Hueso: alteraciones relacionadas con obesidad / Bone: Obesity-Related Disorders

Resumen: El tejido óseo, anteriormente considerado como una estructura mecánica de soporte y movimiento, ha mostrado una participación importante en la homeostasis del organismo, incluyendo al metabolismo energético y el tejido adiposo. En la actualidad se considera un órgano endócrino que sintetiza moléculas reguladoras del metabolismo denominadas osteocinas. A su vez, el tejido adiposo, considerado como una glándula de secreción interna, ayuda a mantener la reserva energética del organismo y produce proteínas y moléculas como las adipocinas, algunas de las cuales afectan directamente al hueso. El análisis del ciclo resorción/formación ósea, muestra que la masa ósea es reflejo del balance entre ambas. Cuando se pierde este balance y hay reducción de la masa ósea con aumento de la fragilidad, aparece la osteoporosis lo que incrementa el riesgo de fractura. Una de cada 3 mujeres y 1 de cada 5 hombres mayores de 50 años presenta una fractura por osteoporosis. La interacción entre tejido adiposo y hueso está mediada por citocinas, osteocinas y adipocinas. La obesidad puede incidir en el hueso por varios mecanismos entre los cuales se encuentran los inflamatorios y los inducidos por citocinas derivadas de los adipocitos como la leptina y la adiponectina que pueden modificar el metabolismo óseo. Evidencias apoyan el efecto negativo de la obesidad sobre la salud del hueso, aunque estudios al respecto aún son contradictorios.

Abstract: The bone tissue, previously considered as a mechanical support for structure and movement, has shown an important participation in the homeostasis of the body, including energy metabolism and adipose tissue. Currently, it is considered an endocrine organ that synthesizes regulatory molecules of metabolism called osteokines. At the same time, the adipose tissue, considered as an internal secretion gland, helps to maintain the body energy and produces proteins and mol ecules such as adipokines, some of which affect the bone directly. The analysis of bone resorption/formation cycle shows that bone mass is a reflection of the balance between both. When this balance is lost and there is a reduction of bone mass with increased fragility, osteoporosis appears and increases the risk of fracture. One in three women and one in five men over 50 years old have a fracture due to osteoporosis. The interaction between adipose tissue and bone is mediated by cytokines, osteokines and adipokines. Obesity may affect the bone by several mechanisms, among which the inflammatory is included and those induced by cytokines secreted by adipocytes such as leptin and adiponectin which can modify bone metabolism. Evidence supports the negative effect of obesity on bone health, although studies about it are still contradictory.

[Adipose tissue: immune function and alterations caused by obesity]. / Tejido adiposo: función inmune y alteraciones inducidas por obesidad.

The adipose tissue, which is currently viewed as an organ with neuroimmunoendocrine functions, participates in the homeostasis of the human organism. It has great plasticity and functional variability based on the intake of nutrients or to the increase or decrease of its tissue volume, which modifies both the function and the number of the cells that form it or reach it. The elements that are released abnormally by these cells, among other cytokines and adipokines, cause both local and systemic inflammation, mainly when they come from the visceral adipose tissue, and they can affect diverse organs like the liver and the cardio-vascular system. It has been pointed out that obesity entails a greater risk for developing inflammatory, metabolic, autoimmune, or allergic diseases, as well as alterations in scarring, and cancer.

El tejido adiposo, actualmente considerado un órgano con funciones neuroinmunoendocrinas, participa en la homeostasis del organismo. Posee gran plasticidad y variabilidad funcional acorde con la ingesta de nutrientes o con el incremento o la disminución de su volumen tisular, el cual modifica la función y el número de las células que lo integran o llegan a él. Los elementos liberados anormalmente por estas células, entre otros citocinas y adipocinas, ocasionan inflamación local y sistémica, predominantemente cuando provienen del tejido adiposo visceral y pueden afectar diversos órganos como el hígado y el sistema cardiovascular. Se ha señalado que la obesidad implica un mayor riesgo de padecer enfermedades inflamatorias, metabólicas, autoinmunes, alérgicas, alteraciones en la cicatrización y cáncer.

