Errores innatos de la inmunidad: ¿Qué debe saber y cuándo debe sospechar el otorrinolaringólogo? / Inborn errors of immunity: What should the otolaryngologist know, and when to suspect them?

Introducción: Los errores innatos de la inmunidad, previamente conocidos como inmunodeficiencias primarias, son un grupo heterogéneo de patologías cuya presentación clínica incluye infecciones recurrentes, persistentes o refractarias al tratamiento en el campo de la otorrinolaringología. Materiales y métodos: Se realizó una revisión narrativa de la literatura a partir de la búsqueda de documentos en PUBMED y EMBASE. Discusión y conclusiones: Los pacientes con sospecha de error innato de la inmunidad requieren un diagnóstico temprano con el fin de disminuir las complicaciones a largo plazo, por lo que la valoración y el abordaje inicial desempeñan un papel fundamental en el reconocimiento de estas enfermedades.

Introduction: Inborn errors of immunity, previously known as primary immunodeficiencies, are a heterogeneous group of pathologies whose clinical presentation includes recurrent, persistent and/or refractory infections to treatment in otorhinolaryngology. Materials and methods: Narrative review of the literature was carried out from the search for articles in PUBMED and EMBASE. Discussion and conclusions: Patients with suspected inborn error of immunity require an early diagnosis to reduce long-term complications; the initial assessment and approach play a fundamental role in the recognition of these diseases

Papel de la alimentación en la respuesta a infecciones respiratorias altas en atletas de élite / Role of nutrition in the response to upper respiratory infections in elite athletes

Las infecciones de las vías respiratorios altas (IVRA), son debilitantes para el potencial deportivo de los atletas de élite. El ejercicio físico activa múltiples vías moleculares y bioquímicas relacionadas con el sistema inmune, sensibles a influencias nutricionales. Sobre este contexto, la inmunonutrición está adquiriendo una nueva dirección orientada a conseguir el equilibrio inmunológico, contraponiéndose con algunas de las teorías que han sentado las bases de la inmunología del ejercicio durante las últimas décadas. Objetivo. Investigar los aspectos nutricionales que puedan mejorar la respuesta inmunológica en deportistas de elite. Estudiar los posibles beneficios del equilibrio inmunológico para mejorar el rendimiento, analizar los factores nutricionales que contribuyan al equilibrio de la respuesta inmunológica y extrapolar la evidencia actual en recomendaciones prácticas de alimentación/suplementación para mejorar la homeostasis de la respuesta inmunológica en atletas de élite, teniendo en cuenta las limitaciones existentes.Resultados. La evidencia científica apunta que se puede potenciar el equilibrio inmunológico y la respuesta inmune a través de la modificación de factores nutricionales. Dentro de los cuales, la vitamina D, los probióticos, la vitamina C y el cinc son los que cuentan con mayor evidencia. Conclusión. Los avances científicos resultan prometedores y de interés para los atletas de élite, debido a que pueden disminuir la incidencia de IVRA, mejorando el éxito deportivo de los mismos. Se requieren más estudios para su validación y aplicación(AU)

Upper respiratory tract infections (URTI) are debilitating for the athletic potential of elite athletes. Physical exercise in elite athletes activates multiple molecular and biochemical pathways related to the immune system, which, at the same time, are sensitive to nutritional influences. Based on this context, immunonutrition is taking a new direction aimed at achieving the immunological balance. Objective. To investigate the nutritional aspects that can improve the immune response in elite athletes. To study the potential benefits of immune balance to improve performance, to analyse nutritional factors that contribute to the balance of the immune response and to extrapolate current evidence into practical dietary/supplementation recommendations to improve the homeostasis of the immune response in elite athletes, considering existing limitations. Results. Scientific evidence suggests that immune balance and immune response can be enhanced through the modification of nutritional factors. Among which, vitamin D, probiotics, vitamin C and zinc are the micronutrients with most evidence. Conclusion. Scientific advances in this field are promising and of great interest to elite athletes since it could decrease the incidence of URTI and, as a consequence, it could improve their sporting success. However, more studies are still required for its validation and application(AU)

Deficiencia de anticuerpos específicos en pacientes pediátricos con infecciones respiratorias recurrentes / Specific antibody deficiency in pediatric patients with recurrent respiratory infections

One of the most frequent consultations in pediatric immunology corresponds to patients with recurrent respiratory infections. The most frequent clinical conditions for what they consult are recurrent viral infections, recurrent acute otitis media, recurrent sinusitis and recurrent pneumonia. Approximately 10% of patients who consult for these conditions may have a specific antibody deficiency. Specific antibody deficiency is a type of primary immunodeficiency, which is classified within the humoral deficit group, where there is a failure in the immune response for polysaccharide antigens with normal immunoglobulin levels. The diagnosis must be made since 2 years old, when the immune system acquires the ability to present a humoral response to polysaccharide antigens. In an undetermined percentage of patients, the specific antibody deficit can be resolved with the maturity of the immune system and there are patients who require prolonged treatment with antibiotic prophylaxis and gamma globulin.

