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4.
J Investig Allergol Clin Immunol ; 32(4): 270-281, 2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-33884956

RESUMO

BACKGROUND AND OBJECTIVE: Nut allergy is a growing problem, yet little is known about its onset in children. Objective: To characterize the onset of nut allergy in children in southern Europe. METHODS: The study population comprised consecutive patients up to 14 years of age who visited allergy departments with an initial allergic reaction to peanut, tree nut, or seed. The allergy work-up included a clinical history, food challenge, skin prick testing, determination of whole-extract sIgE, and ImmunoCAP ISAC-112 assay. RESULTS: Of the 271 children included, 260 were first diagnosed with nut allergy at a mean age of 6.5 years and at a mean (SD) of 11.8 (21.2) months after the index reaction. The most common culprit nuts at onset were walnut (36.5%), peanut (28.5%), cashew (10.4%), hazelnut (8.5%), pistachio (5.4%), and almond (5%). Onset of peanut allergy was more frequent in children ≤6 years and walnut in those aged >6 years (P=.032). In 65% of cases, the allergic reaction occurred the first time the patient consumed the nut, and 35% of reactions were anaphylactic. Overall, polysensitization to nuts was detected by skin prick testing in 64.9% of patients, although this rate was lower among walnut-allergic children (54.7%) and peanut-allergic children (54.1%) (P<.0001). Sensitization to 2S albumins was predominant (75%), especially Jug r 1 (52.8%), whereas sensitization to lipid transfer proteins was less relevant (37%). CONCLUSION: In the population we assessed, the onset of nut allergy occurred around 6 years of age, slightly later than that reported in English-speaking countries. Walnut was the main trigger, followed by peanut. 2S albumin storage proteins, especially Jug r 1, were the most relevant allergens. This study will help guide management and may contribute to preventive strategies in pediatric nut allergy.


Assuntos
Juglans , Hipersensibilidade a Noz , Hipersensibilidade a Amendoim , Alérgenos , Arachis , Criança , Humanos , Imunoglobulina E , Hipersensibilidade a Noz/diagnóstico , Hipersensibilidade a Noz/epidemiologia , Nozes , Hipersensibilidade a Amendoim/diagnóstico , Testes Cutâneos
6.
J. investig. allergol. clin. immunol ; 32(4): 270-281, 2022. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-208239

RESUMO

Background: Nut allergy is a growing problem, yet little is known about its onset in children. Objective: To characterize the onset of nut allergy in children in southern Europe. Methods: The study population comprised consecutive patients up to 14 years of age who visited allergy departments with an initial allergic reaction to peanut, tree nut, or seed. The allergy work-up included a clinical history, food challenge, skin prick testing, determination of whole-extract sIgE, and ImmunoCAP ISAC-112 assay. Results: Of the 271 children included, 260 were first diagnosed with nut allergy at a mean age of 6.5 years and at a mean (SD) of 11.8 (21.2) months after the index reaction. The most common culprit nuts at onset were walnut (36.5%), peanut (28.5%), cashew (10.4%), hazelnut (8.5%), pistachio (5.4%), and almond (5%). Onset of peanut allergy was more frequent in children ≤6 years and walnut in those aged >6 years (P=.032). In 65% of cases, the allergic reaction occurred the first time the patient consumed the nut, and 35% of reactions were anaphylactic. Overall, polysensitization to nuts was detected by skin prick testing in 64.9% of patients, although this rate was lower among walnut-allergic children (54.7%) and peanut-allergic children (54.1%) (P<.0001). Sensitization to 2S albumins was predominant (75%), especially Jug r 1 (52.8%), whereas sensitization to lipid transfer proteins was less relevant (37%). Conclusion: In the population we assessed, the onset of nut allergy occurred around 6 years of age, slightly later than that reported in English-speaking countries. Walnut was the main trigger, followed by peanut. 2S albumin storage proteins, especially Jug r 1, were the most relevant allergens. This study will help guide management and may contribute to preventive strategies in pediatric nut allergy (AU)


