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

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

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

Utilidad de los péptidos 33 y 38 de Lolium perenne en la inmunoterapia de la rinitis polínica / Utility of the peptides 33 and 38 of Lolium perenne in immunotherapy of hayfever

Se aislaron y caracterizaron péptidos del polen de la gramínea Lolium perenne por métodos fisicoquímicos, se estudiaron sus propiedades bioquímicas e inmunológicas, tanto en el conejo como en humanos atópicos que sufrían de rinoconjuntivitis estacional producida por dicho polen, y se presentan los hallazgos inmunoserológicos luego de 3 años de inmunoterapia específica con los péptidos 33 y 38 obtenidos, que resultaron ser los más significativos en la composición fisicoquímica del polen.

Peptides isolated from the Lolium perenne pollen were submitted to several chemical and immunological procedures to establish their antigenicity. Immunotherapy with peptides 33 and 38 showed high potency to develop specific IgG blocking antibodies which correlated with statistical clinical improvement.

La rinitis alérgica local es una entidad prevalente inducida por alérgenos inhalados estacionales y perennes / Local allergic rhinitis is a prevalent entity induced by seasonal and perennial inhalant allergens

La rinitis alérgica local (RAL) es un nuevo fenotipo de rinitis con producción nasal de anticuerpos IgE específicos en ausencia de atopia sistémica que puede afectar a sujetos previamente diagnosticados de rinitis no alérgica y rinitis idiopática. Esta nueva entidad se caracteriza por la existencia de síntomas clínicos sugestivos de rinitis alérgica, producción local de IgE específica y presencia de un patrón inflamatorio Th2 en la mucosa nasal durante la exposición natural, así como tras la prueba de provocación nasal con alérgenos con producción local de IgE específica, triptasa y proteína catiónica de eosinófilos (ECP). La existencia de esta nueva entidad hace necesaria la realización de un diagnóstico alergológico preciso en pacientes con síntomas sugestivos de rinitis alérgicas cuando el prick test y la determinación de IgE específica sérica sean negativos. La detección local de anticuerpos IgE específicos en las secreciones nasales durante la exposición natural a aeroalérgenos y la respuesta positiva a la prueba de provocación nasal con aeroalérgenos con producción local de triptasa, ECP e IgE específica han demostrado ser una aproximación adecuada para detectar pacientes con RAL.

Presentation and diagnosis of allergic fungal sinusitis

Allergic fungal sinusitis [AFS] is a form of fungal disease that has recently been considered a distinct clinicopathologic entity. Other forms of fungal sinusitis include acute-fulminant [invasive], chronic indolent [invasive] and mycetoma [non-invasive]. Objectives were to assess the presentation and to describe the diagnostic techniques for allergic fungal sinusitis in our setup. Descriptive study was conducted in the Department of ENT and Head and Neck Surgery, Khyber Medical College and Khyber Teaching Hospital, Peshawar from January 2002 to April 2008. Twenty-three cases of allergic fungal sinusitis [ASF] were selected for the study. Data like, name, age, sex, address, clinical features, labs [Eosinophil count] and imaging studies [CT and/or MRI] were recorded, including the pre- and postoperative treatment, operative findings and postoperative results, recurrence of disease were also recorded. Surgical procedures were performed on all cases followed by medical treatment. Study revealed that AFS is a disease of younger age, mainly occurring in 2[nd] and 3[rd] decade of life, with male to female ratio 1:1.3. Allergic rhinitis [91%] and nasal polyposis [91%] were important associated factors. Nasal obstruction [96%], nasal discharge [91%], post-nasal discharge [87%] and unilateral multi sinus extension were important clinical features. Increased eosinophil count and increased IgE level was found in 78% cases. Histopathological analysis showed fungal hyphae in all cases and aspergillus was predominant organism on culture. Orbital erosion was seen in 78% and skull base erosion was observed in 9%. Recurrence of disease was seen in nine cases. Allergic fungal sinusitis [AFS] is a disease of young immunocompetent adults. Nasal obstruction, nasal discharge, nasal allergy and proptosis were the most common presentations. Initial diagnosis of allergic fungal sinusitis requires high index of suspicion in patients presenting with chronic rhinosinusitis, such cases should be properly evaluated. Differentiation from invasive forms of fungal sinus disease is crucial

