Granos de polen anemófilos: sensibilización en pacientes alérgicos / Anemophilic pollen grains: sensitization in allergic patients

A nivel mundial, los aeroalérgenos más frecuentes causantes de enfermedades alérgicas son los granos de polen anemófilos. Estos han sido capaces de desencadenar crisis que han reflejado una elevada morbilidad. En Cuba los estudios de sensibilización a granos de polen han sido escasos. Con el objetivo de determinar la sensibilización a granos de polen en pacientes alérgicos y su relación con la presencia de enfermedades alérgicas, se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, de marzo a junio del 2019. La muestra se constituyó de 33 pacientes con asma, rinitis, rinoconjuntivitis alérgica, dermatitis atópica y conjuntivitis alérgica. A todos los pacientes se les realizó historia clínica alergológica y prueba cutánea por punción con extractos alergénicos de: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucaliptus sp. Se aplicaron las frecuencias absolutas, porcientos, desviación estándar, promedio, edad media y test de Spearman para su análisis. La edad media de la muestra fue de 36,9 años, con predominio de mujeres. Más del 50por ciento de los pacientes presentaron sensibilización a granos de polen; y de ellos, el 24,24por ciento resultaron polisensibilizados. El mayor porcentaje de sensibilización fue a Cynodon dactylon. La rinitis alérgica fue la enfermedad que prevaleció en la población estudiada(AU)

Nowadays, the most frequent aeroallergens causing allergy diseases have been anemophilous pollen grains. They have been able to triggers crises that have reflected a high morbidity. In Cuba, studies of sensitization to pollen grains have been scarce. The objective of our research was to determine the sensitization to pollen grains in allergic patients and its relationship with the presence of allergic diseases. A non-randomized, descriptive, cross-sectional, observational study was conducted from March to June 2019. The sample consisted of 33 patients with asthma, allergic rhinitis, rhinoconjunctivitis, atopic dermatitis and allergic conjunctivitis. All patients underwent allergic history and skin prick test testing with allergenic extracts of: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucalyptus sp. Absolute frequencies, percentages, standard deviation, mean, average age, and Spearman´s test were applied for analysis. The average age of the sample was 36.9 years, with a predominance of women. More than 50percent of the patients presented sensitization to pollen grains; of them, 24.24percent polysensitized. The highest percentage of sensitization was to Cynodon dactylon. Allergic rhinitis was the disease that prevailed in the population studied(AU)

Organização do processo de trabalho através de conhecimento, atitudes e práticas para administração segura de vacinas em crianças: uma revisão de escopo / Organización del proceso de trabajo a través de conocimientos, actitudes y prácticas para la administración segura de vacunas en niños: una revisión de alcance / Organization of the work process through knowledge, attitudes, and practices for safe administration of vaccines in children: a scoping review

RESUMO Objetivo: mapear a organização do processo de trabalho através de conhecimento, atitudes e práticas para administração segura de vacinas em crianças. Método: realizou-se uma revisão de literatura com o método Scoping Review, de acordo com as recomendações do guia internacional PRISMA-ScR, e o método do Joanna Briggs Institute Reviewers Manual. A busca eletrônica dos estudos foi realizada nas bases de dados PubMed, CINAHL, Web of Science, Scopus, COCHRANE, LILACS e PsycINFO e na literatura cinzenta, entre os anos 2000 e 2021. Foram incluídos artigos, revisões, teses, dissertações e manuais disponibilizados na íntegra que estivessem em consonância com o objetivo deste estudo, tendo sido contemplando os idiomas inglês, português, italiano, espanhol e francês. Foram excluídos da revisão estudos não gratuitos pela plataforma CAFe, duplicados, que não tivessem relação com a temática pesquisada e não tivessem sua metodologia bem definida. Resultados: a revisão englobou 19 estudos publicados. O Brasil foi o país com maior número de estudos. Os principais achados propiciaram a construção das categorias conceituais. As sete primeiras se referem às principais características dos estudos incluídos nesta revisão de escopo; as outras três categorias objetivaram responder à questão norteadora e foram compostas por indicadores presentes na organização do processo de trabalho antes, durante e após a administração segura de uma vacina na criança. Conclusão: conclui-se que os objetivos desta pesquisa foram alcançados mediante mapeamento da organização do processo de trabalho através de conhecimento, atitudes e práticas para administração segura de vacinas em crianças. Como limitação deste estudo, evidencia-se a escassez de pesquisas que norteiam os cuidados pós-vacinação e sugere-se que novas pesquisas sejam realizadas.

