Presença do alérgeno de soja Gly m 1 no ar em Maringá - PR / Levels of airborne soy allergen Gly m 1 in Maringá, PR, Brazil

Introdução: O conhecimento da aerobiologia local é fundamental para o alergista. Os aeroalérgenos são capazes de sensibilizar e levar ao desenvolvimento de doenças respiratórias alérgicas, portanto devem ser monitorados rotineiramente, tendo em vista possíveis mudanças locais conforme alterações climáticas, poluição e atividades agroindustriais. Objetivo: Verificar a presença e concentração do alérgeno principal da poeira da casca da soja (Gly m 1) na atmosfera da cidade de Maringá-PR e possíveis associações aos fatores climáticos. A escolha da soja deve-se a alta prevalência desta cultura no Brasil e nesta região do país. Até o presente momento, há apenas um estudo piloto feito por este mesmo grupo avaliando a presença deste alérgeno no Brasil. Métodos: Foram realizadas coletas de material atmosférico, durante o período de março de 2017 a março de 2018, durante 24 ou 48 horas distribuídas no decorrer do período, totalizando 70 amostras, das quais 10 foram excluídas por problemas técnicos de coleta. As amostras foram avaliadas pelo método ELISA (Enzyme linked immunosorbent assay ) para Gly m 1, sendo que todas as amostras apresentaram níveis detectáveis do alérgeno. Resultados: A mediana de concentração de Gly m 1 foi de 4,89 ng/m3. Os valores encontrados variaram de 0,66 ng/ m3 a 1826,1 ng/m3. Das 60 amostras analisadas, 23% delas apresentaram valores superiores a 90 ng/m3, sendo os meses de junho/2017 e março/2018 com concentrações mais elevadas. Houve correlação positiva das concentrações de Gly m 1 com as temperaturas máxima, média e mínima, umidade relativa, vento e insolação. Conclusão: Os dados evidenciam exposições constantes da população ao alérgeno do Gly m 1, por vezes em níveis elevados possivelmente capazes de gerar sensibilização e sintomas.

Introduction: Knowledge of local aerobiology is essential for allergists. Because airborne allergens can sensitize the population and lead to allergic respiratory diseases, they must be routinely monitored for the effects of climate change, pollution, and agroindustry. Objective: To verify the airborne presence and concentration of the main soy hull dust allergen (Gly m 1) in Maringá, PR, Brazil and possible associations with climatic factors. Soybeans were selected due to the high prevalence of this crop in this region. To date, only 1 pilot study (conducted by our group) has evaluated this allergen's presence in Brazil. Methods: Atmospheric material was collected between March 2017 and March 2018 in 24- or 48-hour intervals, totaling 70 samples, of which 10 were excluded due to technical problems. The samples were tested for Gly m 1 using enzyme-linked immunosorbent assay, and all samples showed detectable levels of the allergen. Results: The median concentration of Gly m 1 was 4.89 ng/m3, with values ranging from 0.66 ng/m3 to 1826.1 ng/m3. Of the 60 samples, 23% showed values > 90 ng/m3, with June 2017 and March 2018 having the highest concentrations. There was a positive correlation between Gly m 1 concentration and maximum, mean, and minimum temperatures, relative humidity, wind, and insolation. Conclusion: The data show that the population is constantly exposed to the Gly m 1 allergen, sometimes at high levels, which may lead to sensitization and symptoms.

Granos de polen anemófilos: sensibilización en pacientes alérgicos / Anemophilic pollen grains: sensitization in allergic patients

A nivel mundial, los aeroalérgenos más frecuentes causantes de enfermedades alérgicas son los granos de polen anemófilos. Estos han sido capaces de desencadenar crisis que han reflejado una elevada morbilidad. En Cuba los estudios de sensibilización a granos de polen han sido escasos. Con el objetivo de determinar la sensibilización a granos de polen en pacientes alérgicos y su relación con la presencia de enfermedades alérgicas, se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, de marzo a junio del 2019. La muestra se constituyó de 33 pacientes con asma, rinitis, rinoconjuntivitis alérgica, dermatitis atópica y conjuntivitis alérgica. A todos los pacientes se les realizó historia clínica alergológica y prueba cutánea por punción con extractos alergénicos de: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucaliptus sp. Se aplicaron las frecuencias absolutas, porcientos, desviación estándar, promedio, edad media y test de Spearman para su análisis. La edad media de la muestra fue de 36,9 años, con predominio de mujeres. Más del 50por ciento de los pacientes presentaron sensibilización a granos de polen; y de ellos, el 24,24por ciento resultaron polisensibilizados. El mayor porcentaje de sensibilización fue a Cynodon dactylon. La rinitis alérgica fue la enfermedad que prevaleció en la población estudiada(AU)

Nowadays, the most frequent aeroallergens causing allergy diseases have been anemophilous pollen grains. They have been able to triggers crises that have reflected a high morbidity. In Cuba, studies of sensitization to pollen grains have been scarce. The objective of our research was to determine the sensitization to pollen grains in allergic patients and its relationship with the presence of allergic diseases. A non-randomized, descriptive, cross-sectional, observational study was conducted from March to June 2019. The sample consisted of 33 patients with asthma, allergic rhinitis, rhinoconjunctivitis, atopic dermatitis and allergic conjunctivitis. All patients underwent allergic history and skin prick test testing with allergenic extracts of: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucalyptus sp. Absolute frequencies, percentages, standard deviation, mean, average age, and Spearman´s test were applied for analysis. The average age of the sample was 36.9 years, with a predominance of women. More than 50percent of the patients presented sensitization to pollen grains; of them, 24.24percent polysensitized. The highest percentage of sensitization was to Cynodon dactylon. Allergic rhinitis was the disease that prevailed in the population studied(AU)

