Identification of an allergenic calmodulin from Amaranthus palmeri pollen.

INTRODUCTION: Pollens are an important source of allergens that trigger rhinitis or asthma. The allergenic extracts of pollens used to diagnose and treat allergies contain different allergenic antigens. Isolated allergenic proteins are employed in in vitro assays, skin tests and allergenic-specific immunotherapy. Calcium-binding allergens are clinically relevant antigens, and their allergenicity can be affected by Ca2+ binding. In this work, a calmodulin was identified as an allergen from Amaranthus palmeri pollen, an important source of pollinosis in Europe, Asia and North America. MATERIALS AND METHODS: Allergenic calmodulin from A. palmeri pollen was isolated by size-exclusion chromatography and reverse-phase chromatography and identified by mass spectrometry. Sensitization to isolated calmodulin was evaluated by skin prick tests in patients with allergy to A. palmeri pollen. RESULTS: Size-exclusion chromatography yielded two fractions that were recognized by the IgE of patients allergic to A. palmeri pollen. Mass spectrometry analysis of the fractions from reverse-phase chromatography showed peptide sequences that identified a calmodulin. Skin prick tests showed that the isolated calmodulin was recognized by 56% of patients allergic to A. palmeri pollen. CONCLUSION: A. palmeri pollen calmodulin could be a clinically relevant allergen in patients sensitized to this source.

[Determination and analysis of protein profile of different transfer factors]. / Determinación y análisis del perfil proteico de diferentes factores de transferencia.

BACKGROUND: The transfer factor (TF) is the dialyzable extract of leukocytes with cellular immunity transfer properties. Its use has spread in the treatment of a wide range of immunologic, infectious, and even oncological diseases. However, important aspects in their protein profile, component concentrations, and a well-defined action mechanism are not completely unknown. OBJECTIVES: To analyze the protein profiles of different transfer factors marketed in Mexico. METHODS: 6 TF marketed in Mexico were obtained and analyzed, quantifying protein with thaze Bradford method, by high-performance liquid chromatography (HPLC), and polyacrylamide gel electrophoresis (SDS-PAGE). All samples were analyzed in duplicate. RESULTS: The total protein concentrations of all TF analyzed are less than 0.2 mg/mL. The chromatographic profiles showed differences in some TF. The protein concentration was 6 to almost one thousand times lower compared to reports by some manufacturers. CONCLUSION: Almost all transfer factors marketed in Mexico lack a labeling and health record that meets the official standards.

Introducción: El factor de transferencia (FT) es el extracto dializable de leucocitos con propiedades de transferencia de inmunidad celular. Su uso se ha extendido en el tratamiento de una amplia gama de padecimientos inmunológicos, infecciosos y como coadyuvante de padecimientos oncológicos. A pesar de ello, no se conocen completamente aspectos importantes de su perfil proteico, concentraciones de componentes y mecanismos de acción. Objetivos: Analizar los perfiles proteicos de diferentes factores de transferencia comercializados en México. Métodos: Se obtuvieron y analizaron 6 FT comercializados en México. Se realizó la cuantificación de proteínas por el método de Bradford, cromatografía líquida de alta resolución (HPLC) y electroforesis en geles de poliacrilamida (SDS-PAGE). Todas las muestras fueron analizadas por duplicado. Resultados: Las concentraciones de proteínas totales de todos los FT analizados fueron menores de 0.2 mg/mL. Los perfiles cromatográficos mostraron diferencias en algunos FT. La concentración de proteínas resultó de 6 hasta casi mil veces más baja en comparación con lo informado por algunos fabricantes. Conclusión: Casi la totalidad de los factores de transferencia comercializados en México carecen de un etiquetado y registro sanitario que cumpla con las normas oficiales vigentes.

[Allergens used in skin tests in Mexico]. / AIérgenos usados en las pruebas cutáneas en México.