Aging: Some theories, genetic, epigenetic and environmental considerations / Envejecimiento: algunas teorías y consideraciones genéticas, epigenéticas y ambientales

In this review several characteristics of the aging process are described and some theories that try to explain it are briefly mentioned. Although none of them fully explains this phenomenon, they can interact between each other in a complex way, out of which cellular senescence is the common outcome. Molecular changes take place on both genetic and epigenetic levels, and several studies have associated senescence with changes in the epigenetic-mediated chromatin condensation, while others consider that free radicals represent a useful mechanism to explain aging and age-related disorders that, along with the alteration of mitochondrial homeostasis, promote the aging process through the accumulation of damage along time.

En esta revisión se describen varias características del proceso de envejecimiento y de manera resumida algunas de las teorías que intentan explicarlo y, si bien ninguna es totalmente satisfactoria, pueden actuar entre sí de una manera compleja; en ellas, la senescencia celular es el factor común. Las alteraciones moleculares se llevan a cabo tanto a nivel genético como epigenético y varios estudios asocian la senescencia con cambios en la condensación de la cromatina, los cuales están regulados por factores epigenéticos y otros; en esos estudios se considera que los radicales libres representan un mecanismo útil para explicar el envejecimiento y los trastornos relacionados con la edad y que en forma conjunta, con las alteraciones en la homeostasis de la mitocondria, promueven el envejecimiento por daño acumulado a través del tiempo.

[Sleep and immune system]. / Sueño y sistema immune.

Sleep is a process that occupies one third part of the life of the human being, and it is essential in order for the individual to be able to maintain body homeostasis. It emerges as an important regulator of the immune system since, during sleep, the necessary functions to maintain its balance are carried out. On the other hand, decreased sleep has deleterious effects that alter the metabolism and produce an increase in the secretion of C-reactive protein, interleukin (IL)-6 and tumor necrosis factor (TNF). These cytokines activate NF-κB; therefore, sleep disturbance can be a risk factor for the development of chronic inflammatory and metabolic diseases. Pro-inflammatory cytokines IL-1, IL-6 and TNF increase non-rapid eye movement sleep, whereas anti-inflammatory cytokines such as IL-4 and IL-10 decrease it. Sleep can modify the immune system function by inducing changes in the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system. In turn, the circadian rhythm of hormones such as cortisol and adrenaline, which have a nocturnal decrease, favors different activities of the immune system. The purpose of the present review is to address different aspects of sleep and their relationship with the immune system.

El sueño es un proceso que ocupa la tercera parte de la vida del ser humano y resulta imprescindible para que el individuo mantenga la homeostasis del organismo. Emerge como un regulador importante del sistema inmune, ya que durante el sueño se llevan a cabo las funciones necesarias para mantener su equilibrio. Por otro lado, la reducción de sueño tiene efectos adversos que alteran el metabolismo y produce incremento en la secreción de la proteína C reactiva, interleucina (IL)-6 y factor de necrosis tumoral (TNF). Estas citocinas activan a NF-κB, por lo que la alteración en el sueño puede ser un factor de riesgo para desarrollar enfermedades inflamatorias crónicas y metabólicas. Las citocinas proinflamatorias IL-1, IL-6 y TNF aumentan el sueño de movimientos oculares no rápidos y las antiinflamatorias como IL-4 e IL-10 lo disminuyen. El sueño puede modificar la función del sistema inmune induciendo cambios en el eje hipotálamo-pituitaria-adrenal y el sistema nervioso simpático. A su vez, el ritmo circadiano de hormonas como el cortisol y la adrenalina, que descienden en la noche, favorece diferentes actividades del sistema inmune. El objetivo de la presente revisión es abordar diversos aspectos del sueño y su relación con el sistema inmune.

[Senescence of the immune system and alterations related with asthma]. / Senescencia del sistema inmune y alteraciones relacionadas con el asma.