RESUMEN Objetivo: mapear la organización del proceso de trabajo a través de los conocimientos, actitudes y prácticas para la administración segura de vacunas en niños. Método: se realizó una revisión de la literatura mediante el método Scoping Review, según las recomendaciones de la guía internacional PRISMA-ScR y el método Joanna Briggs Institute Reviewers Manual. La búsqueda electrónica de estudios se realizó en las bases de datos PubMed, CINAHL, Web of Science, Scopus, COCHRANE, LILACS y PsycINFO y en la literatura gris entre los años 2000 y 2021. Se incluyeron artículos, revisiones, tesis, disertaciones y manuales disponibles en su totalidad que estuvieran en línea con el objetivo de este estudio, en inglés, portugués, italiano, español y francés. Se excluyeron de la revisión los estudios no gratuitos a través de la plataforma CAFe, los duplicados, los que no estaban relacionados con el tema investigado y los que no tenían bien definida su metodología. Resultados: la revisión incluyó 19 estudios publicados. Brasil fue el país con el mayor número de estudios. Los principales resultados propiciaron la construcción de las categorías concebidas, las siete primeras se refieren a las principales características de los estudios incluidos en esta revisión de alcance, las otras tres categorías tienen como objetivo responder a la pregunta orientadora y se componen de indicadores presentes en la organización del proceso de trabajo antes, durante y después de la administración segura de una vacuna en el niño. Conclusión: se concluye que se lograron los objetivos de esta investigación al mapear la organización del proceso de trabajo a través de los conocimientos, actitudes y prácticas para la administración segura de las vacunas en los niños, se evidencia como limitación de este estudio la escasez de investigaciones que orienten la atención post-vacunación y se sugiere la realización de nuevas investigaciones.

ABSTRACT Objective to map the organization of the work process through knowledge, attitudes, and practices for the safe administration of vaccines in children. Method: a literature review was carried out using the Scoping Review method, in accordance with the recommendations of the international PRISMA-ScR guide, and the method of the Joanna Briggs Institute Reviewers Manual. The electronic search of the studies was carried out in the databases PubMed, CINAHL, Web of Science, Scopus, COCHRANE, LILACS and PsycINFO and in the gray literature, between the years 2000 and 2021. Articles, reviews, theses, dissertations, and manuals available were included. in full that were in line with the objective of this study, having been contemplating the English, Portuguese, Italian, Spanish and French languages. Studies that were not free of charge through the CAFe platform, duplicated, unrelated to the researched theme and that did not have a well-defined methodology were excluded from the review. Results: the review included 19 published studies. Brazil was the country with the highest number of studies. The main findings led to the construction of conceptual categories. The first seven refer to the main characteristics of the studies included in this scope review; the other three categories aimed to answer the guiding question and were composed of indicators present in the organization of the work process before, during and after the safe administration of a vaccine to the child. Conclusion: it is concluded that the objectives of this research were achieved by mapping the organization of the work process through knowledge, attitudes, and practices for the safe administration of vaccines in children. As a limitation of this study, there is a lack of research that guides post-vaccination care, and it is suggested that further research be carried out.

Vacunas e inmunizaciones en recién nacidos y recién nacidos prematuros / Vaccines in newborn and preterm infants

El recién nacido de pretérmino (RNPT), especialmente el menor de 32 semanas de edad gestacional, presenta un mayor riesgo de adquirir infecciones y que estas sean de curso más grave respecto a los recién nacidos de término (RNT), debido, entre otros factores a una inmadurez de varios componentes del sistema inmune. Muchas de estas infecciones son inmunoprevenibles por vacunas disponibles en nuestro medio y la recomendación actual es vacunar a los lactantes nacidos de pretérmino o bajo peso, salvo pocas excepciones, con todas las vacunas rutinariamente recomendadas según su edad cronológica al igual que un RNT. Sin embrago, en muchas oportunidades se observa un retraso en los calendarios de inmunización de estos lactantes principalmente por las aprehensiones respecto a la inmunogenicidad y seguridad de las vacunas en esta población. El objetivo de este artículo es revisar la evidencia disponible respecto a la eficacia y seguridad de las vacunas habitualmente utilizadas en lactantes, enfocados en los RNPT.

Preterm infants, especially those born with less than 32 weeks of gestational age, have a higher risk of acquiring serious infections compared to term infants due among other factors, to a decrease in several components of the immune system. Many of these infections are immunopreventable by vaccines available in our country. The current recommendation is to vaccinate all preterm or low weight born infants with few exceptions, using vaccines routinely recommended according to their chronological age just as term infants. However, on many occasions there is a delay in the immunization schedules of these infants mainly due to the apprehensions regarding the immunogenicity and safety of vaccines in this population. The aim of this article is to review the available evidence regarding the efficacy and safety of vaccines commonly used in preterm infants.