BACKGROUND: Immunotherapy is the only recognized causal treatment for allergies. It is prepared on an individual basis, based on the patient's clinical history and the result of the skin prick test (SPT). An adequate composition of the allergens with which to test the patient is crucial for an optimal diagnosis. OBJECTIVE: To know allergens used in tests in allergy practices in Mexico. MATERIALS AND METHOD: A national survey among all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras Especialistas en Inmunología Clínica y Alergia (COMPEDIA) was carried out. In a second phase respondents were asked to send in the composition of a routine SPT in their clinic. The results are presented descriptively and the frequency is calculated by which certain allergen is tested in the interviewed practices. RESULTS: A survey response rate of 61 (17%) was obtained and 54% showed their SPT content. Weeds' representation in the SPT seems adequate; Atriplex is tested in all allergy practices. Some trees that show cross-reactivity might be eliminated from the SPT, but 20% doesn't test for Cynodon nor Holcus, and 25% doesn't for important allergens as cat, dog and cockroach. House dust and tobacco are still tested with certain frequency. CONCLUSIONS: The selection of which allergens to test in a SPT is based on multiple data, that change continuously with new investigations and discoveries. Our specialty is the most indicated--and obligated--to adjust constantly to these changes to have the best diagnostic tool to detect specific allergies.

[Practice patterns in Mexican allergologists about specific immunotherapy with allergens]. / Patrones de práctica de alergó1ogos mexicanos en cuanto a inmunoterapia específica con alergenos.

BACKGROUND: Immunotherapy has been practiced since over a hundred years. Since the first applications up today changes have occurred in the preparation, dose and duration of the treatment, as well as in the extracts used. Guidelines have been published in Mexico and other countries to try to unify these practice patterns of immunotherapy. PARTICIPANTS AND METHODS: By means of a questionnaire, sent in various occasions to all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunología y Alergia (CoMPedIA) we tried to get a picture of the daily practice patterns of immunotherapy in the allergist's office. Results will be presented in a descriptive manner. RESULTS: A response rate of 61 (17%) was obtained from the College members. For immunotherapy allergists use locally made and imported extracts, generally mixed in their office (20% over 10 allergens in one bottle). Eighty percent adds bacterial vaccine at some point and 60% uses sublingual immunotherapy. Most use Evans without albumin as diluent, don't routinely premedicate, reach maintenance treatment after more than six months and 46% recommends a maximum duration of immunotherapy of two years or less. CONCLUSIONS: We present a diagnosis on the current situation of practice patterns concerning allergen immunotherapy among the members of both Mexican colleges of allergists. The methods used by the allergists for indication, preparation and administration are quite diverse.

[Current and future approaches for the treatment of inflammatory diseases of inferior respiratory tract]. / Abordajes actuales y futuros para el tratamiento de las enfermedades inflamatorias de las vías aéreas inferiores.

Among the allergic disorders we emphasize the inflammatory diseases of the inferior respiratory tract by their incidence, repercussion in daily activities, and by their high cost of medical attention. For their treatment, they require more than one inhaled or systemic drug. Current medicines tend to have adverse or secondary effects, such as: osteoporosis, type 3 diabetes mellitus, tremor or tachycardia. New medicines are being developed with less adverse or secondary effects, and much more selective and specific in the molecules involved in the allergic disease's physiopathology. Among them we find pascolizumab, which inhibits the differentiation made to Th2, as well as the citokines production. Other drugs are: mepolizumab, monoclonal antibody antiCD23, and the selective inhibitor of IgE (AJP13358) Rhu-Mab-E25. Currently, they are being developed some new drugs, such as SB-207499 (SKB) and LAS 31025, which are selective inhibitors of fosfodiesterase. Within the currently studied medicines that offer high specificity to inhibit the synthesis of interleukines we emphasize the presence of humanized monoclonal antibodies antireceptor IL-4. The anti IL-5 (SB-240563) is administered in asthmatic patients to reduce eosinofilia in expectoration. Tosilate of suplatast is a selective IL-4 and IL-5 inhibitor. Ramatroban (BAY or 3405) is an antagonist of the tromboxane A2 receptor, which reduces the inflammatory process of the nasal mucose without hemodynamic effects. Immunotherapy with peptides avoids the response of IgE by the allergen, without mast cell degranulation.

