ABSTRACT
The prevalence of allergic rhinitis (AR), including symptoms of sneezing, nasal itching, airflow obstruction, and nasal discharge caused by histamine and immunoglobulin E (IgE)-mediated reactions, is ~30% in the U.S. Recent studies seem to suggest that the allergic inflammatory processes in AR may be induced by the interaction between an allergen (trigger) and the nasal microbiome (substrate). In this study, we have identified two agents with antihistaminic and microbiome-modulating characteristics that can be administered intranasally, namely, chlorpheniramine maleate (CPM) and xylitol (X). This study aimed to test the efficacy of intranasal CPM plus xylitol (CPM+X) nasal for the treatment of AR in an outpatient setting. A multicenter, randomized, double-blind, 30-day pilot study was conducted during the spring of 2019. After starting five days of placebo therapy (run-in period), patients with moderate-to-severe AR nasal symptoms were randomized to treatment with CPM+X (n=16) spray and nasal saline placebo (PLB; n=13). Both treatments were administered in the form of one spray dose (~100 µL of the solution containing 1.25 mg CPM) per nostril twice a day. Outcome variables were the changes in visual analog scale (VAS) and daily symptoms score (DSS) at days 1, 5, 10, 15, 25, and 30 after the initiation of the treatment. ANOVA (analysis of variance) with repeated revealed a significant treatment-by-time interaction such that the CPM+X group had a significant decrease (p < 0.05) in both DSS (∆-3.0 ± 2.7) and VAS (∆-3.8 ± 2.0) scores compared to PLB after 30 days. The difference in DSS and VAS scores between the groups was evident just after five days (day 10) of using CPM+X. The CPM+X scores were significantly lower (p < 0.008) starting from day 10 compared with day 1, whereas there were no statistically significant (p > 0.008) changes in the PLB during the 30-day treatment window. The present data suggest that nasal CPM+X use effectively improves AR symptoms. A large-scale study of the long-term effects of CPM+X for the treatment of other chronic respiratory disorders and the potential microbiome-modulating effects warrants further investigation.
ABSTRACT
BACKGROUND: Few studies in tropical developing countries have utilized molecular diagnosis to characterize allergen-specific responses to aeroallergens. OBJECTIVE: To investigate the in vivo and in vitro responses of IgE antibodies to inhalant allergens in allergic patients with rhinitis and/or asthma. METHODS: A prospective study in which patients with allergic rhinitis and/or asthma were included. Skin prick tests with 16 inhalant extracts of allergens were carried out and total and specific IgE levels for allergens and their molecular components in the serum were determined. RESULTS: In a total of 189 patients, 73.5% showed high levels of total IgE in the serum. The prick tests were positive for the following allergens: Dust mite extracts; more than 60 %, cat; 29.6 %, dog; 23.4 %, and Periplaneta Americana; 21.6 %. Specific IgE for Dermatophagoides farinae and Pteronyssinus was present in 66.6 % of the patients; for Blomia tropicalis; in 45.0 %, for Ascaris lumbricoides; in 24.7 %, for cat; in 17.3 %, for parrot feathers; in 14.8 %, and for Penicillium notatum; in 12.3 %. IgE antibodies to mite allergens of group 1 and 2 were present in 59.0 % and 70.1 % of the sera; 39.1 % contained IgE to rBlo t5, 30.4 %contained rBla g4, 19.9 % contained rFel d1, 11.8 % contained rArt v3, 11.2 % contained Der p10, 9.9 % contained rBla g2, 9.3 % contained rPer a7, 9.3 % contained nFel d2, and 8.7 % contained rCan f1. CONCLUSIONS: This study confirms that mites are the main sensitizing agents in patients with respiratory allergic diseases in a tropical environment. There was a good correlation between the results of the skin tests and the results of the in vitro tests.
Antecedentes: Pocos estudios en países tropicales y en desarrollo han utilizado el diagnóstico molecular para caracterizar las respuestas específicas a los aeroalérgenos. Objetivo: Investigar las respuestas de anticuerpos IgE in vivo e in vitro a alérgenos inhalantes en pacientes alérgicos con rinitis o asma. Métodos: Estudio prospectivo que incluyó pacientes con rinitis alérgica o asma. Se realizaron pruebas cutáneas por punción con 16 extractos de alérgenos inhalantes y se determinaron los niveles de IgE total y específica para alérgenos y sus componentes moleculares en el suero. Resultados: De 189 pacientes, en 73.5 % se observó niveles elevados de IgE total en el suero. Las pruebas de punción fueron positivas a los siguiente alérgenos: extractos de ácaros más de 60 %, gato 29.6 %, perro 23.4 % y Periplaneta americana 21.6 %. La IgE específica para Dermatophagoides farinae y pteronyssinus estuvo presente en 66.6 %, para Blomia tropicalis, Ascaris lumbricoides, gato, plumas de perico, Penicillium notatum en 45.0, 24.7, 17.3, 14.8 y 12.3 %, respectivamente. Anticuerpos de clase IgE a alérgenos de ácaros de los grupos 1 y 2 estuvieron presentes en 59.0 y 70.1 % de los sueros; 39.1, 30.4, 19.9, 11.8, 11.2, 9.9, 9.3, 9.3 y 8.7 % contenían IgE a rBlot5, rBla g4, rFel d1, rArt v3, Derp 10, rBla g2, rPer a7, nFel d2 y rCan f1, respectivamente. Conclusiones: Se confirma a los ácaros como los principales agentes sensibilizantes en pacientes con enfermedades alérgicas respiratorias en el trópico. Existió buena correlación entre los resultados de las pruebas cutáneas y las pruebas in vitro.