Aurora and crepuscle in infantile allergic rhinitis

Objectives: This study is designed to verify the circadianity of allergic rhinitis in children inhabiting a tropical city and to compare its rhythm in different annual seasons.Introduction: Allergic rhinitis presents a circadian and a circannual variation in the intensity of the symptoms. However, most of the studies are carried out with adults living in temperate/cold cities. Few data are available about children, especially those living in tropical climates.Methods: Observational study based on questionnaires. The caretakers of a total of 218 children inhabiting a tropical city that were diagnosed with active allergic rhinitis the moment they looked for prompt-attendance services were interviewed.Results: Coughing was the major symptom that alerted the caretakers. Blocked and runny noses were also very common. The symptoms were mostly intermittent and stronger during the aurora and the crepuscle. Most of the children woke up in the pre-dawn period.Discussion: The intermittence of the symptoms and the characteristic of woking the children up in predawn suggests that an ideal medication would be efficient in intermittent dosages, to be used only when necessary.Conclusions: The circadian rhythm of infantile allergic rhinitis has some features in common with the circadian rhythm of the asthma. It is similar to adult rhinitis, but presents some peculiarities.

Prevalência de asma e rinite alérgica em escolares no município de Santo Ângelo/RS / Prevalence of asthma and allergic rhinitis among students from Santo Ângelo/RS

Introdução: A asma é uma doença inflamatória crônica, caracterizada por hiper-responsividade das vias aéreas inferiores que se manifesta por episódios recorrentes de sibilância, dispnéia, aperto no peito e tosse. Objetivo: Determinar a prevalência de asma e rinite alérgica em adolescentes do município de Santo Ângelo/RS. Metodologia: Foi realizado um estudo observacional, prospectivo e transversal; a amostra foi constituída por estudantes de 13 a 14 anos. Foram investigadas as variáveis: sexo, idade e interferência dos sintomas das doenças nas atividades diárias através da aplicação de um questionário epidemiológico padronizado do ISAAC (International Study of Asthma and Allergies in Childhood). Resultados: O número de questionários aplicados foi de 1.031, sendo considerados válidos 979 (94,9 por cento). A prevalência de asma nos adolescentes foi de 10,5 por cento, baseada na questão “já teve ou tem asma”. A prevalência de rinite alérgica foi de 34,6 por cento, baseada na questão “já teve ou tem rinite alérgica”. Quanto à polinose “alergia ao pólen na primavera” a prevalência foi de 30,4 por cento. Considerando-se o sub-diagnóstico das doenças, a prevalência de prováveis asmáticos foi de 12 por cento e a de adolescentes com provável rinite de 12 por cento. Conclusão: A prevalência de asma no presente estudo mostrou-se entre os valores médios mundiais e nacionais, já as prevalências de rinite alérgica e polinose mostraram-se elevadas de acordo com as médias de outros estudos. Estes dados apontam que em Santo Ângelo/RS essas doenças constituem um problema de saúde pública entre os adolescentes.

Introduction: Asthma is an inflammatory chronic disease, characterized as a hyperresponsivity of the lower airways that manifests itself through recurrent episodes of sibilance, dyspnea, chest pressure, and coughing. Aim: To determine the prevalence of asthma and allergic rhinitis in adolescents living in the municipality of Santo Ângelo/RS. Methods: An observational transversal, prospective study was performed, the sample comprising 13- and 14-year-old students. The variables sex, age, and interference of the symptoms of the disease in the daily activities were investigated through the administration of the standardized epidemiological questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC). Results: Of the 1,031 questionnaires responded, 979 (94.9 percent) were considered as valid. The prevalence of asthma among the adolescents was 10.5 percent, based on the question: “Have you ever had asthma?”. The prevalence of allergic rhinitis was 34.6 percent, based on the question “Have you ever had allergic rhinitis?. As for pollen allergy during the spring, the prevalence was 30.4 percent. Considering the underdiagnosis of the diseases, the prevalence of probable asthmatics was 12 percent and of adolescents with probable rhinitis was 12 percent. Conclusion: The prevalence of asthma in the present study was consistent with the reported mean world and national values, but the prevalences of allergic rhinitis and pollen allergies were high as compared to the means reported elsewhere. The data indicate that in Santo Ângelo, RS these conditions are a public health problem among adolescents.

Existe relación entre otitits media con efunsión y rinitis alérgica? / Is there a relationship between media with efunsión otitits and allergic rhinitis?

La otitis media con efunsión es una entidad que se define como la presencia de efusión en oído medio detrás de una membrana timpánica sin signos de inflamación activa. Es una enfermedad extremadamente común y quizás la primera causa de cirugía con anestesís general en niños. La incidencia de OME es tan alta que algunos autores refieren que el 90% de la población padece por lo menos un episodio den su infancia.

