Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)最新文献

Objective: The objective of the present study was to design a multi-epitope protein from A. lumbricoides and APD allergens and to evaluate its IgE reactivity preliminarily.

Methods: Using computational tools, a molecule containing multiple "T" epitopes of allergens derived from A. lumbricoides and APD was designed "in silico" This multi-epitope protein (MP1) was expressed using an E. coli system and purified by affinity chromatography using Ni-NTA agarose. Anti-MP1 and anti-HDM extract IgE reactivity was evaluated by Dot-Blot and indirect ELISA from sera of HDM-allergic patients and non-allergic individuals from Barranquilla-Colombia. Allergic individuals had a positive skin test to a standardized battery of inhaled allergens (EUROLINE - Ref: DP 3704-1601-1 E) and mite- specific IgE.

Results: Multi-epitope (MP1) protein was expressed and purified with high purity. Dot-Blot result showed that all sera from allergic patients showed lower IgE reactivity to MP1 compared to HDM extract. By ELISA, significantly lower concentrations of anti-MP1 IgE (Median: 270.86 ng/ml; IQR: 90.3) were observed in contrast to anti-HDM IgE levels (Median: 988.5 ng/ml; IQR: 1117.6) in sera of patients allergic to HDM.

Conclusions: A protein composed of multiple epitopes of A. lumbricoides and HDM allergens was designed, expressed, and purified. Preliminary Dot-Blot results suggest that this molecule shows hypoallergenic properties with very low IgE reactivity compared to mite extract. Further functional studies are needed to understand better the immune response induced by this molecule.

Background: The first report of cerebrospinal fluid rhinorrhea (CSFR) was described in 1679. In 1826 it was reported that one of the possible causes of CSFR was a fistula between the subarachnoid space and the nasal cavity. In 1903, chemical analysis of the fluid was proposed as a diagnostic criterion. In Mexico there has been 32 case reports.

Case report: Forty-nine years old female with a history of nasal polyposis, profuse rhinorrhea and cephalea who attends the allergy department with the suspicion of allergic rhinitis. After anamnesis and physical evaluation, CSFR was suspected. Chemical analysis of the fluid, head CT and biopsy of nasal polyp were performed. An etmoidal fistula associated with carcinoma was confirmed.

Conclusions: Spontaneous fistulas are rare but can erosionate the bone and adjacent tissues. Diagnosis is based on the clinical findings, patient's history and complementary studies such as beta-2-transferrin determination in nasal fluid.

Objective: To evaluate the risk of IgE sensitization and symptoms to shrimp in a population that has received AIT with polymerized mite extract.

Methods: Patients with allergic rhinitis sensitized to dust mites (Dermatophogides spp) with an indication for mite AIT were included. Those patients who had not yet received AIT or had received less than 6 doses were included as controls and those who had received more than 24 doses of AIT were included as cases. Sensitization to shrimp was assessed by skin prick test with complete shrimp extract and/or shrimp-specific IgE.

Results: A total of 68 patients were included; 47 cases and 21 controls. When calculating the odds ratio of sensitization according to time with immunotherapy we observed that there were no differences between the group of cases and controls (OR 0.76 95% CI 0.26 to 2.22 p 0.7 by MacNemar technique). Factors such as consumption or not of shrimp and frequency of consumption do not seem to be related to the outcome.

Conclusion: In contrast to what was reported with aqueous extracts, we observed that AIT with polymerized extracts is not a risk factor for shrimp sensitization. It is necessary to reproduce these results with a larger sample size to explore other factors.

Objective: To report the Tipuana tipu pollen as a new allergen capable of triggering allergic symptoms.

Methods: The pollen counts were made according to standardized technique with a Burkard seven days following the European Aerobiology Society´s Network Group recommendations.1 The trap was installed on the roof of Clinica SANNA, El Golf, San Isidro, which is 20 m high, 12°5'54"S 77°3'6"W in the west-south of the Lima urban area. The sampling period was performed from September 2020 to October 2021. Collection of Tipuana tipu pollens and Preparation of Tipuana tipu pollen extracts 1:20 w/v was done using a previously described method.2 We carried out systematic skin prick testing with Tipuana tipu pollen extract and other aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), molds (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum), cat and dog danders, Periplaneta americana, grass six mix, weed mix (Inmunotek, Spain) on 80 patients (18 to 50 years old) seen in our allergy center, they suffering from november to january rhinitis and/or conjunctivitis symptoms. The majority living near avenues and large green areas, where Tipuana trees grew.