Analysis of serum allergen-specific immunoglobulin E in 3 051 patients with eczema or dermatitis in an allergy clinic / 中华皮肤科杂志

Objective:To analyze measurement results of serum allergen-specific immunoglobulin E (IgE) in patients with eczema/dermatitis.Methods:A retrospective analysis was conducted on serum allergen-specific immunoglobulin E (IgE) levels in 3 051 patients with eczema/dermatitis, who visited the allergy clinic of Huashan Hospital from April 1, 2021 to March 31, 2022. The serum allergen-specific IgE level was detected by using the Phadia allergen detection system, and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis. Comparisons of enumeration data between groups were performed by chi-square test.Results:Among the 3 051 patients with eczema/dermatitis, there were 1 412 with atopic dermatitis and 1 639 were other eczema/dermatitis. Detection of serum allergen-specific IgE showed that 1 629 (53%) patients were positive for allergens, and the number of positive allergen-specific IgEs in each patient was 3.0 ± 1.6. The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae (904/1 522, 59%) , Dermatophagoides pteronyssinus (891/1 513, 59%) and Alternaria alternata (206/1 068, 19%) , and the top 3 common food allergens were shrimps (251/1 432, 18%) , egg white (165/992, 17%) and cow milk (149/994, 15%) . Among the 3 051 patients, 25 (1%) were aged < 2 years, 571 (19%) aged 2 - 12 years, 285 (9%) aged 12 - 18 years, and 2 170 (71%) were aged > 18 years. The most common food allergens were both egg white in the age groups of < 2 years and 2 -12 years (77%, 37%, respectively) , and were both shrimps in the age groups of 12 - 18 years and > 18 years (31%, 17%, respectively) . Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups, with the positive rate ranging from 36% to 84%; in addition, the positive rate of molds was relatively high in the age group of 2 - 12 years (mold mixture: 37%; Alternaria alternata: 27%) . From April 2021 to March 2022, the positive rate of outdoor allergens ranged from 10% to 15% among outpatients in every month; the positive rates of tree pollen and grass pollen increased from April 2021, and peaked in October 2021. The patients with atopic dermatitis showed a significantly increased positive rate of allergens (73%) compared with those with other eczema/dermatitis (37%, χ2 = 389.36, P<0.001) , and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis. Conclusions:The common allergens were Dermatophagoides farina, Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis. Food allergy was more common in infant patients, and inhalation allergy was more common in child, adolescent and adult patients. The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.

Tratamiento de la rinitis alérgica en época de pandemia. Documento de consenso de sociedades médicas de América Latina y el Caribe / Treatment of allergic rhinitis in pandemic times. Consensus statement from medical societies of Latin America and the Caribbean

La rinitis alérgica ha ido en aumento en los países latinoamericanos, dando lugar a una creciente población de pacientes que necesitan tratamiento médico para esta afección respiratoria. Su similitud con la COVID-19 en cuanto a síntomas y la posibilidad de concurrencia con esta, hacen que la rinitis alérgica sea de particular interés para los sistemas de salud. Los países de América Latina y el Caribe han sido particularmente vulnerables por múltiples desafíos, entre estos, las altas tasas de pobreza, el acceso limitado a la atención médica y las limitaciones en la prestación de servicios básicos de salud, así como la ausencia de guías de tratamiento para la rinitis alérgica en situación de pandemia. Con el objetivo de proporcionar orientación esencial para los equipos multidisciplinarios de América Latina y el Caribe con respecto a la evaluación y el tratamiento de la rinitis alérgica durante la pandemia de COVID-19, se revisó literatura científica publicada sobre tratamiento de la rinitis alérgica y COVID-19, y se consideró la opinión de profesionales líderes de sociedades científicas de la región. Se analizaron las diferentes medidas para evitar contagios, y las diferentes estrategias de tratamiento con énfasis en la terapia intranasal y el tratamiento con vacunas contra la alergia. Se formuló una declaración de posicionamiento con la intención de mantener la continuidad del servicio médico en el contexto de una pandemia y minimizar la propagación, infección y complicación asociada con el coronavirus tipo 2 del síndrome respiratorio agudo severo en pacientes con seguimiento o comenzando tratamiento para la rinitis alérgica(AU)

Allergic rhinitis has been increasing in Latin American countries, leading to a growing population of patients who need medical treatment for this respiratory condition. Its similarity to COVID-19 in terms of symptoms and the possibility of concurrence with it, make allergic rhinitis of particular interest to health systems. The countries of Latin America and the Caribbean have been particularly vulnerable due to multiple challenges, including high poverty rates, limited access to medical care and limitations in the provision of basic health services, as well as the absence of guidelines of treatment for allergic rhinitis in a pandemic situation. With the aim of to provide essential management for multidisciplinary teams in Latin America and the Caribbean regarding the evaluation and treatment of allergic rhinitis during the COVID-19 pandemic, published scientific literature on the treatment of allergic rhinitis and COVID-19 was reviewed, and the opinion of leading professionals from scientific societies in the region was considered. The different measures to avoid infections and the different treatment strategies were analyzed, with an emphasis on intranasal therapy and treatment with allergy vaccines. A position statement was formulated with the intention of maintaining continuity of medical service in the context of a pandemic and minimizing the spread, infection and complication associated with severe acute respiratory syndrome coronavirus 2 in patients undergoing or starting treatment for allergic rhinitis(AU)