Subject(s)
Allergens/immunology , Asthma/diagnosis , Asthma/immunology , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/immunology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Prospective Studies , Skin Tests , Tropical Medicine , Young AdultABSTRACT
Introducción: El diagnóstico precoz y seguimiento de la condición celíaca ha sido objeto de importantes cambios, y según la guía ESPGHAN (2012) la serología es ahora una herramienta fundamental. Los principales son los anticuerpos anti-gliadina IgG/IgA, anti-transglutaminasa IgG/IgA, anti-endomisiales (EMA), y los recientemente descritos anti-péptidos deaminados de gliadina (anti-DGPs). El propósito del estudio fue determinar la sensibilidad y especificidad de estos marcadores en 308 individuos con y sin patología. Materiales y métodos: A cada individuo se le realizaron determinaciones de: TTGG y TTGA Qual (AESKU Diagnostics ®, Germany), TgTG, TgTA, AAGG y AAGA por ENEASYSTEM III® (Byogenetix, Italia), Neoep. IgG/A (AESKU Diagnostics®, Germany), EMA IgG e IGA y GAF3X IgG e IgA (Euroimmun, Germany ®). Resultados: Los valores de sensibilidad (S) y especificidad (E) fueron: Para anti-IgA Celicheck: S: 44.44%, E: 97.59%; anti-TTG Qual: S: 14.28%, E: 97.61%; anti-neoepítopes IgG/IgA: S: 54.44%, E: 91.59%; AAG IgG: S: 89.11%, E: 63.19%; AAG IgA: S: 79.11%, E: 68.16%; anti-DGPs IgA: S: 86.67%, E: 96.21% (p<0,05). Conclusiones: Los ATgT IgG e IgA solo son superados por los anti-DGPs. Se debe ampliar las investigaciones para estandarizar este nuevo método de valoración.
Introduction: The diagnosis and management of celiac disease has undergone significant changes, according to the ESPGHAN guide (2012) serology is now an essential tool. The main ones are the anti-gliadin IgG/IgA anti-transglutaminase IgG/IgA, anti-endomysial and the recently described anti-deaminated gliadin peptides (anti-DGPs). The purpose of the study was to determine the sensitivity and specificity of these markers in 308 individuals with and without pathology. Materials and Methods: Each individual is simultaneously made the following determinations: TTGG and TTGA Qual (AESKU Diagnostics®, Germany), TgTG, TgTA, AAGG and AAGA ENEASYSTEM III® (Byogenetix, Italia), Neoep. IgG/A (AESKU Diagnostics®, Germany), EMA IgG, IGA and GAF3X IgG-IgA (Euroimmun, Germany®). Results: The sensitivity (S) and specificity (Sp) were: anti-IgA To Celicheck: S: 44.44%, E: 97.59% anti-TTG Qual: S: 14.28%, E: 97.61% anti-neoepitopes IgG/IgA: S: 54.44%, E: 91.59%; AAG IgG: S: 89.11%, E: 63.19%; AAG IgA: S: 79.11%, E: 68.16% IgA anti-DGPs: S: 86.67% E: 96.21% (p<0.05). Conclusions: IgG and IgA ATGT are surpassed only by anti-DGPs However, it is important to extend the research to standardize this new method of assessment.
ABSTRACT
Introducción: La celiaquía es una enteropatía inmune desencadenada por la ingestión de cereales que contienen gluten en individuos predispuestos genéticamente, caracterizada por un síndrome de malabsorción intestinal con un espectro variable de manifestaciones. Objetivo: Determinar la prevalencia de esta enfermedad en una población de Venezuela. Materiales y Métodos: Se estudiaron 308 individuos de diversas ciudades del país. En cada caso se determinó anticuerpos anti-gliadina IgG e IgA, anti-transglutaminasa IgG e IgA, y anti-endomisiales. En el análisis estadístico se utilizó Instad, SPSS y EPI INFO. Resultados: Se obtuvo 3% de individuos con marcadores positivos; el 20.13% se encontraban entre 1 y 15 años, 11,6% de 16 a 24 años, 7,14% de 25 a 40 años, 26,62% de 41 a 50 años y 34,51% de 51 y 72 años. Aún cuando la mayoría provenían de Caracas, fueron reportados casos en Carabobo, Aragua, Lara, Zulia, Táchira, Anzoátegui, Mérida, Monagas, Guárico, Cojedes, Bolívar, Sucre, Portuguesa y Miranda. Conclusión: Los resultados sugieren una importante prevalencia de esta condición en el país, siendo necesario ampliar estas investigaciones, a fin de determinar la relevancia exacta del problema con una población más representativa e implementar medidas de salud pública adecuadas.
Introduction: Celiac condition is a immune-mediated enteropathy triggered by ingestion of gluten-containing cereals in genetically predisposed individuals, characterized by intestinal malabsorption syndrome a variable spectrum of manifestations. Objective: To determine the prevalence of this disease in the population of Venezuela. Materials and Methods: We studied 308 individuals from various cities. In each case, the determination was made of anti-gliadin IgG and IgA anti-transglutaminase IgG and IgA and anti-endomysial. The statistical analysis was used Entreat, SPSS and EPI INFO. Results: We obtained 3% of patients with positive markers for this condition, of which the 20.13% were between 1 and 15 years, 11.6% from 16 to 24 years, 7.14% from 25 to 40, 26.62% from 41 to 50 and 34.51% of 51 and 72. Although most came from Caracas, positive cases were reported in Carabobo, Aragua, Lara, Zulia, Táchira, Anzoategui, Merida, Monagas, Guárico, Cojedes, Bolívar, Sucre, Portuguesa and Miranda. Conclusion: The results strongly suggest a significant prevalence of this condition in the country, being necessary to extend these investigations to determine the exact significance of the problem with a more representative population and implement appropriate public health measures.
