ABSTRACT
Most Latin-American countries use subcutaneous immunotherapy (SCIT) extracts from the United States and Europe and sublingual immunotherapy (SLIT) from Europe, with the exception of Argentina, Brazil, Cuba and Mexico. The number of researches on immunotherapy (IT) in Latin America has increased extensively in the last years. Only few Latin American countries have their own guidelines on IT, and, in general, the economic resources for medical research on IT are still low in the area. A global approach for the future of IT in Latin America includes to improve standardization, quality control and the production of allergen products, to develop IT guidelines and clinical investigation by the highest number of countries, to improve the regulatory status for allergens products in the area, and to expand IT accessibility for low-income patients. In Cuba, the first registered allergen vaccines were developed and registered in 2006: a standardized (in biologic units) and freeze dried product for SCIT, with a sublingual version developed in 2009. As much as 23.000 IT treatments were applied in 2011, all provided to patients free of charge. In 2012, Cuban researchers developed an IT vaccine with adjuvant for subcutaneous route, which uses Neisseria meningitidis proteoliposome as an adjuvant, added to the purified Dermatophagoides siboney major allergens: Der s1 and Der s2. Since December 2012, this vaccine is in Phase I clinical trial, evaluating its safety, tolerability and immunogenicity in asthmatic patients sensitized to this allergen. Cuban perspectives on IT includes to work on new indications for IT, to investigate the preventive effect and cost-effectiveness for the current vaccines, to develop new products with mixed formulas of house dust mites for SLIT, to complete the phase I and II clinical study for dust mite plus adjuvant vaccine, to develop allergen vaccines for fungi allergy and to complete the Cuban guideline for allergen IT management.
ABSTRACT
Las enfermedades alérgicas y el asma, sobre todo en la población infantil, son afecciones muy frecuentes en todo el mundo y en Cuba. Con el objetivo de determinar la frecuencia de sensibilización a hongos ambientales y su relación con enfermedades atópicas, se realizó un estudio analítico transversal en 100 escolares de 6 a 7 años de una escuela primaria de San Antonio de los Baños, provincia La Habana, en el período comprendido entre septiembre de 2006 y marzo de 2007. El 27 por ciento de la muestra seleccionada padecía de asma, el 40 por ciento de rinitis alérgica y el 26 por ciento de dermatitis atópica. La sensibilización micótica más frecuente resultó Penicillium, para un 50 por ciento de la muestra. No hubo una asociación estadísticamente significativa entre reactividad cutánea a hongos ambientales y la presencia de enfermedades atópicas; tampoco fue significativa su asociación con la enfermedad alérgica respiratoria ni dermatitis atópica. Se concluye que la mayor sensibilización a hongos anemófilos se apreció al Penicillium, aunque sin asociación con la presencia de enfermedades atópicas
The allergic diseases and the asthma, mainly in children, are very frequent affections at world level and in Cuba. The objective of present paper was to determine the sensitization frequency to environmental fungi and its relation to atopic diseases, thus, a cross-sectional and analytical study was conducted in 100 school children aged 6 to 7 from a primary school of San Antonio de los Ba±os, La Habana province, from September 2006 to March, 2007. The 27 percent of the selected sample suffered from asthma, the 40 percent of allergic rhinitis, and the 26 percent had Penicillium for the 50 percent of sample. There was not a significant statistic association between the cutaneous reactivity to environmental fungi and the presence of atopic diseases and its association with the respiratory allergic disease as well as the atopic dermatitis was not significant. We conclude that the greater sensitization to anemophilic fungi was to Penicillium, although without an association with the presence of atopic diseases
Subject(s)
Humans , Male , Female , Child , Anti-Allergic Agents , Dermatitis, Atopic/epidemiology , Penicillium/pathogenicity , Cross-Sectional Studies , Skin Tests/methodsABSTRACT
Las enfermedades alérgicas y el asma, sobre todo en la población infantil, son afecciones muy frecuentes en todo el mundo y en Cuba. Con el objetivo de determinar la frecuencia de sensibilización a hongos ambientales y su relación con enfermedades atópicas, se realizó un estudio analítico transversal en 100 escolares de 6 a 7 años de una escuela primaria de San Antonio de los Baños, provincia La Habana, en el período comprendido entre septiembre de 2006 y marzo de 2007. El 27 por ciento de la muestra seleccionada padecía de asma, el 40 por ciento de rinitis alérgica y el 26 por ciento de dermatitis atópica. La sensibilización micótica más frecuente resultó Penicillium, para un 50 por ciento de la muestra. No hubo una asociación estadísticamente significativa entre reactividad cutánea a hongos ambientales y la presencia de enfermedades atópicas; tampoco fue significativa su asociación con la enfermedad alérgica respiratoria ni dermatitis atópica. Se concluye que la mayor sensibilización a hongos anemófilos se apreció al Penicillium, aunque sin asociación con la presencia de enfermedades atópicas(AU)
The allergic diseases and the asthma, mainly in children, are very frequent affections at world level and in Cuba. The objective of present paper was to determine the sensitization frequency to environmental fungi and its relation to atopic diseases, thus, a cross-sectional and analytical study was conducted in 100 school children aged 6 to 7 from a primary school of San Antonio de los Ba±os, La Habana province, from September 2006 to March, 2007. The 27 percent of the selected sample suffered from asthma, the 40 percent of allergic rhinitis, and the 26 percent had Penicillium for the 50 percent of sample. There was not a significant statistic association between the cutaneous reactivity to environmental fungi and the presence of atopic diseases and its association with the respiratory allergic disease as well as the atopic dermatitis was not significant. We conclude that the greater sensitization to anemophilic fungi was to Penicillium, although without an association with the presence of atopic diseases(AU)
Subject(s)
Humans , Male , Female , Child , Dermatitis, Atopic/epidemiology , Penicillium/pathogenicity , Anti-Allergic Agents , Skin Tests/methods , Cross-Sectional StudiesABSTRACT
BACKGROUND: Allergic diseases represent an international public health problem, in particular asthma in infantile population, the reports of allergic incidence in general population show a not uniform significant statistical increase. OBJECTIVE: To determine the frequency of domestic dust mite sensitization and its relation with atopic diseases in our environment. MATERIAL AND METHOD: In an analytical transversal study the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire was applied to 100 students from 6 to 7 years old in a primary school of San Antonio de los Baños Community in La Habana, Cuba between September 2006 and March 2007. RESULTS: The prevalence of allergic disease in this study corresponded to asthma in 27%, allergic rhinitis in 40% and 26% to atopic dermatitis. The 50% of the allergic infantile population presented a mite positive dermatological scarification tests. The major positivity to the dermatological test was to Blomia tropicalis in 52%. There was a significant statistically association between cutaneous mite reactivity and the presence of atopic diseases. Inside this group, patients with asthma and/or allergic rhinitis had a similar cutaneous response. CONCLUSIONS: Fifty percent of the studied population had a mite sensitization, mainly to Blomia tropicalis, showing a significant statistical association with the presence of atopic diseases, an important health problem in the studied area.