A Study of Skin Sensitivity for Common Allergens in Patients of Nasobronchial Allergy in North India

Objective: The present study is designed to investigate the profile of different allergen sensitivities by skin prick test in patients with nasobronchial allergy (NBA). Materials and methods: A total of 130 patients of NBA were included in the study. Each NBA patient was subjected to the skin prick test with 44 allergens. Results: Out of 130 patients, 98 patients (75.4%) had both bronchial asthma and allergic rhinitis, 11 patients (8.5%) had allergic rhinitis, and 21 patients (16.2%) had bronchial asthma alone. The age of patients ranged from 12 to 60 years, with mean age 26.4 � 10.24 years. The most common allergen came out to be insects (26.2%) followed by dust mites (20.7%), dusts (7.4%), pollens (5.9%), fungi (5.2%), danders (3.8%), and silk (2.2%). Common insect antigens were moth and mosquito (28.9%) followed by the cockroach, housefly (24.4%), and honeybee (18.9%). Common dust allergens were grain dust and house dust. Among pollens, Amaranthus spinosus and Cassia siamea (13.3%) followed by Brassica campestris (12.2%) and Holoptelea integrifolia (10%) were common. Among fungi, Aspergillus fumigatus and Aspergillus niger were common allergens. Conclusion: Common allergens in patients of NBA were identified. Allergen-specific immunotherapy can be a viable option for these patients.

House dust mite fauna characterization in the city of Rio de Janeiro and its importance in allergy diagnosis / Caracterização da fauna dos ácaros de poeira na cidade do Rio de Janeiro e sua importância em diagnósticos de alergias

Introduction: The home environment is one of the most favorable spaces for the development of mites because of its low light, humidity, and temperature. Thus, it contributes to the growing cases of allergies among atopic individuals. Objective: To investigate the faunal profile of house dust mites in the city of Rio de Janeiro and the allergenic potential in this region. Methods: Thirty dust samples were collected from homes in the city of Rio de Janeiro, and the species found were classified according to their morphology, family, and genus by classification key. For the collection region, the total protein level was assessed by the Lowry method and electrophoresis under denaturing conditions (SDSPAGE). Results: There was a predominance of Pyroglyphidae mites, accounting for 84.9% of samples; Tyrophagus putrescentiae accounted for 8%, Blomia tropicalis for 6%, Cheyletus malaccensis for 1%, and Acarus siro for 0.1%. The allergen protein content of the samples was the following: group 1 ­ 25 kDa (Der 1, Der p 1, and Blo t 1), group 2 ­ 15 kDa (Der f 2, Der 2, Tyr p 2, and Blo t 2), and group 3 ­ 29-30 kDa (Der f 3 and Blo t 3), which indicates that people in this region are susceptible to sensitization to these mites. Conclusion: Knowledge of the mite fauna in the region under study allows the guidance of health care professionals to perform skin tests for specific mites and conduct treatment according to the pool of mite extracts containing antigens, making immunotherapy more effective.

Introdução: O ambiente domiciliar é um dos espaços favoráveis para o desenvolvimento de ácaros, tendo em vista a baixa luminosidade, umidade e temperatura, o que contribui para os crescentes casos de alergias em indivíduos atópicos. Objetivo: Investigar o perfil faunístico dos ácaros na cidade do Rio de Janeiro e o potencial alergêncio para essa região. Métodos: Foram coletadas 30 amostras de poeira em residências na cidade do Rio de Janeiro, e as espécies encontradas foram classificadas quanto à morfologia, família e o gênero por chave de classificação. Para as regiões das coletas, a carga total de proteínas contendo os alérgenos foi determinada pelo método de Lowry e eletroforese em condições desnaturantes (SDS-PAGE). Resultados: Os resultados mostram a predominância de 84,9% de ácaros da família Pyroglyphidae; para os demais ácaros o percentual corresponde a 8% Tyrophagus putrescentiae, 6% Blomia tropicalis, 1% Cheyletus malaccensis, e 0,1% de Acarus siro. O conteúdo proteico alergêncio constituinte das amostras foram, grupo 1: 25 kDa (Der 1, Der p 1 e Blo t 1); grupo 2: 15 kDa (Der f 2, Der 2, Tyr p 2 e Blo t 2); e para o grupo 3: 29-30 kDa (Der f 3 e Blo t 3), o que indica uma região passível à sensibilização de indivíduos por estes ácaros. Conclusão: O conhecimento da acarofauna nas regiões em estudo permite orientar a comunidade médica quanto à realização de testes cutâneos, além da terapêutica a partir do pool de extratos de ácaros contendo os antígenos, a fim de tornar a imunoterapia mais eficaz.

Alergia a frutos do mar: principais desafios na alimentação e soluções desenvolvidas por alunos do curso de nutrição e gastronomia / Seafood allergy: main challenges in their diet and solutions developed by students of the nutrition and gastronomy course

A alergia alimentar caracteriza-se por uma reação adversa a um determinado alimento, envolvendo um mecanismo imunológico. Uma das alergias mais comuns encontradas atualmente é a alergia a frutos do mar, a qual se baseia em uma hipersensibilidade a animais desse grupo. O objetivo desta pesquisa é identificar os desafios expostos na alimentação de alérgicos a frutos do mar e formular soluções para essa população baseadas em alimentos nutricionalmente substitutos. Sendo realizado em três etapas: investigação inicial, construção de conceitos e planejamento de uma ação com orientações nutricionais. De acordo com as dificuldades encontradas na alimentação dessa parcela populacional, realizaram-se diferentes preparações, com nutrientes como ômega-3, proteínas, vitaminas do complexo B, zinco, ferro, potássio, magnésio, iodo e selênio, os quais também são encontrados nos frutos do mar, a fim de evitar possíveis contaminações cruzadas e garantir seu aporte nutricional em alimentos substitutos. Foi possível concluir que os alérgicos aos frutos do mar não apresentam uma interferência significativa em sua qualidade de vida, tendo um impacto nutricional pequeno, visto que por meio da alimentação existem outras fontes, necessitando somente de alguns cuidados no dia a dia em virtude das consequências de uma possível contaminação.