Vacunación de la embarazada / Maternal immunization

Las vacunas han sido una de las herramientas más útiles para lograr disminuir la mortalidad infantil. Sin embargo, los beneficios de las vacunas para menores de un año son dispares, debido a que son muy pequeños para ser vacunados. Otro grupo vulnerable son las embarazadas, quienes presentan mayor morbimortalidad por enfermedades como la influenza. La inmunización materna puede proteger a la madre contra las infecciones prevenibles por vacuna y al recién nacido mediante el traspaso de anticuerpos específicos al feto. No hay evidencia de resultados adversos en el embarazo o el feto/recién nacido por la vacunación de mujeres gestantes con vacuna inactivada contra virus, bacterias o toxoides. Por lo tanto, el embarazo no debe impedir que las mujeres reciban las vacunas que están médicamente indicadas. En Chile, se recomienda la vacunación de las mujeres gestantes, antes o durante la temporada de influenza. A fines de 2017 se implementó la vacunación con dTpa de las embarazadas con más de 28 semanas de gestación, con el objetivo de proteger al recién nacido contra el coqueluche y sus complicaciones. En el presente artículo, se hace una revisión de la literatura disponible sobre la vacunación de las embarazadas, principalmente enfocado en inmunización contra la influenza, el coqueluche y los beneficios en sus hijos.

Vaccines have been one of the most useful tools to reduce infant mortality. However, the benefits of vaccines for children under one year are disparate, because they are too small to be vaccinated. Another vulnerable group are pregnant women, who have a higher morbidity and mortality due to diseases such as influenza. Maternal immunization can protect the mother against vaccine-preventable infections and the newborn by transferring specific antibodies to the fetus. There is no evidence of adverse outcomes in pregnancy or the fetus / newborn by vaccination of pregnant women with inactivated vaccine against viruses, bacteria or toxoids. Therefore, pregnancy should not prevent women from receiving vaccines that are medically indicated. In Chile, vaccination is recommended for pregnant women, before or during the influenza season. In addition to the end of 2017, vaccination with Tdap of pregnant women with more than 28 weeks of gestation was implemented, with the aim of protecting the newly born against pertussis and its complications. In this article, we review the available literature on the vaccination of pregnant women, mainly focused on immunization against influenza, pertussis and benefits in their children.

Vacunas en salud laboral: una oportunidad para prevenir e invertir en salud / Vaccines in occupational medicine: an opportunity to prevent and invest in health

La vacunación es la medida preventiva más costo-efectiva para evitar las enfermedades infecciosas inmunoprevenibles, a nivel individual y comunitario. Los riesgos biológicos laborales, deben ser manejados en un sistema de gestión del riesgo, donde la vacuna es el elemento clave de protección personal (EPP) específico cuya provisión y uso obligatorio tiene normas legislativas referidas a la entrega por el empleador, la capacitación en la prevención y el uso por el trabajador. En Chile, hay 8.364.282 trabajadores según datos de Superintendencia de Seguridad Social (SUSESO). La Ley 16.744 y sus Decretos Supremos (DS) indican las condiciones que se deben mantener en los lugares de trabajo y el derecho a saber por parte del trabajador; también existen circulares del Ministerio de Salud que incluyen situaciones y grupos especiales laborales a vacunar, pero es necesaria una normativa que oriente a trabajadores dependientes e independientes y a empleadores sobre qué vacunas colocar, en qué situaciones y a quiénes dependiendo de la actividad laboral. En este artículo, hacemos una reseña de la situación legal, de recomendaciones en otros países y enumeramos algunas vacunas que podrían implementarse en la población expuesta a riesgo.

Vaccination is the most cost-effective measure for immune-preventable infectious diseases, at individual and community level. Biological occupational hazards must be faced in a risk management system, where the vaccine is a specific key as an element of personal protection, whose provision and obligatory use has legislative norms related to the delivery by the employer, the training in the prevention and the use by the worker. Several countries count with technical guides for vaccination in the working population. In Chile in 2018, there were 8.364.282 workers according with Superintendence of Social Security. Law 16.744 and Supreme Decrees indicate the environmental conditions for workers and the right to know the risks; also, Ministry of Health has issued circulars where some working conditions need specific vaccination. Is for that reason that is necessary a regulation that guides dependent and independent workers and employers on when and which vaccines must be used depending on the labor activity. In this article, we review the legal situation, other guides in different countries and list some vaccines that could be implemented in the population at specifical risks.

Vacunas en pacientes con VIH/SIDA / Immunizations in HIV/AIDS patients

Los sujetos con infección por Virus de inmunodeficiencia humana (VIH) tienen mayor susceptibilidad de adquirir infecciones por su deterioro inmunológico. Según el deterioro inmunológico y el uso de terapia antiretroviral (TARV) en niños y adultos VIH (+), la intensidad de la respuesta inmune a las vacunas es menor que la población general. Por este motivo es preferible administrar vacunas una vez que la TARV haya permitido la inmunoreconstitución, y se recomiendan dosis de refuerzo. Por otra parte, las vacunas vivas atenuadas deben ser usadas con precaución, y están contraindicadas en inmunosupresión severa.