Una de las consultas más frecuentes en inmunología pediátrica corresponde a pacientes con infecciones respiratorias recurrentes. Los cuadros clínicos más frecuentes por lo que consultan son infecciones virales recurrentes, otitis media aguda recurrente, sinusitis recurrente y neumonía recurrente. Aproximadamente el 10% de los pacientes que consultan por estos cuadros puede presentar una deficiencia de anticuerpos específica. La deficiencia anticuerpo específica es un tipo de inmunodeficiencia primaria, que se clasifica dentro del grupo de déficit humorales, en donde existe una falla en la respuesta inmune para antígenos polisacáridos con niveles de inmunoglobulinas normales. El diagnóstico se debe realizar después de los 2 años que es cuando el sistema inmune adquiere la capacidad de presentar respuesta humoral a antígenos polisacáridos. En un porcentaje no determinado de pacientes, el déficit de anticuerpos específicos se puede resolver con la madurez del sistema inmunológico y existen pacientes que requieren tratamiento prolongado con profilaxis antibiótica y gamaglobulina.

Colonización por hongos ambientales en el paciente alérgico respiratorio no controlado / Colonization by environmental fungi in the uncontrolled respiratory allergic patient

Introducción: La presencia de hongos en las vías respiratorias puede provocar en personas susceptibles diversas manifestaciones alérgicas. Objetivo: Determinar si las especies fúngicas aisladas de la mucosa nasal de pacientes alérgicos respiratorios pueden ser definidas como alergenos sensibilizantes a través de las pruebas cutáneas. Métodos: Estudio observacional, prospectivo y de corte transversal, donde el universo estuvo constituido por todos los pacientes con diagnóstico de alergia respiratoria o inicio de asma bronquial variable descompensada, mayores de 2 años y menores de19,que se asistieron en las consultas de alergia en La Habana, desde enero 2016 a enero 2017. La muestra obtenida fue de 80 pacientes alérgicos respiratorios. Resultados: Del total de pacientes con clínica de asma, rinitis o ambas, se obtuvieron pruebas cutáneas por el test de Prick positivas a hongos en 52 de ellos (65 por ciento) con una polisensibilización en 24 para 46,1 por ciento. La reactividad cruzada de mayor relevancia se produjo con los alérgenos de Aspergillus, Penicillium y Alternaria. El cultivo resultó positivo en 54 muestras nasales (67 por ciento). El género de hongos predominante en los pacientes alérgicos fue el Aspergillus en 70,3 por ciento y dentro de este el Aspergillus fumigatus en 52,6 por ciento. Conclusiones: El estudio de la micobiota nasal es una prueba que debe interpretarse junto con las pruebas cutáneas para el diagnóstico de enfermedades alérgicas por hongos ambientales y tener en cuenta su importancia para el control epidemiológico en la exposición a hongos(AU)

Introduction: The presence of fungi in the respiratory tract can cause different allergic manifestations in sensitive persons. Objective: To determine if fungi species isolated from the nasal mucosa of respiratory allergic patients can be defined as allergen-sensitive by means of skin tests. Methods: Observational, prospective and cross-sectional study, where the overall sample consisted of all patients with a diagnosis of respiratory allergy or onset of decompensated variable bronchial asthma, over 2 years old and under 19 years old who attended to Allergy consultations in Havana, from January 2016 to January 2017. The sample obtained was 80 respiratory allergic patients. Results: Of the total number of patients with symptoms of clinical asthma, rhinitis or both, Prick´s skin tests were obtained by fungal positive test in 52 of them (65 percent) with a polysensitization in 24 (46.1 percent). The most relevant cross reactivity occurred with the allergens of Aspergillus, Penicillium and Alternaria. The culture was positive in 54 nasal samples (67 percent). The predominant fungal genus in allergic patients was Aspergillus in 70.3 percent and within this Aspergillus fumigatus in 52.6 percent. Conclusions: The study of nasal mycobiota is a test that should be interpreted together with skin tests for the diagnosis of allergic diseases due to environmental fungi and it must be taken into account its importance for epidemiological control in fungal exposure(AU)