Senescence is an irreversible process by which cells enter to a permanent cell cycle arrest with generalized molecular changes. Senescent cells remain metabolically active and most of them show a secretory phenotype; through its secretion may induce senescence or cancer in other cells. The secretory cells in the so-called transient senescence may participate in embryogenesis, tissue regeneration and immune response. The deleterious changes associated with age affect the immune system members and the immune senescence cause poor response to vaccines and susceptibility to cancer and infections. These latter are a frequent cause of asthma mostly in the elderly, the incidence is increasing in old people, and it may be related with those anatomical, physiological and immune changes caused by age, asthma chronicity and external agents. Comorbidity in the elderly worsens the ailment and hinders diagnosis, therefore, knowledge and handling of these clinical entities must be in control by the physicians responsible of the first level attention to old patients.

La senescencia, proceso por el cual la célula entra en un estado de parálisis per-manente del ciclo celular, implica cambios moleculares generalizados. Las células senescentes permanecen metabólicamente activas y la mayoría expresa el fenotipo secretor; mediante su secreción inciden en otras células y pueden inducir senes-cencia o cáncer. Por el contrario, en la llamada senescencia transitoria, las células secretoras pueden participar en la embriogénesis, la regeneración tisular y la res-puesta inmune normal. Los cambios deletéreos asociados con la edad afectan a los integrantes del sistema inmune y la inmunosenescencia ocasiona pobre respuesta a vacunas y susceptibilidad a cáncer e infecciones. Estas últimas son causa fre-cuente de asma, sobre todo en ancianos, en quienes al parecer su incidencia va en aumento, lo que puede estar en relación con los cambios anatómicos, fisiológicos e inmunes ocasionados por la edad, la cronicidad del asma y los factores externos. La comorbilidad en los ancianos agrava el padecimiento y dificulta el diagnóstico, por lo que el conocimiento y manejo de estas entidades clínicas, deben ser del do-minio de los médicos responsables de la atención primaria de los adultos mayores.

Increased anxiety-like behavior is associated with the metabolic syndrome in non-stressed rats.

Metabolic syndrome (MS) is a cluster of signs that increases the risk to develop diabetes mellitus type 2 and cardiovascular disease. In the last years, a growing interest to study the relationship between MS and psychiatric disorders, such as depression and anxiety, has emerged obtaining conflicting results. Diet-induced MS rat models have only examined the effects of high-fat or mixed cafeteria diets to a limited extent. We explored whether an anxiety-like behavior was associated with MS in non-stressed rats chronically submitted to a high-sucrose diet (20% sucrose in drinking water) using three different anxiety paradigms: the shock-probe/burying test (SPBT), the elevated plus-maze (EPM) and the open-field test (OFT). Behaviorally, the high-sucrose diet group showed an increase in burying behavior in the SPBT. Also, these animals displayed both avoidance to explore the central part of the arena and a significant increase in freezing behavior in the OFT and lack of effects in the EPM. Also, high-sucrose diet group showed signs of an MS-like condition: significant increases in body weight and body mass index, abdominal obesity, hypertension, hyperglycemia, hyperinsulinemia, and dyslipidemia. Plasma leptin and resistin levels were also increased. No changes in plasma corticosterone levels were found. These results indicate that rats under a 24-weeks high-sucrose diet develop an MS associated with an anxiety-like behavior. Although the mechanisms underlying this behavioral outcome remain to be investigated, the role of leptin is emphasized.

[Common and inductors factors of inflammation in asthma and obesity]. / Factores comunes e inductores de inflamación en asma y obesidad.

The incidence of asthma and obesity is increasing, therefore they have been classified as public health problems; epidemiology suggests a link between these diseases. It has been detected a relationship between the body mass index and lung function, moreover some works show a direct correlation between the aforementioned index and severity of asthma. By a search for articles in indexed journals from medical databases with the key words asthma and obesity: pathogenesis, inflammation, adipokines, hypoxia, nutrition, pregnancy, this paper deeps in the knowledge about basic elements that offer an asthma and obesity link. It was found that the association between body mass index and asthma is more frequent in women. Asthma and obesity might be influenced by genetic elements and fetal programming; at the same time obesity could influence asthma by several mechanisms such as inflammation, hormones and mechanical respiratory dysfunction. The existing coincidence between several inducers and factors which exacerbate these diseases as well as in some molecular routes shows a potential relation between both pathological entities.