Factors associated with allergic rhinitis in Priest Hospital.

OBJECTIVE: To study the prevalence and factors associated with allergic rhinitis (AR) in the priest and novices who came for treatment in Priest Hospital MATERIAL AND METHOD: The retrospective study of 110 priests with allergic rhinitis was conducted between January 2006 to June 2007. Questionnaire about allergic history, eosinophile count, prick and intradermal skin test were done. RESULTS: Most of the priests with the first manifestation of allergic rhinitis were in the age between 14 to 66 years with mean of 28.93 years. Specific factors related to allergic rhinitis were house dust (87.3%), animal dandruff (40.9%), pollen (35.5%) and insects (20%). Allergens that had positive skin test were house dust mite (54.4%), dog dandruff (50%), house dust (48.2%), Bermuda grass (44.5%), Sedge (42.7%), and Para grass (39.1%). Non-specific factors which induced rhinitis symptoms were joss stick (56.8%) and smoke (51.8%). CONCLUSION: All of the factors both the specific and non specific were associated with AR. Future clinical management guidelines for AR must take into account from the results of this study. Such guidelines must promote relief from allergen exposure, emotional burden and the negative impact on daily activities. Health education to the priests to eradicate allergen from their living place and maintain strong partnership with healthcare professionals for sustainable result.

Asthma and other allergic diseases in 13-14-year-old schoolchildren in Urmia: an ISAAC study

We determined the prevalence and risk factors of asthma, allergic rhinitis and atopic eczema in 3000 13-14-year-old schoolchildren in Urmia, Islamic Republic of Iran. We used the International Study of Asthma and Allergies in Childhood [ISAAC] written and video questionnaires. With the written questionnaire, the prevalence of current symptoms [within the past 12 months] was: wheeze 14.5%, allergic rhinitis 23.6% and eczema 10.1%. Self-reported asthma ever was only 2.1%. With the video questionnaire, the prevalence of wheeze was lower; 7.4% for wheeze at rest ever and 4.6% during the past 12 months. Boys had a significantly higher prevalence for most items examined except for eczema

Doença alérgica polínica: polens alergógenos e seus principais alérgenos / Pollen allergic disease: pollens and its major allergens

Pacientes com alergia a pólen de gramíneas, comumente denominada polinose, freqüentemente apresentam reatividade a alérgenos de pólen de inúmeras gramíneas devido às reatividades cruzadas entre anticorpos IgE dirigidos contra proteínas presentes nos polens de gramíneas. Nesse contexto, pólen de Italian ryegrass (Lolium multiflorum), ou azevém anual, gramínea da família Poaceae cultivada no Sul do Brasil, é considerado o principal agente sensibilizante em pacientes com polinose. Nessa região, o azevém é capaz de produzir grande quantidade de pólen. Adicionalmente, outras gramíneas da família Poaceae crescem naturalmente no Sul, entretanto, sem relevância clínica. Extratos de pólen derivados de gramíneas homólogas ou heterólogas são freqüentemente empregados no diagnóstico e tratamento da alergia sazonal a pólen, sendo que para esses fins não se encontra comercialmente disponível no Brasil extrato padronizado de pólen de L. multiflorum. Futuros estudos serão importantes para melhor caracterizar a reatividade cruzada entre alérgenos de pólen de L. multiflorum e alérgenos de outras gramíneas com o objetivo de aprimorar o diagnóstico e imunoterapia de pacientes com alergia a pólen causada por L. multiflorum.

Patients with grass pollen allergy, commonly called pollinosis, often present reactivity to pollen allergens from a number of grass species due to cross-reactivity of IgE antibodies to pollen proteins present in pollen grasses. In this context, Italian rye grass (Lolium multiflorum) pollen of the Poaceae family cultivated in Southern Brazil has been considered a major sensitizing agent in patients with pollinosis. In this region, Italian rye grass is capable of producing a great amount of pollen. In addition to L. multiflorum, other Poaceae grasses are naturally grown as weed in Southern Brazil, but with no clinical relevance. Pollen extracts derived from homologous or heterologous grasses are often used for both diagnosis and treatment of seasonal allergy. However, no standardized L. multiflorum pollen extract is commercially available in Brazil and mixed grass extracts are commonly used for diagnosis and immunotherapy of grass pollen allergy. Further studies are required to better characterize the cross-reactivity between L. multiflorum and other grass pollen allergens for improving the diagnosis and immunotherapy to L. multiflorum pollen allergy.

