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1.
Arch. argent. pediatr ; 120(1): 21-29, feb 2022. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1353407

ABSTRACT

Introducción. La alergia a las proteínas de la leche de vaca es la alergia alimentaria más frecuente en los niños y para su diagnóstico se emplean historia clínica dirigida y prueba de provocación oral (PPO), el dosaje sérico de inmunoglobulina E específica (sIgE) y pruebas cutáneas de puntura (SPT, por su sigla en inglés). Sin embargo, su utilidad diagnóstica es difícil de establecer en la población local. El objetivo fue evaluar la utilidad de las pruebas para el diagnóstico de alergia a las proteínas de la leche de vaca (PLV) en la población estudiada. Población y métodos. Análisis retrospectivo de datos de pacientes atendidos en la Unidad de Alergia del Hospital Elizalde entre 2015 y 2018. Se evaluaron SPT y sIgE para leche, alfa-lactoalbúmina, beta-lactoglobulina y caseína, seguidos de PPO y se determinó la utilidad diagnóstica para cada prueba, y sus combinaciones. Resultados. Se evaluaron las pruebas de 239 pacientes. La PPO fue hospitalaria en el 54,8 % de los casos, por reexposición domiciliara en el 35,5 % y en el 9,6 % por incorporación de PLV a la madre. La mayor especificidad fue la de SPT con caseína (96,7 %; intervalo de confianza [IC95%]: 90,8-99,3) y la mayor sensibilidad, la de la combinación de SPT y sIgE con los 4 alérgenos (55,3 %; IC95%: 45,7-64,6). Conclusiones. El trabajo estableció la utilidad diagnóstica de las SPT y el sIgE en la población estudiada.


Introduction. Cow's milk protein allergy is the most common food allergy among children. It can be diagnosed based on a guided history taking and using an oral food challenge (OFC), serum specific immunoglobulin E levels (sIgE), and skin prick tests (SPT). However, it is difficult to establish their diagnostic performance in the local population. Our objective was to assess the usefulness of tests used to diagnose cow's milk protein (CMP) allergy in the studied population. Population and methods. Retrospective analysis of data from patients seen at the Unit of Allergy of a tertiary care pediatric hospital between 2015 and 2018. SPT and sIgE tests were done for milk, alpha-lactalbumin, beta-lactoglobulin, and casein, followed by an OFC, and the diagnostic usefulness of each test, as well as their combination, was established. Results. The tests of 239 patients were assessed. OFC was performed at the hospital in 54.8 % of cases, via a rechallenge test at home in 35.5 %, and through CMP intake by the mother in 9.6 %. The highest specificity was observed with the casein SPT (96.7 %; 95 % confidence interval [CI]: 90.8-99.3) and the highest sensitivity, with the 4-allergen SPT and sIgE combination (55.3 %; 95 % CI: 45.7-64.6). Conclusions. The study established the diagnostic usefulness of SPT and sIgE in the studied population.


Subject(s)
Humans , Animals , Infant , Milk Hypersensitivity/diagnosis , Immunoglobulin E , Cattle , Skin Tests , Allergens , Cross-Sectional Studies , Retrospective Studies
3.
J. pediatr. (Rio J.) ; 97(4): 387-395, July-Aug. 2021. tab
Article in English | LILACS | ID: biblio-1287040

ABSTRACT

Abstract Objective Allergic sensitization is one of the key components for the development of allergies. Polysensitization seems to be related to the persistence and severity of allergic diseases. Furthermore, allergic sensitization has a predictive role in the development of allergies. The aim of this study was to characterize the pattern of sensitization of atopic patients treated at different pediatric allergy referral centers in Brazil. Methods A nation-wide transversal multicenter study collected data on patients attended in Brazil. Peripheral blood samples were collected to determine the serum levels of allergen-specific IgE. If allergen-specific IgE was higher than 0.1 kUA/L, the following specific components were quantified. Results A total of 470 individuals were enrolled in the study. Mite sensitization was the most frequent kind in all participants. A high frequency of sensitization to furry animals and grasses featured in the respiratory allergies. Regarding components, there was a predominance of sensitization to Der p 1 and Der p 2. It has been verified that having a food allergy, atopic dermatitis, or multimorbidity are risk factors for the development of more severe allergic disease. Conclusion Studies on the pattern of allergic sensitization to a specific population offer tools for the more effectual prevention, diagnosis, and treatment of allergic diseases. Sensitization to dust mites house was the most prevalent in the evaluated sample. High rates of sensitization to furry animals also stand out. Patients with food allergy, atopic dermatitis, or multimorbidity appear to be at greater risk for developing more severe allergic diseases.