Patients with Human Immunodeficiency Virus (HIV) are more susceptible to acquiring infections due to their immune deterioration. The intensity of the immune response to vaccines is lower than general population, depending on immune status and the use of antiretroviral therapy (ARV). For this reason, it is preferable to administer vaccines once ART has allowed immune reconstitution, and booster doses are recommended. On the other hand, live vaccines should be used with caution, and are contraindicated in severe immunosuppression.

Immunization throughout the Life Course at the Primary Care Level in the Context of the COVID-19 Pandemic, 21 May 2020

Provide recommendations regarding vaccination as an essential service at the primary care level in the context of the COVID-19 pandemic.

A Therapeutic Oral Vaccine Candidate against Propionibacterium acnes: Preparation and Immunological Evaluation of Nanoparticles Encapsulated Sialidase-CAMP Fusion Protein

Abstract Acne Vulgaris is a common skin disease caused by Propionibacterium acnes, an anaerobic microbiota of human skin that plays a vital role in the pathology of acne. The aim of this study was to prepare nanoparticles containing an acne recombinant protein and determine its ability as an oral acne vaccine in mice. The recombinant Sialidase-CAMP gene was expressed and purified in a prokaryotic host. The chitosan nanoparticles containing the recombinant protein were prepared, encapsulated, and administered by both oral and subcutaneous routes to Balb/c mice. Sera IgA and IgG and stool IgA titers were measured by ELISA, and the immunized mice were challenged against P. acnes. A 65 kDa recombinant protein was confirmed by SDS-PAGE and western blot. The size and zeta potential of nanoparticles were 80 nm and +18 mV, respectively. After oral immunization, the serum IgG and IgA titers were 1:3200 and 1:16, respectively, and the stool IgA titer was 1:8. In the subcutaneous route, the serum IgG titer was 1:51200. Immunized mice showed no inflammation in the ear of challenged mice. It is the first study that examines a chitosan-nanoparticulated acne fusion protein as an applicable acne vaccine candidate with appropriate immunogenicity potential. Further studies are required to validate the clinical usefulness of this vaccine candidate.

Nickel, chromium and cobalt: the relevant allergens in allergic contact dermatitis. Comparative study between two periods: 1995-2002 and 2003-2015

Abstract: Background: Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects. Objectives: To analyze and compare with previous studies the profile of metal sensitization between 2003-2015. Methods: Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology. Results: Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001). Study limitations: The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives. Conclusion: The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes.

Yellow fever outbreak in Brazil: the puzzle of rapid viral spread and challenges for immunisation

We discuss the complex eco-social factors involved in the puzzle of the unexpected rapid viral spread in the ongoing Brazilian yellow fever (YF) outbreak, which has increased the reurbanisation risk of a disease without urban cases in Brazil since 1942. Indeed, this rapid spatial viral dissemination to the Southeast and South regions, now circulating in the Atlantic Forest fragments close to peri-urban areas of the main Brazilian megalopolises (São Paulo and Rio de Janeiro) has led to an exponential increase in the number of yellow fever cases. In less than 18 months, 1,833 confirmed cases and 578 deaths were recorded most of them reported in the Southeast region (99,9%). Large epizooties in monkeys and other non-human primates (NHPs) were communicated in the country with 732 YF virus (YFV) laboratory confirmed events only in the 2017/2018 monitoring period. We also discuss the peculiarities and similarities of the current outbreak when compared with previous great epidemics, examining several hypotheses to explain the recent unexpected acceleration of epizootic waves in the sylvatic cycle of the YFV together with the role of human, NHPs and mosquito mobility with respect to viral spread. We conclude that the most feasible hypothesis to explain this rapidity would be related to human behavior combined with ecological changes that promoted a significant increase in mosquito and NHP densities and their contacts with humans. We emphasize the urgent need for an adequate response to this outbreak such as extending immunisation coverage to the whole Brazilian population and developing novel strategies for immunisation of NHPs confined in selected reserve areas and zoos. Finally, we stress the urgent need to improve the quality of response in order to prevent future outbreaks and a catastrophic reurbanisation of the disease in Brazil and other South American countries. Continuous monitoring of YFV receptivity and vulnerability conditions with effective control of the urban vector Aedes aegypti and significant investments in YF vaccine production capacity and research and development for reduction of adverse effects are of the highest priority.