Antecedentes: La alergia a frutos secos es un problema creciente. Sin embargo, existe poca información relativa al inicio de su establecimiento en la población infantil. Objetivos: Describir el debut de alergia a frutos secos en niños del sur de Europa. Métodos: Se incluyeron pacientes de hasta 14 años que acudieron de forma consecutiva a la consulta de alergia debido a una reacción inicial con cacahuete, frutos secos o semillas. El estudio alergológico incluyó realización de historia clínica, provocación oral, prueba intraepidérmica (SPT), determinación de IgE específica para extracto completo y mediante ImmunoCAP ISAC-112. Resultados: De los 271 niños incluidos, 260 se diagnosticaron de alergia a frutos secos por primera vez a los 6,5 años de media, habiendo tenido la reacción índice 11,8 (±21,2SD) meses antes. Los frutos secos responsables en el debut fueron nuez (36,5%), cacahuete (28,5%), anacardo (10,4%), avellana (8,5%), pistacho (5,4%) y almendra (5%). La instauración de la alergia a cacahuete fue más frecuente en niños ≤6 años y para nuez en >6 años (p=0,032). En el 65% de los casos, la reacción alérgica sucedió en la primera vez en que el paciente consumía el fruto seco, y el 35% de las reacciones fueron anafilaxia. En conjunto, la polisensibilización a frutos secos se identificó en el 64,9% de los pacientes, aunque este porcentaje fue significativamente inferior en niños alérgicos a nuez (54,7%) y cacahuete (54,1%) (p<0,0001). La sensibilización a albúminas 2S fue predominante (75%), especialmente a Jug r 1 (52,8%), mientras que la identificación de LTP fue menos relevante (37%). Conclusión: En nuestra población, el debut de alergia a frutos secos sucedió alrededor de los 6 años de edad, ligeramente más tardío al reportado en países anglosajones. La nuez fue el principal desencadenante, seguido de cacahuete, y las albúminas de almacenamiento 2S, especialmente Jug r 1, fueron los alérgenos más relevantes (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Hipersensibilidade Imediata/diagnóstico , Hipersensibilidade a Nozes e Amendoim/diagnóstico , Estudos Prospectivos , Testes Cutâneos
9.
Klin Lab Diagn ; (6): 36-9, 2011 Jun.
Artigo em Russo | MEDLINE | ID: mdl-21851009

RESUMO

The ability of the synthetic peptide IMG-5, that reproduces one of the antigenic determinants of the protein filaggrin, to show antigenic activity was studied when anti-cyclic citrullinated peptide antibodies (ACCPAb) to filaggrin were found in the serum samples of patients with rheumatoid arthritis (RA). The binding of IMG-5 to ACCPAb has been shown to be specific (dose-dependent and reversible). The serum samples from patients with RA, controls, and donors show a significant difference in the interaction of the synthetic peptide with ACCPAb (p < 0.005 and p < 0.0001, respectively). The level of IgM rheumatoid factor (RF) detected in patients with RA differs greatly from that in the controls. In the patients with RA versus the controls, the specificity of ACCPAb determination was as high as 87; and the sensitivity was 40.5%. When ACCPAbs were determined using the commercial kit CCP, the specificity and sensitivity were 94 and 47.3%, respectively. The specificity of RF detection was equal to 50% and the sensitivity was 70%. The sensitivity of the test using IMG-5 is a maximum in X-ray stage IRA (69.2%) and falls in its stage III (26.7%). On the contrary, the sensitivity of the commercial kit and RF determination increases from X-ray stage I (46.2 and 53.8%, respectively) to II (66.7 and 80%). The sensitivity of the used tests in varying RA activities has demonstrated that they are most effective in patients with moderate RA activity. The concurrent detection of ACCPAb and RF increases the probability of differentiating RA from other rheumatic diseases.


Assuntos
Artrite Reumatoide/sangue , Autoanticorpos/sangue , Proteínas de Filamentos Intermediários/imunologia , Peptídeos Cíclicos/imunologia , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Proteínas Filagrinas , Humanos , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Masculino , Pessoa de Meia-Idade , Fator Reumatoide/sangue , Sensibilidade e Especificidade
10.
Curr Diabetes Rev ; 7(3): 148-58, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21418003

RESUMO

The aim of the present review is to synthesis findings from studies on the relationship between socioeconomic position (SEP) and incidence, prevalence and mortality of type 2 diabetes mellitus (T2DM) in Europe between the years 1999 and 2009. A systematic search was carried out in the National Library of Medicine's PubMed database. The search was limited to articles published between January 1999 and December 2009, in English or Spanish. Additional requirements for inclusion were: (i) presentation of empirical results directly related with SEP and the prevalence, incidence or mortality of diabetes, (ii) dealing with T2DM, (iii) carried out in Europe, and (iv) mainly focused only on diabetes. Of the 19 articles found, twelve studied the relationship between SEP and the prevalence of T2DM, two dealt with diabetes incidence, three with mortality and two studied both inequalities in mortality and prevalence. People with more deprived SEP have greater incidence, more prevalence and higher mortality due to T2DM, although the magnitude and significance of the associations varied from one study to another. Part of these inequalities is explained by SEP differences in the prevalence of the established T2DM risk factors. SEP inequalities in T2DM tended to be greater in women than in men. There is consistent evidence that SEP inequalities in T2DM incidence, prevalence and mortality are present in Europe, especially among women. Improving accessibility of physical activity in terms of both price and availability, access to healthy food, and access to health services, will be key to achieving a reduction of SEP related diabetes inequalities in Europe.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/economia , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Masculino , Modelos Biológicos , Classe Social , Fatores Socioeconômicos , Fatores de Tempo
11.
Bull Exp Biol Med ; 151(5): 615-8, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22462059

