Sensitization to cat allergen and its association with respiratory allergies: cross-sectional study

ABSTRACT Cats are a significant source of allergens that contribute towards worsening of allergic diseases. The aim of this study was to investigate the association between sensitization to cat allergens and allergic respiratory diseases.This was an observational retrospective study based on the skin pricktests results of patients at a tertiary-level hospital in São Paulo. A total of 1,985 test results were assessed. The prevalence of sensitization to cat allergen was 20% (399 patients). Our data indicated that in this population of atopic patients, a positive skin prick test result for cat allergen was not associated significantly with a diagnosis of respiratory allergy.

Murciélagos y ácaros en la alergia respiratoria / Bats and house-dust mites in respiratory allergy

Se valoró la posibilidad de que estos mamíferos ingirieron ácaros del hábitat (dermatophagoides pteronyssinus), y que sus antígenos formaran parte de las heces del murciélago (murcielaquina), y resultaren indirectamente alergénicos para los pacientes atópicos que habían revelado hipersensibilidad a dichas heces...

The possibility that house-dust mite antigens coming from dermatophagoides pteronyssinus were hidden in bat feces was studied in those atopic patients suffering rhinitis and asthma that revealed hypersensibility to bat feces...

Laboratory animals and respiratory allergies: The prevalence of allergies among laboratory animal workers and the need for prophylaxis

OBJECTIVE: Subjects exposed to laboratory animals are at a heightened risk of developing respiratory and allergic diseases. These diseases can be prevented by simple measures such as the use of personal protective equipment. We report here the primary findings of the Laboratory Animals and Respiratory Allergies Study regarding the prevalence of allergic diseases among laboratory animal workers, the routine use of preventive measures in laboratories and animal facilities, and the need for prevention programs. METHODS: Animal handlers and non-animal handlers from 2 Brazilian universities (University of São Paulo and State University of Campinas) answered specific questionnaires to assess work conditions and symptoms. These subjects also underwent spirometry, a bronchial challenge test with mannitol, and skin prick tests for 11 common allergens and 5 occupational allergens (rat, mouse, guinea pig, hamster, and rabbit). RESULTS: Four hundred fifty-five animal handlers (32±10 years old [mean±SD], 209 men) and 387 non-animal handlers (33±11 years old, 121 men) were evaluated. Sensitization to occupational allergens was higher among animal handlers (16%) than non-animal handlers (3%, p<0.01). Accessibility to personal protective equipment was measured at 85% (median, considering 73 workplaces of the animal handler group). Nineteen percent of the animal handlers indicated that they wear a respirator at all times while handling animals or working in the animal room, and only 25% of the animal handlers had received an orientation about animal-induced allergies, asthma, or rhinitis. CONCLUSION: In conclusion, our data indicate that preventive programs are necessary. We suggest providing individual advice to workers associated with institutional programs to promote a safer work environment. .

Avoidance of allergens by the patients with bronchial asthma.

OBJECTIVES: Association between environmental allergens and bronchial asthma is well established. A great number of substances found in the environment can precipitate or aggravate respiratory symptoms in asthmatics. Avoiding allergens is recognized as an integral part of management. Through various educational interventions the patients can be taught various measures to avoid these allergens. The present study was undertaken to evaluate the impact of 'self care manual' an educational intervention on the avoidance of various environmental allergens. METHODS: The total enrolled patients were 523 of which 260 were included in the study group to whom 'self care manual' was given and 263 in the control group with no access to self care manual. A fourteen items interview schedule consisting of three parts was administered. The first two subparts were in the form of checklist to know the various allergens which were inducing symptoms in the patients and weather they could avoid these triggers. The third part which was open ended was administered to know their ways of avoiding these triggers. All the patients were followed up at 2 weeks, 6 months and at 1 year. RESULT: Mean age of the subjects in both the groups was 36.72 +/- 11.52 years and 34.33 +/- 12.86 years respectively. Both the groups were comparable on majority of the socio-demographic variables. The number of patients whose symptoms were aggravated by a particular triggering factor reduced significantly on each successive visit in the study group. Almost all the patients started avoiding their triggers in follow-ups in the study group. In control group this change was only for few triggers. More and more patients started using inhalers on exposure to dust or triggering weather conditions. They started slowing down for exercises and diverted their attentions against triggering emotional situations. CONCLUSION: Patient education should be an essential component in the overall management of bronchial asthma. Control of asthma symptoms is better achieved with avoidance of allergens. This can be accomplished by emphasizing these facts particularly with the use of self care manuals.

