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1.
Rev Alerg Mex ; 69 Suppl 1: s46-s54, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34998310

RESUMO

An increasing number of studies are analyzing the relationship between serum vitamin D levels and the development of sensitization and allergic diseases in genetically predisposed individuals, as well as the impact of vitamin D supplementation. This article reviews the literature on this subject. Clinical trials, meta-analyses and systematic reviews consulted in PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane and manual resources were included, with the keywords: vitamin D, 25 hydroxyvitamin D, cholecalciferol, asthma, rhinitis, allergy, 25-OH-D, 1,25 hydroxyvitamin D, supplementation. The results show a positive linear trend, however, differ. We should keep in mind that in the studies there is heterogeneity of population groups and associated factors, which may modify such studies. It is necessary to increase research to clarify this relationship and to have successful interventions from the patient's approach to the strengthening of pharmacological and immunological treatment of allergic patients with these diseases.


Cada vez son más los trabajos que analizan la relación de los niveles séricos de vitamina D y el desarrollo de sensibilizaciones y enfermedades alérgicas en los individuos con predisposición genética, así como el impacto de su suplementación. El presente artículo efectúa una revisión de la literatura acerca de este tema. Se incluyeron ensayos clínicos, metaanálisis y revisiones sistemáticas consultadas en PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane y recursos manuales, con las palabras clave: vitamina D, 25 hidroxivitamina D, colecalciferol, asma, rinitis, alergia, 25-OH-D, 1,25 hidroxivitamina D, suplementación. Los resultados muestran una tendencia lineal positiva; sin embargo, algunos difieren. Debemos tener en mente que en los estudios existe heterogeneidad de los grupos poblacionales y los factores asociados, lo que puede modificarlos. Es necesario incrementar las investigaciones para clarificar esta relación y tener intervenciones exitosas desde el abordaje del paciente hasta el fortalecimiento del tratamiento farmacológico e inmunológico de los pacientes alérgicos con estas enfermedades.


Assuntos
Asma , Hipersensibilidade , Deficiência de Vitamina D , Asma/tratamento farmacológico , Colecalciferol , Humanos , Hipersensibilidade/epidemiologia , Vitamina D , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/epidemiologia , Vitaminas/uso terapêutico
2.
Handb Exp Pharmacol ; 268: 359-366, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34159483

RESUMO

Air pollution is worldwide a major public health problem and affects large part of the population. Air pollution does not only harm the respiratory tract system but also the other organs of the body. The damage may result directly from the pollutants toxicity, because the pollutant enters into the organs through a direct route or indirectly through systemic inflammation. There is accumulating evidence suggesting that ambient air pollution not only affects the human lung and the cardiovascular system, but also has negative effects on allergic diseases. In this regard, it has been shown that exposure increases the risk of allergies and eczema in children and adults. However, the mechanism how ambient air pollution affects the skin is not well investigated up to now and needs further research.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Hipersensibilidade , Adulto , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Criança , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/etiologia , Pulmão , Fatores de Risco
3.
Handb Exp Pharmacol ; 268: 367-390, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34196809

RESUMO

The prevalence of allergic diseases is increasing rapidly and has already reached an epidemic level. Two major drivers of this development are climate change and globalization, which both induce an increase in allergens. Concomitant climate change fosters the spreading of the latter on a global scale. The increase in allergens not only aggravates the symptoms and the degree of suffering for patients who already are allergic, but also gives rise to new cases of allergies. The distribution of allergies in society follows a steep socioeconomic gradient worldwide. According to well-established theories of justice such a distribution of the allergy burden is unfair. This fact adds a major ethical dimension and challenge to the allergy epidemic. This chapter draws on the key points of policies for allergy prevention and treatment. It shows how related programs and measures can be conceptualized and prioritized according to the principles of distributional justice.


Assuntos
Hipersensibilidade , Pólen , Alérgenos , Mudança Climática , Humanos , Hipersensibilidade/epidemiologia , Internacionalidade
4.
Handb Exp Pharmacol ; 268: 331-357, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34223997

RESUMO

There has been a substantial increase in the incidence and the prevalence of allergic disorders in the recent decades, which seems to be related to rapid environmental and lifestyle changes, such as higher exposure to factors thought to exert pro-allergic effects but less contact with factors known to be associated with protection against the development of allergies. Pollution is the most remarkable example of the former, while less contact with microorganisms, lower proportion of unprocessed natural products in diet, and others resulting from urbanization and westernization of the lifestyle exemplify the latter. It is strongly believed that the effects of environmental factors on allergy susceptibility and development are mediated by epigenetic mechanisms, i.e. biologically relevant biochemical changes of the chromatin carrying transcriptionally-relevant information but not affecting the nucleotide sequence of the genome. Classical epigenetic mechanisms include DNA methylation and histone modifications, for instance acetylation or methylation. In addition, microRNA controls gene expression at the mRNA level. Such epigenetic mechanisms are involved in crucial regulatory processes in cells playing a pivotal role in allergies. Those include centrally managing cells, such as T lymphocytes, as well as specific structural and effector cells in the affected organs, responsible for the local clinical presentation of allergy, e.g. epithelial or airway smooth muscle cells in asthma. Considering that allergic disorders possess multiple clinical (phenotypes) and mechanistic (endotypes) forms, targeted, stratified treatment strategies based on detailed clinical and molecular diagnostics are required. Since conventional diagnostic or therapeutic approaches do not suffice, this gap could possibly be filled out by epigenetic approaches.