Immunogenic potential of Rhipicephalus (Boophilus) microplus aquaporin 1 against Rhipicephalus sanguineus in domestic dogs / Potencial imunogênico da aquaporina 1 de Rhipicephalus (Boophilus) microplus contra o carrapato Rhipicephalus sanguineus em cães domésticos

Abstract This study evaluated a recombinant aquaporin 1 protein of Rhipicephalus (Boophilus) microplus (RmAQP1) as antigen in a vaccine against R. sanguineus. Five dogs were immunized with RmAQP1 (10 µg) + adjuvant (Montanide) (G1), and five were inoculated with adjuvant only (G2), three times. Twenty-one days after the last immunization, animals of both groups were challenged with R. sanguineus larvae, nymphs and adults, and their biotic potential was compared. Blood samples were collected before each immunization and every 28 days after the last immunization for 10 weeks. Serum antibody titers (IgG) were assessed by ELISA. We observed that: engorgement period of adult females from G1 was 12% shorter than G2; larvae from G1 had 8.7% longer engorgement period than G2 and weighed 7.2% less; nymphs from G1 had 4.5% shorter engorgement period than G2 and weighed 3.6% less; although the antibody titers increased following the second immunization, they rapidly decreased after the third immunization. Results indicated low immunoprotection of RmAQP1 against adult R. sanguineus ticks, and possible efficacy on larvae and nymphs fed on immunized dogs. Further studies should be performed for a full evaluation of the immunoprotection of RmAQP1 against R. sanguineus infestations in dogs.

Resumo Este estudo avaliou a proteína recombinante (aquaporina) do carrapato Rhipicephalus (Boophilus) microplus como antígeno em vacina contra Rhipicephalus sanguineus. Cinco cães foram imunizados com RmAQP1 (10 µg) + adjuvante (G1) e cinco foram inoculados apenas com adjuvante (G2), três vezes. 21 dias após a última imunização todos os animais foram desafiados com larvas, ninfas e adultos de R. sanguineus, e potencial biótico dos carrapatos foi comparado. Amostras de sangue foram coletadas antes de cada imunização e a cada 28 dias após a última imunização, durante 10 semanas. Títulos de anticorpos dos soros dos cães foram avaliados por ELISA. Resultados: o período de ingurgitamento das fêmeas do G1 foi 12% mais curto que o período de ingurgitamento de G2; o período de ingurgitamento das larvas do G1 8,7% foi mais longo e o peso 7,2% menor que no caso de G2; o período de ingurgitamento das ninfas do G1 4,5% foi mais curto e peso 3,6% menor que no caso do G2; aumento dos títulos de anticorpos do G1 após a segunda imunização e declínio após a terceira imunização. Os resultados indicaram baixo potencial de imunoproteção de RmAQP1 contra R. sanguineus adultos, e possível eficácia contra larvas e ninfas, na dose testada. Sugere-se desenvolver novos estudos para melhor avaliação da eficácia de RmAQP1 contra R. sanguineus em cães.

Sensitization by subcutaneous route is superior to intraperitoneal route in induction of asthma by house dust mite in a murine mode / Sensibilização por via subcutânea é superior à intraperitoneal na indução de asma por ácaro em modelo murino

ABSTRACT Objective To develop a new experimental model of chronic allergic pulmonary disease induced by house dust mite, with marked production of specific immunoglobulin E (IgE), eosinophilic inflammatory infiltrate in the airways and remodeling, comparing two different routes of sensitization. Methods The protocol lasted 30 days. BALB/c mice were divided into six groups and were sensitized subcutaneously or intraperitoneally with saline (negative control), Dermatophagoides pteronyssinus (Der p) 50 or 500mcg in three injections. Subsequently they underwent intranasal challenge with Der p or saline for 7 days and were sacrificed 24 hours after the last challenge. We evaluated the titration of specific IgE anti-Der p, eosinophilic density in peribronchovascular space and airway remodeling. Results Both animals sensitized intraperitoneally and subcutaneously produced specific IgE anti-Der p. Peribronchovascular eosinophilia increased only in mice receiving lower doses of Der p. However, only the group sensitized with Der p 50mcg through subcutaneously route showed significant airway remodeling. Conclusion In this murine model of asthma, both pathways of sensitization led to the production of specific IgE and eosinophilia in the airways. However, only the subcutaneously route was able to induce remodeling. Furthermore, lower doses of Der p used in sensitization were better than higher ones, suggesting immune tolerance. Further studies are required to evaluate the efficacy of this model in the development of bronchial hyperresponsiveness, but it can already be replicated in experiments to create new therapeutic drugs or immunotherapeutic strategies.

RESUMO Objetivo Desenvolver um novo modelo experimental de doença pulmonar alérgica crônica por ácaro, com proeminente produção de imunoglobulina E (IgE) específica, infiltrado inflamatório eosinofílico nas vias aéreas e remodelamento, comparando duas vias diferentes de sensibilização. Métodos O protocolo teve duração de 30 dias. Camundongos BALB/c foram divididos em seis grupos submetidos à sensibilização por via subcutânea ou intraperitoneal com solução salina (controles negativos),Dermatophagoides pteronyssinus (Der p) 50 ou 500mcg, em três aplicações. Posteriormente, foram submetidos à provocação intranasal com Der p ou salina por 7 dias e sacrificados 24 horas após o último desafio. Avaliamos a titulação de IgE específica anti-Der p, densidade eosinofílica no espaço peribroncovascular e remodelamento das vias aéreas. Resultados Tanto os animais sensibilizados por via subcutânea como intraperitoneal produziram IgE específica anti-Der p. Ocorreu aumento da eosinofilia peribroncovascular apenas nos animais que receberam menor dose de Der p. Porém apenas o grupo sensibilizado com Der p 50mcg subcutânea apresentou remodelamento significativo das vias aéreas. Conclusão Neste modelo murino de asma, as duas vias de sensibilização levaram à produção de IgE específica e eosinofilia nas vias aéreas. No entanto, apenas a via subcutânea foi capaz de induzir ao remodelamento. Além disso, doses menores de Der p utilizadas foram superiores às mais elevadas, sugerindo tolerância. Mais estudos são necessários para avaliar a eficácia deste modelo no desenvolvimento da hiperresponsividade brônquica, mas ele pode ser replicado em experimentos para criação de novas estratégias terapêuticas medicamentosas ou imunoterápicas.