La incidencia de asma y obesidad está en aumento, por lo que se han catalogado como problemas de salud pública. Los datos epidemiológicos sugieren una relación entre ellas y se ha detectado una asociación entre el índice de masa corporal y la función pulmonar. Diversos estudios demuestran una correlación directa entre este índice y el asma. Mediante la búsqueda de referencias en bases de datos médicos de artículos publicados en revistas indizadas, con las palabras clave asma y obesidad: patogénesis, inflamación, adipocinas, hipoxia, nutrición, embarazo, este artículo profundiza en el conocimiento de los elementos básicos que interrelacionan el asma con la obesidad. Se encontró que la asociación existente entre el índice de masa corporal y el asma es más evidente en el sexo femenino. El asma y la obesidad pueden estar influidas por elementos genéticos y programación fetal. A su vez, la obesidad puede incidir en el asma por diversos mecanismos, como los mecánicos, hormonales o inflamatorios. La coincidencia existente entre varios inductores y elementos que exacerban a estas enfermedades, así como en algunas vías moleculares, ponen de manifiesto una relación potencial entre ambas afecciones.

[Allergic hypersensitivity to antiretroviral drugs: etravirine, raltegravir and darunavir]. / Hipersensibilidad alérgica a antirretrovirales: etravirina, raltegravir y darunavir.

All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient. A better understanding of the adverse effects of antiretroviral agents is of interest not only for HIV specialists, but also for other physicians who care allergy reactions in HIV-positive patients. Each antiretroviral medication is associated with its own specific adverse effects or may cause problems only in particular circumstances. In this article some adverse allergic effects of HAART therapy in the treatment of HIV from a patient are reviewed. Our aim is to gain a working knowledge of these adverse effects, promoting the early recognition and reversal of potentially serious adverse effects, and reducing the potential for adverse drug interactions.

Todos los fármacos antirretrovirales tienen efectos adversos que pueden manifestarse a corto o largo plazo. El riesgo de efectos secundarios específicos varía de un fármaco a otro, de una clase de medicamento a otra y de un paciente a otro. Una mejor comprensión de estos efectos es de interés no sólo para los especialistas en VIH, sino también para otros médicos que atendemos las reacciones alérgicas en los pacientes VIH-positivos. Cada fármaco antirretroviral se asocia con sus propios efectos adversos específicos o puede causar problemas sólo en circunstancias particulares. En este artículo se revisan algunos efectos alérgicos adversos del tratamiento antirretroviral de gran actividad (TARGA) en el tratamiento del VIH de un paciente. Nuestro objetivo es obtener un conocimiento práctico de estos efectos adversos, promoviendo el reconocimiento temprano y la reversión de los efectos adversos graves y reducir las interacciones farmacológicas adversas.

[Occupational asthma]. / Asma ocupacional.

The occupational asthma is the most common form of lung disease caused by factors that are attributed to a specific working environment in industrialized countries. It causes variable limitation of airflow and/or hyper-responsiveness of the airway due to contact with specific agents present in an atmosphere of work and not to stimuli found out of this place. It is recognized more and more frequently, and many agents are capable of causing occupational asthma by different pathophysiological mechanisms. More than 400 agents causing occupational asthma are known and every year new triggers are detected. Numerous factors contribute to the pathogenesis of occupational asthma induced chemically, including immunological, non-immunological mechanisms of epithelial damage, airway remodeling, oxidative stress, neurogenic inflammation as well as genetic factors. The most important risk factors for occupational asthma include: atopy, smoking and genetic factors. The diagnosis is based on the clinical history, skin tests, immunological tests and functional studies. The fundamental treatment is removing the worker from exposure as soon as possible. The advance in the knowledge of the pathogenesis of occupational asthma will importantly influence in the prevention and the management of this disease.

