[Prosopis spp. in allergic diseases]. / Prosopis spp. en enfermedades alérgicas.

OBJECTIVES: To demonstrate cutaneous reactivity and the participation of Prosopis pollen in patients with allergic diseases who attend the Allergy and Clinical Immunology Service of the General Hospital of Mexico, in Mexico City. METHODS: A retrospective and cross-sectional study was carried out by analyzing clinical records that had a complete medical history of patients between the ages of 3 and 79 years, with diagnoses of allergic rhinitis, asthma, and rhinoconjunctivitis. RESULTS: 1285 patients were studied; the frequency of positive skin reactivity for Prosopis was 27.78 %; 82.97 % had a diagnosis of allergic rhinitis, 4.39 % had a diagnosis of asthma, and 12.64 % had a diagnosis of rhinoconjunctivitis. CONCLUSIONS: Prosopis pollen plays an important role in diseases of allergic etiology. It is important to consider the antigenic combination with other families such as Chenopodiaceae.

Objetivos: Demostrar la reactividad cutánea y la participación del polen de Prosopis en los pacientes con enfermedades alérgicas que acuden al Servicio de Alergia e Inmunología Clínica del Hospital General de México, en la Ciudad de México. Métodos: Se llevó a cabo un estudio retrospectivo y transversal de expedientes clínicos que contaran con historia clínica completa, de pacientes entre tres y 79 años de edad con diagnósticos de rinitis, asma y rinoconjuntivitis alérgica. Resultados: Se estudiaron 1285 pacientes. La frecuencia de reactividad cutánea positiva para Prosopis fue de 27.78 %; 82.97 % cursaba con diagnóstico de rinitis alérgica, 4.39 % de asma y 12.64 % de rinoconjuntivitis. Conclusión: El polen de Prosopis participa importantemente en enfermedades de etiología alérgica. Es importante considerar el cruce antigénico con otras familias como las Chenopodiaceas.

[The prevalence of sensitization to cockroaches. Experience of an allergy service]. / Prevalencia de sensibilización a cucaracha. Experiencia de un servicio de alergia.

BACKGROUND: Allergy skin prick tests are important tools for the diagnosis of respiratory allergic diseases. Cockroach antigens have been identified as the cause of rhinitis, asthma, and other allergic diseases. OBJECTIVE: To show that the cockroach antigen participates in the cause of allergic diseases. METHODS: A retrolective and cross-sectional study was carried out, for which clinical records and history of atopy were reviewed; the results were obtained from blood biometry, nasal cytology, total IgE, and coproparasitoscopic serial tests. After prior informed consent, skin tests were applied in 3-74 year-old patients. RESULTS: 1,837 patients were studied; the prevalence of cutaneous reactivity to the cockroach antigen was of 17.90%; 56% of the patients had a diagnosis of allergic rhinitis, and only 6% had been diagnosed with asthma and rhinitis. CONCLUSION: The application of the cockroach antigen in skin tests must be considered in the practice of all allergists.

Antecedentes: Las pruebas cutáneas por técnica de punción son herramientas importantes para el diagnóstico de la alergia respiratoria. Se han identificado los antígenos de las cucarachas como responsables del desarrollo de rinitis, asma y otras enfermedades alérgicas. Objetivo: Demostrar la participación del antígeno de cucaracha en enfermedades alérgicas. Métodos: Se llevó a cabo un estudio retrolectivo y transversal, para el cual se revisaron historias clínicas y los antecedentes de atopia; se recolectaron los resultados de biometría hemática, citología nasal, IgE total y estudio coproparasitoscópico seriado. Previo consentimiento informado se aplicaron pruebas cutáneas en pacientes de tres a 74 años. Resultados: Se estudiaron 1837 pacientes, la prevalencia de reactividad cutánea al antígeno de cucaracha fue de 17.90 %; 56 % de los pacientes tenía diagnóstico de rinitis alérgica y solo 6 %, de asma y rinitis. Conclusión: Se debe considerar la aplicación del antígeno de cucaracha en las pruebas cutáneas en la práctica del alergólogo.

