Subject(s)
Asthma/epidemiology , Asthma/mortality , Child , Female , Humans , Latin America/epidemiology , Male , PrevalenceABSTRACT
Little information is available on mite allergen levels and rates of sensitization to domestic mites in South America. The purpose of this study was to establish the rate of sensitization to domestic mites in asthmatics and measure mite allergen levels in pillows and mattresses of mite allergic individuals in Santa Fe, Argentina. Dust samples were collected from the pillows and mattresses of 56 asthmatics (24 females and 32 males, mean age 17.6 +/- 11.5 years), who had been previously skin tested with standardized extracts of Dermatophagoides pteronyssinus, Dermatophagoides farinae and (1:50 w/v) extracts of Aleuroglyphus ovatus, Blomia tropicalis, Chortoglyphus arcuatus. A wheal > or = 3 mm was considered positive. Sensitization to Lepidoglyphus destructor and Euroglyphus maynei was determined by RAST and considered positive when a serum bound > or = 1% of the total counts added. Forty six individuals had a positive skin test to D. pteronyssinus, 43 to D. farinae, 27 to A. ovatus, 38 to B. tropicalis, 27 to C. arcuatus; 38 of 54 individuals had a positive RAST to E. maynei and 22 of 54 to L. destructor. The mean Group 1 (Der p 1 + Derf 1) level in pillows (n = 48) was 6.7 micrograms/g (1-55.4) and in mattresses (n = 52) 4.3 micrograms/g (1-38.8). There is a high degree of sensitization to domestic mites among asthmatics in Santa Fe. High mite allergen levels (> 2 micrograms/g) can be detected very often in pillows and mattresses.
Subject(s)
Allergens/adverse effects , Glycoproteins/immunology , Hypersensitivity/etiology , Mites/immunology , Adolescent , Adult , Animals , Antigens, Dermatophagoides , Argentina , Bedding and Linens , Child , Female , Humans , Male , Urban PopulationABSTRACT
The prevalence of positive skin prick tests to the mite species Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis, Chortoglyphus arcuatus, Lepidoglyphus destructor and Aleuroglyphus ovatus was determined in 297 asthmatic adults and children living in seven cities of five Latin American countries. A standardized protocol and a common battery of extracts were used at each site. The mean wheal diameters were measured after 15 min, and those > or = 3 mm were considered positive. Sensitization to D. pteronyssinus varied from 60.7% in Cartagena to 91.2% in São Paulo; to D. farinae from 53.3% in Córdoba to 97.2% in Caracas; to A. ovatus from 26.6% in Bogotá to 71.2% in São Paulo; to B. tropicalis from 46.5% in Mexico City to 93.7% in São Paulo; to C. arcuatus from 33.3% in Mexico City to 75% in São Paulo; and to L. destructor from 30% in Mexico City to 76.2% in São Paulo. This study reported the results of skin test sensitivities in both children and adults. The studies from São Paulo and Córdoba were confined to children and thus could be compared; there was a significantly higher prevalence of cutaneous sensitivity to mite allergens in the children of São Paulo than in those of Córdoba (p < 0.001 for all mite species). Cutaneous sensitivity to mite allergens is very common in young and adult asthmatics in Latin America, in areas both at sea level and at high altitudes. Environmental control measures should be reinforced in the treatment of asthmatics in Latin America.