Food allergy is characterized by an adverse reaction to a given food, involving an immunological mechanism. One of the most common allergies currently found is seafood allergy, which is based on hypersensitivity to animals in this group. The objective of this research is to identify the challenges exposed in the feeding of seafood allergies and formulate solutions for this population based on nutritionally substitute foods. Being carried out in 3 stages, initial investigation, construction of concepts and planning of an action with nutritional guidance. According to the difficulties encountered in feeding this portion of the population, different preparations were carried out, with nutrients such as: ômega-3, proteins, B vitamins, zinc, iron, potassium, magnesium, iodine and selenium. Which are also found in seafood. In order to avoid possible cross-contamination and ensure their nutritional intake in substitute foods. It was possible to conclude that seafood allergies do not present a significant interference in their quality of life, having a small nutritional impact, since through food there are other sources, requiring only some care on a daily basis due to the consequences of possible contamination.

Labeling food allergens in the packaged food pyramid groups in Brazil: analysis of descriptions, ambiguities, and risks / Rotulagem de alérgenos alimentares em alimentos embalados segundo grupos alimentares da pirâmide brasileira: análise da descrição, riscos e ambiguidades

ABSTRACT Objective: The aim of this study was to evaluate allergenic labeling components of packaged foods for "What is the quality of food labels?" and "What is the group of Brazilian Food Pyramid that 'May contain' is predominant?." Methods: The photographs of 916 products were obtained, of which 518 were analyzed. Data from each label were evaluated according to Brazilian Food Pyramid Groups (i.e., Cereals, Fruits, & Vegetables; Soybean & products; Milk & dairy products; Meat & eggs; Fats & oils; and Sugars & sweets). Ten items were analyzed in each label, namely, the presence of a list of ingredients, alert phrase for allergy sufferers, grouping of the alert phrase, phrase location, uppercase phrase, the phrase in bold, the color of alert phrase contrasting to the background, adequate font size, do not claim the absence for any allergen with the ingredients, and others factors that make it difficult to read. For the second question, a structured questionnaire was completed, and products were classified into two categories, namely, "Contain" and "May contain." Results: The quality of the label was appropriate, and 69% of packaged foods had at least one allergen. The information "May contain" were higher in cow's milk (Cereals and Meat & eggs), soy (Soybean & products), and egg protein (Cereals). Soybean & products were the highest insecurity group. Conclusions: Brazilian health professionals can count on good-quality labeling of packaged products. Consequently, they could promote patients' and parents/caregivers' education to consult the labels and manage the risks in processed foods about precautionary allergen labeling. Soybean & products were the most significant insecurity for food choices between Brazilian Pyramid Groups.

RESUMO Objetivo: Avaliar os componentes alergênicos da rotulagem de alimentos embalados e responder "Qual é a qualidade da rotulagem?" e "Qual é o grupo de alimentos em que a expressão 'Pode conter' é predominante?". Métodos: Foram obtidas fotografias de 916 produtos, dos quais 518 foram analisados. Os dados dos rótulos foram avaliados de acordo com os grupos da pirâmide alimentar brasileira (Cereais, Frutas & Vegetais; Soja & Derivados; Leite & Laticínios; Carne & Ovos; Gorduras & Óleos; Açúcares & Doces). Dez itens foram analisados nos rótulos: presença de lista de ingredientes; frase de alerta para alérgicos; frase de alerta; local da frase; frase em letras maiúsculas; frase em negrito; a cor da frase de alerta contrastando com o fundo; tamanho de fonte adequado; não alegar ausência de qualquer alérgeno; outros fatores de difícil leitura. Para a segunda questão, foi respondido questionário estruturado, e os produtos classificados em categorias: "Contém" e "Pode conter". Resultados: A qualidade do rótulo foi adequada e 69% dos alimentos embalados continham pelo menos um alérgeno. A informação "Pode conter" foi mais identificada em: proteína do leite (Cereais e Carnes e ovos), soja (Soja & derivados) e proteína do ovo (Cereais). Soja e derivados foi o grupo alimentar de maior insegurança. Conclusões: Profissionais de saúde podem contar com rotulagem de boa qualidade dos produtos embalados e, consequentemente, promover a educação de pais/cuidadores para consultar os rótulos e gerenciar os riscos em alimentos processados. Soja e produtos são os alimentos com maior insegurança entre os Grupos da Pirâmide Brasileira.