CORAL SNAKE ANTIVENOM PRODUCED IN CHICKENS (Gallus domesticus) / Antiveneno de serpiente coral producido en gallinas (Gallus domesticus)

The production of anti-snake venom from large mammal's blood has been found to be low-yielding and arduous, consequently, antivenom immunoglobulins for treatment are achieved regularly as polyvalent serum. We have standardized an undemanding technique for making purified immunoglobulin IgY antivenom consisting of polyclonal antibodies against coral snake venom in the egg yolk of immunized hens. We have adapted a reported process of antibody purification from egg yolks, and achieved 90% antibody purity. The customized technique consisted of the removal of lipids from distilled water-diluted egg yolks by a freeze–thaw sequence. The specific immunoglobulins were present in the egg yolk for up to 180 days postimmunization. Therefore, by means of small venom quantities, a significant amount of immunoglobulins were found in an adequately purified state (The obtained material contained about 90% pure IgY). The antigen binding of the immunoglobulins was detected by a double immunodiffusion test. Titers of antibodies in the yolk were estimated with a serum protection assay (Median effective dose = ED50) (ED50= 477 mg/kg). Given that breeding hens is economically feasible, egg gathering is noninvasive and the purification of IgY antibodies is quick and easy, chicken immunization is an excellent alternative for the production of polyclonal antibodies. To the best of our knowledge, this is the first coral snake antivenom prepared in birds.

La producción de antiveneno de serpiente usando sangre de grandes mamíferos se ha encontrado que es de bajo rendimiento y de trabajo arduo, en consecuencia, las inmunoglobulinas antiveneno para el tratamiento se obtienen generalmente, como suero polivalente. Hemos estandarizado una técnica poco exigente para la fabricación de inmunoglobulina purificada IgY, que consistió en generar anticuerpos policlonales contra el veneno de la serpiente coral en huevos de gallinas inmunizadas. La técnica consistió en la eliminación de lípidos de las yemas del huevo, diluidas en agua y en una secuencia de congelación-descongelación. Las inmunoglobulinas específicas estuvieron presentes en la yema de huevo hasta 180 días después de la inmunización. La unión del antígeno a las inmunoglobulinas se detectó mediante un ensayo de inmunodifusión doble. Los títulos de anticuerpos en la yema fueron estimados con un ensayo de protección (dosis efectiva media = ED50). Dado que las gallinas reproductoras son económicamente viables, la recolección de huevos es no invasiva y la purificación de anticuerpos IgY es rápida y fácil, la inmunización de la gallina es una excelente alternativa para la producción de anticuerpos policlonales. A nuestro entender, esta es el primer anti-veneno contra serpiente de coral preparado en aves.

Recent Advances in Toxoplasma gondii Immunotherapeutics

Toxoplasmosis is an opportunistic infection caused by the protozoan parasite Toxoplasma gondii. T. gondii is widespread globally and causes severe diseases in individuals with impaired immune defences as well as congenitally infected infants. The high prevalence rate in some parts of the world such as South America and Africa, coupled with the current drug treatments that trigger hypersensitivity reactions, makes the development of immunotherapeutics intervention a highly important research priority. Immunotherapeutics strategies could either be a vaccine which would confer a pre-emptive immunity to infection, or passive immunization in cases of disease recrudescence or recurrent clinical diseases. As the severity of clinical manifestations is often greater in developing nations, the development of well-tolerated and safe immunotherapeutics becomes not only a scientific pursuit, but a humanitarian enterprise. In the last few years, much progress has been made in vaccine research with new antigens, novel adjuvants, and innovative vaccine delivery such as nanoparticles and antigen encapsulations. A literature search over the past 5 years showed that most experimental studies were focused on DNA vaccination at 52%, followed by protein vaccination which formed 36% of the studies, live attenuated vaccinations at 9%, and heterologous vaccination at 3%; while there were few on passive immunization. Recent progress in studies on vaccination, passive immunization, as well as insights gained from these immunotherapeutics is highlighted in this review.

Study of Immunization Status and Outcome of Diphtheria Patients.

