while to mixed fungi was HLA- A[1], A[30], B[8], Cw[4]. So persons with HLA-A[1], B[8] are more susceptible to develop bronchial asthma, so we must kept him away from sources of external allergens

Aeropalinología de Santiago / Aeropalynology of Santiago

Se realizó un estudio aeropalinológico en Santiago (33º21'S-70º38'W), entre los años 1993-1996. Antecedentes clínicos publicados postulan que el polen es uno de los agentes causales importantes de las alergias en esta ciudad. A pesar de ello, hasta ahora no se conocían las concentraciones reales de granos de polen/m3 en la atmósfera a las que están expuestas las personas sensibilizadas. El presente tiene como objetivo conocer el origen del polen atmosférico, las concentraciones de granos de polen/m3, el aporte aeropolínico de las especies nativas y la dinámica aeropolínica de las especies alergogénicas, para establecer un calendario políclinico. Se cuantificó el polen aéreo desde junio 93 a junio 96 utilizando para la retención del polen un captador tipo Hirst. Paralelamente a esto se realizó una recolección de plantas urbanas y de su respectivo polen para hacer colecciones de referencia. Se registró un total de 96 taxa representados aeropolínicamente, los alergogénicos que se encuentran en mayor concentración se representan graficados en concentraciones de granos de polen/m3 porcentajes acumulados y períodos de polinización. Se concluye que el polen aéreo del área estudiada procede principalmente de especies introducidas, siendo la gran mayoría productoras de polen de comprobada alergogenicidad. El aporte políclinico en la atmósfera de la flora nativa es mínimo, no superado el 2,5 por ciento del total. Además, la cantidad del polen alergogénico en el aire está presente durante todo el año, acentuándose en los meses de primavera y verano. Por esta razón la población sensible a las alergias polínicas está expuesta a tener síntomas de polinosis permanentemente. Las taxa más importantes en el registro aéreo son plantanus, acer, poaceae, cupresaceae, fraxinus, quenopodiaceae, plantago y rumex

O impacto do meio ambiente no trato respiratório / The impact of the environment upon the respiratory tract

Objetivos: A poluiçäo do ar tem sido um problema de significância mundial, com repercussöes crescentes no trato respiratório, ao longo dos anos. Os objetivos desta revisäo säo apresentar resultados de estudos sobre os potenciais efeitos deletérios de alérgenos e poluentes sobre o trato respiratório. Método: Foram analisadas publicaçöes à respeito de cada agente envolvido, sejam poluentes ambientais ou alérgenos domiciliaares. Resultados: Observa-se um aumento na prevalência de asma e alergias em crianças de países ocidentais, nas últimas décadas, envolvendo a participaçäo de vários de varios fatores ambientais. Os alérgenos de ácaros domésticos, seguidos por alérgenos de animais domésticos, têm sido apontado como as mais importantes causas de sensibilizaçäo precoce, em indivíduos geneticamente susceptíveis. Os efeitos dos poluentes na funçäo pulmonar säo mais observados em indivíduos asmáticos. Torna-se especialmente importante determinar o modo de açäo dos poluentes nas vias aéreas dos asmáticos, uma vez que a asma é uma doença inflamatória, com grande afluxo de células às mucosas das vias aéreas. Entre os poluentes ambientais, os elementos liberados pela fumaça do tabaco, o NO2, o O3 e o CO säo associados a um aumento de morbidade, açöes deletérias específicas. Conclusäo: Há evidências de que a maior exposiçäo a alérgicos ambientais e a poluentes e irritantes, associados a mudanças na dieta, alateraçöes no padräo de exposiçäo a agentes infecciosos e o uso de antibióticos, tenham favorecidos uma maior ocorrência de doenças respiratórias, nos últimos 30 anos.

Controle ambiental nas doenças alérgicas: prós e contras / Environmental control in allergic diseases what is yes and what is not

Objetivos: Controle ambiental é parte integrante e importante da estratégia global de qualquer tratamento alérgico e está continuamente recebendo novas informaçoes científicas. Discute-se aqui a importância deste controle, as alérgenos principais do ambiente domiciliar e quais sao as medidas de controle que sao eficientes e as que nao sao. Métodos: Testes cutâneos, contagem direta de ácaros, testes de guanina e métodos de controle dos alérgenos ambientais sao também os aspectos clínicos e a quantidade de alérgenos detectados no ambiente e provocadores de sensibilizaçao do paciente alérgico. Resultados: Alguns métodos utilizados funcionam e outros nao para diminuir a quantidade de alérgenos ambientais. Conclusao: O controle ambiental deve fazer parte da estratégia global do tratamento do alérgico.