RESUMO

Immunogenic characteristics of filaggrin protein molecule as an antigen for antibodies to filaggrin, markers of early rheumatoid arthritis, were studied. Two new peptide motives, possible epitopes for antibodies to filaggrin, were shown in the filaggrin molecule by predictive analysis using programmed algorithms. Only IMG-3 and its cyclic form IMG-4 exhibited antigenic reactivity with sera from rheumatoid arthritis patients, differing significantly from the reactivity with donor sera. The immunogenic characteristics of IMG-3 differed from the characteristics of a previously described epitope.


Assuntos
Artrite Reumatoide/imunologia , Epitopos/imunologia , Proteínas de Filamentos Intermediários/imunologia , Fragmentos de Peptídeos/imunologia , Motivos de Aminoácidos/imunologia , Sequência de Aminoácidos , Artrite Reumatoide/sangue , Estudos de Casos e Controles , Mapeamento de Epitopos , Epitopos/química , Fibrina/química , Proteínas Filagrinas , Humanos , Proteínas de Filamentos Intermediários/química , Dados de Sequência Molecular , Fragmentos de Peptídeos/química , Ligação Proteica , Análise de Sequência de Proteína , Homologia de Sequência de Aminoácidos
12.
Acta Anaesthesiol Scand ; 52(5): 708-15, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18419726

RESUMO

BACKGROUND: Opioids have inhibitory effects on gastric motility, but the mechanism is far from clear. Electrical slow waves in the stomach determine the frequency and the peristaltic nature of gastric contractions. The primary aim of this study was to investigate the effects of the opioid fentanyl on gastric myoelectric activity. As there were large variations between the subjects, we investigated whether the variation was correlated to single nucleotide polymorphisms (SNP) of the mu-opioid receptor (MOR) gene. METHODS: We used cutaneous multichannel electrogastrography (EGG) to study myoelectrical activity in 20 patients scheduled for elective surgery. Fasting EGG was recorded for 30 min, followed by intravenous administration of fentanyl 1 microg/kg and subsequent EGG recording for 30 min. Spectral analysis of the two recording periods was performed and the variables assessed were dominant frequency (DF) of the EGG and its power (DP). Genetic analysis of the SNP A118G and G691C of the MOR gene was performed with the polymerase chain reaction technique. RESULTS: There was a significant reduction in DF and DP after intravenous fentanyl. However, there was a large variation between the patients. In eight subjects EGG was unaffected, five subjects had a slower DF (bradygastria) and in six subjects the slow waves disappeared. We found no correlation between the EGG outcome and the presence of A118G or G691C in the MOR gene. CONCLUSIONS: Fentanyl inhibited gastric myoelectrical activity in about half of the subjects. The variation could not be explained by SNP in the MOR gene. Because of small sample size, the results must be regarded as preliminary observations.


Assuntos
Analgésicos Opioides/farmacologia , Fentanila/farmacologia , Motilidade Gastrointestinal/efeitos dos fármacos , Motilidade Gastrointestinal/genética , Receptores Opioides mu/genética , Adulto , Idoso , Analgésicos Opioides/metabolismo , Eletrofisiologia , Feminino , Fentanila/metabolismo , Motilidade Gastrointestinal/fisiologia , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Nucleotídeo Único , Náusea e Vômito Pós-Operatórios/fisiopatologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Estômago/fisiologia
13.
Acta Anaesthesiol Scand ; 52(3): 420-6, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18269392