Background: With advent of EPI and UIP, most of the vaccine preventable diseases have shown a decline; however, Diphtheria continues to remain an endemic disease and has also shown resurgence nationally as well as internationally. Aims and Objectives: To study Diphtheria morbidity and mortality trends. To note variation with respect to age, sex, immunization status, seasonal variation and outcome. Materials and Method: A retrospective analysis of hospital records over the period of 3 years from Jan/2008 to Dec/2010 obtained with permission of hospital superintendent Dr. Jhala from infectious disease hospital in Ahmedabad, Gujarat. Details of 247 cases regarding age, sex, immunization status were taken as per the hospital case records. Results: Of 247 cases, 114 were male (46%), 133 (54%) Females, 71 (29%) were under 5 Years, 103 (42%) were in 6 – 12 years and 35 (14%) were in 13- 20yrs, 38 patients (15%) were noted within 21-60yrs group, a total of 73 (29.5%) patients were observed in adult and adolescent group. Mortality was 0.47%. Incidence was more in months of September to March. In the present study, 85 (34.4%) were completely immunized, 31 (12.55%) were partially immunized and for 18 (7.3%) vaccination status was unknown. 113 (45.75%) were not immunized. Conclusion: Diphtheria continues to remain a major public health concern in spite of being a vaccine preventable disease, though common in pediatric age it is increasingly common in adoloscent and adults. High level of clinical suspicion needed to keep the mortality rates on lower side. A strict implementation of vaccination programmes with follow up booster dose is necessary which will increase the herd immunity, leading to decrease in diphtheria prevalence.

Diagnóstico situacional do preparo eadministração de imunobiológicos / Situational diagnosis of preparation and administration of immunobiologics / Diagnóstico situacional de preparación y administración de inmunobiológicos

Esta pesquisa objetivou especificar como se caracteriza o preparo e a administração de imunobiológicos por viaintramuscular e descrever as condições ambientais nas quais são realizados esses procedimentos. Trata-se de uma pesquisa descritiva que utilizou observações não participativas registradas em um diário de campo, seguindo um roteiro específico. Foi realizada com sete profissionais de enfermagem, em Vassouras-RJ, em 2009. Os resultados mostram que os profissionais não estão realizando a higienização das mãos e os que a realizam o fazem de forma inadequada; foi evidenciada a não reconstituição cuidadosa dos imunobiológicos e a administração foi realizada da forma mais satisfatória. A maioria das Unidades são casas adaptadas e as salas apresentam um fluxo prejudicado por serem pequenas e utilizadas para execução de outros procedimentos. É fundamental que os enfermeiros mantenham supervisão detalhada do processo de imunização e que realizem ações de educação permanente visando à qualidade no cuidado.

This study aimed to describe specifically the preparation, and administration by intramuscular injection, of immunobiologics, and to describe the environmental conditions where these procedures are performed. This was a descriptive study of seven nursing workers in Vassouras, Rio de Janeiro State, in 2009, using non-participatory observations recorded in a diary, and following a specific script. The results show hand hygiene is either not practiced or only poorly so, immunobiologics were reconstituted without due care, and that administration was performed more satisfactorily. Most facilities are adapted houses where flows are irregular, because rooms are small and are used for other procedures. Itis essential that nurses monitor the immunization process in detail, and undertake continuing education to assure quality of care.

Esta investigación objetivó especificar como se caracteriza la preparación y la administración de inmunobiológicos por via intramuscular y describir las condiciones ambientales en que son ejecutados esos procedimientos. Se trata de una pesquisa descriptiva que usó observaciones no participantes registradas en un diario de campo, conforme una ruta específica. Fue hecha con siete profesionales de enfermería, en Vassouras-RJ-Brasil, en 2009. Los resultados muestran que los profesionales no hacen la higienización de las manos y los que la hacen lo hacen de forma inadecuada; fue evidenciada la no reconstitución cuidadosa de los inmunobiológicos y la administración fue llevada a cabo en la forma más satisfactoria. La mayoría de las Unidades son casas adaptadas y las salas tienen un flujo conturbado porque son pequeñas y utilizadas para otros procedimientos. Es fundamental que los enfermeros mantengan supervisión detallada del proceso de inmunización y que realizen acciones de educación permanente mirando a la calidad en el cuidado.