Protective roles of free avian respiratory macrophages in captive birds

In the mammalian lung, respiratory macrophages provide front line defense against invading pathogens and particulate matter. In birds, respiratory macrophages are known as free avian respiratory macrophages (FARM) and a dearth of the cells in the avian lung has been purported to foreordain a weak first line of pulmonary defense, a condition associated with high mortality of domestic birds occasioned by respiratory inflictions. Avian pulmonary mechanisms including a three tiered aerodynamic filtration system, tight epithelial junctions and an efficient mucociliary escalator system have been known to supplement FARM protective roles. Current studies, however, report FARM to exhibit an exceptionally efficient phagocytic capacity and are effective in elimination of invading pathogens. In this review, we also report on effects of selective synthetic peroxisome proliferator activated receptor gamma (PPAR γ) agonists on non phlogistic phagocytic properties in the FARM. To develop effective therapeutic interventions targeting FARM in treatment and management of respiratory disease conditions in the poultry, further studies are required to fully understand the role of FARM in innate and adaptive immune responses.

Contagens leucocitárias e sintomas de infecções respiratórias após curto período de treinamento concorrente / Leukocyte counts and symptoms of upper respiratory tract infections after a short period of concurrent training

Introdução: Pessoas comumente iniciam a prática de exercícios por períodos não compatíveis com o nível de treinabilidade, podendo induzir diminuição da competência imunológica. Objetivos: Analisar as possíveis modulações nas contagens dos leucócitos circulantes e incidência de sintomas de infecções do trato respiratório superior, ao final de uma semana de treinamento concorrente. Métodos: Participaram dez voluntários do gênero masculino e sedentários, submetidos a uma semana de treino concorrente com cinco sessões em dias sequenciais, apresentando intensidades moderadas e duração de cem minutos. Resultados: Não foram observadas alterações nas contagens dos leucócitos. Quanto aos sintomas de infecções do trato respiratório superior, 10% dos voluntários apresentaram coriza, 20% congestão nasal e 40% dor de cabeça ao final da intervenção. Conclusões: A referida intervenção não apresenta potencial para modular negativamente as contagens dos leucócitos. Contudo, a incidência de sintomas de infecções do trato respiratório superior pode estar associada à diminuição da funcionalidade celular, possivelmente decorrente do volume delineado nas sessões.

Introduction: People often begin to practice exercises for periods not compatible with their level of trainability, and this could to induce a decrease in immune competence. Objective: To analyze the possible modulations in counts of circulating leukocytes and incidence of infections of the upper respiratory tract symptoms at the end of a week of concurrent training. Methods: A total of ten volunteers and sedentary male gender underwent a week of concurrent training sessions with five sequential days, with moderate intensity and duration of hundred minutes. Results: No changes were observed in leukocyte counts. As symptoms of upper respiratory tract infections, 10% of the volunteers had coryza, 20% nasal congestion, and 40% headache at the end of intervention. Conclusions: Such intervention has no potential to negatively modulate leukocyte counts. However, the incidence of symptoms of upper respiratory tract infections may be associated with decreased cellular functionality, possibly due to the volume outlined in the sessions.

Human adenovirus detection among immunocompetent and immunocompromised patients presenting acute respiratory infection

INTRODUCTION: Human adenoviruses (HAdV) play an important role in the etiology of severe acute lower respiratory infection, especially in immunocompromised individuals. The aim of the present study was detect the HAdV through different methods: direct fluorescence assay (DFA) and nested-polymerase chain reaction (PCR-nested) from patients with acute respiratory infection (ARI) up to 7 days of symptoms onset. METHODS: Samples (n=643) were collected from different risk groups during from 2001 to 2010: 139 adults attended in an Emergency Room Patients (ERP); 205 health care workers (HCW); 69 from Renal Transplant Outpatients (RTO); 230 patients in hematopoietic stem cell transplantation (HSCT) program. RESULTS: Among all patients (n=643) adenovirus was detected on 13.2% by DFA and/or PCR: 6/139 (4.3%) adults from ERP, 7/205 (3.4%) from HCW samples, 4/69 (5.8%) from RTO and 68/230 (29.5%) from HSCT patients. Nested PCR showed higher detection (10%) compared to DFA test (3.8%) (p < 0.001). HSCT patients presented significantly higher prevalence of HAdV infection. CONCLUSIONS: Adenovirus detection through nested-PCR assay was higher. However the inclusion of molecular method in laboratorial routine diagnostic should be evaluated considering the reality of each specific health service. .