RESUMO

BACKGROUND: The aim of the present study was to examine the level of unconsciousness measured with bispectral index (BIS) at different minimal alveolar concentration (MAC) levels of sevoflurane, and to study the hemodynamic and BIS reactions during noxious stimulation with transcutaneous electrical nerve stimulation (TENS) and an ice water pain test (IWP). METHODS: This study was approved by the Ethics Committee and was performed on 10 healthy, young volunteers (six males and four females), ASA physical status I. Anesthesia was induced and maintained with sevoflurane in an oxygen/air mixture. The volunteers were spontaneously breathing, but if necessary, ventilation was mechanically supported. TENS and IWP were performed at 1.0, 1.5 and 2.0 MAC of sevoflurane. RESULTS: At 1.0 MAC, there was a significant increase in BIS during pain stimulation both with IWP (P<0.03) and with TENS (P<0.005), but at 1.5 MAC there were no changes. A marked variation in BIS was seen at 2.0 MAC, with periods of burst suppression and periods of high BIS values despite clinical signs of deep anesthesia. These marked variations in BIS were seen before, during and after pain stimulation. One volunteer (# 8) had a short episode of convulsions at 2.0 MAC. CONCLUSION: BIS, heart rate and blood pressure increased during pain stimulation at 1.0 MAC but not at 1.5 MAC of sevoflurane. There was a remarkable variation in BIS at 2.0 MAC of sevoflurane, with BIS values indicating wakefulness despite clinical signs of deep anesthesia. This BIS variation is probably caused by epileptogenic activity due to sevoflurane.


Assuntos
Anestésicos Inalatórios/farmacologia , Eletroencefalografia , Éteres Metílicos/farmacologia , Medição da Dor/efeitos dos fármacos , Alvéolos Pulmonares/metabolismo , Estimulação Elétrica Nervosa Transcutânea/efeitos adversos , Adulto , Anestesia , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Relação Dose-Resposta a Droga , Eletrodos Implantados , Eletroencefalografia/efeitos dos fármacos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Humanos , Masculino , Monitorização Intraoperatória/instrumentação , Dor/fisiopatologia , Medição da Dor/métodos , Sevoflurano , Inconsciência/fisiopatologia
14.
Ann Allergy Asthma Immunol ; 86(6): 686-90, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11428743

RESUMO

OBJECTIVE: The aim of this study was to compare two types of lentil extracts for use in skin prick tests for the diagnosis of lentil clinical allergy. METHODS: Thirty-six patients with a history of allergic reactions after the ingestion of lentils were skin tested with two types of lentil extracts at 0.05, 0.5, 5, and 10 mg/mL. Both extracts were extracted at 40 degrees C and afterward, one of them was boiled for 15 minutes. Thirty-three of these patients underwent oral challenges with lentils and three had a convincing recent history of lentil anaphylaxis. RESULTS: Twenty patients had a positive oral challenge; 13 were negative. Skin prick tests performed with the boiled extract at 0.5 and 5 mg/mL were positive in 96% and 100% of patients with positive food challenge, and in 31% and 85% of those with negative food challenge, respectively; positive skin test results were similar in both groups using the crude extract. Mean wheal sizes using the boiled extract at 0.5, 5, and 10 mg/mL were significantly greater in patients with a positive oral challenge than in those with a negative one (4.9, 6.8, and 7.4 mm versus 1.9, 3.5, and 5.1 mm, respectively; P < 0.05) These mean values were not statistically different using the crude extract. CONCLUSIONS: These data suggest that lentil extracts for the diagnosis of lentil hypersensitivity should be heated, since boiled extracts, used at a concentration of 0.5 or 5 mg/mL, best identify clinically sensitive individuals.


Assuntos
Fabaceae/efeitos adversos , Hipersensibilidade Alimentar/diagnóstico , Extratos Vegetais/imunologia , Plantas Medicinais , Administração Oral , Adolescente , Alérgenos/efeitos adversos , Criança , Pré-Escolar , Feminino , Hipersensibilidade Alimentar/etiologia , Temperatura Alta , Humanos , Tolerância Imunológica , Lactente , Masculino , Extratos Vegetais/administração & dosagem , Testes Cutâneos
15.
J Investig Allergol Clin Immunol ; 10(4): 187-99, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11039834

RESUMO

Legumes are an important source of proteins and their consumption is very frequent in the Mediterranean region and in some Asian and African countries. In some of these regions, lentils and chickpeas are one of the main food allergens. Legumes are also used as food additives due to their emulsifying properties and can be present in many manufactured foods. These hidden food allergens have the potential of causing adverse reactions in legume-sensitive subjects. The allergenic composition of various legumes has been investigated. They have been found to contain multiple allergens, a few of which have been cloned and sequenced. Legumes contain acid-resistant and thermostable allergens. There is a significant degree of cross-reactivity among legumes, the clinical relevance of which seems to be dependent on the dietary habits in different communities. In Spain, the consumption of several legumes is frequent and, therefore, clinical allergy to more than one species in children is common. Clinical manifestations include cutaneous, digestive and respiratory symptoms. Legumes can cause life-threatening reactions in sensitized individuals. Inhalation of steam, powder or flour from some legumes may cause respiratory diseases such as rhinitis, asthma and hypersensitivity pneumonitis. Soybean allergy is generally transitory, but clinical allergy to peanuts is rarely outgrown. The natural history of other legume allergies is less known and more studies are necessary to reach definite conclusions.