El asma ocupacional es la forma más común de enfermedad pulmonar causada por factores que se atribuyen a un ambiente laboral específico en países industrializados. Causa limitación variable del flujo aéreo e hiperrespuesta de las vías aéreas debido al contacto con agentes específicos presentes en un ambiente de trabajo y no a estímulos encontrados fuera de este lugar. Se reconoce cada vez con más frecuencia y muchos agentes son capaces de causar asma ocupacional por diferentes mecanismos fisiopatológicos. Se conocen más de 400 agentes causantes de asma ocupacional y cada año se detectan nuevos desencadenantes. Numerosos factores contribuyen a la patogénesis de asma ocupacional inducida químicamente, incluidos mecanismos inmunológicos, no inmunológicos, de daño epitelial, remodelación de las vías aéreas, estrés oxidativo, inflamación neurogénica y factores genéticos. Entre los factores de riesgo de asma ocupacional están: la atopia, el tabaquismo y factores genéticos. El diagnóstico se basa en la historia clínica del paciente, pruebas cutáneas, inmunológicas y estudios funcionales. El tratamiento principal es la remoción del trabajador del sitio de exposición tan pronto como sea posible. El avance en el conocimiento de la patogénesis del asma ocupacional influirá de manera importante en la prevención y el tratamiento de esta enfermedad.

[The role and importance of the microRNAs in the diagnosis and development of diseases]. / Importancia de los microARN en el diagnóstico y desarrollo de enfermedades.

MicroRNAs are small non-coding ribonucleic acids of endogenous nature. They persist in various groups of eukaryotes and perform critical functions during the development and the cell homeostasis. They have from 19 to 25 nucleotides in length and regulate the translation of the target RNA messenger (mRNA). MicroRNAs can inhibit its translation, stabilizing it or inducing its degradation. They regulate the genetic expression and are involved in the control of cellular functions (the differentiation, the proliferation, the apoptosis and the metabolism). They are also involved in the response to stress, the angiogenesis, the oncogenesis and in cardiovascular functions. That is the reason why their abnormal expressions are associated to many pathological conditions. The aim of this review was to describe the importance of microRNAs, their biological origin and their role in various diseases, such as cancer, diabetes, obesity, and neurological disorders. The microRNAs are an attractive therapeutic target because it has been observed that just one of them can regulate several genes and it could influence all the signaling route; besides, they could inhibit themselves in vivo without adverse effects related to the usual therapeutic agents. Since they can be detected in serum, plasma, urine and saliva samples in a stable, reproducible and consistent form between individuals of the same species, we expect them to be useful as biomarkers for the clinical diagnosis and the monitoring of diseases.

Los microARN son ácidos ribonucleicos pequeños no codificantes, endógenos, que se encuentran conservados en varios grupos de eucariontes y que desempeñan funciones críticas durante el desarrollo y la homeostasis celular. Son secuencias de una longitud entre 19 y 25 nucleótidos, que regulan la traducción de un ARN mensajero (ARNm) blanco, que inhiben su traducción, estabilizándolo o llevándolo a su degradación. Los microARN son reguladores de la expresión génica y participan en el control de procesos celulares como la diferenciación, la proliferación, la apoptosis y el metabolismo; también están involucrados en la respuesta al estrés, en la angiogénesis, la oncogénesis y los procesos cardiovasculares. De ahí que su desregulación o expresión anormal esté relacionada con numerosas condiciones patológicas. Esta revisión describe la importancia de los microARN, su biogénesis y su participación en enfermedades como cáncer, diabetes, obesidad y trastornos neurológicos. Los microARN representan un atractivo blanco terapéutico porque se ha observado que uno solo puede regular a muchos genes blanco e influir en toda la vía de señalización; además, pueden inhibirse in vivo sin muchos de los efectos adversos relacionados con los agentes terapéuticos tradicionales. Dado que se pueden detectar en suero, plasma, orina y saliva en forma estable, reproducible y consistente entre individuos de la misma especie, se espera que puedan utilizarse como biomarcadores para el diagnóstico clínico y monitoreo de enfermedades.

[Epigenetics, environment and asthma]. / Epigenética, medio ambiente y asma.