[Study of serum IgE and nasal secretion eosinophils count in patients with allergic rhinitis]

Allergic rhinitis is a chronic disease of upper respiratory tract which can be presented as asthma. Some investigators have reported a significant relationship between the disease and the number of eosinophils in nasal secretion of the patients. This study aims to evaluate the serum IgE and it's relation with nasal secretion eosinophils count in patients with allergic rhinitis. In this study, serum IgE of 92 patients with non anatomical nasal complication were investigated using ELISA method [IEMA WELL Q-D]. Nasal secretion smears of the patients were also evaluated for eosinophils count. Age, sex, profession and past history of allergic reactions in patients and their families were also investigated. 48. 9% of the patients had high titers of serum IgE [>100 IU/ml]. Also, eosinophils over 5/HPF were seen in 15. 6% of patients, nasal secretion smears. There was no significant relationship between eosinophils count and presence of allergic rhinitis in the patients. Otherwise, there was a significant correlation between rhinitis and patients, profession and their locality of living [P<0. 05]. Detection of serum IgE is mandatory for diagnosis of allergic rhinitis. Besides, it seems that nasal secretion eosinophils count alone is not a reliable finding for diagnosis of the disease

Clinico-immunologic evaluation of allergy to Himalayan tree pollen in atopic subjects in India--a new record.

Exposure to local pollen allergens has a direct bearing on the prevalence of allergic symptoms among the inhabiting atopic population. The populations in the Himalayas and around it are exposed to a variety of pollen grains from trees growing in the region, but the pollen-population interaction has not been clinically investigated. Himalayan tree pollen from five different taxa, i.e. Alnus nitida (AN), Betula utilis (BU), Cedrus deodara (CD), Mallotus phillipensis (MP) and Quercus incana (QI) were evaluated for their allergenicity in the Indian population by in vivo (skin prick test) and in vitro (ELISA) clinico-immunological methods. The presence of specific IgE against these tree pollen in the sera of skin test positive patients was taken as evidence for sensitization to these pollen. The average skin positivity in atopic populations recorded at different allergy centers in India varied from 2.2% against AN, to 4.7% against MP pollen. Significantly raised specific IgE against these pollen were observed in the sera of hypersensitive patients. The sensitization pattern to Himalayan tree pollen in these atopic populations varied. It was concluded that skin prick test positivity and raised IgE antibodies specific to AN, BU, CD, MP and QI established Himalayan tree pollen as important sensitizers in the atopic populations of India. A high incidence of skin sensitivity was observed to pollen antigens of Cedrus deodara, Mallotus phillipensis and Quercus incana in patients of Chandigarh residing in the hills and foothills of the Himalayas while Alnus nitida, Betula utilis and Cedrus deodara were important sensitizers in Delhi patients. The skin sensitization pattern against these pollen was in accordance with the level of exposure to these pollen of the subjects residing in that part of the country.

Skin testing in allergic rhinitis: Experience in Oman

Two hundred and thirty nine Omani patients of perennial and seasonal allergic rhinitis were investigated for the prevalent patterns of allergens by prick testing. They were tested with 31 commonly encountered allergens. The results were analyzed with respect to age and sex incidence and patterns of prevalence of allergens. The commonest allergens were found to be house dust mite. Followed by cat fur, hay dust and mixed threshings

Rhinosinusitis among the patients with perennial or seasonal allergic rhinitis.

Although no hypothesis is universally accepted, allergic rhinitis (AR) may play an important role in the occurrence of rhinosinusitis. This study was carried out to investigate the frequency and severity of rhinosinusitis among patients with seasonal or perennial AR. This study included 73 patients with AR. Findings related to rhinosinusitis of these patients were demonstrated by computed tomography (CT), and were scored according to the Lund-Mackay CT scan staging system. Fifty-two of the 73 patients (71.2%) were shown to have findings of rhinosinusitis. Of these 52, twenty-four patients (77.4%) had perennial AR and 28 (66.7%) patients had seasonal AR. The mean total CT staging score of rhinosinusitis was 4.2 +/- 3.2 in patients with perennial AR and 2.6 +/- 1.3 in patients with seasonal AR. Although the frequency of rhinosinusitis among patients with perennial AR was higher than among seasonal ones, this was statistically insignificant (p = 0.32). But CT staging scores of rhinosinusitis among the patients with perennial AR were significantly higher than among the seasonal AR group (p = 0.014). Although there was no significant difference between the frequency of rhinosinusitis of seasonal and perennial AR, the severity of rhinosinusitis was more severe in cases with perennial AR, in this study. Early management of an allergic disease is essential if its long-term consequences are to be prevented or minimized.

