RESUMO
Summary: Dogs and cats are the most common pets worldwide. In Italy, the prevalence of allergic sensitization to cats and dogs is 16% and 9% respectively. The limited standardization of allergenic extracts, especially for dogs, emphasizes the importance of Component Resolved Diagnosis (CRD) for accurate diagnosis and subsequent prescription of allergen immunotherapy (AIT). However, this low standardization is the main factor contributing to the unsatisfactory clinical efficacy of traditional AIT, AIT with modified allergens, and intralymphatic allergen-specific immunotherapy (ILAIT). Emerging immunological approaches, particularly for controlling the primary cat allergen, show promise but are hindered by high costs (e.g., use of anti-Fel d 1 monoclonal antibodies in humans) or by exclusively targeting Fel d 1 produced by one's own animal (e.g., immunizing cats to induce neutralizing antibodies against Fel d 1 or including an egg product with anti Fel d 1 IgY antibodies in feline diet). Further studies are imperative for standardizing pet allergens, enhancing the efficacy of various AIT modalities, and exploring other immunological approaches, to optimize the relationship between pets and their owners and prevent distressing "forced removals".
Assuntos
Alérgenos , Dessensibilização Imunológica , Hipersensibilidade , Animais de Estimação , Gatos , Dessensibilização Imunológica/métodos , Dessensibilização Imunológica/tendências , Animais , Cães , Humanos , Alérgenos/imunologia , Hipersensibilidade/imunologia , Hipersensibilidade/terapia , Hipersensibilidade/diagnóstico , Animais de Estimação/imunologiaRESUMO
Introduction: Among allergic patients, pet avoidance is commonly recommended. It is difficult for patients to accomplish this because of their emotional attachment to the pets, and its effectiveness is controversial. Objective: To explore the applicability and effectiveness of pet avoidance measures among sensitized patients. Materials and methods: We evaluated 288 patients with asthma, rhinitis, conjunctivitis and/or dermatitis using skin prick test to measure their sensitization to cats, dogs and other animals to which they were exposed. Exposure to animals was evaluated in each patient (pets at home, frequent indirect exposure or no exposure). In those patients sensitized to animals some avoidance measures, such as removing pets from home and preventing indirect exposure, were recommended. On the following two appointments, we evaluated patients' fulfillment of these recommendations. Results: Sensitization to cats, dogs and birds was high (9%, 48%, 14%, respectively), as well as direct and indirect exposure (30%, 46%, 24%, respectively). Most patients denied contact with other animals (horses, hamsters, rabbits or cows), and sensitization to them was low. During the follow-up of patients sensitized to their pets at home (n=50), most of them refused to remove them from their house due to emotional attachment, and only two followed this recommendation. Conclusions: High exposure to animals could explain the frequency of sensitization to pets in this population. However, emotional attachment and prevalent indirect exposure to animals among sensitized patients make avoidance recommendations impractical or impossible to achieve.
Introducción. Entre los pacientes alérgicos se recomienda comúnmente la evitación de mascotas; sin embargo, es difícil que los pacientes cumplan con esta recomendación debido al apego emocional y, además, su efecto clínico no es claro. Objetivo. Explorar la aplicabilidad de las medidas de evitación entre pacientes sensibilizados a mascotas . Materiales y métodos. En 284 pacientes con asma, rinitis, conjuntivitis y dermatitis, se evaluó la sensibilización a gatos, perros y otros animales mediante pruebas de punción epidérmica. Se evaluó, igualmente, el nivel de exposición a animales (mascotas en la casa y exposición indirecta frecuente). A aquellos pacientes sensibilizados a los animales, se les recomendaron medidas de evitación como retirar la mascota de la casa y evitar la exposición indirecta. En las dos citas médicas siguientes se evaluó el cumplimiento de estas recomendaciones. Resultados. La sensibilización a gatos, perros y aves fue alta (9, 48, y 14 %, respectivamente), al igual que la exposición directa o indirecta a estos animales (30, 46, 24 %, respectivamente). La mayoría de los pacientes negó el contacto frecuente con otros animales (caballos, hámsteres, conejos, vacas) y la sensibilización a estos fue baja. La mayoría de los pacientes sensibilizados a su propia mascota (n= 50) se rehusó a retirar la mascota de la casa y solo dos de ellos siguieron la recomendación de hacerlo. Conclusiones. La exposición frecuente a los animales podría explicar la gran frecuencia de sensibilización a las mascotas en esta población. Sin embargo, el apego emocional y la exposición indirecta frecuente, hacen que las recomendaciones de evitación sean imprácticas o casi imposibles de lograr.