Hipersensibilidade a fungos em crianças asmáticas de uma comunidade do Recife, Pernambuco / Hypersensitivity to molds in asthmatic children from a community of Recife, Pernambuco

OBJETIVOS: identificar a sensibilização a testes cutâneos de hipersensibilidade imediata para fungos em crianças asmáticas, residentes em comunidade urbana de baixa renda. MÉTODOS: no período de março de 1997 a junho de 1998 foram avaliadas 13 crianças com mais de três episódios de dispnéia nos últimos 12 meses, selecionadas a partir de um estudo transversal, em que todos os 123 escolares de 6 a 10 anos residentes na comunidade responderam ao questionário International Study of Asthma and Allergies in Childhood. Nas 13 crianças com asma em atividade, foram aplicados testes cutâneos de hipersensibilidade imediata para avaliar resposta a seis extratos fúngicos padronizados: Aspergillus mix, Penicillium mix, Hormodendrum cladosporidiodes, Alternaria tenius, Helminthosporium interseninatum e Mold mix. RESULTADOS: dentre as 13 crianças analisadas, 12 apresentaram sensibilididade a pelo menos um dos fungos testados (12/13), cujos extratos com maior frequência de positividade foram: Aspergillus mix (7/13), Penicillium mix (6/13) e Hormodendrum cladosporidiodes (5/13). CONCLUSÕES: a freqüência elevada de hipersensibilidade aos extratos de fungos nas crianças avaliadas sugere a necessidade de estudos analíticos observacionais para esclarecer uma possível associação causal entre fungos e asma.

OBJECTIVES: to identify prick test hypersensitivity to molds in asthmatic school children in a low-income urban community. METHODS: thirteen children who had more than three asthma attacks in the last 12 months from March'1997 to June'1998 were evaluated. These children were selected from a previous cross-sectional survey studying 123 children from 6 to 10 years old residing at the low-income urban community of Campo do Banco-Várzea, Recife, Pernambuco. The 123 children were tested by the International Study of Asthma and Allergies in Childhood survey to determine asthma. The 13 asthmatic children selected were evaluated with the prick test for immediate hypersensitivity to six standard mold extracts: aspergillus mix, penicillium mix, hormodendrum cladosporidiodes, alternaria tenius, helminthosporium interseminatum and mold mix. RESULTS: there were 12 mold-sensitive children from the group of 13 children, showing a positive result to at least one of the mold extracts used (12/13). Mold extracts of higher positive incidence were: Aspergillus mix (7/13), Penicillium mix (6/13) and Hormodendrum Cladosporidiodes (5/13). CONCLUSIONS: the evaluated children had high prick test reactivity to mold extracts. The findings indicate the need for additional studies to analyze a possible association between fungal exposure and asthma.

Pattern of sensitization to common environmental allergens amongst atopic Singapore children in the first 3 years of life.

This study was aimed to investigate the sensitization pattern to a range of common allergens in young Singaporean children. A cross-sectional study involving 75 children aged below 3 years was carried out. They presented between December 1995 and April 2000 with symptoms of asthma, rhinitis, eczema, or food allergy. Their levels of allergen-specific serum IgE to a panel of foods (egg white, milk, soy protein, shrimp, wheat and peanut), pet dander, dust mites and cockroaches were measured with Pharmacia CAP System radioallergosorbent test kits. Serum IgE levels greater than 0.35 kU/l represented a positive result. Four children could not be tested with the complete panel because of insufficient serum. The prevalence of sensitization was highest for cow's milk (45.9%) followed by egg white (38.7%), dust mites Dermatophagoides pteronyssinus (31.4%) and Blomia tropicalis (25.5%). Sensitization to ingested allergens was significantly more prevalent in children aged 1 year or younger than in the older children (70.4% of those below 1 year, and 50% of those aged 1-3 years; p < 0.02). Sensitization to inhaled allergens, such as dust mites, was more likely to manifest as respiratory symptoms (allergic rhinitis and asthma), while ingested allergens were associated with gastrointestinal symptoms and eczema (p < 0.001). It was concluded that infants and young children are at high risk of sensitization to common environmental substances. Allergen avoidance is therefore important even in the very young. The prevalence of sensitization to food allergens is higher compared to inhalant allergens in young children.

Efecto de la combustión del tabaco en la propiedad inmunoquímicas de la albúmina / Effect of tobacco smoke in the immunochemistry properties of albumin