[Cutaneous reactivity to common ivy (Hedera helix) pollen extract in allergic patients]. / Reactividad cutánea al extracto del polen de hiedra común (Hedera helix) en pacientes con enfermedades alérgicas.

BACKGROUND: Common ivy is an ubiquitous ornamental plant found indoors and outdoors. It may cause occupational contact dermatitis and asthma. Many traditional and naturistic preparations may contain their extracts, hence sensitization may occur by several routes. OBJECTIVE: To determine the prevalence of sensitization to Hedera helix pollen by skin prick test on allergic subjects. METHODS: Skin prick tests (SPT) with 24 pollen extracts, including Hedera helix extract, were performed on 62 patients with allergic rhinitis, asthma, allergic conjunctivitis and atopic dermatitis. It was determined the frequency of sensitization to pollen extracts and the differences in the reactivity patterns among patients who showed a positive or negative result with Hedera helix extract. A cluster analysis was made to identify cross-allergenicity among pollen extracts. RESULTS: Eleven out of 62(17.7%) patients had a positive SPT with common ivy pollen extract. The main differences found were the number of pollen species to which patients were allergic. Patients with atopic dermatitis had a nine-fold higher frequency of positive skin tests with Hedera extracts, than subjects with other allergic diseases. CONCLUSIONS: Hedera helix pollen extract is a frequent cause of sensitization among allergic patients, and show cross-allergenicity with pollen from different sources. There is a higher frequency of positive skin tests with Hedera extract in patients with atopic dermatitis than with other allergies.

[Anaphylaxis Due to Ingestion of Ivy Syrup (Hedera hÈlix). Report of two Cases]. / Anafilaxia por ingesta de jarabe de hiedra (Hedera helix). Reporte de dos casos.

Common ivy is an ornamental plant, that is ubiquitous in Mexico. Its allergens can cause contact dermatitis, asthma and allergic rhinitis. We describe two cases of anaphylaxis related to common ivy syrup ingestion. We performed skin prick test with Hedera helix syrup, and using a dialized and ultrafiltered of common ivy syrup commercial presentation (dry common ivy extract: 7mg/ml), as well as using Hedera helix pollen extract. We describe two cases of anaphylaxis related to ingestion of Hedera helix syrup. Skin prick test with the commercial presentation and with the pollen extract were positive in both patients. In this study we confirmed the causal relationship of anaphylaxis due to the ingestion of ivy syrup in two patients through skin prick tests with ivy syrup and ivy pollen extract. Common ivy can cause contact dermatitis, asthma and allergic rhinitis, but we do not know the allergens that could be related to systemic and respiratory reactions, then, more studies in this topic are requiered.

[Atlas of the most important allergenic pollens in Mexico]. / Atlas de los pólenes alergénicos de mayor relevancia en México.

The importance of pollens as etiologic agents of allergy in Mexico is out of question, as have been demonstrated since 1940 in several studies performed in order to identify allergenic flora in many cities of México. With the aim to improve the knowledge about pollens related to allergic diseases we made an atlas with photographs of the most relevant allergenic pollens in México according to skin tests performed in allergic patients. Photographs of 31 taxa and a brief description of their microscopic features are presented along with their taxonomical relationships.

[Basis to modify the immunotherapy regimen at the Allergy Service, General Hospital of Mexico]. / Fundamentos para modificar el esquema de la inmunoterapia en el servicio de Alergia del Hospital General de México.

BACKGROUND: In Mexico, the way allergen immunotherapy is performed has remained without changes for many years. Here we present the modifications that have been performed in the General Hospital of Mexico to make immunotherapy more effective. OBJECTIVE: To show the changes implemented to make immunotherapy faster and more effective by changing the volume of allergy vaccines from 5 or 10 mL to 3 mL, and the theoretical and practical support for the change. MATERIAL AND METHOD: The amount of protein delivered in each immunotherapy shot was computed to show how they change along the treatment. Results for schedules for 3, 5 and 10 mL were compared. RESULTS: Results showed serial rises and falls in protein amount injected every time a new vaccine flask starts to be used. However, in the case for 3 mL vaccines schedules, those changes are less pronounced. CONCLUSIONS: Due to these results we suggest a schedule of immunotherapy with 3 mL vaccines that allow getting the maintenance doses in a shorter time and at lower cost.