Subject(s)
Asthma/immunology , Hypersensitivity/epidemiology , Mites/immunology , Adolescent , Adult , Animals , Child , Child, Preschool , Female , Humans , Latin America/epidemiology , Male , Prevalence , Skin TestsABSTRACT
La alergia a los ácaros del polvillo doméstico en asociación al asma es, actualmente considerado un problema de diseminación mundial. Entre el 70 al 90% de los pacientes asmáticos tienen test cutáneo positivos a extractos de ácaros, particularmente a D. pteronyssinus y D. farinae. Numerosos estudios han encontrado sensibilidad cutánea a otros Piroglífidos, tal el caso de E. maynei. En los depósitos de granos, alimentos y maderas, entre otros, se han hallado ácaros que se desiganaron "de almacenamiento" y que ahora son llamados "domésticos" ya que también se pueden encontrar en las viviendas. No conocíamos la prevalencia de sensibilidad a extractos de otros ácaros del sub-orden astigmata. En este estudio se presentan la frecuencia de sensibilización cutánea en niños asmáticos de Córdoba y niños y adultos asmáticos de Santa Fe a extractos de D. pteronyssinus, D. farinae, B. tropicalis, A. ovatus, C. arcuatus y L. destructor. Tanto en los pacientes asmáticos de Córdoba como de Santa Fe, la mayor frecuencia de sensibilización cutánea fue a D. pteronyssinus, 63.3% y 72.7% respectivamente. B. tropicalis fue el segundo alergeno hallado en Córdoba (58.3%) y D. farinae en Santa Fe (66.6%). Los extractos alergénicos de los otros ácaros estudiados arrojaron positividades entre el 6 y el 57.5% de los casos estudiados. Los ácaros del sub-orden Astigmata, no Piroglífidos, son capaces de inducir sensibilidad cutánea en niños y adultos asmáticos de nuestro país
Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Adult , Mites/immunology , Allergens , Asthma/immunology , Hypersensitivity/diagnosis , Mites/classification , Allergens/isolation & purification , Asthma/etiology , Dust/adverse effects , Skin Tests/methodsABSTRACT
La alergia a los ácaros del polvillo doméstico en asociación al asma es, actualmente considerado un problema de diseminación mundial. Entre el 70 al 90% de los pacientes asmáticos tienen test cutáneo positivos a extractos de ácaros, particularmente a D. pteronyssinus y D. farinae. Numerosos estudios han encontrado sensibilidad cutánea a otros Piroglífidos, tal el caso de E. maynei. En los depósitos de granos, alimentos y maderas, entre otros, se han hallado ácaros que se desiganaron "de almacenamiento" y que ahora son llamados "domésticos" ya que también se pueden encontrar en las viviendas. No conocíamos la prevalencia de sensibilidad a extractos de otros ácaros del sub-orden astigmata. En este estudio se presentan la frecuencia de sensibilización cutánea en niños asmáticos de Córdoba y niños y adultos asmáticos de Santa Fe a extractos de D. pteronyssinus, D. farinae, B. tropicalis, A. ovatus, C. arcuatus y L. destructor. Tanto en los pacientes asmáticos de Córdoba como de Santa Fe, la mayor frecuencia de sensibilización cutánea fue a D. pteronyssinus, 63.3% y 72.7% respectivamente. B. tropicalis fue el segundo alergeno hallado en Córdoba (58.3%) y D. farinae en Santa Fe (66.6%). Los extractos alergénicos de los otros ácaros estudiados arrojaron positividades entre el 6 y el 57.5% de los casos estudiados. Los ácaros del sub-orden Astigmata, no Piroglífidos, son capaces de inducir sensibilidad cutánea en niños y adultos asmáticos de nuestro país
Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Adult , Hypersensitivity/diagnosis , Asthma/immunology , Mites/immunology , Allergens/diagnosis , Asthma/etiology , Mites/classification , Allergens/isolation & purification , Dust/adverse effects , Skin Tests/methodsABSTRACT
The increase in the incidence of bronchial asthma is not necessarily accompanied by an increase in death rates; furthermore, the knowledge of the intimate physiopathogenic mechanisms of the disease, the appearance of new drugs with pharmaceutical forms that make them more available for patients, should improve the effectiveness of the treatment. In spite of that, the asthma death rate curves increase as drug sales increase. Some authors think this is caused by factors depending on the patient, the health system and, nowadays, the inappropriate use of the available drugs is thought to be one of the reasons for the increase in asthma death rates, and the use of drugs that only supply to the patient an adequate bronchodilation may mask the underlying inflammatory process, what unavoidably leads to irreversible deteriorations in the airways, with smooth muscle hypertrophy and thickening of the basal membrane. It is logical to think that children's bronchial asthma is the first stage of a progressive illness, in which the allergic factor is really meaningful, and that is why a suitable prophylaxis with early use of drugs with antiinflammatory activity may prevent the development of irreversible deteriorations of bronchial and lung parenchyma. Oral or inhalatant corticoids, disodium cromoglycate, ketotifen and nedocromil are the drugs with well-known antiinflammatory activity, though they have a different site of action, as corticoids act directly on inflammatory cells, inhibiting the activity of macrophages and particularly of eosinophils, while cromoglycate, nedocromil and ketotifen inhibit mediators release, thus stabilizing mastocyte membrane.