Las condiciones en que se realiza la combustión del tabaco durante el acto de fumar favorecen el arrastre de diferentes componentes del cigarrillo, incluyéndose los que se generan en la ignición y que llegan al aparato respiratorio del sujeto que aspira el humo del tabaco. En el extremo de la combustión del cagarrillo la temperatura alcanza 600ºC pero en el punto opuesto, que se pone en contacto con los labios del fumador, la temperatura es menor; por lo anterior se considera que en el cigarrillo se forma un gradiente de temperatura que puede ser capaz de transportar los productos del tabaco. Para demostrar que sí es posible encontrar componentes inmunorreactivos en el humo del tabaco se diseñó un modelo en el cual se usaron dos series de cigarrillos. La serie experimental de cigarrillos fue inyectada con distintas concentraciones de una solución de albúmina sérica bovina (albúmina sérica bovina) y la control recibió salina-fosfato (SSF) sin ninguna proteína. Ambos grupos de cigarrillos permanecieron a 20ºC durante 48 horas para permitir su secado. Posteriormente, se procedió a la combustión de cada serie por separado y el condensado del humo del tabaco producido se dejó en solución salina-fosfato. Los condensados de humo del tabaco derivados de los cigarrillos con mayor concentración de albúmina sérica bovina presentaron más proteína total que los cigarrillos controles. La identificación de la albúmina sérica bovina, que previamente se había colocado en los cigarrillos, se realizó con técnicas inmunoserológicas en las cuales se demostró una banda correspondiente a la albumina sérica bovina, la cual fue revelada con los anticuerpos policlonales anti-albúmina sérica bovina. Los condensados de humo del tabaco producidos con cigarrillos sin albúmina sérica bovina no reaccionaron con los anticuerpos anti-albúmina sérica bovina. La cuantificación de la albvúmina sérica bovina en cada conjunto de cigarrillos mostró de 15 a 601 mcg por cada cigarrillo, de acuerdo con la dosis de albúmina sérica bovina aplicada inicialmente. Se concluye que una fracción de la proteína puesta a los cigarrillos conserva su inmunorreactividad en el condensado del humo del tabaco; por lo cual es posible que los sujetos fumadores al aspirar el humo se pongan en contacto con estructuras del tabaco que desencadenan una respuesta inmunitaria anti-tabaco

Alergenos más frecuentes causantes de sensibilización respiratoria / More frequent allergens causing of respiratory sensitization

Se realizó una revisión prospectiva-retrospectiva de 50 expedientes clínicos de pacientes que acudieron al Servicio de Alergia e Inmunología Clínica del Centro Hospitalario 20 de Noviembre, con alergia respiratoria. Se determinó la frecuencia de la sensibilización respiratoria a diversos alergenos utilizados en la práctica clínica en forma convencional mediante intradermorreacciones. Los pacientes fueron más sensibles al polvo casero y Capriola dactylon (100 por ciento y 50 por ciento, rspectivamente). Otros alergenos causantes de sensibilización en los pacientes fueron: Dermatophagoides pteronyssinus(42 por ciento); Lolium perenne (34 por ciento), Amaranthus palmeri (20 por ciento), y Artemisa ludovisiana (18 por ciento) entre otros

Validez del diagnóstico clínico de rinitis alérgica / Validity of the clinical diagnosis of allergic rhinitis

Las rinitis alérgicas son entidades frecuentemente diagnosticadas en la consulta diaria del otorrinolaringólogo, en base a los signos y síntomas de los pacientes. Sin embargo, para confirmar dicho diagnóstico se considera necesario realizar pruebas de hipersensibilidad. El presente estudio tiene por fin determinar si es válido el diagnóstico de rinitis alérgica basado exclusivamente en los signos y síntomas mas frecuentes que presentan pacientes con etiología alérgica comprobada. Los resultados del estudio señalaron que el diagnóstico clínico de rinitis alérgica tiene una sensibilidad muy alta pero una especificidad muy baja, ocasionando problemas que se sobre diagnostique esta enfermedad si no se usan las técnicas de laboratorio apropiadas

Respiratory atopy and domestic mite sensitization in Rio de Janeiro

Domestic mites occur in a significant percentage of homens in Rio de Janeiro, a tropical geographic region of Brazil. Local weather conditions (hot and humid) promote the significant mite proliferation. Objective. We are registering the allergic mite sensitization of a population with asthma and/or rhinitis living in this coastal area. Methods. A total of 600 patients with asthma and/or rhinitis aged>=2 years underwent 3,810 allergy skin tests (Multi-Test). Eight different extracts were applied: American house dust (Ahd), Brazilian house dust (Bhd), Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Blomia tropicalis (Bt), Chortoglyhphus arcuatus (Ca), Aleuroglyphus ovatus (Ao) and Lepidoglyphus destructor (Ld). RAST to Dp, Bt, Ca, Ao and Ld were performed with sera of randomized 14 atopic subjects. Results A positive immediate skin test to at least one allergen was detected in 387 patients (64,5 percent). Domestic mite sensitization was documented in about 90 percent of the atopic individuals. Bt has unique antigens since 4.15 percent of the subjects had positive exclusive reactions. RAST analyses showed that both Dp and Bt are the most important local mite sensitizers with cross-reactivity to the other mites. Conclusion. This study confirms that domestic mites are the most prevalent local allergens associated with asthma and/or rhinitis. Sensitization to Bt was very common and it should be checked routinely for the diagnosis of respiratory atopy in Rio de Janeiro

Asma y tratamiento con Beta-agonistas / Asthma and ist treatment with beta agonists

El aumento de la morbilidad y la mortalidad por asma constituye uno de los problemas cimeros de la medicina actual y su relacion con el uso de los broncodilatadores beta-agonistas esta aun por esclarecer. Revisamos la literatura medica de las ultimas decadas y exponemos los resultados mas importantes