[Sensitization to pollens of Oleaceae family in a group of patients from Mexico City]. / Sensibilización a pólenes de la familia Oleaceae en un grupo de pacientes de la Ciudad de México.

BACKGROUND: In Mexico City, where the Olive trees are scarce, the Oleaceae family has been recognized as one of the most important causes of pollen allergy, possibly related to cross-reactivity with other pollens of the Oleaceae family, as Fraxinus excelsior, Ligustrum vulgaris and Osmanthus americanus. OBJECTIVE: To know the prevalence of sensitization to the Oleaceae family in Mexico City, cross-reactivity, as well as concurrent sensitizations, and vegetables and fruits associated to oral allergy syndrome (OAS). PATIENTS AND METHOD: A prospective, longitudinal study was carried out during two months, among patients who attended the outpatient allergy clinic of the General Hospital of Mexico with symptoms suggestive of respiratory allergy. A questionnaire to search OAS was used, and skin Prick tests to pollens were performed. RESULTS: Among 279 patients, 164 (58.8%) had respiratory allergy and positive skin prick test (SPT) to pollens. Olea europaea had the highest prevalence of SPT reactivity (52.4%), followed by Fraxinus excelsior (43.3%), Ligustrum vulgaris (36.6%) and Osmanthus americanus (15.9%). There were OAS in 53.5%, 50.7%, 50% and 53.8%, respectively, mainly related to peach, apple, kiwi, pear and banana. Olive monosensitization was found in 5.5%. CONCLUSION: In this study, Olea europaea had the highest prevalence of positive reactivity to pollens in Mexico City, then its sensitization must be determined routinely.

[Identification of Amaranthus palmeri pollen allergens comparing recognizing pattern between allergic and non-allergic]. / Identificación de los alergenos del polen de Amaranthus palmeri comparando el patrón de reconocimiento entre alérgicos y no alérgicos.

BACKGROUND: Amaranthus palmed pollen is an important allergenic agent in Mexico. A high proportion of subjects allergic to pollen grains are allergic to this species. In this study, we analyzed the different response of three groups: one of patients allergic to A. palmeri; one of patients allergic to other pollen species different from A. palmeri, and one of non-allergic subjects. OBJECTIVE: To identify proteins that are recognized preferentially by patients allergic to A. palmeri that could be considered as its allergens. MATERIAL AND METHODS: T cell response was determined by lymphoproliferative assays with eight protein fractions in the range of 14 to 103 kDa obtained by electroelution, and the total protein extract. IgE recognition was determined by Western blot. RESULTS: Even though some individuals in the three groups showed cellular responses to some of the protein fractions, as well as IgE recognition of the pollen proteins, the allergic subjects had the strongest responses on average. Preferential recognition of some proteins was evident in A. palmeri pollen allergic patients. CONCLUSIONS: Differences among the three groups were not statistically significant. However, we found four proteins with molecular weights of 17.9, 20.1, 26.6 and 66.5 kDa, which can be proposed as allergens.

Sensibilización a distancia: dermatofítides / Sensibilization at distance: dermatophytides

El mecanismo de producción de la hiposensibilización a distancia (ID o IDE), cualquiera que sea su origen, ha sido difícil de dilucidar, lo cual ha sido el motivo para realizar esta revisión. La mayor parte de los hongos poseen una estructura compleja compuesta por La N-acetil glucosamina, la cual es fundamental en la producción de IDES, debido a que: es el antígeno de superficie de los dermatofitos que va a producir la formación de dichas IDES, ya que es semejante a la colágena tipo I de la piel y los glucosamin-glicanos que se utilizan para su conservación. Cuando se monta una respuesta inmunitaria contra la glucosamina de los dermatofitos se hace una reacción cruzada contra la colágena tipo I de la piel