Asthma is a chronic inflammatory disease of the respiratory tract with a complex genetic background influenced by the exposition to a series of environmental factors. Genetic studies can only elucidate part of the heritability and susceptibility of asthma and even though several diseases have an evident genetic etiology, only a fraction of the genes involved in their pathogenicity have been identified. The epigenetic regulation of the latter is a fact one should bear in mind in order to explain the major triggers of diseases whose understanding is complicated, such as allergies and asthma. External stimulus such as nourishment, stress, physical activity, atmospheric pollution, tobacco smoking and alcohol drinking can induce either gene silencing or gene expression. In this regard, epigenetics can explain how these environmental factors influence our genetic inheritance. There is growing evidence that backs-up the fact that DNA methylation, histone post-translational modification and microRNA expression are influenced by the environment. This helps explaining how several of the risk factors mentioned contribute to the development and inheritance of asthma. In this review, different environmental factors and their relation with the main epigenetic regulatory mechanisms will be analyzed, as well as their possible role in the development of asthma.

El asma es una enfermedad inflamatoria crónica que afecta las vías respiratorias y tiene un componente genético complejo, que está mediada por la exposición a una variedad de desencadenantes ambientales. Los estudios genéticos no aclaran en su totalidad la herencia y susceptibilidad al asma. Muchas enfermedades son de origen genético; sin embargo, sólo se ha encontrado una fracción de los genes que las explican. La epigenética puede utilizarse para esclarecer las causas principales de padecimientos que son difíciles de entender, como la alergia y el asma. Estímulos externos como la nutrición, el estrés, la actividad física, la contaminación atmosférica y el consumo de tabaco y alcohol pueden silenciar o activar los genes. Al respecto, la epigenética ofrece explicaciones de cómo estos factores modifican sutilmente la herencia. Cada vez hay más evidencias que demuestran que los marcadores epigenéticos reconocidos, como la metilación del ADN, la modificación de histonas y la expresión de microRNAs están influidos por el ambiente. Esto ayuda a entender cómo muchos factores de riesgo similares a los señalados contribuyen a la aparición y herencia del asma. En esta revisión se analizan diferentes factores ambientales y su relación con los principales mecanismos epigenéticos, así como su posible influencia en la aparición del asma.

[New trends in macrophages, inflammation and adipose tissue]. / Nuevo rumbo en macrófagos, inflamación y tejido adiposo.

Obesity is considered a low-inflammatory condition. An increasing number of reports suggest that the adipose tissue itself might be a source of proinflammatory factors and a target of inflammatory processes. Accumulating evidence suggest the involvement of adipose tissue derived proteins, collectively known as adipokines as well as other factors produced in this tissue by cells besides to adipocytes, like fibroblasts, lymphocytes and macrophages. The burden of obesity on health extends across multiple organs systems and diseases (atherosclerosis, coronary heart diseases, osteoarthritis, diabetes, hypertension, dyslipidemia). The high incidence and its chronic inflammatory condition have had a wide impact. The chronic nature of obesity produces a tonic low-grade activation of the innate immune system that affects steady-state measures of metabolic homeostasis over time. In this review we highlight the macrophage participation in the generation of obesity-induced inflammation.

[Immunological mechanisms involved in pregnancy]. / Mecanismos inmunológicos involucrados en el embarazo.

Pregnancy progresses through mechanisms that allow the embryo implantation and its development during gestation. Those mechanisms involve the immune cells that participate in the regulation of immune tolerance and response, as well as the protection conferred by Th2 cytokines and molecules expressed on trophoblast cells. Local factors expressed in the fetal interface as HLA-G, which inhibits the cytotoxicity of uterine natural killer cells and induces apoptosis of activated CD8 cells; transforming growth factor-beta, that induces tolerance, and uterine natural killer cells that are functionally different to the peripheral, as well as circulating progesterone and the glicodeline molecules that are important regulators of the immune response, also intervene in the process. From the conventional immunological point of view, pregnancy is a unique immune condition in which the fetus, semiallogenic, avoids being rejected immunologically by the mother, apparently by inducing a tolerance more than a sensitization

The involvement of NF-?B Transcription factor in asthma.