Role of mast cells in the pathogenesis of allergic contact dermatitis / 中华皮肤科杂志

Allergic contact dermatitis (ACD) is a T cell-mediated inflammatory skin disease induced by contact allergens. The role of mast cells in ACD remains controversial. In the sensitization phase, mast cells play a pro-inflammatory role by releasing inflammatory cytokines to promote recruitment of neutrophils, and affect the sensitization process by stimulating or inhibiting the migration of dendritic cells. During the elicitation phase, mast cells promote non-allergen-specific inflammation, and enhance allergen-specific inflammation in moderate ACD, but inhibit allergen-specific inflammation in severe and chronic ACD. In addition to the IgE-Fcε receptor I-histamine pathway, Mas-related G-protein coupled receptor B2/X2 (MrgprB2/X2) can mediate the activation of mast cells, leading to the release of tryptase to drive non-histaminergic itch, and may serve as a new target for the treatment of ACD.

Advances and utility of laboratory investigation in diagnosis of pediatric allergic diseases / 中华检验医学杂志

The rapid increase of childhood allergic disorders has become one of the major challenges in the pediatric health care system. Laboratory diagnosis is essential in order to determine appropriate strategies towards best clinical practice strategies, including accurate diagnosis, prophylaxis and optimized management. Once there are sufficient clinical grounds to support a diagnosis of allergy, confirmatory in vivo and in vitro tests should be performed. In vivo tests mainly include skin prick tests and allergen provocation tests. Provocation tests are the gold standard for diagnosing allergic diseases. In vitro tests mainly include allergen-specific IgE antibody, Th2 related cytokines, and mast cell activity markers. These tests can clarify the immune state status of the patient and lead to optimized treatment, such as avoiding allergens avoidance, allergens-specific immunotherapy, and anti-IgE therapy. Controlling disease progress and preventing relapses can benefit children who are suffering from the consequences of allergies.

Ácaros en sistemas de ventilación de edificios industriales: bioindicadores de la calidad del aire interior / Mites in ventilation systems of industrial buildings: bioindicators of indoors air quality

La Organización mundial de la Salud, ha señalado que 92% de la población mundial vive en lugares donde los niveles de calidad del aire se han reducido por debajo de los límites fijados, estimando que a nivel mundial aproximadamente 90% de las personas respiran aire contaminado y que la población de las ciudades pasa entre el 80 y el 90% de su tiempo en recintos cerrados, en un ambiente contaminado en mayor o menor grado; puesto que los niveles de contaminación pueden llegar a ser de 10 a 100 veces más elevados en espacios interiores respecto a los exteriores. La deficiencia en la calidad del aire interior puede dar origen a la manifestación de síntomas respiratorios relacionados como rinitis alérgica y asma, entre otras patologías y se estima que, a nivel global, millones de personas sufren de ambas enfermedades, reduciendo la calidad de vida de la población. Los ácaros constituyen los sensibilizantes respiratorios más extendidos en lugares de trabajo y están presentes en casi todos los hábitats, inclusive en el ambiente aéreo, movilizados por el viento o aerosoles, siendo la principal fuente de alérgenos interiores asociados a rinitis y asma. La presente revisión describe las características de los ácaros como fuente de contaminación ambiental y su posible utilidad como futuros bioindicadores de calidad del aire interior en sistemas de ventilación de edificios industriales con el fin de reducir la exposición y sensibilización de los trabajadores a sus alérgenos(AU)

The World Health Organization has pointed out that 92% of the world's population lives in places where air quality levels have fallen below the limits set, estimating that approximately 90% of people worldwide they breathe polluted air and that the population of cities spends between 80 and 90% of their time indoors, in an environment that is polluted to a greater or lesser degree; since pollution levels can be 10 to 100 times higher indoors than outdoors. The deficiency in indoor air quality can give rise to the manifestation of related respiratory symptoms such as allergic rhinitis and asthma, among other pathologies, and it is estimated that, globally, millions of people suffer from both diseases, reducing the quality of life of the population. mites are the most widespread respiratory sensitizers in the workplace and are present in almost all habitats, including in the air environment, moved by the wind or aerosols, being the main source of indoor allergens associated with rhinitis and asthma. This review describes the characteristics of mites as a source of environmental contamination and their possible use as future bioindicators of indoor air quality in ventilation systems of industrial buildings in order to reduce the exposure and sensitization of workers to their allergens(AU)

Alergias alimentarias en pediatría: frecuencia, características clínicas y alergenos más frecuentes en pacientes de un consultorio pediátrico de alergia de referencia

RESUMEN Introducción: Las alergias alimentarias constituyen una patología cada vez más frecuente en la infancia. Es importante conocer sus características para su prevención y mejor abordaje terapéutico. Objetivo: Determinar la frecuencia, las características clínicas y los tipos de alimentos desencadenantes de las alergias alimentarias más frecuentes, en pacientes pediátricos en un consultorio de referencia, entre marzo 2016-marzo de 2019. Materiales y Métodos: estudio transversal, descriptivo, observacional con datos secundarios de fichas clínicas de pacientes de menores de 18 años. Se estudiaron edad, sexo, manifestaciones clínicas y tipo de alergeno alimentario desencadenante, detectado por RAST. Resultados: La mediana de edad de diagnóstico fue de 10 meses, fueron lactantes 52(73%) pacientes, 10(14%) fueron prescolares y el resto escolares y adolescentes; 43(60%) fueron varones. Las lesiones cutáneas estuvieron presentes (aisladas o combinadas con otros síntomas) en 46 casos (64%); los síntomas respiratorios en 38 casos (53%); gastrointestinales en 30 casos (42,2%). La leche fue el alergeno alimentario detectado en 52 (73%) pacientes, el huevo en 33 (46%), el trigo en 7(9,8%), la soja en 6(8,5%), el gluten en 5(7%); las golosinas, el maní, el maíz y los embutidos en 2 (2,8%) niños y finalmente la sandía, el tomate y los condimentos en 1(1,4%) caso. Se registró un único alérgeno en 46 casos (64,7%), dos alérgenos en 16 casos (22,5%), tres alérgenos en 5 casos (7%), y más de tres alérgenos en 4 casos (5,6%). Conclusiones: Los lactantes son los más afectados por las alergias alimentarias siendo más prevalentes los síntomas cutáneos y digestivos. La proteína de leche de vaca es el alergeno más frecuente seguido por el huevo.