Results: We found a total of 952 grains/m³ of Tipuana tipu pollen between November 2020 to january 2021, with the maximum concentration of 37 grains/m³ on December 10^th. We also found other airborne pollen Types: Poaceae, Myrtaceae, Compositae and Betulaceae. 14/80 patients (17,5%) showed positive skin prick test only to Tipuana tipu extract. Most of the patients with positive tests to Tipuana extract presented symptoms of rhinoconjunctivitis during the Tipuana pollination period. Four patients showed positive skin prick test to Tipuana tipu and grass 6 mix extracts, most of the rest of our patients were sensitized to dust mites' extracts (Dermatophagoides pteronyssinus).

Conclusions: The west-south population of Lima urban city is exposed to Tipuana tipu pollen. We do not foud previous publications about Tipuana tipu allergy. Almost 18% of the patients tested in our sample were mono-sensitized to this pollen. The results of this study should be compared with data from the forthcoming years, to identify seasonal and annual fluctuations, extend the traps to other locations in Lima, and of course try to standardize and improve the Tipuana tipu pollen extract.

Objective: To present the baseline clinical and demographic characteristics of CRSwNP patients over the age of 18 enrolled in a Patient Support Program (PSP) prior to biologic treatment.

Methods: Descriptive, cross-sectional study performed in a Colombian CRSwNP asthma PSP sponsored by Sanofi from Aug-2021 to Jul-2022. Data was collected from CRSwNP patients, prior to the start of Dupilumab treatment, who consented to the use of their data. The following information was reported: Age, reporting city, treating medical specialty, comorbidities, and persistence of treatment.

Results: 339 patients were included, 171 (50,4%) were women and 168 (49,6%) were men. The mean age at Dupilumab treatment initiation was 52,4 years. 62,8% began treatment during adulthood (26-59y), while 34.1% started at elderly (+60y) and 3.1% were young adults (18-25y). Most cases (29,7%) were included in Bogotá, followed by Antioquia (19%), Valle del Cauca (7,3%) and the remaining 44% nationwide. Comorbidities were present in 67,1% of the patients, with diagnosis of allergic rhinitis, atopic dermatitis, asthma, and other non-type 2 inflammatory diseases. Nasal surgical history was present in 89,6% of the patients, most of them with one to three previous surgeries. Continuous treatment was observed in 70,3% of patients for 6 to 12 months, in 21,3% for more than 12 months and in 8,4% for less than six months. The most frequently treating medical specialty was otorhinolaryngology (79,6%), followed by allergology (16%) and other medical professionals (4,4%).

Conclusions: There is concordance with the literature on a higher presentation of the disease in women than in men. There is a large proportion of patients with nasal surgical history and type 2 inflammatory comorbidities by the moment of biologic treatment initiation. The care and identification of CRSwNP colombian patients is mainly provided by otorhinolaryngologists, followed by allergologists.

Objective: To identify and registry the most important fungal spores trapped in our aerobiology station, as well as to report the prevalence of skin sensitization to these allergens.

Methods: The pollen counts were made according to standardized technique with a Burkard seven days spore trap, following the American Academy of Allergy, Asthma and Immunology (AAAAI) through National Allergy Bureau (NAB) recommendations. The trap was installed on the roof of Clinica SANNA, El GOLF, San Isidro, which is 20 m high, 12°5'54"S 77°3'6"W in the west-south of the Lima urban area. The sampling period was performed from September 2020 to October 2021. Skin prick tests were carried out according to the recommendations of the Spanish Society of Allergology and Clinical Immunology (SEAIC) in 200 patients (18 to 60 years old) with symptoms of rhinoconjunctivitis and/or asthma, who were evaluated in the Allergology Service of Clinica SANNA el Golf. Allergenic extracts were applied, dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), cat and dog danders, cockroach (Periplaneta americana), grass 6 mix, weed mix, molds (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum, Nigrospora spp.), INMUNOTEK-Spain provided the extracts. We also tested other fungal allergens such as Fusarium spp, Stemphylium spp, Curvularia spp, a mixture of Helmintosporum/Dreschlera spp. from the DIATER-Argentina laboratory.

Results: We identified spores of Alternaria alternata, Cladosporium spp., Nigrospora spp., Stemphylium spp., Fusarium spp., Curvularia spp., Dreschlera/Helmintosporum spp. The patients showed sensitization to Cladosporium herbarum (14%), Fusarium spp. (13,5%), Nigrospora spp. (8%), Alternaria Alternata (7%), Stemphylium (6%), Dreschlera/Helmintosporium spp. (5,5%), Curvularia spp. (3%), Aspergillus fumigatus (2,5%).

Conclusions: The inhabitants of the south-western area of the urban city of Lima are exposed to different fungal spores with allergenic potential, with a higher concentration being identified during the summer/autumn months. Cutaneous sensitization is demonstrated in variable percentages to the fungal spores identified in this aerobiological sampling. The results of this study should be expanded and compared with data in the forthcoming years, identify seasonal and annual fluctuations and extend the traps to other locations in Lima.