[Occupational asthma and reactive airway dysfunction syndrome]. / Asma ocupacional y síndrome de disfunción reactiva de las vías respiratorias.

Occupational asthma could be defined as a reversible lung disorder characterized by attacks of breathing difficulty, wheezing, and cough, which are caused by various agents found in the workplace. Incidence varies from 2 to 15% in adult work population; actually there is no data for the child population. Allergic occupational asthma is due to allergic sensitization to a specific substance or material present at the workplace; non-allergic occupational asthma occurs because of the high exposure to an irritant also at the workplace. Over the past few years, more people have been diagnosed as having asthma because of some workplace exposure. The identification of occupational asthma in workers is important because early detection may lead to the control of the worker's symptoms and control of the chemicals in the workplace. In Latin America there is no data about occupational asthma, maybe for the scarce information about it or for its difficult diagnosis.

[HIV-infection and its implications on allergic diseases]. / Infección por VIH y sus implicaciones en enfermedades alérgicas.

INTRODUCTION: In 1980 AIDS appeared in the USA in the homosexual community. CHARACTERISTICS OF THE VIRUS: A particle of HIV is formed by two identical RNA chains that are packed within a center of viral proteins, and surrounded by a double layer of fosfolipids derived from the cellular membrane of the host. CLINICAL SYMPTOMS: It starts with a severe infection, evolving in a progressive chronic infection reaching a final phase with a T CD4+ cellular count under 200 cells per mm3, with incident infections, neoplasias, consumption syndrome, renal dysfunction, and degeneration of the central system. CONSEQUENCES IN ALLERGIC REACTION: Reactions to the use of drugs are the most frequent form of hypersensitivity caused by HIV compared to the general population. In this condition, a profile of TH2 cytocines are produced and they induce the synthesis of IgE against the drugs. IgE levels have been related to the progression of this condition. CONCLUSION: The increase of IgE is a risk factor to allergic reactions against these medications, as well as a severity index.

[Prevalence and potential triggering factors of chronic urticaria and angioedema in an urban area of northeastern Mexico]. / Prevalencia y factores desencadenantes potenciales de urticaria crónica y angioedema en un área urbana del noreste de México.

BACKGROUND: Urticaria and angioedema are illnesses of easy diagnosis, but to solve them or to determine their cause is complex, as well as the therapeutic management of chronic cases. OBJECTIVE: To determine the prevalence, possible precipitating factors and chronic urticaria characteristics. MATERIAL AND METHODS: A questionnaire was applied to 4,000 persons selected at random, from the ages of 18-50 years, women and men. We made up simple frequencies, odds ratio, confidence interval at 95%. Possible interventions from the some variables were determined through regression logistic model. RESULTS: Chronic urticaria and angioedema prevalence was 4.8%. From the 147 sick persons, 71.4% were women (p = 0.00) 51.70% had only wheals, 10.88% angioedema alone and 37.41% of the patients with chronic urticaria also have angioedema. Potential triggering factors that we found were 18.36% drugs (p = 0.00) and 4.08% foods (p = 0.00). Family (p = 0.00) and personal allergy (p = 0.00) antecedents were documented in 55.8% and 68.70%, respectively. In 40.1% symptoms interfere with daily activities of the patients and 53.1% of patients had symptoms at night. CONCLUSIONS: Despite of being a retrospective study, the results show us that the chronic urticaria and angioedema are important health problems in the northeastern of Mexico. We can not identify the etiology, and the symptoms can disturb quality of life of the patients. Female sex, family and personal allergy antecedent could be important for these pathology presentations.