ABSTRACT Introduction: Food allergies are an increasingly frequent pathology in childhood. In order to prevent them and to offer a better therapeutic approach, it is important to characterize them. Objective: To determine the frequency, clinical characteristics and types of foods that trigger the most frequent food allergies, in pediatric patients at a referral clinic, between March 2016-March 2019. Materials and Methods: This was a cross-sectional, descriptive, observational study with secondary data from clinical records of patients under 18 years of age. Age, sex, clinical manifestations and type of triggering food allergen, detected by RAST, were studied. Results: The median age of diagnosis was 10 months, 52 (73%) patients were infants, 10 (14%) were preschool and the rest were schoolchildren and adolescents; 43 (60%) were male. Skin lesions were present (isolated or combined with other symptoms) in 46 cases (64%); respiratory symptoms in 38 cases (53%); gastrointestinal in 30 cases (42.2%). Milk was the food allergen detected in 52 (73%) patients, egg in 33 (46%), wheat in 7 (9.8%), soy in 6 (8.5%), gluten in 5 (7%); sweets, peanuts, corn and sausages in 2 (2.8%) children and finally watermelon, tomato and condiments in 1 (1.4%) case. A single allergen was recorded in 46 cases (64.7%), two allergens in 16 cases (22.5%), three allergens in 5 cases (7%), and more than three allergens in 4 cases (5.6%). Conclusions: Infants are the most affected by food allergies, skin and digestive symptoms are more prevalent. Cow's milk protein is the most common allergen followed by eggs.

Molecular sensitization profile of patients with lipid transfer protein syndrome and associated clinical characteristics / Perfil de sensibilização molecular de doentes com síndrome de proteínas de transferência lipídica e associação com características clínicas

Introduction: Lipid transfer proteins (LTPs) can cause a diversity of food allergy phenotypes, broadly defined as LTP syndrome. Objective: The aims of this study were to characterize the molecular profile of patients with this syndrome and to evaluate any possible association with clinical phenotypes. Methods: Retrospective study of patients followed up from April 2011 to April 2019. Patients with LTP syndrome and sensitization to Pru p 3, diagnosed by ImmunoCAP ISAC® (Phadia, Thermo Fisher Scientific, Sweden), were selected. Statistical analysis was conducted in IBM SPSS® v20. Results: One hundred patients were assessed, 64% of which were females, with a mean age 27.2±11.8 years (15% pediatric). Mean age at first reaction was 19.9±10 years. According to clinical presentation, two groups were created: local reaction (LR) (n=28) and systemic reaction (SR) (n=72). The following parameters were analyzed in association with the SR group: LTP sensitization profile, co-sensitization to profilins or PR-10 proteins, presence of atopy, and gender. In univariate analysis, a positive association was found between the SR group, female sex (odds ratio [OR] 2.8, p=0.02), and presence of Jug r 3 (OR 2.6, p=0.03). There was a negative association between the SR group, the presence of Par j 2 (OR 0.16, p < 0.01), and co-sensitization to profilins (OR 0.11, p < 0.01). In multivariate analysis, only the presence of Par j 2 kept statistical significance (OR 0.023, p < 0.01). Conclusions: Molecular profile characterization may be useful as a predictor of disease expression in an individual, making a relevant contribution to improved follow-up of these patients. Sensitization to Par j 2 seems to provide protection for the occurrence of SR.

Introdução: As proteínas de transferência lipídicas (LTP) são causa de uma variedade de fenótipos de alergia alimentar globalmente definidos como síndrome LTP. Objetivo: O nosso objetivo é caracterizar o perfil molecular destes doentes e avaliar associação com os fenótipos clínicos. Metodologia: Estudo retrospectivo em que foram selecionados doentes com síndrome de LTP e sensibilização ao alergênio molecular pru p 3 em ImmunoCAP ISAC® (Phadia, Thermo Fisher Scientific, Suécia) realizados de abril de 2011 a abril de 2019. A análise estatística foi realizada através do software IBM SPSS® v20. Resultados: Cem doentes, 64% do sexo feminino, com média de idades à data do exame de 27,2±11,8 anos (idade pediátrica - 15%). A média de idades da primeira reação foi de 19,9±10 anos. Foram constituídos dois grupos com base na apresentação clínica à data da realização do exame: local (LR) n = 28; sistêmica (SR) n = 72. Os seguintes parâmetros foram avaliados em relação ao grupo SR: perfil de sensibilização a LTP, co-sensibilização com profilinas ou PR-10, presença de atopia e gênero. Na análise univariada foi encontrada associação positiva com grupo SR para sexo feminino (Odds ratio (OR) 2,8, p = 0,02) e presença de Jug r 3 (OR 2,60, p = 0,03). Associaram-se negativamente à doença sistêmica a presença de Par j 2 (OR 0,16, p < 0,01) e de profilinas (OR 0,11, p < 0,01). Na análise multivariada apenas manteve significado estatístico a presença de par j 2 (OR 0,023, p < 0,01). Conclusões: A caracterização do perfil molecular pode ser útil como preditos da expressão da doença, sendo uma importante ferramenta no seguimento destes doentes. A presença de Par j 2 parece ser fator protetor de reação grave.

