[Family education, a model for allergy prevention]. / Educación familiar, un modelo de prevención alérgica.

It is frequent the lack of family adherence toward the therapeutic measures of the allergic diseases. The incidence in the therapeutic non compliance of the asthmatic patients vary from 20 to 80%. In the last decades, the symptomatic expression of the atopic diseases (AD) in the infancy, and in the adolescence of Venezuelans has been transformed into a health care problem, with an inaccessible therapeutic cost for the state and the family. The setup of the first allergic prevention program improved attitudes and perceptions toward bronchial asthma, allergic rhinitis, and atopic dermatitis, by the education of the risk family group, based on the results from previous investigations and adapted to the procedures and customs that govern our current society. A research project, through a multi-disciplinary group included an educational program model for the prevention of allergic diseases in a population from Caracas, Venezuelan allergic pregnant mothers, and their respective couples of a high and middle socioeconomic levels with no helminthic infections (n = 482), group A. Two subgroups were randomly selected for prospective evaluation: A1 (n = 20) without participation in the preventive program or control group, and A2 (n = 15) with participation in the program or intervened group, including strategies to be applied by the family, application of measures and reached goals; immunologic, pediatric, and nutritional sequential control; group B (n = 66), to validate the laboratory tests, and group C (n = 364) to validate immunoclinical diagnoses, in vivo immunodiagnostic tests to the parents and children (clinical history, skin prick tests for cow's milk, egg white, wheat, soybean, cladosporium and Dermatophagoides pteronnysinus), and in vitro tests (total serum IgE, Phadiatop, and Rast to the allergens previously selected). In conclusion, the program permits the identification of atopic risk children, sponsors the systematical application of intervention measures, economic, viable and projected toward the family affected, indicating a positive change through a self-family-management training and new conduct plans, facilitating the participation among the family, the community and the health team, that certifies, an optimistic therapy in the reduction of the clinical manifestations of the atopic diseases in young infants from this tropical population studied.

The influence of environment and parasitism on the prevalence of asthma in two Venezuelan regions.

The point prevalence of bronchial asthma and the influence of environmental conditions among 100 individuals chosen from two Venezuelan regions, i.e., rural and urban, were investigated by history, routine laboratory tests, determination of total and specific IgE antibody to common allergens and spirometric tests. The point prevalence of bronchial asthma was 3.0% in rural subjects who were also highly parasitized by helminths and 3.6% in subjects from the urban region. A significative difference in skin responses to Dermatophagoides pteronnysinus was observed in urban asthmatics when compared with rural asthmatics. A similar response to selected allergens was found among both populations. The prevalence of infestation by Ascaris in rural asthmatics was high compared with that of rural controls. Total IgE levels were elevated for both populations, but significatively higher (p less than 0.05) for rural individuals. Results suggest a significative point prevalence of bronchial asthma in both regions, despite the helminth infestation of rural subjects. The effects of environmental factors, their concentration and time of exposure are considered as main factors responsible for allergic reactivity observed in the Venezuelan regions studied.

Alergia y parásitos: una asociación disociable / Alergy and parasities: an asociation dissoluble

Estudios epidemiológicos han intentado evaluar como las infecciones parasitarias por helmintos puede modular la respuesta alérgica, generando importantes controversias. En este estudio se observó una significativa prevalencia de enfermedades alérgicas (rinitis y asma bronquial en individuos infectados por helmintos)

Immunopathology of human schistosmiasis mansoni: II. NK activity and stimulation by specific antigen

Dezesseis doentes infectados e näo tratados com S.mansoni (5 com infecçäo recente e 11 com doenças crônica), foram submetidos à avaliaçäo de atividade de células exterminadoras naturais (NK) "in vitro" frente a células alvo de linhagem K562. Os níveis de atividade das células NK em 9 de 11 doentes (82%) com a infecçäo crônica foram significativamente menores (média = 15 ñ 6%) quando comparados aos pacientes com infecçäo recente (média = 4 ñ 9%, p <0,001) e aos indivíduos do grupo controle (média = 38 ñ 13%, p < 0,001). Porém, tanto nos doentes como nos controles, a atividade de células NK foi estimulada pelo antígeno solúvel do parasito adulto (SAWA), indicando que as células NK, mesmo na fase crônica da infecçäo, têm capacidade de responder ao antígeno dos parasitos. Estes resultados sugerem a possível participaçäo das células NK no mecanismo efetor de defesa contra o S.mansoni