Selective antibody deficiency and its relation to the IgG2 and IgG3 subclass titers in recurrent respiratory infections

Selective antibody deficiency with normal immunoglobulins [SADNI] may be identified as part of distinct primary or secondary immunodeficiency disorders. The clinical manifestations include recurrent, often severe or prolonged, upper or lower respiratory tract infections. To evaluate SADNI in patients with recurrent sinopulmonary infections and its relation to IgG subclass deficiencies. Methods: In a case-control study, anti-pneumococcal antibody titer and IgG2, IgG3 levels before injection of pneumococcal vaccine and anti-pneumococcal antibody titer at least 4 weeks the vaccination were measured in 46 patients and 54 controls. The results were compared using student's t-test. There was a significant correlation between age and anti-pneumococcal antibody titers before and after vaccination in patients. No significant relation was found between pre and post vaccination pneumococcal antibody titer and IgG2 and IgG3 in cases and controls [p>0.05]. The mean of anti-pneumococcal antibody before and after vaccination were significantly different in cases and controls and were higher in control group [p=0.01, p=0.001, respectively]. Anti-pneumococcal antibody titers in 97.8% of cases and 100% of controls group were normal [>3.4 micro g/ml]. 34.8% of cases and 9.1% of controls had low titers of anti-pneumococcal antibody [<20 micro g/ml] while 18.7% of cases and no controls failed to respond to vaccine. Evaluation of anti-pneumococcal antibody titer in patients with recurrent, chronic and severe respiratory infections with normal immunoglobulin levels seems to be necessary as early diagnosis. Treatment of such a cases could prevent later sequelae such as mastoiditis and bronchiecstasia

Morphologic features frommdxmice spleens, used for duchenne muscular dystrophy studies

The mdx mice model is widely used for Duchenne muscular dystrophy (DMD) studies, which is present in a high percentage from newborns human males. Therefore, the aim of this study was to evaluate possible morphological changes from spleens in these mice and to compare with normal mice (Mus musculus) in contribution to DMD understanding and its consequences on immune system by affected individuals. The study was performed by light and scanning electron microscopy (SEM) techniques beyond immunohistochemistry. Was found microscopically an increased number of lymph nodes and decreased in red pulp region by mdx, beyond a larger VEGF-C (vascular endothelial growth factor C) expression stimulates lymphangiogenesis in red pulp region from spleen. These findings suggest a spleen adaptation in order to supply immunological demand due upper respiratory infection, which are common in individuals affected by Duchenne muscular dystrophy.

Infecciones respiratorias en niños con síndrome de Down / Respiratory infections in children with Down syndrome

Down syndrome (DS) is the most common chromosomal abnormality among live-born infants. Respiratory tract infections are the most important cause of mortality in individuals with DS at all ages. In recent decades several studies have been performed to elucidate abnormalities of the immune system in DS. Non-immunological factors, including abnormal anatomical structures, congenital heart disease and gastro esophageal reflux, may play a role in the increased frequency of respiratory tract infections. Addressing immunological and non-immunological factors involved in the pathogenesis of infectious diseases may reduce the susceptibility to infections in DS children.

Síndrome de Down (SD) es la anormalidad cromosómica más común entre los recién nacidos vivos. Las infecciones respiratorias son la causa más importante de mortalidad en individuos con SD en todas las edades. En las últimas décadas se han realizado varios estudios para aclarar las anormalidades del sistema inmune en SD. Factores no-inmunológicos, incluyendo estructuras anatómicas anormales, enfermedad cardíaca congénita y reflujo gastroesofágico, pueden desempeñar un papel en el aumento de la frecuencia de infecciones del tracto respiratorio. Abordar los factores inmunológicos y no inmunológicos implicados en la patogenia de las enfermedades infecciosas puede reducir la susceptibilidad a las infecciones en los niños SD.