Subject(s)
Humans , Animals , Child , Asthma , Brazil/epidemiology , Immunoglobulin E , Allergens , Pyroglyphidae
4.
Rev. cuba. pediatr ; 93(1): e758, ene.-mar. 2021. tab, fig
Article in Spanish | LILACS, CUMED | ID: biblio-1251754

ABSTRACT

Introducción: El síndrome de hiperIgE es una inmunodeficiencia primaria poco frecuente de etiología desconocida, con afectación multisistémica; causada por mutaciones dominantes del gen que codifica la proteína transductora de señal y activadora de la transcripción, STAT-3, por lo que condiciona un déficit en la generación de las células Th17 a partir de las células T CD4+ y explica la susceptibilidad de estos pacientes a las infecciones por Stafilococus aureus y Cándida albicans. Objetivo: Contribuir al conocimiento de esta inmunodeficiencia para su detección precoz y tratamiento oportuno. Presentación del caso: Se trata de una lactante, con puente nasal amplio, hiperlaxitud, erupción eccematosa desde el período neonatal, infecciones cutáneas, óticas, pulmonares con presencia de neumatoceles y candidiasis mucocutánea. Se detectaron concentraciones elevadas de IgE sérica y eosinofília. Se trató con inmunomoduladores, antihistamínicos, antimicrobianos y vitaminoterapia. Se logró mejoría clínica. Conclusiones: El síndrome de hiperIgE-AD es una inmunodeficiencia primaria poco frecuente caracterizada por altas concentraciones de IgE, eosinofilia, abscesos cutáneos, eccemas, candidiasis mucocutánea crónica e infecciones pulmonares recidivantes, neumatoceles y bronquiectasias; también se presentan alteraciones del tejido conectivo, esquelético y vascular. Se requiere de alto grado de sospecha clínica y es importante la atención precoz de las infecciones, que en general presentan una respuesta tórpida sistémica. Las alternativas terapéuticas están dirigidas a prevenir la sepsis y al control de los síntomas(AU)


Introduction: Hyper IgE syndrome is a rare primary immunodeficiency of unknown etiology, with multi systemic impact; it is caused by dominant mutations of the gene that codifies the protein transducer of signal and activator of transcription (STAT-3), therefore it determines a deficit in the generation of Th17 cells from T CD4+ cells, and explains the sensitivity of these patients to the infections caused by Stafilococus aureus and Candida albicans. Objective: Contribute to the knowledge of this immunodeficiency for its early detection and timely treatment. Case presentation: Newborn with wide nasal bridge, hypermovility, eczematose rash since the neonatal period; cutaneous, ear, and pulmonary infections with presence of neumotoceles and mucocutaneous candidiasis. There were detected high concentrations of seric IgE and eosinophilia. The patient was treated with immunomodulators, antihestamines, antimicrobial drugs and vitaminotherapy. It was achieved a clinical improvement. Conclusions: Hyper IgE syndrome-AD is a rare primary immunodeficiency characterized by high concentrations of IgE, eosinophilia, cutaneous abscesses, eczemas, chronical mucocutaneous candidiasis and recurrent pulmonary infections, neumatoceles and bronchiectasis; it also presents alterations in the connective, skeletal and vascular tissue. It is required a high level of clinical suspicion and it is important the early care of the infections, which generally present a systemic torpid response. The therapeutic alternatives are directed to prevent a sepsis and to control the symptoms(AU)


Subject(s)
Humans , Female , Infant , Candidiasis, Chronic Mucocutaneous , Immunoglobulin E , Knowledge , Hypergammaglobulinemia , Immunologic Factors , Anti-Infective Agents
5.
Med. U.P.B ; 40(1): 82-85, 03/03/2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1177504

ABSTRACT

El accidente apídico implica un bajo riesgo de morir por reacciones agudas como anafilaxia. Es frecuente que se desconozcan otros riesgos como el hepático y el neurológico. Dentro de las complicaciones menos conocidas está la polineuropatía aguda conocida como Guillain- Barré. La causa más ampliamente descrita es la reacción cruzada entre IgE y la proteína básica de mielina. A continuación, se reporta el primer caso en América Latina sobre la asociación entre Guillain-Barré y accidente por picadura de abejas. En este caso, hay criterios de causalidad como el nexo temporal, la plausibilidad biológica y la coherencia con otros artículos reportados en la literatura médica.


Bee sting accident usually implies a low risk of dying from acute reactions such as anaphylaxis. Other risks such as liver and neurological risks are often unknown. Among the lesser-known complications caused by this type of accident is the acute polyneuropathy known as Guillain-Barré. The most widely described cause is the cross reaction between IgE and myelin basic protein. The article reports the first case in Latin America on the association between Guillain-Barré and a bee sting accident. In this case, there are causality criteria such as temporal link, biological plausibility, and consistency with other articles reported in the medical literature


O acidente elapídico implica um baixo risco de morte por reações agudas, como anafilaxia. Outros riscos, como hepáticos e neurológicos, são frequentemente desconhecidos. Entre as complicações menos conhecidas está a polineuropatia aguda conhecida como Guillain-Barré. A causa mais amplamente descrita é a reação cruzada entre a IgE e a proteína básica da mielina. A seguir, é relatado o primeiro caso na América Latina sobre a associação entre Guillain-Barré e um acidente com picada de abelha. Nesse caso, há critérios de causalidade como vínculo temporal, plausibilidade biológica e consistência com outros artigos relatados na literatura médica


Subject(s)
Humans , Animals , Guillain-Barre Syndrome , Polyneuropathies , Bees , Bites and Stings , Immunoglobulin E , Accidents , Cross Reactions , Death , Anaphylaxis , Liver
6.
Chinese Acupuncture & Moxibustion ; (12): 1349-1353, 2021.
Article in Chinese | WPRIM | ID: wpr-921058

