[Diagnostic use of enzymatic RAST skin tests and determination of eosinophils in nasal mucosa in allergic rhinitis]. / Utilidad diagnóstica de las pruebas cutáneas RAST enzimático y determinación de eosinófilos en moco nasal en la rinitis alérgica.

AIMS: Allergic rhinitis is the most frequent disease mediated by immunoglobulin E (IgE). Nasal challenge is the gold standard for the diagnosis of allergic rhinitis. Skin tests (ST) are the most used diagnostic method to detect the presence of specific IgE bind to skin mast cells. The exposition of the nasal mucous membrane to the allergen is followed by an increase of the local eosinophils; the count of eosinophils in nasal mucous (ENM) is a diagnostic test for allergic rhinitis. Enzymatic RAST or enzymatic allergo-sorbent test (ESA) measures the level of serum allergen-specific IgE. OBJECTIVE: To measure the sensitivity, specificity, and diagnostic precision of ST, EAST and ENM in allergic rhinitis. METHOD: We studied 241 individuals, 162 of them had allergic rhinitis, and 79 were healthy controls. They underwent nasal challenge and intradermic ST for Dermatophagoies spp (acarus). Fraxinus americana (Ash-tree), Amaranthus palmieri (quelite), Cynodon Dactylon (capriola) and Felis catus (cat), EAST for Dermatophagoides pteronyssinus (acarus), and ENIVI. Results of ST, EAST and ENIVI were compared with their corresponding nasal challenge, and the prevalence of allergic rhinitis for each allergen was calculated. The best cut point was assessed by means of receiver-operator curves (ROC), and sensitivity, specificity, positive predictive value, negative predictive value, inter-observer concordance coefficient, area under ROC (0), standard error of 0 (SEO), and 95% confidence interval of 0 of each test were calculated using the best cut point. RESULTS: ST and EAST had the best sensitivity and specificity. ENM had the lowest sensitivity and specificity. CONCLUSION: For the diagnosis of Dermatophagoides spp allergic rhinitis ST for Dermatophagoides spp and EAST for Dermatophagoides pteronyssinus have the same diagnostic precision. According to the indexes for diagnostic precision, and inter-observer concordance coefficient, ST and EAST are useful to diagnose allergic rhinitis induced by the evaluated allergens. ENIVI is a test that is not very useful for the diagnosis of allergic rhinitis.

Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos / Disodium chromoglicate reduces in vitro phogcytic activity of the polymorphonuclear cells in asthmatic patients and healthy

El cromoglicato disódico (CGDS) interfiere con el trasporte de la membrana celular inhibiendo la liberación de mediadores y la activación de polimorfonucleares (PMN), al impedir el incremento del calcio libre intracelular. Para determinar si el CGDS disminuye la actividad fagocítica in vitro de PMN se incubaron PMN de personas sanas y asmáticos alérgicos con CGDS o con solución salina balanceada de Hank (SSBH) y se evaluó su actividad fagocítica con la técnica de quimioluminiscencia. Al comparar las muestras no se encontró diferencia significativa con la actividad fagocítica entre las incubadas con CGDS y las incubadas en SSBH sin CGDS; tampoco se halló diferencia en la actividad fagocítica entre los asmáticos y sanos y no hay diferencia en la capacidad fagocítica de PMN entre asmáticos y sanos

[In vitro effect of disodium cromoglycate on phagocytic activity of polymorphonuclear cells of healthy asthmatic patients]. / Efecto in vitro del cromoglicato disódico sobre la actividad fagocítica de los polimorfonucleares de pacientes asmáticos sanos.

Disodium chromoglicate interferes cellular membrane transport, inhibits mediators release and activation of polymorfonuclear cells (PMN) by blocking intracellular free calcium increment. In order to assess if DC reduces in vitro phagocytic activity of PMN, these cells obtained from allergic asthmatic patients and healthy subjects were incubated with DC or Hanks solution (HS). Their phagocytic activity was measured with chemoluminiscence technique. There were not significant differences in phagocytic activity between the cells incubated with DC and those incubated with HS, nor between cells from asthmatic patients and healthy subjects. We conclude that DC has not in vitro effect on phagocytic activity of PMN from healthy and asthmatic subjects. There are no difference in PMN phagocytic capacity between healthy and asthmatic subjects.

[Effect on FEV1 induced by the administration of salbutamol with aerochamber and metered dose inhaler]. / Efecto en el VEF1 al administrar salbutamol con la cámara de retención, espaciador e inhalador de dosis medida.

There are several devices known as spacers and aerochambers designed to help in the administration of drugs in spray into pulmonary airways in asthmatic patients. This study was done to determine the effect on FEV1 of salbutamol given through an aerochamber compared with metered dose inhaler and spacer. Thirteen asthmatic patients who met all selection criteria proposed, were included. Spirometry was operformed before and after salbutamol application by means of one of the aforementioned devices, assigned at random. The effect on FEV1 with metered dose inhaler was 22.76%, with spacer it was of 23.35% and with aerochamber it was of 23.94%. Statistical analysis did not show significant differences among groups. These data suggest that each of the three devices tested have the same effectiveness for administration of salbutamol in spray. This is, however, a preliminary study.