Frecuencia de sensibilización alimentos y aero-alergenos en pacientes recibidos en el laboratorio de Corpodiagnostica C.A. durante el periodo 2010-2011 / Frequency of sensitization for food and aero-allergens in patients reciived in a Venezuelan laboratory during 2010-2011 period

La alergia tipo I se ha definido como una reacción inmunológica adversa mediada por IgE que se produce después de una exposición repetida al alérgeno. La prevalencia de las alergias ha aumentado considerablemente en los últimos 20 años, lo que aumenta la necesidad del estudio de la respuesta a varios alérgenos. El objetivo fue evaluar la frecuencia de sensibilización a alimentos y aero-alérgenos en los pacientes referidos al Laboratorio de Corpodiagnostica C.A. durante el periodo 2010-2011. Se determinó niveles de IgE específica a 2445 pacientes, usando el método inmunoblot in vitro RIDA Allergy-screen (r-Biopharm, Alemania). La tasa de sensibilización total medida por IgE específica a alimentos fue de 30,43%, donde los alimentos más comunes fueron Leche, Queso, Trigo, Maíz y Cerdo; mientras que la tasa de sensibilización para aero-alérgenos fue de 46,16%; de los cuales los más comunes fueron los ácaros mayores y B. tropicalis. Este estudio provee de una herramienta importante para la identificación de los alérgenos alimentarios y respiratorios de mayor prevalencia en la población venezolana.

Type I allergy had been defined as an adverse immunologic reaction mediated by IgE that occurs after a repeated exposure to the allergen. The prevalence of the allergies has increased considerably in the last 20 years, thus increasing the need of study the response to several allergens. The objective was to evaluate the frecuency of foods and respiratory allerges sensitization in patients referred to Corpodiagnostica Laboratory (Caracas, Venezuela, ISO 9001:2008 certified laboratory) in the period that correspond from January 2010 to July 2011. We determinated specific IgE levels to 2445 patients, by the in vitro RIDA® Allergy-screen immunoblot method (r-biopharm®, Germany). The total sensitization rate mediated by specific IgE to food allergen was 30,43% where the foods most common were milk, cheese, wheat flour, corn and pork; while the sensitization for aero-allerges was 46,16%; the most common were the major mites and B. tropicalis. This study provides an important tool for the identification of food and aero-allergens with major prevalence in the Venezuelan population.

Induction of humoral responses to BHV-1 glycoprotein D expressed by HSV-1 amplicon vectors

Herpes simplex virus type-1 (HSV-1) amplicon vectors are versatile and useful tools for transferring genes into cells that are capable of stimulating a specific immune response to their expressed antigens. In this work, two HSV-1-derived amplicon vectors were generated. One of these expressed the full-length glycoprotein D (gD) of bovine herpesvirus 1 while the second expressed the truncated form of gD (gDtr) which lacked the trans-membrane region. After evaluating gD expression in the infected cells, the ability of both vectors to induce a specific gD immune response was tested in BALB/c mice that were intramuscularly immunized. Specific serum antibody responses were detected in mice inoculated with both vectors, and the response against truncated gD was higher than the response against full-length gD. These results reinforce previous findings that HSV-1 amplicon vectors can potentially deliver antigens to animals and highlight the prospective use of these vectors for treating infectious bovine rhinotracheitis disease.

Establishment and characterization of an infectious cDNA clone of a classical swine fever virus LOM strain

Classical swine fever virus (CSFV) causes a highly contagious disease among swine that has an important economic impact worldwide. CSFV strain LOM is an attenuated virus of low virulent strain of Miyagi isolated from Japan in 1956. Eight DNA fragments representing the genome of the CSFV strain LOM were obtained by RT-PCR. These were used to determine the complete nucleotide sequence and construct a full-length cDNA clone which was called Flc-LOM. Sequence analysis of the recombinant clone (Flc-LOM) revealed the presence of eight mutations, resulting in two amino acid substitutions, when compared to the parental sequence. RNA transcripts of both LOM and Flc-LOM were directly infectious in PK-15 cells. The rescued Flc-LOM virus grew more slowly than the parental virus, LOM, in the cells. Intramuscular immunization with Flc-LOM was safe and highly immunogenic in pigs; no clinical signs or virus transmission to sentinel animals were observed after 35 days. CSFV-specific neutralizing antibodies were detected 14 days post-infection. After challenge with the virulent CSFV strain SW03, pigs immunized with Flc-LOM were shown to be fully protected. Thus, our newly established infectious clone of CSFV, Flc-LOM, could serve as a vaccine candidate.

Vacunas. Cuba 1959-2008

Un autor indispensable ha podido finalmente hacer contribuciones importantes, redactando varios capítulos, aportando documentos valiosos, precisando momentos cruciales de la historia de los 50 años en que se enmarca el texto: el Dr. Galindo, quien ha dedicado tiempo a esta obra, sin apartarse de las tareas que de modo permanente le reclamam las autoridades del Ministerios en relación con la vacunación. Durante este periodo él ha pasado él ha pasado a ser asesor del programa después de 26 años como director. El libro es extenso, son muchos los aspectos que se relacionan con las vacunas. Hemos incluido los antecedentes relevantes de épocas anteriores a la que se dedica el estudio. Siempre aparecerá alguna laguna, pero el recorrido ha sido amplio, en algunos casos prolijo. Se reproducen originales de documentos oficiales, discursos, artículos de revistas, testimonios, que se unen a textos escritos para esta obra.