ABSTRACT

OBJECTIVE@#To observe the efficacy of acupoint thread-embedding combined with fluticasone propionate aerosol for chronic persistent bronchial asthma of lung-spleen @*METHODS@#A total of 120 children with chronic persistent bronchial asthma were randomly divided into an observation group (60 cases, 9 cases dropped off) and a control group (60 cases, 7 cases dropped off). The control group was treated with fluticasone propionate aerosol (125 μg per inhalation), twice a day; based on the control group treatment, the observation group was treated with acupoint thread-embedding at Dingchuan (EX-B 1), Feishu (BL 13), Zusanli (ST 36) and Danzhong (CV 17), once half a month. Both groups were treated for 3 months. The pulmonary function, serum IgA, IgE levels and TCM symptom score were compared between the two groups before and after treatment, and the clinical efficacy was evaluated.@*RESULTS@#After treatment, the large airway function (peak expiratory flow [PEF], forced expiratory volume at the first second [FEV1]) and small airway function (maximal expiratory flow at 25% of the forced capacity [MEF25%], maximal expiratory flow at 50% of the forced capacity [MEF50%], maximal expiratory flow at 75% of the forced capacity [MEF75%] and midexpiratory flow 25%-75% [MEF25%-75%]) were higher than those before treatment (@*CONCLUSION@#Acupoint thread-embedding combined with fluticasone propionate aerosol could improve the pulmonary function, TCM symptoms and serum IgA and IgE levels in children with chronic persistent bronchial asthma of lung-spleen


Subject(s)
Acupuncture Points , Acupuncture Therapy , Asthma/drug therapy , Child , Humans , Immunoglobulin A , Immunoglobulin E , Lung
7.
J. bras. pneumol ; 47(1): e20200279, 2021. tab
Article in English | LILACS | ID: biblio-1134931

ABSTRACT

ABSTRACT In this cross-sectional study, we investigated the relationship that levels of vitamin D had with eosinophil counts and IgE levels in 26 children with asthma (6-12 years of age) in the city of Londrina, Brazil. Vitamin D levels were found to correlate significantly, albeit moderately, with age (r = −0.51) and eosinophilia (r = −0.49), although not with IgE levels (r = −0.12). When we stratified the sample into two groups by the median vitamin D level (< or ≥ 24 ng/mL), we found that those in the < 24 ng/mL group were older, had higher eosinophil counts, and had higher IgE levels. To our knowledge, this is the first study to show an association between low levels of vitamin D and more pronounced eosinophilia in children with asthma in Brazil.


RESUMO A associação entre níveis de vitamina D, eosinófilos e IgE foi analisada transversalmente em 26 crianças (6-12 anos) com asma na cidade de Londrina (PR). Foram observadas correlações moderadas dos níveis de vitamina D com idade (r = −0,51) e eosinofilia (r = −0,49), mas não com IgE (r = −0,12). Ao separar a amostra pelo ponto de corte obtido com a mediana dos níveis de vitamina D (< ou ≥ 24 ng/mL), valores mais altos de idade, eosinófilos e IgE ocorreram no grupo abaixo desse ponto. Pelo que sabemos, este estudo exploratório é o primeiro a mostrar uma associação entre níveis baixos de vitamina D e eosinofilia mais acentuada em crianças asmáticas no Brasil.


Subject(s)
Humans , Child , Asthma , Vitamin D Deficiency/complications , Vitamin D , Brazil , Immunoglobulin E , Cross-Sectional Studies , Eosinophils
8.
Rev. bras. parasitol. vet ; 30(1): e023920, 2021. graf
Article in English | LILACS | ID: biblio-1251364

ABSTRACT

Abstract Fish consumption plays an important role in human diet. Hoplias malabaricus, commonly known as traíra, is a freshwater fish widely appreciated in several Brazilian states and frequently infected by Eustrongylides sp. fourth-instar larvae (L4). The aim of the present study was to evaluate allergenic potential of Eustrongylides sp. L4 crude extract (CEE). BALB/c mice were immunized intraperitoneally (IP) by 10 μg CEE with 2 mg of aluminum hydroxide on days 0 and 35. Specific IgG and IgE antibody levels were determined after immunization and cellular immunity was evaluated by assessing intradermal reaction in ear pavilion. Epicutaneous sensitization was performed in dorsal region by antigen exposure using a Finn-type chamber containing 50 μg of CEE or saline solution, followed by evaluation of specific antibody levels. IP immunization resulted in a gradual increase in IgG antibody levels and transitory IgE production. Significant increase in ear thickness was observed in cellular hypersensitivity reaction. In case of antigen exposure by epicutaneous route, CEE was able to induce meaningfully increased levels of specific IgG and IgE antibodies as well as heightened cellular immunity. Both intraperitoneal immunization and epicutaneous contact with Eustrongylides sp. larval antigens were observed for first time to be capable of inducing immunological sensitization in mice.


