[Variabilidad del patrón de sensibilidad alérgica en adultos mayores].

Objective: Describe the pattern of allergic sensitivity in elderly. Methods: Elderly (>60 years old) with a diagnosis of allergic respiratory disease in whom sensitivity was identified by pricking with ALK-abello extracts (Port Washington, NY, United States) were included. The results were analyzed using descriptive statistics and compared with a series of young adults in a 3:1 ratio. Association analyzes were performed with c2 test using SPSSv.21 software (SPSS software, IBM, NY, USA). Results: 17 elderlies, predominantly women were identified (70%) with an average age of 64 years, 52% suffered from asthma and 47% allergic rhinitis, 82% were predominantly intradomiciliary polysensitive (82%), the most frequent being Dermatophagoides pteronyssinus (50%), decreasing to < 18% (p<0.01) to various species (Ligustrum vulgare, Salsola kali, Periplaneta americana, Canis familiaris, Juniperus sp and Fraxinus sp). Interestingly, AM were more sensitive to mites compared to young adults (p<0.01/OR= 8.92). This may be because the reactivity of the skin may decrease with age. Conclusions: The main allergic sensitivity that can be identified by conventional techniques in elderly is Dermatophagoides pteronyssinusm, up to 50%.

Objetivo: Describir el patrón de sensibilidad alérgica en adultos mayores. Métodos: Se incluyeron AM (>60 años) con diagnóstico de enfermedad respiratoria alérgica en quienes se identificó la sensibilidad mediante prick con extrac- tos ALK-abello (Port Washington, NY, Estados Unidos). Los resultados se analizaron mediante estadística descriptiva y se compararon con una serie de adultos jóvenes en relación 3:1. Los análisis de asociación se realizaron con prueba de c2 usando el software SPSSv.21 (SPSS software, IBM, NY, EUA). Resultados: Se identificaron 17 AM, predominantes mujeres (70%) edad promedio de 64 años, 52% padecían asma y 47% rinitis alérgica, 82% eran polisensibles predominantemente intradomiciliares (82%), el más frecuente Dermatophagoides pteronyssinus (50%), disminuyendo a < 18% (p<0.01) a diversas especies (Ligus- trum vulgare, Salsola kali, Periplaneta americana, Canis familiaris, Juniperus sp y Fraxinus sp). Interesantemente, los AM fueron más sensibles a ácaros en compara- ción con adultos jóvenes (p<0.01/OR= 8.92). Esto se puede deber a que la reactividad de la piel pudiera disminuir con la edad. Conclusiones: La principal sensibilidad alérgica que puede ser identificada por técnicas convencionales en adultos mayores es el Dermatophagoides pteronys- sinusm, hasta en un 50%.

Biologic Therapies for Asthma and Allergic Disease: Past, Present, and Future.

The discovery of the mechanism underlying allergic disease, mouse models of asthma, and bronchoscopy studies provided initial insights into the role of Th2-type cytokines, including interlukin (IL)-4, IL-5 and IL-13, which became the target of monoclonal antibody therapy. Omalizumab, Benralizumab, Mepolizumab, Reslizumab, and Tezepelumab have been approved. These biologicals have been shown to be good alternative therapies to corticosteroids, particularly in severe asthma management, where they can improve the quality of life of many patients. Given the success in asthma, these drugs have been used in other diseases with type 2 inflammation, including chronic rhinosinusitis with nasal polyps (CRSwNP), atopic dermatitis, and chronic urticaria. Like the Th2-type cytokines, chemokines have also been the target of novel monoclonal therapies. However, they have not proved successful to date. In this review, targeted therapy is addressed from its inception to future applications in allergic diseases.