Evaluation of the immune humoral response of Brazilian patients with Rubinstein-Taybi syndrome

Rubinstein-Taybi syndrome (RTS) is a rare developmental disorder characterized by craniofacial dysmorphisms, broad thumbs and toes, mental and growth deficiency, and recurrent respiratory infections. RTS has been associated with CREBBP gene mutations, but EP300 gene mutations have recently been reported in 6 individuals. In the present study, the humoral immune response in 16 RTS patients with recurrent respiratory infections of possible bacterial etiology was evaluated. No significant differences between patients and 16 healthy controls were detected to explain the high susceptibility to respiratory infections: normal or elevated serum immunoglobulin levels, normal salivary IgA levels, and a good antibody response to both polysaccharide and protein antigens were observed. However, most patients presented high serum IgM levels, a high number of total B cell and B subsets, and also high percentiles of apoptosis, suggesting that they could present B dysregulation. The CREBBP/p300 family gene is extremely important for B-cell regulation, and RTS may represent an interesting human model for studying the molecular mechanisms involved in B-cell development.

Respiratory syncitial virus in children with acute respiratory infections.

Objective. To study the nutritional status of children with Respiratory Syncitial virus infection. Methods. One hundred and twenty six children with acute respiratory infection, between the age of 4-24 months, were investigated for RSV infection with bronchiolitis, pneumonia and upper respiratory tract infection. Nasopharyngeal aspirates were collected and cytokine responses were determined by ELISA. Upper respiratory tract infections were detected in 16.66%, bronchiolitis in 30.15% and Pneumonia in 53.17% children. Results. Of the 126 patients, 46.66% children were positive for RSV while 58.33% were negative for RSV. Children with bronchiolitis were more commonly positive for RSV compared to URTI and pneumonia. RSV was almost equally distributed among boys (42.5%) and girls (48.7%). More children were RSV positive when the mean age lesser (8.4 mo) was compared to RSV negative (9.93 mo). Well nourished children and children with normal birth weight had more RSV positives, though not statistically significant. In a sub sample analysis of cytokines done (n=25), Interleukin-2 and Interleukin-8 levels were higher in the RSV positive children and these levels declined after 5 days of illness. Conclusions. RSV is more commonly associated with bronchiolitis in younger infants with normal birth weight or more weight for age (WFA). Proinflammatory cytokine IL-8 was secreted at high concentrations in the nasopharyngeal aspirate in all the children.

Aspectos da admissão e evolução de crianças hospitalizadas com suspeita de pneumonia adquirida na comunidade em Salvador / Aspects of admission and outcome of children hospitalized with suspected community-acquired pneumonia in Salvador

A pneumonia na infância permanece um assunto relevante, tendo em vista a sua elevada taxa de mortalidade mundial, principalmente nos países em desenvolvimento. Objetivo: Descrever o resultado da hospitalização de crianças internadas com suspeita diagnostica de pneumonia. Desenho do estudo: Coorte retrospectiva. Material e métodos: Foi realizado acompanhamento retrospectivo de pacientes internados com suspeita de pneumonia em um centro pediátrico, de outubro de 2002 a outubro de 2005. A partir dos prontuários médicos, dados demográficos, de história clínica, do exame físico, do tratamento, da evolução e do desfecho foram coletados e registrados em formulário específico para o estudo. Todos os casos incluídos tiveram as radiografias de tórax avaliadas por radiologista cego às informações clínicas, com o objetivo de definir a presença ou não de infiltrado pulmonar e avaliar a presença de alterações radiológicas outras. A população do estudo foi alocada -“m quatro grupos diferente? para que pudessem ter suas variáveis comparadas entre pacientes com características semelhantes. Resultados: No grupo das crianças > 2 meses de idade, internadas com diagnóstico clínico-radiológico de pneumonia e tratadas com penicilina cristalina, as freqüências de febre (46,4% vs. 26,3%, /’=0,002), taquipnéia (73,6% vs. 59,4%,

Isolation and characterization of avian metapneumovirus from chickens in Korea

Avian metapneumovirus (aMPV) causes upper respiratory tract infections in chickens and turkeys. Although the swollen head syndrome (SHS) associated with aMPV in chickens has been reported in Korea since 1992, this is the study isolating aMPV from chickens in this country. We examined 780 oropharyngeal swab or nasal turbinate samples collected from 130 chicken flocks to investigate the prevalence of aMPV and to isolate aMPV from chickens from 2004-2008. Twelve aMPV subtype A and 13 subtype B strains were detected from clinical samples by the aMPV subtype A and B multiplex real-time reverse transcription polymerase chain reaction (RRT-PCR). Partial sequence analysis of the G glycoprotein gene confirmed that the detected aMPVs belonged to subtypes A and B. Two aMPVs subtype A out of the 25 detected aMPVs were isolated by Vero cell passage. In animal experiments with an aMPV isolate, viral RNA was detected in nasal discharge, although no clinical signs of SHS were observed in chickens. In contrast to chickens, turkeys showed severe nasal discharge and a relatively higher titer of viral excretion than chickens. Here, we reveal the co-circulation of aMPV subtypes A and B, and isolate aMPVs from chicken flocks in Korea.

