RESUMO
INTRODUCCIÓN: En Portugal los datos del papel de Der p 1 y Der p 2 en niños con alergia al ácaro del polvo son escasos. La inmunoterapia específica (IE) con alérgenos es el único tratamiento que mejora los síntomas, reduce la necesidad de terapia farmacológica y modifica la historia natural de la enfermedad. Con este trabajo, los autores estudian la epidemiología local y buscan aclarar si el análisis molecular de los alérgenos principales es una ventaja para decidir y/o modificar la decisión de iniciar IE en niños con indicación clínica y sensibilizados a Dermatophagoides pteronyssinus. MÉTODOS: Estudio retrospectivo de los niños con asma y/o rinitis. Período de estudio: enero de 2013 a diciembre de 2016. CRITERIOS DE INCLUSIÓN: 1) prick-test positivo a Dermatophagoides pteronyssinus; y 2) enfermedad clínicamente relevante bajo tratamiento. Los valores de Der p 1 y Der p 2 ≥ 0,35kUA/l fueron considerados positivos. La significación estadística se estableció en p < 0,05. RESULTADOS: Se incluyeron en el estudio 279 pacientes. Edad media 9,55 años (min. 4-máx. 17). El asma estuvo presente en 199 niños (71,3%) y rinitis en 245 (87,8%). Der p 1 y Der p 2 fue<0,35kUA/l en 29 (10,4%) pacientes. Der p 1/Der p 2 se correlacionó con el tamaño de la pápula de prick-test, con el valor de los eosinófilos y la IgE total. CONCLUSIONES: Der p 1 y Der p 2 son alérgenos dominantes en nuestra población y puede haber beneficios en la determinación de estos niveles de alérgenos moleculares en pacientes con un prick-test positivo e indicación clínica para IE
INTRODUCTION: In Portugal, data on the role of Der p 1 and Der p 2 in patients with house dust mite (HDM) allergy are scarce. Allergen-specific immunotherapy (sIT) is the only treatment that improves symptoms, reduces the need for pharmacological therapy and modifies the natural history of the disease. With this study, the authors aim to understand the local epidemiology and to clarify if the molecular assay of major allergens is advantageous in deciding and/or modifying the decision to initiate sIT in children with clinical indication which are sensitized to Dermatophagoides pteronyssinus. METHODS: Retrospective study with analysis of patients with asthma and/or rhinitis. Study period: January/2013-December/2016. Inclusion criteria: 1) positive prick-test to Dermatophagoides pteronyssinus; and 2) clinically relevant disease under treatment. Assay Der p 1 and Der p 2 values ≥ 0.35 kUA/L were considered positive. Statistical significance was set at P < .05. RESULTS: The clinical files of 279 patients. Mean ages 9.55 years (min.4-max.17). Asthma was present in 199 children (71.3%) and rhinitis in 245 (87.8%). Der p 1 and Der p 2 was < 0.35kUA/L in 29 (10,4%) patients. The value of Der p 1/Der p 2 correlated with the size of the prick-test papule, the value of the eosinophils and the total IgE. CONCLUSIONS: Der p 1 and Der p 2 are dominant allergens in our population and there may be benefits in determining these molecular allergen levels in patients with a positive prick-test and a clinical indication for sIT prior to a decision of initiating sIT or not
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Asma/imunologia , Asma/terapia , Alérgenos/imunologia , Antígenos de Dermatophagoides/imunologia , Rinite/imunologia , Dessensibilização Imunológica/métodos , Imunoterapia/métodos , Estudos Retrospectivos , Hipersensibilidade/imunologia , Testes CutâneosRESUMO
INTRODUCTION: In Portugal, data on the role of Der p 1 and Der p 2 in patients with house dust mite (HDM) allergy are scarce. Allergen-specific immunotherapy (sIT) is the only treatment that improves symptoms, reduces the need for pharmacological therapy and modifies the natural history of the disease. With this study, the authors aim to understand the local epidemiology and to clarify if the molecular assay of major allergens is advantageous in deciding and/or modifying the decision to initiate sIT in children with clinical indication which are sensitized to Dermatophagoides pteronyssinus. METHODS: Retrospective study with analysis of patients with asthma and/or rhinitis. STUDY PERIOD: January/2013-December/2016. INCLUSION CRITERIA: 1) positive prick-test to Dermatophagoides pteronyssinus; and 2) clinically relevant disease under treatment. Assay Der p 1 and Der p 2 values ≥0.35 kUA/L were considered positive. Statistical significance was set at P<.05. RESULTS: The clinical files of 279 patients. Mean ages 9.55 years (min.4-max.17). Asthma was present in 199 children (71.3%) and rhinitis in 245 (87.8%). Der p 1 and Der p 2 was <0.35kUA/L in 29 (10,4%) patients. The value of Der p 1/Der p 2 correlated with the size of the prick-test papule, the value of the eosinophils and the total IgE. CONCLUSIONS: Der p 1 and Der p 2 are dominant allergens in our population and there may be benefits in determining these molecular allergen levels in patients with a positive prick-test and a clinical indication for sIT prior to a decision of initiating sIT or not.