Resumo Consumir peixe constitui papel importante na dieta humana. Hoplias malabaricus, comumente chamado de traíra, peixe de água doce largamente apreciado no Brasil, é frequentemente infectado com larvas de quarto estágio (L4) de Eustrongylides sp. O presente estudo objetivou avaliar o potencial alergênico do Extrato Bruto de L4 de Eustrongylides sp. (EBE). Camundongos BALB/c foram imunizados intraperitonealmente (IP) por 10 μg de EBE com 2 mg de hidróxido de alumínio nos dias 0 e 35. Após imunização, determinaram-se níveis específicos de anticorpos IgG e IgE e avaliou-se a imunidade celular pela reação intradérmica no pavilhão auricular. Realizou-se sensibilização epicutânea na região dorsal pela exposição ao antígeno, utilizando-se câmara tipo Finn, contendo 50 μg de CEE ou solução salina. Após exposições, foram avaliados níveis específicos de anticorpos. Na imunização via IP, houve aumento gradual nos níveis de anticorpos IgG e produção de IgE transitória. Foi observado aumento significativo na espessura do pavilhão auricular na reação de hipersensibilidade celular. Na exposição ao antígeno pela via epicutânea, o EBE induziu aumento significante nos níveis de anticorpos IgG e IgE específicos e induziu imunidade celular. Pela primeira vez, observou-se que a imunização intraperitoneal e contato epicutâneo com antígenos larvares de Eustrongylides sp. são capazes de induzir sensibilização imunológica em camundongos.


Subject(s)
Animals , Rabbits , Rodent Diseases , Nematoda , Brazil , Immunoglobulin E , Immunoglobulin G , Disease Models, Animal , Mice, Inbred BALB C
9.
J. pediatr. (Rio J.) ; 96(6): 725-731, Set.-Dec. 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1143192

ABSTRACT

Abstract Objective: To assess the frequency of baked egg tolerance in IgE-mediated egg allergy patients through the oral food challenge and to assess the tolerance predictability of different skin prick tests, as well as specific serum IgE measurement to egg proteins. Methods: In this cross-sectional study, 42 patients with a diagnosis of egg allergy were submitted to different skin prick tests with egg (in natura, boiled, muffin, ovalbumin, and ovomucoid), and specific IgE to egg white, ovalbumin, and ovomucoid; as well as to the oral food challenge with food containing egg, extensively baked in a wheat matrix. Results: Of the total, 66.6% of patients tolerated the ingestion of egg-containing foods in the oral food challenge. A comparative analysis with positive and negative oral food challenge found no significant differences regarding age, gender, other food allergies, or even specific skin prick tests and IgE values between the groups. Conclusions: The study demonstrated an elevated frequency of baked egg food-tolerant individuals among egg allergy patients. None of the tested markers, skin prick tests, or specific IgE, were shown to be good predictors for identifying baked egg-tolerant patients. The oral food challenge with egg baked in a matrix is central to demonstrate tolerance and the early introduction of baked foods, improving patients' and families' quality of life and nutrient intake.


Resumo Objetivo: Avaliar a frequência de tolerância a alimentos assados com ovo em pacientes com alergia ao ovo mediada por IgE por meio do teste de provocação oral e verificar a capacidade de predição de tolerância ao ovo por meio de teste cutâneo de leitura imediata (Skin Prick Test ou SPT) e de dosagem sérica de IgE específica para componentes do ovo. Métodos: Estudo transversal, 42 pacientes com diagnóstico de alergia ao ovo foram submetidos a SPT com ovo (in natura, cozido, bolinho, ovoalbumina e ovomucoide), IgE específica para clara de ovo, ovoalbumina e ovomucoide e ao teste de provocação oral com alimento com ovo extensamente assado em matriz de trigo. Resultados: Dos pacientes, 66,6% toleraram a ingestão do alimento com ovo durante o teste de provocação oral. Não encontramos diferenças em relação a idade, gênero, outras alergias alimentares ou mesmo entre os valores dos SPT e IgE específica na análise comparativa entre os grupos com teste de provocação oral positivo e teste de provocação oral negativo. Conclusões: Foi demonstrada uma elevada frequência de indivíduos tolerantes a ingestão de alimentos assados com ovo entre os pacientes com alergia a ovo mediada por IgE. Nenhum dos marcadores testados, SPT ou IgE específica, demonstrou ser bom preditor para identificar os pacientes tolerantes. Consideramos que os testes de provocação oral com alimentos com ovo assado sejam fundamentais para a introdução desses assados, melhorar a qualidade de vida e a ingestão de nutrientes dos pacientes e famílias.


Subject(s)
Humans , Quality of Life , Cooking , Egg Hypersensitivity/diagnosis , Immunoglobulin E , Skin Tests , Allergens , Ovomucin , Cross-Sectional Studies , Eggs , Immune Tolerance
10.
Rev. bras. anestesiol ; 70(6): 642-661, Nov.-Dec. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1155771

ABSTRACT

Abstract This second joint document, written by experts from the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Society of Anesthesiology (SBA) concerned with perioperative anaphylaxis, aims to review the pathophysiological reaction mechanisms, triggering agents (in adults and children), and the approach for diagnosis during and after an episode of anaphylaxis. As anaphylaxis assessment is extensive, the identification of medications, antiseptics and other substances used at each setting, the comprehensive data documentation, and the use of standardized nomenclature are key points for obtaining more consistent epidemiological information on perioperative anaphylaxis.