Ineffectiveness for infants of immunization of mothers with pneumococcal capsular polysaccharide vaccine during pregnancy

Pneumococcal (Pnc) carriage is associated with pneumococcal diseases. Breast feeding and maternal vaccination may be a useful approach to prevent pneumococcal infection in young infants. We examined the risk of Pnc carriage by infants at six months of age after pneumococcal polysaccharide vaccination of pregnant women. We selected 139 pregnant woman. The woman were randomly allocated to receive 23-valent polysaccharide vaccines during pregnancy (Group 1) after pregnancy (Group 2) or not receive any vaccine (Group 3). Nasopharyngeal swabs were collected from the infants at three and six months of age. The infants were evaluated monthly during the first six months. We included 47 mothers in Group 1, 45 mothers in Group 2 and 47 mothers in Group 3. Forty-seven percent of the babies were exclusively breast fed until six months, 26 percent received both breast feeding and artificial feeding and 13 percent received only artificial feeding. Among those patients, 26 percent were colonized by Pnc at six months (12 from Group 1, 13 from Group 2, and 12 from Group 3). There was no significant difference in colonization between the three groups. Thirty percent of the children were colonized by a non-susceptible strain. We concluded that young infants (three months old) are already susceptible to pneumococcal carriage. Vaccination during pregnancy with a polysaccharide vaccine did not decrease Pnc colonization.

Analysis of the sputum and inflammatory alterations of the airways in patients with common variable immunodeficiency and bronchiectasis

INTRODUCTION: Common variable immunodeficiency is characterized by defective antibody production and recurrent pulmonary infections. Intravenous immunoglobulin is the treatment of choice, but the effects of Intravenous immunoglobulin on pulmonary defense mechanisms are poorly understood. OBJECTIVE: The aim of this study was to verify the impact of intravenous immunoglobulin on the physical properties of the sputum and on inflammatory alterations in the airways of patients with Common variable immunodeficiency associated with bronchiectasis. METHOD: The present study analyzed sputum physical properties, exhaled NO, inflammatory cells in the sputum, and IG titers in 7 patients with Common variable immunodeficiency and bronchiectasis with secretion, immediately before and 15 days after Intravenous immunoglobulin. A group of 6 patients with Common variable immunodeficiency and bronchiectasis but no sputum was also studied for comparison of the basal IgG level and blood count. The 13 patients were young (age=36±17 years) and comprised predominantly of females (n=11). RESULTS: Patients with secretion presented significantly decreased IgG and IgM levels. Intravenous immunoglobulin was associated with a significant decrease in exhaled NO (54.7 vs. 40.1 ppb, p<0.05), sputum inflammatory cell counts (28.7 vs. 14.6 cells/mm³, p<0.05), and a significant increase in respiratory mucus transportability by cough (42.5 vs. 65.0 mm, p < 0.05). CONCLUSION: We concluded that immunoglobulin administration in Common variable immunodeficiency patients results in significant improvement in indexes of inflammation of the airways with improvement in the transportability of the respiratory mucus by cough.

Efeito da pré-exposição de vias aéreas de ratos com enterotoxina estafilocócica do tipo B (SEB) sobre a inflamação alérgica pulmonar / Effect of the pre-exposition of rats airways with staphylococci enteroxin type B (SEB) on pulmonary allergic inflammation

As enterotoxinas estafilocócicas (SEs) são produzidas e excretadas por algumas cepas da bactéria Staphylococcus aureus. A asma é uma doença caracterizada por resposta inflamatória crônica das vias aéreas. A admnistrração sistêmica de SEB em coelhos...

The staphylococci enterotoxin (SEs) are produced and secreted by some kind of Staphylococcus aureus. The asthma is a disease characterized by a chronic inflammatory response of the airways. the systemic administration of SEB in rabbits causes a pulmonary inflammation characterized...

