Relación entre sensibilización alérgica por pruebas cutáneas y grados clínicos de rinitis / Relationship between allergic sensitization by skin test and severity of rhinitis

INTRODUCCIÓN: La rinitis alérgica (RA) es una enfermedad inflamatoria de la mucosa nasal mediada por IgE. Existen controversias en los diferentes estudios acerca de la relación entre la gravedad de los síntomas de RA y la magnitud de la sensibilización medidas por pruebas cutáneas con alergenos. OBJETIVOS: Relacionar la magnitud de sensibilización alérgica con los grados clínicos de la RA. POBLACIÓN Y MÉTODO: Estudio Observacional, analítico y transversal, que incluyó pacientes de ambos sexos, entre 6 y 18 años con diagnóstico de RA. Se clasificaron según el grado clínico establecido por Allergic rhinitis and its impact on asthma (ARIA). La sensibilización alérgica se midió a través de pruebas cutáneas por puntura con aeroalergenos y se determinó su magnitud según: PC1 (número de alérgenos positivos), PC2 (sumatoria de milímetros de pápulas) e Índice de atopía (relación entre PC2/PC1). Se dividieron según la presencia de monosensibilización y/o polisensibilización. ANÁLISIS ESTADÍSTICO: Se realizó estadística descriptiva y analítica utilizando prueba de Wilcoxon Mann Withney y prueba de Kruskal Wallis. Se consideró un valor significativo a una p<0,05. RESULTADOS: Se incluyeron 156 pacientes con una mediana de edad de 11,18 años (5-18,66 años). No se encontró diferencia en los valores de PC1, PC2 ni en el índice de atopía entre los cuatro grados clínicos de rinitis (p=0,3370, p=0,2222 y p=0,8774 respectivamente). Tampoco se observó diferencia en el índice de atopia entre los pacientes monosensibilizados y polisensibilizados (p=0,5493). Al comparar la rinitis según la frecuencia no se encontró diferencia en los valores de PC1, PC2 ni en el índice de atopía entre los grupos intermitente y persistente (p=0,0810; p=0,0587 y p=0,5705). Con respecto a la gravedad de la rinitis no se encontró diferencia en los valores de PC1, PC2 ni en el índice de atopía entre los grupos leve y moderado/grave (p=0,5693; p=0,1653 y p=0,4613). CONCLUSIONES: Las pruebas cutáneas por puntura de lectura inmediata no son un método diagnóstico capaz de diferenciar los grados clínicos de rinitis. (AU)

INTRODUCTION: Allergic rhinitis (RA) is an inflammatory disease of nasal mucosal mediated by IgE. There are controversies in the different studies about the relationship between the severity of RA symptoms and the magnitude of sensitization measured by skin tests with allergens. OBJECTIVE: Relate the magnitude of allergic sensitization to the clinical grades of AR. PATIENTS AND METHODS: In a observational, analytical and crosssectional study, we included patients aged 6 to 18 years with diagnosis of allergic rhinitis (RA). Were classified according to the clinical grade established by Allergic Rhinitis and its Impact on Asthma (ARIA) guide. Allergic sensitization was measured through skin prick test with aeroallergens and their magnitude was determined according to: PC1 (Number of positive allergens), PC2 (sum of millimeters of papules) and index of atopy (relation between PC2/PC1). The patients were divided in two groups according to the presence of monosensitization and/or polysensitization. RESULTS: We included 156 patients with a median age of 11,18 years (5-18,66 years). There were no difference in the values of PC1, PC2 or in the index of atopy between the clinical grades of rhinitis (p=0,337; p=0,2222 and p=0,8774 respectively). There was no difference in the index of atopy between monosensitized and polysensitized patients (p=0,5493). When comparing rhinitis according to the frequency, no difference was found in the values of PC1, PC2 or the index of atopy between the intermittent and persistent groups (p=0,0810; p= 0,0587 and p= 0,5705). Regarding the severity of rhinitis, no difference was found in the values of PC1, PC2 or in the index of atopy between the mild and moderate/severe groups (p=0,5693; p=0,1653 and p= 0,4613). CONCLUSIONS: Skin prick tests with aeroallergens are not a diagnostic method capable of differentiating the clinical grades of rhinitis. (AU)

Copper and zinc status in rats with acute inflammation: focus on the inflamed area.

Status of copper and zinc in plasma, blood cells, liver and hind paws (sectioned at the tibio-tarsal joint) were evaluated in rats with carrageenan-induced paw-oedema; moreover, concentrations of copper and zinc in the supernatant and cell fractions obtained from exudates pooled from rats with carrageenan-induced pleurisy were also determined. The evaluation of copper and zinc status in the blood and in the liver of rats with carrageenan-induced paw oedema, showed that only minor variations differentiated this experimental pathology from the previously studied carrageenan-induced pleurisy in rat. In inflammatory exudates withdrawn from pleural cavity, copper concentrations were found to be higher than the basal values measured in the whole paw, whereas zinc concentrations were found to be dramatically lower. Thus, the induction of the carrageenan paw-oedema determined an increase in copper and a decrease in zinc concentrations in the inflamed paw; however, in the inflamed paw, the total amounts of both copper and zinc were found to be significantly increased.

Copper and zinc status in adjuvant-arthritic rat: studies on blood, liver, kidneys, spleen and inflamed paws.

The status of copper and zinc in plasma, blood cells, kidneys, spleen and hind paws was evaluated in tail-injected adjuvant-arthritic rats, during both the asymptomatic (3 and 7 days after the inoculum) and symptomatic (14, 21 and 30 days after the inoculum) phases of the experimental disease. During the symptomatic phase, inflamed rats were studied divided into two groups on the basis of their arthritic scores (low-score L.S. and high-score H.S. arthritic rats). Copper (both in concentration and total amount) was found significantly increased in plasma, blood cells, liver, spleen and arthritic paws, whereas, in the kidneys, it was found to be lower than normal. Zinc was found to be remarkably increased in the liver. In blood, zinc was found to be decreased in plasma, but almost unchanged in the cellular fraction. Zinc total amount (but not concentration) was increased in the spleen, most likely because of a significant increase in spleen weight. As previously described in the case of acute inflammation, zinc concentration was found to be significantly decreased in arthritic paws, whereas the total amount of the metal present in these inflamed tissues was higher than normal. The status of copper and zinc may well differentiate L.S. from H.S. arthritic rats, especially during the latest phase of the experimental disease, and particularly because of a normalization of the considered parameters in the low-score group. Many of the changes observed in the status of both metals were seen prior the appearance of arthritis. The overall accumulation of copper and zinc which is induced in rat by the development of adjuvant arthritis, is suggested to further sustain the hypothesis of increased body requirements for both metals during inflammation.