Resumo Este segundo documento, escrito por especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória, tem por objetivo revisar os mecanismos fisiopatológicos, agentes desencadeantes (em adultos e crianças), assim como a abordagem diagnóstica durante e após o episódio. Por se tratar de uma avaliação abrangente, a identificação das medicações, antissépticos e outras substâncias usadas em cada região, registros detalhados, e nomenclatura padronizada são pontos fundamentais para a obtenção de dados epidemiológicos mais fidedignos sobre a anafilaxia perioperatória.


Subject(s)
Humans , Child , Adult , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Perioperative Period , Anaphylaxis/diagnosis , Anaphylaxis/etiology , Societies, Medical , Vasodilator Agents/adverse effects , In Vitro Techniques , Mastocytosis/complications , Brazil , Preoperative Care , Immunoglobulin E/immunology , Bradykinin/adverse effects , Skin Tests/methods , Risk Factors , IgA Deficiency/complications , Drug Hypersensitivity/physiopathology , Allergy and Immunology , Symptom Assessment , Anaphylaxis/physiopathology , Anesthesiology , Angioedema/chemically induced , Terminology as Topic
11.
Arch. argent. pediatr ; 118(6): 418-422, dic 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1146110

ABSTRACT

Introducción: Las alergias alimentarias afectan, mayoritariamente, a los niños en los primeros años de vida. Existen escasos datos epidemiológicos en nuestro país.Objetivos: Determinar los agentes causales, describir la prevalencia y características de los pacientes con alergia alimentaria en una población pediátrica argentina.Pacientes y métodos: Estudio retrospectivo observacional, de corte transversal, de pacientes menores de 18 años. Resultados: Se incluyeron 321 pacientes; se confirmó alergia alimentaria en un 64 % (207) de los casos. El 53 % (109) presentó mecanismo mediado por inmunoglobulina E; el 68 % (140), alergia a las proteínas de la leche de vaca; el 20 % (41), alergia al huevo, y el 12 % (24), anafilaxia como manifestación clínica. La prevalencia global de alergia alimentaria fue del 0,87 % (IC 95 %: 0,7-0,9).Conclusiones: La prevalencia global de alergia alimentaria fue del 0,87 %. La leche de vaca resultó el principal alérgeno incluso en adolescentes.


Introduction: Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce. Objectives: To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population. Patients and methods: Observational, retrospective, cross-sectional study on patients younger than 18 years. Results:A total of 321 patients were included; food allergy was confirmed in 64 % (207) of cases. An immunoglobulin E-mediated mechanism was observed in 53 % (109); cow's milk protein allergy, in 68 % (140); egg allergy, in 20 % (41); and anaphylaxis as clinical manifestation, in 12 % (24). The overall prevalence of food allergy was 0.87 % (95 % confidence interval: 0.7-0.9). Conclusions: The overall prevalence of food allergy was 0.87 %. Cow's milk was the main allergen, even among adolescents


Subject(s)
Humans , Male , Female , Child , Adolescent , Food Hypersensitivity/diagnosis , Immunoglobulin E/immunology , Epidemiologic Studies , Cross-Sectional Studies , Retrospective Studies , Milk Hypersensitivity
12.
Biosci. j. (Online) ; 36(6): 2172-2185, 01-11-2020. tab, graf
Article in English | LILACS | ID: biblio-1148284

ABSTRACT

Canine demodicosis is a common inflammatory parasitic skin disease caused by Demodex mites. House dust mites, such as Dermatophagoides spp., play an important role in the pathogenesis of canine atopic dermatitis (AD). The goal of this experimental work was to investigate whether demodectic dogs could be previously exposed/sensitized to house dust mites' antigens. First the prevalence of demodicosis in a southeastern region of Brazil was investigated by analyzing clinical files of dogs that were admitted to a Veterinary Hospital. Subsequently, the IgG responses to Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df) and IgE to D.pteronyssinus (Dp) were evaluatedin two groups, AD or demodicosis dogs. Additionally, the major IgE-binding Dp proteins that are recognized by sera from dogs with demodicosis and AD were evaluated. A total of 2,599 clinical files were analyzed to identify the major parasitic skin diseases in dogs from this region, considering the age, sex and breed of the animals. The epidemiological study identified 111 animals with skin diseases; from these 20.7% presented demodicosis. Afterwards, serum samples were obtained from another groups of demodicosis, AD, and healthy dogs, and analyzed for Dp and Df-specific IgG, and IgE antibody levels, Dp IgG avidity by ELISA and IgE-binding Dp-specific proteins by immunoblot. IgG and IgE antibodies to Dp were detected in sera from additional groups of dogs with AD, demodicosis or healthy, with higher IgE levels to Dp in AD than demodectic or healthy dogs. IgG to Df was detected, despite with smaller levels compared to Dp in sera from demodectic dogs, and also in healthy dogs. Immunoblot showed IgE-binding to Dp proteins in sera of dogs with demodicosis and AD; with strong reactivity for the 72 and 116 kDa antigens detected by sera from demodicosis dogs. However, sera from healthy dogs >12 months old also presented reactivity to these bands. In conclusion, the detection of Dp-IgG and IgE antibodies in sera from demodectic dogs indicates previous exposure and sensitization to the house dust mite, respectively, more than cross-reactivity between demodex mites and Dp antigens detected by canine antibodies. Additionally, higher Dp-specific IgE levels were found in dogs with AD compared with those with demodicosis or healthy, suggesting that Dp-specific IgE could better discriminate dogs with AD from healthy ones or even those with demodicosis.