Objetivo: Determinar la carga económica anual del asma, desde una perspectiva institucional y con base en la clasificación recomendada por GINA, en una cohorte retrospectiva de adultos atendidos en el Instituto Nacional de Enfermedades Respiratorias (INER) de México.

Métodos: Estudio observacional, longitudinal y retrospectivo, llevado a cabo a partir de la información recabada de 247 pacientes femeninas con asma. Se estimaron los costos directos anuales: visitas, pruebas de laboratorio, tratamiento farmacológico y de las crisis o exacerbaciones, para determinar la carga anual de la enfermedad desde una perspectiva institucional, y según la clasificación de la Iniciativa Global para el Asma.

Resultados: El costo promedio anual fue de $43,813,92, que aumentó en relación con la necesidad de aumento de dosis de corticoides inhalados y beta-agonistas de acción prolongada. El costo promedio de la consulta médica fue de $2004.57, $982.82 por gestión de crisis y $2645.95 por pruebas de laboratorio. El tratamiento farmacológico representó la principal carga económica, con un costo promedio anual de $38,180.58.

Conclusiones: Los resultados resaltan una carga económica del asma estimada en un costo anual por paciente de $43,813.92 MXN (DE=93,348.85), en el contexto del tercer nivel de atención en el sistema de salud público mexicano. La gravedad del asma, los tratamientos y los biológicos fueron los principales factores que aumentaron los costos directos de la atención.

Food allergy is a common chronic disorder that affects infants, children, adolescents, and adults. The prevalence of food allergy has increased in recent decades throughout the world, not limited to Western countries. Since there is no treatment, this focuses on avoiding allergens, in addition to educating patients and caregivers in the emergency treatment of acute reactions, for example: application of epinephrine. Studies suggest that accidental reactions occur in about 45% of children with food allergies each year, although most reactions are mild or moderate in severity. Hospital admissions for food anaphylaxis vary from 4 to 20 per 100,000 inhabitants; Deaths are rare, with an estimated incidence of 0.03 to 0.3 per million people with food allergy. Death from food anaphylaxis is rare and appears to have remained stable, possibly due to increases in food allergen labeling, diagnostic services, rates of intramuscular epinephrine prescription, and awareness of food allergies. Omalizumab is a drug approved for several disorders (chronic hives or difficult asthma) and may help reduce symptoms associated with food allergy. The relative importance of alternative technologies, management strategies and policies for food allergy varies from one region to another, due to differences in the epidemiology, education, socioeconomic well-being, and cultural preferences of the population.

The close relationship between the microbiota and allergic diseases has been known for several years, particularly food allergy. Although the best studied microbiota is that related to bacteria, viruses, parasites and fungi are also constituents of this, although their role is not definitively clarified. The microbial world interacts with the human body constantly, we are in daily contact with an infinite and innumerable number of varieties of microbes in our environment, some of them can pass through the body without causing any harm, while others generate undesirable risk for the body. health. Alteration of the original composition of the microbiota (dysbiosis) is associated with food allergy. This dysbiosis is related to changes in habits, method of termination of pregnancy (birth or cesarean section), replacement of breastfeeding or interruption at an early age; decrease in family size; loss of contact with farm animals or pets; inappropriate prescription or abuse of antibiotics. The transition from a diet based exclusively on milk to one with solid foods is associated with a drastic increase in microbial diversity. Immunomodulatory components of the microbiota (cell surface polysaccharides), dietary factors (vitamin A), and production of secondary metabolites (short-chain fatty acids and secondary bile acid metabolites) promote differentiation of the RORγt+ cell population Treg. ILC3 produces IL-2, which plays a decisive role in maintaining intestinal homeostasis.

Food allergy is an immune response to proteins in food. It usually affects 8% of children and 2% of adults in Western countries. Non-IgE-mediated food allergy mainly affects the gastrointestinal tract. Gastrointestinal food allergies are classified, by their underlying pathogenesis, as: IgE-mediated, non-IgE-mediated, or mixed. The symptoms of patients with food protein-induced allergic proctocolitis originate from local inflammation of the distal colon, which causes hematochezia in neonates. It can affect the entire gastrointestinal tract and cause symptoms of intractable emesis, with subsequent metabolic disorders and hypovolemic shock. Food protein-induced enterocolitis syndrome is a non-IgE-mediated allergy that usually appears in childhood, with prolonged repetitive vomiting, starting 1 to 4 hours after ingestion of food. The manifestation in adults is usually triggered by the consumption of shellfish. Atopic diseases affect 40-60% of patients with food protein- induced enterocolitis syndrome, including 40-50% of those with food protein-induced enteropathy and proctocolitis. Probiotics (Lactobacillus GG) can alleviate the symptoms of allergic proctocolitis induced by food proteins, by altering the composition of the intestinal microbiota. Fecal microbiota transplantation (FMT) can change intestinal microecology efficiently compared to food or probiotics.