Allergie et immunologie最新文献

Background: EPD is the only preventive symptomatic immunotherapy available on the market and approved by competent bodies. Recent double-blind placebo controlled (DBPC) studies have demonstrated its efficacy in seasonal and perennial rhinitis. The aim of the study was to confirm the efficacy and safety of a single dose of immunotherapy administered six-eight weeks before the pollen season.

Methods: Two simultaneous DBPC trials were carried out. The first consisted of 20 children with grass-pollen seasonal rhinitis (Bollate-Milano, Italy) and the second included 30 adult patients with Parietaria-pollen seasonal rhinitis (Genova, Italy). EPD was administered only to the active groups.

Results: A significant difference in favour of the active treatment groups was seen in oral antihistamine use (p < 0.05) during the peak pollen seasons. Throughout the pollen seasons, rhinoconjunctivitis scores for the two groups in both studies presented no significant difference, even if the values were lower in the active groups.

Conclusions: The oral antihistamine reduction, observed in the active groups during the seasonal period, supports the efficacy of this treatment, although a significant improvement in the rhinoconjunctivitis symptoms was not observed, probably due to the use of oral antihistamine in the placebo groups. The overall profile of the EPD was good. It could be particularly suited for short term therapy to prevent seasonal symptoms in allergic patients.

Patients with respiratory pathologies in the forms of tracheitis, rhino-sinusitis, and asthma sometimes have symptoms of gastro-oesophageal reflux, that should be taken into consideration in order to treat the co-factors associated with the etiopathology. However, these patients, because of their respiratory handicaps, are frequently unwilling to submit themselves to traumatic investigations. Oesophageal scintigraphy, because of its perfect tolerance and reliability, seems to be an examination that is adapted to the situation to resolve this dilemma.

Unlabelled: The study had the aim of establishing the incidence of sensitization to profilin (a panallergen found in pollens and foods of vegetal origin) in pollen-allergic patients. We evaluated the consequences of such sensitizations on the results of specific IgE, the positivity of skin tests and clinical signs.

Methods: 94 consenting patients, allergic to pollens (trees and/or grasses and/or weeds) replied to a questionnaire and had skin tests to purified profilin and measurement of serum anti-profilin IgE.

Results: Two groups were defined: one group was sensitized to profilin (GSP), with positive skin test and anti profilin IgE of 31 patients, and a group non-sensitive to profilin (GNSP) (negative skin test and anti-profilin IgE) of 41 patients. Discordant results were found in 22 patients. Taking in account the two groups, sensitization to profilin was 43%. The two groups were homogenous for age, sex, ethnics and clinical signs. Food allergy was more frequent but not statistically different (p = 0.09) in the group GSP (51.6%) than the GNSP (31.7%), in particular allergy to fruits of the Rosaceae family. Pollen polysensitization (to three species, trees, weeds and grasses) was more frequent in the GSP group (64.5%) than the GNSP (12.5). Polysensitization to pollens and foods was also more frequent in the sensitized group (65.5%) than in the non-sensitized group (12.5%). In a sub-group with normal levels of total IgE pollen polysensitization was more frequent in patients who were sensitive to profilin. On biological investigation, sensitization to profilin influenced the result of anti-latex IgE and also the IgE to many vegetal allergens. These results show the value of seeking a sensitization to profilin in patients with pollinoses.

The best approach to managing peanut allergy is to educate patient and family. We developed specific consultation for children with peanut allergy. We follow a structurized program in a pedagogical manner. The objectives of this program are to encourage appropriate understanding, recognition of the signs of allergy, and if it is necessary, to teach how to inject oneself with an epinephrine injection. The aim of these sessions is to improve knowledge on basic allergy, recognition of hidden foods, on reading labelling, on recognition of earliest signs and finally on use of epinephrine as a rescue treatment. Behaviour in restaurant and most of all at school is also precised. The interview began with the parents and children, followed by discussions and pedagogical games. Our subjects experiences, described below, suggest that these educational programs are beneficial. As the others chronic pathologies, patients with this program seem to have less allergic reactions, and are able to respond with the appropriate behaviour when symptoms appear. Three months later, we conduct the efficiency of the treaning.

Objectives: To determine the prevalence of asthma, wheezing, hay fever, and eczema among primary school children aged 6-13 years in United Arab Emirates (UAE).

Design: A cross-sectional study on school children was performed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires.

Setting: Government primary school children in seven Emirates, in UAE.

Subjects: Subjects were selected by a multi-stage stratified sampling design. 4200 children targeted for this study, but only 3200 children aged 6-13 years were agreed to participate and responded to the study. The overall response rate was 69.8%.

Results: The prevalence of physician diagnosed asthma was 13%, in addition, the wheeze by history was 15.6%. Furthermore, the prevalence of nocturnal cough was 21%. On the other hand, the prevalence of eczema was 11% and hay fever was 14.9%. Parental asthma but not parental atopy was associated with an increased risk of asthma and wheezing in children.

Conclusions: The prevalence of asthma and wheezing in UAE is consistent with that in neighbouring Gulf countries.

The concentration of airborne pollen from Cupressaceae was regularly monitored++ in Lisbon during 1997 and 1999, and the phenology of flowering cypress was studied in several species of the genus from 1992 to February 2000. Both methods showed a peak of pollen abundance during the month of February, with the airborne pollen concentration decreasing strongly to March and April. The results obtained are in accordance with the literature for the Mediterranean area, but in Lisbon the peak started and finished earlier than in other Mediterranean towns already studied.

Nowadays, the prevalence of atopic diseases in so-called developed countries is estimated to exceed 30%. Furthermore, it may reach over 50% in two generations. Based on such facts, the so-called "atopic predisposition" can not be defined as an abnormal genotype consisting of certain "atopic gene(s)" possessed by a minority of unfortunate people. Rather, the gene(s) that cause atopic diseases reside in the common human gene repertoire, and several environmental factors would cause the overexpression of some constitutive gene(s), leading to the development of atopic diseases. The author considers that overexpression and production of Th2 cytokines, especially IL-5, may be a key event. The recent prevalence of atopic diseases in developed countries may be mediated by a change of Th2 polarization due to modern retrogression of environmental factors such as bacterial and viral infections that favor Th1 polarization. The "atopic trait" might be actually an "atopic phenotype" rather than an "atopic genotype". In other words, the atopic trait seems not to be a genotype that decides the development of an atopic disease on an all or nothing basis, but a phenotype that determines the susceptibility to the disease. Of course, the familial nature of atopic diseases is undeniable, but this does not necessarily indicate the genetic nature of atopic diseases. For example, if a parent suffers from tuberculosis, the possibility that the children will develop tuberculosis markedly increased. However, tuberculosis is a truly infectious disease. In this article, several environmental factors those may affect the recent sharp increase of atopic diseases are discussed.