Demodicose canina é uma doença inflamatória comum da pele causada por ácaros do gênero Demodex. Ácaros da poeira doméstica como Dermatophagoides spp. desempenham papel importante na patogênese da dermatite atópica canina (DA). O objetivo desse trabalho experimental foi investigar se cães com demodicose poderiam ser previamente expostos/sensibilizados com antígenos de ácaros da poeira doméstica. A princípio, investigou-se a prevalência de demodicose em uma região sudeste do Brasil, analisando-se prontuários clínicos de cães admitidos em um Hospital Veterinário. Posteriormente, as respostas de IgG a Dermatophagoides pteronyssinus (Dp) e D. farinae (Df) e IgE a D. pteronyssinus (Dp) foram avaliadas em dois grupos, DA ou demodicose. Também foram avaliadas as principais proteínas Dp reconhecidas por anticorpo IgE presente em soros de cães com demodicose e DA. Um total de 2.599 prontuários clínicos foram analisados para identificar as principais doenças parasitárias da pele em cães dessa região, considerando a idade, sexo e raça dos animais. O estudo epidemiológico detectou 111 animais com doenças de pele e destes, 20,7% apresentavam demodicose. Posteriormente, amostras de soro foram obtidas de outros grupos de cães com demodicose, DA ou saudáveis, e analisadas quanto aos níveis de IgG e IgE específicos para Dp e Df, avidez de IgG a Dp por ELISA e proteínas específicas de Dp reconhecidas por IgE por immunoblot. Anticorpos IgG e IgE para Dp foram detectados em soros de grupos adicionais de cães com DA, demodicose ou saudáveis, com níveis mais altos de IgE para Dp na DA do que no soro de animais saudáveis. Níveis de IgG específicos para Df foram detectados, apesar serem menores em comparação com os detectados para Dp em soros de cães demodéticos, e também em cães saudáveis. A análise de immunoblot demonstrou detecção de IgE para proteinas de Dp em soros de cães com demodicose e DA; com forte reatividade para os antígenos de 72 e 116 kDa detectados por soros de cães com demodicose. No entanto, soros de cães saudáveis > 12 meses de idade também apresentaram reatividade a essas bandas. Em conclusão, a detecção de anticorpos Dp-IgG e IgE específicos em soros de cães demodéticos indica exposição prévia e sensibilização aos ácaros, respectivamente, mais do que reatividade cruzada entre ácaros Demodex e antígenos Dp detectados por anticorpos caninos. Além disso, níveis de Dp-IgE específicos mais elevados encontrados em cães com DA, sugerem que esses anticorpos poderiam discriminar melhor cães com DA daqueles saudáveis ou mesmo demodéticos.


Subject(s)
Immunoglobulin E , Immunoglobulin G , Dermatophagoides pteronyssinus , Dogs
13.
Rev. bras. anestesiol ; 70(5): 534-548, Sept.-Oct. 2020. tab
Article in English | LILACS | ID: biblio-1143957

ABSTRACT

Abstract Experts from the Brazilian Association of Allergy and Immunology (ASBAI) and the Brazilian Society of Anesthesiology (SBA) interested in the issue of perioperative anaphylaxis, and aiming to strengthen the collaboration between the two societies, combined efforts to study the topic and to prepare a joint document to guide specialists in both areas. The purpose of the present series of two articles was to report the most recent evidence based on the collaborative assessment between both societies. This first article will consider the updated definitions, treatment and guidelines after a perioperative crisis. The following article will discuss the major etiologic agents, how to proceed with the investigation, and the appropriate tests.


Resumo Especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória reuniram-se com o objetivo de intensificar a colaboração entre as duas sociedades no estudo desse tema e elaborar um documento conjunto que possa guiar os especialistas de ambas as áreas. O objetivo desta série de dois artigos foi mostrar as evidências mais recentes alicerçadas na visão colaborativa entre as sociedades. Este primeiro artigo versará sobre as definições mais atuais, formas de tratamento e as orientações após a crise no perioperatório. No próximo artigo serão discutidos os principais agentes causais e a condução da investigação com testes apropriados.