Work-related asthma / Asma relacionada ao trabalho

ABSTRACT Work-related asthma (WRA) is highly prevalent in the adult population. WRA includes occupational asthma (OA), which is asthma caused by workplace exposures, and work-exacerbated asthma (WEA), also known as work-aggravated asthma, which is preexisting or concurrent asthma worsened by workplace conditions. In adults, the estimated prevalence of OA is 16.0%, whereas that of WEA is 21.5%. An increasing number of chemicals used in industrial production, households, and services are associated with the incidence of adult-onset asthma attributable to exposure to chemicals. This review article summarizes the different types of WRA and describes diagnostic procedures, treatment, prevention, and approaches to patient management. It is not always easy to distinguish between OA and WEA. It is important to establish a diagnosis (of sensitizer-/irritant-induced OA or WEA) in order to prevent worsening of symptoms, as well as to prevent other workers from being exposed, by providing early treatment and counseling on social security and work-related issues.

RESUMO A asma relacionada ao trabalho (ART) é um acometimento com elevada prevalência na população adulta. A ART inclui a asma ocupacional (AO), desencadeada pela exposição a um agente presente em um determinado ambiente de trabalho, e a asma agravada ou exacerbada pelo trabalho (AA/ET), que acomete indivíduos com antecedentes de asma ou que iniciaram um quadro de asma concomitante, mas sem relação causal com o ambiente de trabalho. Estima-se que 16,0% e 21,5% da asma no adulto sejam AO e AA/ET, respectivamente. O elevado e crescente número de substâncias químicas usadas na produção industrial, no uso domiciliar ou em serviços é responsável pela incidência de asma associada à exposição a agentes químicos na vida adulta. Este artigo de revisão descreve os principais tipos de ART, os procedimentos para seu diagnóstico, tratamento e prevenção e as condutas frente ao diagnóstico. Nem sempre é fácil a distinção entre AO e AA/ET. A importância do diagnóstico (AO ou AA/ET e asma induzida por sensibilizantes ou irritantes) tem relação com a adoção de medidas de prevenção para evitar que novos indivíduos sejam expostos e que os acometidos apresentem agravamento da doença, utilizando tratamento precoce e fornecendo orientação sobre aspectos previdenciários e trabalhistas.

Brown spider venom toxins: what are the functions of astacins, serine proteases, hyaluronidases, allergens, TCTP, serpins and knottins?

Accidents caused by the bites of brown spiders (Loxosceles) generate a clinical condition that often includes a threatening necrotic skin lesion near the bite site along with a remarkable inflammatory response. Systemic disorders such as hemolysis, thrombocytopenia, and acute renal failure may occur, but are much less frequent than the local damage. It is already known that phospholipases D, highly expressed toxins in Loxosceles venom, can induce most of these injuries. However, this spider venom has a great range of toxins that probably act synergistically to enhance toxicity. The other protein classes remain poorly explored due to the difficulty in obtaining sufficient amounts of them for a thorough investigation. They include astacins (metalloproteases), serine proteases, knottins, translationally controlled tumor proteins (TCTP), hyaluronidases, allergens and serpins. It has already been shown that some of them, according to their characteristics, may participate to some extent in the development of loxoscelism. In addition, all of these toxins present potential application in several areas. The present review article summarizes information regarding some functional aspects of the protein classes listed above, discusses the directions that could be taken to materialize a comprehensive investigation on each of these toxins as well as highlights the importance of exploring the full venom repertoire.(AU)

Analysis of allergens in children with common allergic diseases in Guangzhou / 公共卫生与预防医学

Objective To understand the distribution of allergens in children with common allergic diseases in Guangzhou, and to provide evidence for the prevention and treatment of environmental allergens in children with different allergic diseases. Methods This study enrolled a total of 6 869 children with allergic diseases, including wheezing diseases and asthma (1 013 cases), allergic rhinitis (660 cases), allergic conjunctivitis (422 cases), eczema (2 762 cases), atopic dermatitis (831 cases) and urticaria (1 181 cases). Western blotting was used to detect the serum allergen type E specific antibodies (sIgE) of the patients. The results were statistically analyzed. Results The total positive rate of sIgE in 6 869 children was 74.01%. The positive rate of male children (75.02%) was higher than that of female children (72.25%). The positive rate of inhalation allergens (53.47%) was higher than that of food allergens (57.39%). House dust mites and milk were the most common inhalation allergens and food allergens, respectively. Eczema was the most common allergic disease in infants and toddlers. Allergic rhinitis and urticaria were common in school-age children. Conclusion The main allergens causing allergic diseases in children in Guangzhou were dust mites and milk. Different allergic diseases had its specific allergens. It is necessary to take targeted prevention measures accordingly.