Assuntos
Fabaceae/efeitos adversos , Fabaceae/imunologia , Hipersensibilidade Alimentar/etiologia , Plantas Medicinais , Alérgenos/administração & dosagem , Alérgenos/imunologia , Reações Cruzadas , Hipersensibilidade Alimentar/terapia , Humanos , Exposição Ocupacional
16.
Int Arch Allergy Immunol ; 121(2): 137-43, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10705224

RESUMO

The chick pea, Cicer arietinum, is a legume commonly consumed in Spain and other Mediterranean countries. The sera of 29 children (mean age: 8.4 years) with a current or past history of allergic reactions after ingestion of chick pea, and positive skin tests to this legume, were used to study the allergenic composition of raw and boiled chick pea extracts. The patient population was divided into 2 groups: group 1 consisted of 19 patients with clinical sensitivity confirmed by either positive oral challenges or a convincing recent history of anaphylaxis after eating chick peas, and group 2 consisted of 10 patients with clinical sensitivity in the past, but tolerant at the time of blood extraction. Six atopic children, not allergic to legumes, were included as controls. Specific IgE to the raw and boiled extracts was measured by ELISA. The allergenic composition of both extracts was analyzed by SDS-PAGE and immunoblots. There were no significant differences between specific IgE levels to the raw and boiled extracts (p = 0.23). The mean levels in group 1 were significantly higher than in group 2 and controls (p = 0.0001). Multiple IgE binding proteins/peptides were detected in both extracts in the molecular weight range of 10-106 kD. Only nontolerant patients recognized a similar number of bands in both extracts. Chick pea extracts contain a majority of heat-stable allergens, which could be responsible for the clinical sensitivity to chick pea. Patients with a current clinical allergy to chick pea have statistically higher specific IgE levels than tolerant patients and controls.


Assuntos
Fabaceae/efeitos adversos , Fabaceae/imunologia , Hipersensibilidade Alimentar/etiologia , Imunoglobulina E/sangue , Plantas Medicinais , Adolescente , Adulto , Alérgenos/química , Alérgenos/imunologia , Criança , Pré-Escolar , Eletroforese em Gel de Poliacrilamida , Ensaio de Imunoadsorção Enzimática , Feminino , Hipersensibilidade Alimentar/imunologia , Temperatura Alta , Humanos , Immunoblotting , Masculino , Extratos Vegetais/química , Extratos Vegetais/imunologia , Testes Cutâneos
17.
Med Clin (Barc) ; 111(7): 263-6, 1998 Sep 12.
Artigo em Espanhol | MEDLINE | ID: mdl-9789242

RESUMO

naphylaxis after the intake of paprika and with rhinoconjunctivitis symptoms related to her current occupation, as spices-and-condiment seller, induced the patient to attend to a medical consult. The patient tolerated another solanaceous in her diet. The study was based on skin test using own extracts of different solanaceous, both at room temperature and after warming them up. Skin test with prick-by-prick test were also carried out with fresh solanaceous. All skin tests showed a positive result. The study was completed with conjunctival challenge-test using all the different extracts (positive result with paprika) and use-test with fresh solanaceous (positive result with paprika). In laboratory study, specific IgE was detected to all the solanaceous, as well as histamine release-test positive. Crossed-reactivity between the paprika antigenic determinant recognized by the patient and the one presented by the rest of solanaceous could not be detected using RAST-inhibition studies. This results and the good tolerance of other solanaceous in diet could show that the paprika's antigenic determinant, what induced allergic symptoms in the patient, was not present in the rest of solanaceous.


Assuntos
Anafilaxia/etiologia , Capsicum/efeitos adversos , Conjuntivite Alérgica/etiologia , Hipersensibilidade Alimentar/etiologia , Doenças Profissionais/etiologia , Plantas Medicinais , Hipersensibilidade Respiratória/etiologia , Rinite/etiologia , Adolescente , Feminino , Humanos , Testes Cutâneos , Alcaloides de Solanáceas/imunologia
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