Subject(s)
Humans , Child , Adult , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Perioperative Period , Anaphylaxis/diagnosis , Anaphylaxis/etiology , Societies, Medical , Vasodilator Agents/adverse effects , In Vitro Techniques , Mastocytosis/complications , Brazil , Preoperative Care , Immunoglobulin E/immunology , Bradykinin/adverse effects , Skin Tests/methods , Risk Factors , IgA Deficiency/complications , Drug Hypersensitivity/physiopathology , Allergy and Immunology , Symptom Assessment , Anaphylaxis/physiopathology , Anesthesiology , Angioedema/chemically induced , Terminology as Topic
14.
Article in English | WPRIM | ID: wpr-762177

ABSTRACT

PURPOSE: Alterations in the intestinal microbiota in early life affects the development of atopic dermatitis (AD) in humans. This study aimed to further investigate the effects of gut dysbiosis in early life in an ovalbumin (OVA)-induced mouse model of AD. METHODS: The AD mouse model was developed by serial OVA sensitization and mice were treated with an antibiotic cocktail in their drinking water for 2 weeks before primary sensitization. Probiotics (Lactobacillus rhamnosus, 1 × 10⁹ CFU) or 100 µL of fresh fecal supernatant were orally administered daily from 1 week before the first sensitization until the end of the study. RESULTS: The AD mice which received antibiotics had significantly aggravated phenotypes, including clinical score, transepidermal water loss, and histopathology, compared to those treated with healthy feces or probiotics. Total systemic immunoglobulin E production and skin interleukin (IL) 4 levels were significantly increased in the antibiotic-treated mice compared to the other groups. Antibiotic treatment also increased the levels of IL17 and group 3 innate lymphoid cells (ILC3) in the gut and significantly suppressed the production of short-chain fatty acids (SCFAs) and decreased the number FOXP3⁺ cells. CONCLUSIONS: Our results suggest that the status of the gut microbiota in early life in the mouse may play a crucial role in AD development through intestinal SCFA production through regulate the numbers of CD4⁺IL17⁺/CD4⁺FOXP3⁺ regulatory T cells and ILC3s.


Subject(s)
Animals , Anti-Bacterial Agents , Cytokines , Dermatitis, Atopic , Drinking Water , Dysbiosis , Fatty Acids , Fatty Acids, Volatile , Feces , Gastrointestinal Microbiome , Humans , Immunoglobulin E , Immunoglobulins , Interleukins , Intestines , Lymphocytes , Mice , Microbiota , Ovalbumin , Ovum , Phenotype , Probiotics , Skin , T-Lymphocytes, Regulatory , Water
15.
Article in English | WPRIM | ID: wpr-762175

ABSTRACT

PURPOSE: Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70). METHODS: The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC. RESULTS: A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure. CONCLUSIONS: The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.


Subject(s)
Allergens , Asthma , Asthma, Occupational , Bronchial Hyperreactivity , Humans , Immunoglobulin E , Inhalation , Methacholine Chloride , Molecular Weight , Occupational Exposure , Prognosis
16.
Article in Chinese | WPRIM | ID: wpr-880756

ABSTRACT

OBJECTIVE@#To observe the therapeutic effect of different doses of dihydroartemisinin (DHA) on atopic dermatitis (AD) in mice and explore the mechanism.@*METHODS@#Forty-two C57BL/6 mice were randomly divided into 7 groups (@*RESULTS@#Treatment with 25, 75, and 125 mg/kg DHA and dexamethasone all alleviated AD symptoms of mice, reduced the severity scores of skin lesions, and ameliorated pathological changes of the skin tissue. DHA at 125 mg/kg produced the most obvious therapeutic effect and significantly alleviated mast cell infiltration in the lesions as compared with the other treatment groups (@*CONCLUSIONS@#DHA is effective for the treatment of AD in mice with an optimal dose of 125 mg/kg. The therapeutic effect of DHA is achieved probably through regulation of local immunity by inhibiting mast cell infiltration in the lesions.


Subject(s)
Animals , Anti-Inflammatory Agents/therapeutic use , Artemisinins , Cytokines , Dermatitis, Atopic/drug therapy , Immunoglobulin E , Mast Cells , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Skin
17.
Article in Chinese | WPRIM | ID: wpr-826382

ABSTRACT

To investigate the clinical manifestations and laboratory characteristics of 6 cases of pemphigoid nodularis (PN). The clinical and laboratory data of 6 patients with PN admitted to the Department of Dermatology,Peking Union Medical College Hospital from January 2016 to August 2019 were retrospectively analyzed. PN mainly occurred in middle-aged and elderly people,with an average age of (58±16) years. Eosinophils were elevated in 4 patients. Immunoglobulin E (IgE) level was (530±672) kU/L in five patients. Direct immunofluorescence showed IgG and/or C3 deposition on basal membrane zone. Indirect immunofluorescence showed positive IgG anti-basement membrane zone,with a titer of 1:40-1:320. Enzyme-linked immunosorbent assay showed the anti-BP180 antibodies were positive [24-85 U/ml,average(43±26) U/ml] in 5 patients. None of the patients had neurological disorders. One patient was lost to follow-up. The disease recurred in 3 of 5 patients during the follow-up,and two patients still received maintenance corticosteroids. PN mainly occurs in middle-aged and elderly individuals. It is featured by elevated eosinophils and total IgE and relatively low anti-BP180 antibody titers. Recurrence is common but PN is less likely to be associated with neurological diseases.