Alergia al látex: Un problema médico en incremento / Latex allergy: A growing medical problem

Los productos de látex son escenciales en la vida cotidiana y en la práctica médica. Su uso se ha ralacionado con un incremento en la frecuencia de reacciones alérgicas. La presentación clínica más común es la hipersensibilidad tardía de origen no inmunológico. Aunque menos frecuente, la hipersensibilidad inmediata puede ocasionar reacciones anafilácticas graves, inclusive letales. En pacientes con factores de riesgo, es necesaria la detección oportuna del problema. En el momento actual, la única medida contra la alergia al látex consiste en evitar por completo todo contacto con sus antígenos

Los alergenos del ambiente tabacalero / Allergens of tobacco environment

Se halló 16 a 60 esporos fúngicos/litro aire y de 100 a 100.000 esporos de actinomicetos termófilos/g polvo del piso en los secaderos de tabaco. Los hongos eran Alternaria sp (21 por ciento), Aspergillus sp (15 por ciento), Asp. fumigatus (7 por ciento), Asp. glaucus (5,5 por ciento), Asp. nidulans (13,3 por ciento), Chaetomiun sp (2,3 por ciento), Chrysosporium spp (5,5 por ciento), Cladosporium sp (3,1 por ciento), Curvularia sp (0,8 por ciento), Dactylaria sp (3,1 por ciento), Nogrospora sp (5,5 por ciento), Penicillium spp (11,7 por ciento), Talaromyces sp (2,3 por ciento) y no identificado (3,9 por ciento). Los Thermoactinomyces eran Tha. thalpophilus (66,6 por ciento), Tha. sacchari (6,7 por ciento), Tha. vulgaris (6,7 por ciento) y otros Tha. spp (20 por ciento). También el humo de cigarrillos contenía esporos viables de Thermoactinomyces. El 7 ñ 3,3 por ciento de los trabajadores tenían anticuerpos anti-Tha. thalpophilus demostrados por doble inmunodifusión

Pólenes relevantes para la rinitis alérgica estacional en la ciudad de Bahía Blanca y zona de influencia / The importance of the pollen for seasonal allergic rhinitis in Bahia Blanca city and influence zone

Se estudió la importancia etiológica de diversas especies vegetales en la rinitis y/o asma en Bahía Blanca y zona de influencia, teniendo en consideración los postulados de Thomen. Métodos: se realizaron pruebas cutáneas (prick test) con 55 alérgenos estandarizados en 50 pacientes con rinoconjuntivitis estacional o exacerbada estaciomnalmente, con o sin asma. Los resultados obtenidos fueron cotejados con los registros florísticos, fenológicos y aeropalinológicos de la región en estudio. Resultados: de los alérgenos utilizados cuatro hierbas de la familia Gramineae (Poa pratensis, 70 por ciento; Phalaris arundinacea, 58 por ciento; Agrupyrum repens, 54 por ciento y Agrostis alba, 54 por ciento) son los que produjeron reacciones más intensas, seguidas por Olea europaea (olivo), árbol perteneciente a las Oleaceae. Altos registros aeropalinológicos coincidieron con las especies más alérgenicas, salvo Cupresus spp y Fraxinus que presentaron los mayores volúmenes de polen aéreo y baja sensibilidad (10 por ciento y 6 por ciento). Conclusiones: a) los alérgenos más reactivos no coinciden con la abundancia relativa de la especie homóloga en la zona. Tal desviación de los postulados de Thomen debe explicarse por la existencia de reacciones cruzadas con especies taxonómicamente afines, b) los taxones más relevantes pertenecen a las familias Gramineae tomada en su conjunto, Oleaceae (olivo) y Salicaceae (álamos); c) nuestros resultados revelan semejanzas con los obtenidos por otros autores para países de la cuenca del Mediterráneo, pero se apartan de los correspondientes a América del Norte y Escandinavia