Good clinical practice recommendations in allergen immunotherapy: Position paper of the Brazilian Association of Allergy and Immunology - ASBAI.

Background: Allergen Immunotherapy (AIT) represents one of the pillars in the treatment of allergic diseases. AIT is the only therapeutic strategy with curative potential, promoting the reduction of drug use and long-term symptom control even after the end of the treatment. The European Academy of Allergy, Asthma and Immunology (EAACI) guidelines, position papers of World Allergy Organization (WAO), and the US Practice Parameters are the leading official documents that set scientific standard for the use of AIT in the world. The use of AIT in Brazil has specific regional conditions due to the pattern of allergen sensitization, as well as genetic, socioeconomic, and cultural characteristics, climate conditions, and the availability of allergenic extracts. The most prevalent house dust mites are Dermatophagoides pteronyssinus, Dermatophagoides farinae and their allergens have the highest clinical relevance. Blomia tropicalis is also very frequent. This position paper has been prepared by the Brazilian Association of Allergy and Clinical Immunology (ASBAI) Taskforce on AIT for respiratory allergy and Hymenoptera venom allergy. Objective: According to the current scientific literature adapted to the Brazilian reality, this position paper aims to establish the main recommendations for the good clinical practice parameters for AIT in Brazil. Methods: A systematic review using the Pub Med and Cochrane databases was performed, and the websites of major allergy and immunology organizations were consulted. The research was limited to English language literature and was conducted between March 30, 2002, and March 30, 2022. The terms used for the research were: Allergen Immunotherapy, sublingual immunotherapy (SLIT), subcutaneous immunotherapy (SCIT), venom-specific immunotherapy (VIT), and allergen extract. Results: The several recommendations that establish the clinical practices for AIT recommended by the main Allergy, Asthma and Immunology world organizations were analyzed and adapted to the Brazilian situation. Conclusion: This position paper establishes the main recommendations for the effective clinical practice of AIT in Brazil, using current knowledge of evidence-based medicine and precision medicine.

Posicionamento da Associação Brasileira de Alergia e Imunologia sobre o manejo da imunoterapia específica com alérgenos (ITA) em pacientes vacinados contra COVID­19 / Position statement of the Brazilian Association of Allergy and Immunology on the management of allergen-specific immunotherapy (AIT) in patients vaccinated against COVID­19

A pandemia de COVID-19 representa um grande desafio para todas as especialidades médicas. A imunoterapia com alérgenos (ITA) é considerada o único procedimento terapêutico capaz de modificar a história natural das doenças alérgicas, e caracteriza o estado da arte na área de Alergia e Imunologia. Esta estratégia terapêutica de imunomodulação é capaz de promover a remissão e controle das doenças alérgicas por períodos prolongados, mesmo após o seu término. Existem poucos dados em relação ao emprego da ITA em pacientes vacinados contra COVID-19, e até o momento não há um posicionamento oficial das sociedades internacionais da área de Alergia e Imunologia Clínica. Este documento tem como objetivo estabelecer recomendações práticas para o manejo da ITA em pacientes que receberam a vacina contra COVID-19. Os fenômenos imunológicos envolvidos na imunoprofilaxia vacinal e no mecanismo de ação da ITA foram comparados, proporcionando o estabelecimento de recomendações precisas.

The COVID-19 pandemic represents a serious challenge for all medical specialties. Allergen-specific immunotherapy (AIT) is considered the only therapeutic procedure capable of modifying the natural history of allergic diseases and characterizes the state of the art in the field of allergy and immunology. This therapeutic strategy of immunomodulation is able to promote remission and control of allergic diseases for prolonged periods, even after cessation. There are few data regarding use of AIT in patients vaccinated against COVID-19 and, to date, there is no official position statement published by international allergy and clinical immunology societies. This document aims to establish practical recommendations for the management of AIT in patients who have received the COVID-19 vaccine. The immunological mechanisms involved in immunoprophylaxis with vaccines and the mechanism of action of AIT have been compared to provide a solid basis for establishing precise recommendations.

Prevalência das dermatoses no ambulatório de dermatologia da UNISUL / Prevalence of dermatosis at UNISUL dermatology ambulatory

Dermatoses são problemas comuns e podem refletir uma doença sistêmica ou um problema primário da pele. A prevalência de desordens cutâneas varia e depende da população estudada e a definição da importância.Objetivo: Traçar o perfil dos pacientes atendidos no ambulatório de Dermatologia da UNISUL, no período de fevereiro de 2003 a 31 de agosto de 2005.Métodos: Estudo com delineamento transversal na coleta dos dados baseado em demanda ambulatorial. Os dados foram obtidos através do BDAM (Boletim Diário de Atendimento Médico) ou dos prontuários médicos utilizados para anamnese dos pacientes durante as consultas.Resultados: Foram realizadas 1005 consultas dermatológicas no período estudado, gerando um total de 1220 diagnósticos; 537 pacientes se consultaram no ambulatório. As mulheres corresponderam a 65 dos pacientes atendidos. A doença mais freqüente foi a psoríase com 143 (11,72) diagnósticos, seguida dos eczemas com 106 (8,68) diagnósticos e das micoses superficiais com 105 (8,60) diagnósticos.Conclusão: Onze dermatoses foram responsáveis por 72 dos diagnósticos. Mulheres adultas foram responsáveis pela maioria das consultas...

Dermatosis are common problems and can reflect a systemic illness or a primary problem of the skin. The prevalence of cutaneous disorders varies and depends of the population studied and the importance of the definition. Objective: To define the patient profile consulted at UNISUL Dermatology ambulatory, in the period from February 2003 to August 31st 2005. Methods: Cross-sectional study on the collection of data based on the clinic demand. The data were gotten through BDAM (daily bulletin of Medical attendance) or on the medical records used for anamnesis of the patients during the consultation. Results: One thousand and five (1005) dermatological consultations in the studied period had been carried through, generating a total of 1220 diagnosis; 537 patients had consulted in the clinic. The women had corresponded 65 of the consulted patients. The most frequent dermatosis was psoriasis with 143 (11,72) of the diagnosis, followed by eczemas with 106 (8,68) diagnosis and superficial mycosis with 105 (8,60) diagnosis.Conclusion: Eleven dermatosis had been responsible for 72 of the diagnosis. Adult women had been responsible for the majority of the consultations...