Respiratory allergy in Mexican patients with cystic fibrosis.

BACKGROUND: the purpose of this study was to investigate the presence of respiratory allergy in 30 Mexican patients bearing cystic fibrosis (CF). METHODS AND RESULTS: all patients completed a clinical history, had a physical examination, total serum IgE, nasal and blood eosinophils determinations and evaluation of skin prick tests for 36 allergens. In 26.6% of the patients included in the study was detected respiratory allergy diagnosed on clinical and laboratory analyses. Skin prick tests of 11 (36.6%) of the patients were positive to at least one allergen and Aspergillus fumigatus (A. fumigatus) was the most frequently observed allergen in 23% of the cases. CONCLUSIONS: we have demonstrated in this study that Mexican patients also present a coexistence of respiratory allergy in patients bearing CF.

[Morphological features of the nasal mucosa in healthy children exposed to different concentrations of atmospheric pollution]. / Características morfológicas de la mucosa nasal en niños sanos expuestos a differentes concentraciones de contaminación atmosférica.

OBJECTIVE: During the last decades the impact of pollution in big cities on the upper respiratory tract of children has become an issue of interest. The purpose of the present study was to determine if exposure of healthy children to different concentrations of atmospheric pollution alters morphologically the nasal respiratory epithelium. MATERIAL AND METHODS: In this randomised, prospective, open clinical trial we included 71 healthy children matched for age and sex and divided them into 3 groups: Group I, 31 children from Mexico City. Group II, 21 children from Tula, Hidalgo a moderate polluted area, and Group III, 19 children from Contepec, Michoacán, a rural non-polluted area. We took a nasal biopsy from the lower turbinate and performed nasal cytology in all children. The samples were examined twice by a pathologist with a double-blind technique. Ozone measurements were taken during 1992. RESULTS: Nasal symptoms (nasal obstruction, pruritus and dryness) were present in 96.8%, 71.4% and 52.6% of patients in groups I, II and III respectively (p = 0.001). We also found bilateral hypertrophy turbinates in 100% of children in group I versus 81% and 73% in groups II and III (p = 0.009). Citologic examination disclosed no significant differences among the study groups, although p values were 0.06 respecting inflammation and abnormal goblet cells when we compared group I versus group II and III. Respecting histological examination we found significant differences when comparing group I versus II and III in squamous metaplasia (p = 0.02) and pseudoepitheliomatous hyperplasia (p = 0.003), with not significant differences among keratinization (p = 0.06) and dysplasia (p = 0.06). CONCLUSIONS: The results of this study indicate that exposure to a polluted atmosphere is followed by severe changes in the histology and cytology of the nasal mucosa in healthy children, with these changes being more frequent and severe in the more polluted areas. These findings implicate that we must put more attention on the long term effects of atmospheric pollution in order to establish stronger control measures.

[Applications and aims of molecular biology]. / Aplicaciones y metas de la biología molecular.

Clonal studies define the proteic sequence of several allergens leading to the recombination and the use of them for immunotherapy extracts. It has been possible to clone the receptors for IgE in basophils and mast cells and the regulation mechanisms had been delucidated. In a near future it will be possible to design recombinant molecules for the specific inhibition of synthesis and receptors of IgE and avoid the signal transmissions and the release of mediators. The diagnosis of several diseases is based in molecular techniques, inclusive in uterus. Genes for various diseases had been cloned in immunology; recombinations with gamma interferon had been used for treatment of subjects with atopic dermatitis and chronic granulomatous disease.

[Viruses precipitating asthmatic crises]. / Los virus como desencadenantes de crisis asmáticas.

Study made with 45 patients in the allergy service of the Instituto Nacional de Pediatría, with the purpose of analyzing the virus participation in the precipitation of asthmatic crisis in children who lived in the southeast of Mexico City. The subjects were included in the study if they presented signs of atopy or infection of the superior air channels. Pollen allergics, rhinosinusitis, smokers relatives and patients who own pets were excluded. In this population group, the participation of the virus were RSV, influenza B and parainfluenza.

[The role of neuropeptides in the physiopathogenesis of asthma]. / El papel de los neuropéptidos en la fisiopatogenia del asma.

This article review the effects of neuropeptides in the pathogenesis of Asthma. It is a review of literature and show most important neuropeptides, physical and chemical characteristics effects and some clinical studies about them.

[In vitro and in vivo acari tests]. / Pruebas in vitro e in vivo a ácaros.

We studied 40 children with one o more perennial allergic diseases (bronchial asthma, allergic rhinitis, and/or atopic dermatitis) to assess the value in our country of in vivo and in vitro tests more frequently used in the diagnosis of allergy, such as total serum IgE, specific allergen IgE (RAST) and prick skin test in patients sensitives to D. pteronissinus, D. farinae or both. All patients had positive prick skin tests. Total serous IgE was elevated in 95% of cases with poor correlation coefficient (r) between prick skin test reactivity and total serous IgE concentration with no statistical significance. On the other hand, 95% of patients showed a positive RAST with a correlation coefficient of 0.31 (p less than 0.05). We concluded that in our country clinical history and prick skin tests are sufficiently accurate in a reasonable way to make a diagnosis of allergic etiology in patients sensitives to mites of the house dust.