UNLABELLED: PubMed search was performed using the key words: NF-?B, nuclear factors, asthma. Articles were selected based on their relevance to this review. OBJECTIVE: To review the literature regarding the involvement of the nuclear factor kappa-B (NF-?B) transcription factor in asthma. RESULTS: NF-?B is a critical transcription factor for the production of many inflammatory cytokines. NF-?B is associated with several diseases, including asthma, where there is an inflammation of the airways with cell infiltration. It is activated in bronchial asthmatic patient biopsies and active in the epithelium of the airways in mice after stimulation. It also participates in the maintenance of the chronic inflammatory response. NF-?B also acts synergistically with other transcription factors, to induce the maximal expression of genes involved with asthma. Activation of NF- ?B by several stimuli induces the release and degradation of the inhibitory protein I-?B from the dimeric complex followed by translocation of NF-?B to the nucleus. CONCLUSIONS: The NF-?B pathway is central to the pathogenesis of asthma. NF?B is an important therapeutic target for the treatment of asthma, including intermediate products on the signaling pathway and protein related to Rel. Alterations in the NF-?B signaling pathway are associated with the disease.

[Allergy to materials used in dental procedures]. / Alergia a materiales utilizados en procedimientos dentales.

OBJECTIVE: To provide a review of the literature regarding the pathological effects of material used in clinical dentistry. DATA SOURCES: PubMed search was performed using the key words: dental biomaterial, odontologic toxicity, odontologic allergy, dental allergens, dental resins. STUDY SELECTION: Articles were selected based on their relevance to this topic. RESULTS: The biomaterials used in orthodontic or dental treatment may lead to alterations of greater biological importance in susceptible or sensitized individuals, and may be able to alter the functions of cells in the mouth, including dentinogenesis and tissue repair; toxicity and mutagenicity have been observed. Some of them release potential antigens or allergens capable of inducing immune or immediate and delayed allergic reactions of diverse severity and extension, which may include extraoral damage. CONCLUSIONS: The number of patients with pathology originated by dental materials has increased. The scarce knowledge about it delays diagnosis. The study of biomaterials used in odontologic procedures and its harmful effect must be encouraged, as well as its pathological manifestations which require more clinical investigation and diffusion, with the aim to give more and better information to dentists, family and allergy physicians so that they can provide prompt and successful care.

[Peripheral anticholinergic syndrome]. / Sindrome anticolinérgico periférico.

This is a case report of a woman of 38 years old, studied and analyzed at the service of allergy and immunology with clinical manifestations of allergic rhinitis; studies of laboratory, cabinet and intradermal test were made to corroborate this diagnosis and the treatment with specific hyposensitization, oral antihistaminines and inhaled steroids was started. Two years later the patient referred urinary retention without important antecedents, so, a peripheral anticholinergic syndrome (PAS) was suspected, a urodynamic test study was carried out consisting in a uroflujometry, static and dynamic urethral profile, cystometry, flow pressure study and electromyography, which diagnosed low urinary obstruction (functional) and vesical sphincter pseudodysfunction, demonstrating the PAS associated with oral antihistamines.

Maize (Zea mays): allergen or toleragen? Participation of the cereal in allergic disease and positivity incidence in cutaneous tests.

BACKGROUND: The maize (zea mays) is considered one of the fundamental nutrients in the diet of the Mexican population. It can cause allergic reactions, according to reports from countries other than Mexico. OBJECTIVE: To know the participation of maize in the etiology of allergic disease and the incidence of positivity to its antigens by cutaneous tests, in Mexican patients. METHODS: Six hundred sixty-one patients were studied. There were obtained a complete clinical history and samples for laboratory tests, as well as the results of cutaneous tests. RESULTS: Of 661 patients, 56 (8.5%) manifested allergic symptoms attributable to maize, which correlated (p < 0.0001) with a positive cutaneous response to its antigens. Fifty (88%) of them worked with maize and had a significant relative risk value (RR=102). The remaining six patients did not work with maize, four of them were included in the group who had a positive response for both allergens (n = 25), and two in that one with positive response for only one of these allergens (n = 100). CONCLUSIONS: The low frequency (8.5%) to which the allergic disease was attributed to maize, and the strong association (88%) with workers of maize induce us to consider the influence of some differences concerning to the cereal, such as physical characteristics, years and frequency to contact with, and specially to its entrance route. In fact, it plays an important role in the development of either toleragenic or immunogenic response to an antigen.