La historia clínica: instrumento diagnóstico para la rinitis alérgica / The diagnostic value of the medical history in the allergic rhinitis

Objetivo. Determinar el valor diagnóstico de la historia clínica en casos de rinitis alérgica. Material y métodos. Se estudiaron 112 sujetos, de uno y otro sexo, de entre 2 y 31 años de edad. Se formaron dos grupos, pareados, uno de casos y otro de controles. Se les realizó: historia clínica, exámenes de laboratorio y gabinete. Como estándar de oro para el diagnóstico se utilizaron las pruebas cutáneas. Se determinó sensibilidad (S), especificidad (E), valor predictivo positivo (VP+), valor predictivo negativo (VP-) y valor de p. Resultados. De la población total, 53.57 por ciento correspondieron al sexo femenino y el resto al masculino. El tiempo medio de evolución de la rinitis fue de cuatro años, con un promedio de cinco cuadros agudos por mes. En 80 por ciento de los pacientes la rinitis fue de tipo perenne. El 57.14 por ciento reportaron antecedentes familiares de alergia (S=57 por ciento, E=100 por ciento, p=0.0001). Los datos clínicos reportados fueron: estornudos en 75 por ciento de los casos (S=75 por ciento, E=100 por ciento, p=0.0001), obstrucción nasal en 50 por ciento (S=50 por ciento, E=100 por ciento, P=0.0001). 30.35 por ciento rebasaron el límite superior de eosinófilos circulantes (S=30.35 por ciento, E=91 por ciento, P=0.0049), 26.78 por ciento tuvieron concentraciones elevadas de IgE (S=26 por ciento, E=87.5 por ciento, p=0.0002), en 78.57 por ciento se encontraron eosinófilos en moco nasal (S=39.28 por ciento, E=89.28, p=0.0009) y en 10.34 por ciento se identificó parasitosis intestinal (p=NS). Conclusión. De acuerdo con los resultados se propone una amplia difusión entre el equipo de salud del primer nivel de atención a fin de promover una actitud de cambio, donde se utilice a la historia clínica como instrumento de diagnóstico oportuno para la rinitis alérgica

Efecto de budesonide en rinitis alérgica / Effects by budesonide in allergic rhinitis

Se evaluó mediante estudio doble ciego la eficacia de Budesonide, glucocorticoide no halogenado en pacientes con rinitis alérgica aguda estacional e hipersensibilidad a ácaros domésticos, pólenes, polvo de cereales, hongos aerógenos y soja. Se estudiaron 56 paientes de ambos sexos, 36 niños y 20 adultos, provenientes de poblaciones cerealeras: Gral. Deheza, Sampacho, Moldes y Río Cuarto. El diagnóstico de terreno alérgico se realizó por historia clínica, examen de mucosa nasal, dosaje de IgE sérica total y estudio de exudado nasal seriado, por técnica de Hansel. El diagnóstico de los alergenos involucrados se realizó por pruebas cutáneas y de degranulación de basófilos. Antes y después de la administración de la droga se estableció una escala de 0 a 6 puntos para evaluación de los síntomas; un punto por presencia de cada síntoma: rinorrea, prurito nasal, estornudos, obstrucción nasal, alteraciones de la olfación y otros (conjuntivitis, cefaleas, palidez de mucosas y/o dolor). Se administró el producto A 26 niños y 10 adultos. Los pacientes que recibieron Budesonide tanto niños como adultos, mostraron mejoría respecto al grupo placebo (p<0,01) y respecto de la evaluación previa al tratamiento (p<0,01). Los trastornos en la olfación mejoraron en los grupos con Budesonide: 22 niños: 84,62 por ciento y 8 adultos: 80 por ciento y en ninguno de los que recibieron placebo. En los grupos que emplearon el glucocorticoide disminuyeron todos los síntomas con diferencias estadísticamente muy significativas tanto en los grupos antes vs después como al compararlos con los grupos correspondientes que recibieron placebo. El producto aplicado en tópico intranasal, estaría indicado con posibilidades de efectos benéficos en el tratamiento de rinitis alérgica tanto en niños como en adultos