Estado de vitamina A y su relación con antecedentes infecciosos en escolares venezolanos / Vitamin A status and the relationship with morbidity in venezuelan school children

La vitamina A (VA) cumple una función importante sobre el sistema inmunológico demostrándose una relación sinérgica entre estado corporal de VA, y procesos infecciosos. El objetivo fue evaluar la relación entre niveles séricos de retinol y la Citología de Impresión Conjuntival (CIC) con el estado nutricional antropométrico y antecedentes infecciosos en escolares de bajos recursos económicos de una zona urbana de Valencia. Se evaluaron 445 niños (4-13 años de edad), de ambos géneros. Se determinó: retinol sérico (HPLC-r), proteína C reactiva (nefelometría), CIC (ICEPO), los indicadores antropométricos peso-talla (PT) y talla-edad (TE) según referencia nacional y el registro de enfermedades infecciosas (diarrea, enfermedades respiratorias, sarampión y parasitosis) dos meses previos al estudio. El 92,3 por ciento estaban en situación de pobreza, 7 por ciento presentó déficit nutricional (PT ≤ p10), 10,8 por ciento exceso (PT > p90) y 1,5 por ciento talla baja (TE = p3); 18 por ciento de los niños presentó al menos un episodio de diarrea, 39,8 por ciento infección respiratoria superior, 28,1 por ciento inferior y 32,8 por ciento parasitosis. El 10,3 por ciento mostró niveles altos de PCR (> 10 mg/L), el valor promedio de retinol fue 35,7 ± 9,2 μg/dL con una prevalencia de valores bajos (< 20 μg/dL) de 0,7 por ciento, niveles marginales (20-30 μg/dL) de 27,4 por ciento y 9,5 por ciento déficit de VA según CIC. Se encontró correlación significativa entre retinol sérico y CIC y asociación significativa entre retinol sérico y las enfermedades respiratorias superiores únicamente. No se encontró asociación entre los indicadores antropométricos con el estado de vitamina A ni con la morbilidad. No fue posible demostrar la relación entre el estado de vitamina A y los antecedentes infecciosos como diarrea, enfermedades del tracto respiratorio inferior y sarampión, sin embargo, la alta prevalencia de morbilidad y de niveles marginales de VA, hacen que el grupo estudiado...

Vitamin A (VA) is an essential micronutrient for the immune system and several researchs have shown a synergic relationship between vitamin A status and morbidity. The aim was to show the relationship between serum retinol level, Conjunctival Impression Cytology (CIC), anthropometric status, and morbidity in low income school children. 445 children (both genders) between 4 and 13 years old were assessed. Serum retinol levels (HPLC-r), C-reactive protein (nefelometry) and CIC (ICEPO), anthropometric indicators (Weight-height (WH), height-age (HA)according to national references values), morbidity (diarrhea, respiratory tract infections, measles, and parasitosis) two months prior to the evaluation, were determined. The poverty was 92.3%, wasting (WH ≤ p10) 7%, overweight (WH > p90) 10.8%, and stunting (HA = p3) 1.5%. 18% had one or more diarrhea episodes, 39.8% upper respiratory tract infections, 28.1% lower respiratory tract infections, and 32.8% intestinal parasitosis; 10.3% showed ahigh level of C-reactive protein (CRP > 10 mg/L). The average retinol level was 35.7 ± 9.2 μg/dL, with 0.7% low level(< 20 μg/dL), 27.4% of the children at risk of vitamin A deficiency (20-30 μg/dL), and 9.5% deficient according CIC. There was a significant correlation between serum retinol and CIC, and a significant association between serum retinol and upper respiratory tract infections, but not between morbidity and CIC. There was not a significant association between anthropometric indicators and vitamin A status and morbidity. In this study it was not possible to demonstrate the relationship between vitamin A status and diarrhea, measles, lower respiratory tract infections and parasitosis but the high prevalence of marginal serum retinol levels and morbidity in this group makes it susceptible to nutritional surveillance.

Inmunoestimulantes orales en enfermedades respiratorias infantiles / Immunostimulants of respiratory diseases in children

Ya que las infecciones respiratorias infantiles son muy frecuentes, se ha intentado prevenirlas de diferentes formas, por ejemplo estimulando el sistema inmune del niño. Actualmente existe disponibilidad de medicamentos, cuyas características farmacológicas se describen en este artículo.