[Ketotifen in allergic diseases]. / Ketotifeno en las enfermedades alérgicas.

This study included the review of 1000 clinical histories of allergic diseases, in a retrospective way, that was seeing in the Service of Allergy of the Instituto Nacional de Pediatría in Mexico city. All the patients were previously diagnosed with several allergic pathologiest like: bronchial asthma, rhinitis, asthma and rhinitis, atopic dermatitis, etc. All the patients received as main therapeutic treatment ketotifen at least during 3 months to 12 months. Global improvement in all patients with the use of ketotifen, reach 84%, including all the pathologiest studied. The tolerance of the drug specially in children was very good.

[Serum levels of IgE in children with invasive amebiasis]. / Niveles de IgE sérica en niños con amibiasis invasora.

In order to determine whether an elevation of the IgE serum level exist in children with invasive amebiasis when compared with a control group, a prospective, observational and descriptive study was performed on 20 patients from the problem group and 21 from a control group, where the possibility of other causes which could raise the IgE levels were dismissed. This antibody was measured in serum and compared with the reported levels of mexican and foreign populations. A notable elevation of the IgE level was found in the studied groups, without any significant differences between them. It wasn't demonstrated that the serum level is as high as immunological response against E. histolytica.

[Immunoenzymatic evaluation of serum IgE in onchocerciasis in Chiapas, Mexico]. / Evaluación inmunoenzimática de IgE sérica en oncosercosos de Chiapas, México.

Concentrations of total serum IgE were measured by an immunoenzymatic assay (Phadezym-PRIST) in 60 mexican onchocerciasis patients. In order to detect IgE antibodies against adult Onchocerca volvulus antigens, separately six onchocerciasis sera were depleted of IgE antibodies by using a mixture of Onchocerca gutturosa, Ascaris suum and Fasciola hepatica antigenic extracts coupled with sepharose 4B. Additionally, the sera were incubated with an adult O. volvulus antigenic extract coupled with sepharose 4B. The differences found between the IgE levels before and after incubation with heterologous antigens show that the median IgE value against O. volvulus adults antigens varies between 20 and 65 percent of the total serum IgE.

[Bronchodilator effect of fenoterol in asthma]. / Efecto broncodilatador del fenoterol en el asma.

For a sympathomimetic bronchodilator to be effective, it should be transported in an active form, from the place of administration to the receptor site, as well as the kind of medication and its route of administration. It has been shown both in the laboratory as well as in clinical studies that the intensity and duration of the sympathomimetic bronchodilator effect keeps decreasing although the tolerance does not seem to be clinically so important for the new bronchodilators. The beta 2 agonists are used via oral, parenteral and inhalatory route. The rapidity of the action by inhalation makes this method effective to treat intermittent symptoms or during acute exacerbations in bronquial asthma. In this study, 29 patients were included, of which 18 were symptomatic and 11 were asymptomatic asthmatics. Those patients with symptomatic and asymptomatic asthmatics were included in the first and second group respectively. The criteria of exclusion for both groups were: patients with restrictive or non-reversible bronchopulmonary disease, cardiovascular disease, thyrotoxicosis, patients under treatment with steroids and acute infection. The age was lower than 6 years and more than 15 years. A clinical history and a spirometric study (without medication) were performed to determine the basal line values of the forced spirometry volume one second (VEF1) and the vital capacity (CV). An inhalation of fenoterol in aerosol was administered immediately afterwards. At 3, 20, 30 and 60 minutes new spirometries were carried out to determine the initial and the therapeutic effect.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ketotifen in the prophylaxis of infantile asthma. Controlled clinical trials]. / Ketotifeno en la profilaxis del asma infantil. Ensayo clínico controlado.

The heterogeneity in the aetiology and the precipitating factors, as well as the pathology of asthma makes the response to the conventional treatment also variable. Ketotifen is a derivative of the cyclohepatotifen which has shown to have an antianaphylactic effect which inhibits chemical mediator release in mast cells and basophils. This effect is similar to that of the methylxanthines inhibiting phosphodiesterase propitiating the increase of CAMP and favouring bronchodilatation. It also exerts a blocking action on the H receptors of histamine and possesses a calcium antagonist effect in the depolarized smooth muscle; for this reason it is probable that ketotifen does not have a direct effect on the contraction of smooth fibres provoked by diverse stimuli. The present work is a prospective study with placebo group and double blind method to evaluate the effectivity and tolerance of ketotifen as a prophylaxis for extrinsic bronchial asthma in 60 children. This is to observe if there exists or not a reduction in the frequency, intensity and duration of signs and symptoms. Among the most interesting conclusions observed are the following: The general characteristics of both the ketotifen group as well as the placebo group did not show any significative statistical differences which were susceptible of comparison among them. The ketotifen proved itself as very efficient, obtaining a reduction which was highly significative of the asthmatic symptomatology (p less than 0.001). In the placebo group some highlights were obtained which can be attributed to the fact that both groups received desensitizing immunotherapy to diverse allergens. Nevertheless, in general terms, the symptomatology did not diminish in this group in a significative way.(ABSTRACT TRUNCATED AT 250 WORDS)