Subject(s)
Adult , Aged , Autoantibodies , Blood , Enzyme-Linked Immunosorbent Assay , Eosinophils , Humans , Immunoglobulin E , Blood , Middle Aged , Pemphigoid, Bullous , Diagnosis , Pathology , Retrospective Studies
18.
Asia Pacific Allergy ; (4): 4-2020.
Article in English | WPRIM | ID: wpr-785461

ABSTRACT

BACKGROUND: Banana fruit has been recognized as an important food allergen source. Nowadays banana hypersensitivity had been reported more frequently with various presentations from oral allergy syndrome to anaphylaxis.OBJECTIVE: This study aims to describe the pattern of banana hypersensitivity and the sensitivity of diagnostic test.METHODS: Six patients who experienced banana hypersensitivity were recruited from adult allergy clinic, Ramathibodi Hospital, Mahidol University between 2015–2018. Demographic data, pattern of banana allergy consisted of the onset of reaction, symptoms, severity, cross-reactivity to kiwi, avocado, latex including type and amount of banana were collected. Skin test, serum specific IgE to banana and open-label food challenge test had been applied.RESULTS: All patients experienced multiple episodes of banana anaphylaxis. Regarding the diagnostic investigation, prick-to-prick skin test had higher sensitivity (sensitivity, 100%; 95% confidence interval [CI], 54.07%–100%) than the commercial banana extract (sensitivity, 83.33%; 95% CI, 35.88%–99.58%) and serum specific IgE to banana (sensitivity, 50%; 95% CI, 11.81%–88.19%). The discordance between skin prick test using commercial banana extract and skin test was reported. The cross-reactivity between the species of banana, kiwi, the avocado was documented in all patients. Latex skin prick test and application test were applied with negative results. From the oral food challenge test, a case of banana anaphylaxis patient can tolerate heated banana.CONCLUSION: The various phenotypes of banana hypersensitivity were identified. The prick-to-prick test showed the highest sensitivity for diagnosis of banana allergy. However, component resolved diagnostics might be needed for conclusive diagnosis.


Subject(s)
Adult , Anaphylaxis , Diagnosis , Diagnostic Tests, Routine , Food Hypersensitivity , Fruit , Hot Temperature , Humans , Hypersensitivity , Hypersensitivity, Immediate , Immunoglobulin E , Latex , Musa , Persea , Phenotype , Skin , Skin Tests , Thailand
19.
Article in Korean | WPRIM | ID: wpr-785353

ABSTRACT

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, characterized by a complex pathophysiology and a variety of clinical phenotypes. However, heterogeneous clinical phenotypes are generally not considered in treating AD. To date, phenotypes and endotypes have been proposed to classify AD mainly based on differences in age, IgE, severity, race, skin barrier dysfunction, immune (Th2/Th17/Th22) polarization, and skin microbiome. Various biologics to target polarized immune pathways, including dupilumab, have been newly developed for the personalized treatment of moderate-to-severe AD. Further understanding of AD pathophysiology and identification of novel biomarkers will not only allow clinically useful stratification of AD and but also achieve precision medicine for the prevention and treatment of AD.


Subject(s)
Biological Products , Biomarkers , Continental Population Groups , Dermatitis, Atopic , Humans , Immunoglobulin E , Microbiota , Phenotype , Precision Medicine , Skin , Skin Diseases
20.
Article in Korean | WPRIM | ID: wpr-785351

ABSTRACT

PURPOSE: Recently, the prevalence of allergic rhinitis (AR) in Korean children has been increased. The aim of this study was to investigate the clinical characteristics of rhinitis and to compare clinical parameters between AR and nonallergic rhinitis (NAR) in children.METHODS: We retrospectively reviewed the medical records of 1,034 children under 18 years of age who visited Korea University Anam Hospital for rhinitis symptoms from January 2008 to December 2017. Clinical data, including clinical features, comorbidities, blood test results, allergen sensitization profile, and pulmonary function test parameters, were collected.RESULTS: Among the 1,034 children with rhinitis, 737 (71.3%) were AR and 297 (28.7%) were NAR. The prevalence of AR gradually increased with age. The median levels of eosinophil count (4.1%), serum total IgE (204.4 IU/L), eosinophil cationic protein (ECP) concentration (17.9 µg/L), and fractional exhaled nitric oxide (FeNO) (22.0 ppb) were significantly higher in children with AR than in those with NAR. The sensitization rate to the inhalant allergens increased with age; however, food allergen sensitization rate tended to decrease. Median levels of eosinophil count, total IgE, ECP, and FeNO were significantly higher in the poly-sensitized group than in the mono-sensitized and nonsensitized groups.CONCLUSION: More than 70% of Korean children who have rhinitis symptoms are AR. Children with AR more likely to have higher levels of FeNO and bronchial asthma. Poly-sensitized children showed increased rates of atopic dermatitis and bronchial asthma.


Subject(s)
Allergens , Asthma , Child , Comorbidity , Dermatitis, Atopic , Eosinophil Cationic Protein , Eosinophils , Hematologic Tests , Humans , Immunoglobulin E , Korea , Medical Records , Nitric Oxide , Prevalence , Respiratory Function Tests , Retrospective Studies , Rhinitis , Rhinitis, Allergic
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