Risk factors for bronchial asthma in children with allergic rhinitis / 中国学校卫生

Objective@#To explore the risk factors of bronchial asthma in children with allergic rhinitis, and to provide evidence for the early diagnosis, treatment and prevention of asthma in children with allergic rhinitis.@*Methods@#Children with allergic rhinitis and children with allergic rhinitis and asthma, who attended the Allergy Clinic of the Capital Institute of Pediatrics from November 2019 to October 2020, were recruited for the study. Medical history, clinical characteristics, allergen types and risk factors were collected and analyzed.@*Results@#A total of 117 children with allergic rhinitis and 111 children with allergic rhinitis that subsequently developed into asthma were included. The results of the univariate analysis showed that the occurrence of asthma in children with allergic rhinitis was associated with the course of rhinitis, severity of rhinitis, type of rhinitis, seasonal onset, history of pet contact, family history of allergic diseases, mold, ragweed, dermatophagoides culinae and dust mite sensitization( χ 2=6.15, 8.79, 3.99, 9.44, 5.17, 4.43, 8.48, 10.38, 6.18, 5.31, P <0.05). The Logistic regression analysis showed that rhinitis severity( OR = 7.03 ), family history of allergic diseases( OR =8.24), mold( OR =5.19), and household dust mite sensitization ( OR =25.25) were positively correlated with the occurrence of asthma in children with allergic rhinitis( P <0.05), and dust mite sensitization was the strongest risk factor.@*Conclusion@#The development of asthma in children with allergic rhinitis is affected by many factors, among which the severity of rhinitis, family history of allergic diseases and dust mite sensitization are the most important factors.

Diagnosis and treatment of contact urticaria / 中华皮肤科杂志

Contact urticaria is a kind of chronic inducible urticaria, and can be classified into immunologic contact urticaria, non-immunological contact urticaria and contact urticaria of unknown pathogenesis according to pathophysiological mechanisms. The allergens responsible for contact urticaria are various, and there have been increasing reports on contact urticaria induced by related ingredients in cosmetics and by occupational exposure of healthcare workers in recent years. Detailed medical history and physical examination are the key to the diagnosis of contact urticaria, and a variety of skin tests can assist in the diagnosis. The main aim of treatment is to control symptoms, and avoiding contact with allergens is the key to preventing recurrence.

"Experimentando" a alergia à marijuana (Cannabis sativa), e os porquês de ficarmos "ligados" / "Experiencing" an allergy to marijuana (Cannabis sativa), and the reasons for staying "aware"

O primeiro relato de reação alérgica à Cannabis sativa foi publicado em 1971, com a descrição de uma mulher de 29 anos que após fumar maconha pela primeira vez apresentou sintomas compatíveis com uma reação anafilática. A alergia à maconha pode manifestar-se por sintomas diversos, inclusive graves e generalizados, com reações cruzadas, principalmente, mas não exclusivamente, com frutas e vegetais. Portanto, é de suma importância familiarizar-se com os sinais e sintomas da alergia à Cannabis, conhecer as opções disponíveis para o diagnóstico, as perspectivas de tratamento e como orientar o paciente. Esta revisão tem por objetivo destacar a diversidade de rotas de sensibilização e reações à planta, enfatizando a heterogeneidade de apresentações da alergia à Cannabis.

The first report of an allergic reaction to Cannabis sativa was published in 1971, with the description of a case of a 29-yearold woman who had symptoms consistent with an anaphylactic reaction after smoking marijuana for the first time. A marijuana allergy can manifest by various symptoms, including severe and disseminated symptoms with cross-reactions mainly, but not exclusively, with fruits and vegetables. Therefore, it is extremely important to become familiar with the signs and symptoms of a cannabis allergy and to know the options available for diagnosis, treatment perspectives, as well as how to guide the patient. This review aims to highlight the diversity of sensitization routes and reactions to the plant, emphasizing the heterogeneity of presentations of a cannabis allergy.

Caracterización de la rinitis alérgica en el Hospital Universitario General Calixto García. Octubre 2016-Octubre 2017 / Characterization of allergic rhinitis in the General Calixto Garcia University Hospital. October 2016-October 2017

Las enfermedades alérgicas van en aumento importante en todo el mundo. La rinitis alérgica es una enfermedad inflamatoria crónica de la mucosa nasal IgE mediada, alérgeno-específica con participación de diversas células. Nos propusimos caracterizar la rinitis alérgica en pacientes atendidos en el Hospital Universitario General Calixto García. Se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, entre octubre 2016 y octubre 2017. En una muestra de 100 pacientes que cumplieron los criterios de inclusión, se realizó historia clínica alergológica empleando variables como: edad, sexo, antecedentes patológicos personales y familiares, procedencia, manifestaciones clínicas, y prueba cutánea por punción. Predominó el sexo femenino entre 30 y 39 años de edad, de área urbana, antecedentes patológicos familiares y personales de asma y conjuntivitis. La rinitis intermitente leve prevaleció en nuestro estudio, así como la sensibilidad a Dermatophagoides pteronyssinus. La tercera década de la vida fue la edad promedio de los pacientes. Se concluye que los pacientes presentaron una alta sensibilidad a Dermatophagoides pteronyssinus. La rinitis persistente leve, con la mitad de los casos, obtuvo mayor predominio por la duración de los síntomas(AU)

Allergic diseases are increasing significantly worldwide. Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, IgE-mediated, allergen-specific with the participation of various cells. The aims of this study was to characterize allergic rhinitis in patients treated at the General Calixto García University Hospital. Descriptive cross-sectional non-randomized observational study was carried out between October 2016 and October 2017. A sample of 100 patients who meet the inclusion criteria was studied. Allergological medical history was performed using variables such as age, sex, personal and family pathological history, origin, clinical manifestations, and puncture skin test. Female sex predominated between 30 and 39 years old, urban area, family and personal pathological history of asthma and conjunctivitis. Mild intermittent rhinitis predominated in our study. Sensitivity to Dermatophagoides pteronyssinus. The third decade of life was the average age of the patients in this study. We summarize that patients had presented a high sensitivity to Dermatophagoides pteronyssinus. Mild persistent rhinitis with half of the cases had a greater predominance for the duration of symptoms(AU)