Proposal to Screen for Zinc and Selenium in Patients with IgA Deficiency.

The increase in life expectancy can be a consequence of the world's socioeconomic, sanitary and nutritional conditions. Some studies have demonstrated that individuals with a satisfactory diet variety score present a lower risk of malnutrition and better health status. Zinc and selenium are important micronutrients that play a role in many biochemical and physiological processes of the immune system. Deficient individuals can present both innate and adaptive immunity abnormalities and increased susceptibility to infections. Primary immunodeficiency diseases, also known as inborn errors of immunity, are genetic disorders classically characterized by an increased susceptibility to infection and/or dysregulation of a specific immunologic pathway. IgA deficiency (IgAD) is the most common primary antibody deficiency. This disease is defined as serum IgA levels lower than 7 mg/dL and normal IgG and IgM levels in individuals older than four years. Although many patients are asymptomatic, selected patients suffer from different clinical complications, such as pulmonary infections, allergies, autoimmune diseases, gastrointestinal disorders and malignancy. Knowing the nutritional status as well as the risk of zinc and selenium deficiency could be helpful for the management of IgAD patients. OBJECTIVES: to investigate the anthropometric, biochemical, and nutritional profiles and the status of zinc and selenium in patients with IgAD. METHODS: in this descriptive study, we screened 16 IgAD patients for anthropometric and dietary data, biochemical evaluation and determination of plasma and erythrocyte levels of zinc and selenium. RESULTS: dietary intake of zinc and selenium was adequate in 75% and 86% of the patients, respectively. These results were consistent with the plasma levels (adequate levels of zinc in all patients and selenium in 50% of children, 25% of adolescents and 100% of adults). However, erythrocyte levels were low for both micronutrients (deficiency for both in 100% of children, 75% of adolescents and 25% of adults). CONCLUSION: our results highlight the elevated prevalence of erythrocyte zinc and selenium deficiency in patients with IgAD, and the need for investigation of these micronutrients in their follow-up.

Curcuma longa L. ameliorates asthma control in children and adolescents: A randomized, double-blind, controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Roots of Curcuma longa L. are used as medicine for millennia. They possess several pharmacological properties, including anti-inflammatory action, and can be suitable for asthma treatment. AIM OF THE STUDY: We aimed to test the hypothesis that, in children and adolescents with persistent asthma, the administration of powdered roots of C. longa for 6 months, in addition to standard treatment, compared to placebo, will result in better disease control. PATIENTS AND METHODS: We conducted a randomized, double-blind, placebo-controlled, phase II clinical trial. Patients were randomly assigned to receive 30 mg/kg/day of C. longa for 6 months, or placebo. Data were collected prospectively. All patients were categorized for asthma severity and control according to GINA-2016 and underwent pulmonary function tests. RESULTS: Overall, both groups experienced amelioration of their frequency of symptoms and interference with normal activity, but no differences were found between the two treatment groups. However, patients receiving C. longa experienced less frequent nighttime awakenings, less frequent use of short-acting ß-adrenergic agonists, and better disease control after 3 and 6 months. CONCLUSION: The powdered roots of C. longa led to less frequent nighttime awakenings, less frequent use of short-acting ß-adrenergic agonists, and better disease control after 3 and 6 months, when compared to placebo.

Gammaglobulin for primary immunodeficiency: when should it be used? / Gamaglobulina para imunodeficiência primária: quando usar?

Antibodies are an essential component of the adaptative immune response and hold long-term memory of the immunological experiences throughout life. Antibody defects represent approximately half of thewell-known primary immunodeficiencies requiring gammaglobulin replacement therapy. On the other hand this therapy can be used for some diseases that do not belong to this group, like hyper IgM syndrome, immunodeficiency with thymoma and severe combined immunodeficiency. This therapy is a safe procedure and induces dramatic improvement in the clinical outcome of patients, reducing the risks of death and complications.

Anticorpos são componentes essenciais da resposta imunológica adaptativa e apresentam memória imunológica em longo prazo. Defeitos de anticorpos representam aproximadamente metade das imunodeficiências primárias conhecidas e requerem terapia de reposição de gamaglobulina. Por outro lado, esta modalidade terapêutica pode ser usada para algumas outras doenças que não pertencem a este grupo, como síndrome de hiper IgM, imunodeficiência com timoma e imunodeficiência combinada grave. Este tratamento é um procedimento seguro e acarreta em significativa melhora clínica dos pacientes, reduzindo os riscos de morte e complicações.