Assuntos
Asma , Hipersensibilidade , Metilação de DNA , Epigênese Genética , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/genética , Hipersensibilidade/prevenção & controle , Processamento de Proteína Pós-Traducional
5.
Rev Alerg Mex ; 68(4): 264-275, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34904562

RESUMO

Autoimmune rheumatic diseases are multisystemic disorders that mainly affect joints and muscles; some examples of these conditions are: rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren's syndrome (SS). In general, autoimmune rheumatic diseases have a high prevalence worldwide and are highly disabling for those who have them. At present, one of the main limitations for the management of these diseases is that their triggering factor continues to be unknown in most cases and the knowledge of the factors associated with their exacerbation is limited. In this review, the possible link of allergies as a possible trigger for autoimmune rheumatic diseases will be explored. We will also analyze the basic and general aspects of both diseases and the development of allergic processes and hypersensitivity reactions to drugs used in the treatment of rheumatic diseases.


Las enfermedades reumáticas autoinmunes son trastornos multisistémicos que afectan principalmente las articulaciones y los músculos; algunos ejemplos de estas afecciones son la artritis reumatoide, el lupus eritematoso sistémico y el síndrome de Sjögren. En general, las enfermedades reumáticas autoinmunes tienen una alta prevalencia en todo el mundo y son altamente incapacitantes para quienes las padecen. Una de las principales limitaciones en la actualidad para el manejo de estas enfermedades es que su factor desencadenante sigue siendo desconocido en la mayoría de los casos y el conocimiento de los factores asociados con su exacerbación es limitado. En esta revisión se explorará la posible relación de las alergias como desencadenante de enfermedades reumáticas autoinmunes. También analizaremos los aspectos básicos y generales de ambas enfermedades y el desarrollo de procesos alérgicos y reacciones de hipersensibilidad a los fármacos utilizados en el tratamiento de enfermedades reumáticas.


Assuntos
Doenças Autoimunes , Hipersensibilidade , Doenças Reumáticas , Síndrome de Sjogren , Doenças Autoimunes/epidemiologia , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/etiologia , Sistema Imunitário , Doenças Reumáticas/epidemiologia , Síndrome de Sjogren/epidemiologia
7.
Medicine (Baltimore) ; 100(42): e27447, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34678875

RESUMO

BACKGROUND: To our knowledge, there is no comprehensive evidence quantifying the plausibility of the association between maternal free sugar intake during pregnancy and the development of offspring's allergic diseases. Thus, this systematic review examines the weight of evidence for causality from cohort studies on the association between maternal free sugar intake during pregnancy and the development of allergies in offspring. METHODS: The present meta-analysis is prepared and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We search PUBMED, Scopus, EMBASE, and Cochrane Library databases through October, 2021. All clinical trials to assess the efficacy of maternal sugar intake during pregnancy on allergies in offspring are considered eligible for analysis. The Comprehensive Meta-Analysis Software 2 program is used for statistical analyses of the pooled data. A P value < .05 is considered statistically significant. The outcome measure is development of allergic disease among offspring assessed by any method (parental history, doctor diagnosed, or questionnaire based). RESULTS: It is hypothesized that high free sugar consumption during pregnancy may be associated with the development of allergies in offspring.


Assuntos
Hipersensibilidade/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Açúcares/administração & dosagem , Ensaios Clínicos como Assunto , Feminino , Humanos , Gravidez , Projetos de Pesquisa
8.
JAMA Netw Open ; 4(10): e2131034, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34698847

RESUMO

Importance: Allergic history in individuals with confirmed anaphylaxis to a messenger RNA (mRNA) COVID-19 vaccine is common. However, the risk factors for allergy symptoms after receiving the vaccine are unknown. Objective: To assess the association between self-reported history of high-risk allergy and self-reported allergic reactions after mRNA COVID-19 vaccination of health care employees. Design, Setting, and Participants: This cohort study obtained demographic, medical, and vaccine administration data of employees of Mass General Brigham from the institutional electronic health record. Employees who received at least 1 dose of an mRNA COVID-19 vaccine between December 14, 2020, and February 1, 2021, and who completed at least 1 postvaccination symptom survey in the 3 days after vaccination were included. Exposures: Self-reported history of high-risk allergy, defined as a previous severe allergic reaction to a vaccine, an injectable medication, or other allergen. Main Outcomes and Measures: The primary outcome was 1 or more self-reported allergic reactions in the first 3 days after dose 1 or dose 2 of an mRNA COVID-19 vaccine. Multivariable log binomial regression was used to assess the association between allergic reactions and high-risk allergy status. Results: A total of 52 998 health care employees (mean [SD] age, 42 [14] years; 38 167 women [72.0%]) were included in the cohort, of whom 51 706 (97.6%) received 2 doses of an mRNA COVID-19 vaccine and 474 (0.9%) reported a history of high-risk allergy. Individuals with vs without a history of high-risk allergy reported more allergic reactions after receiving dose 1 or 2 of the vaccine (11.6% [n = 55] vs 4.7% [n = 2461]). In the adjusted model, a history of high-risk allergy was associated with an increased risk of allergic reactions (adjusted relative risk [aRR], 2.46; 95% CI, 1.92-3.16), with risk being highest for hives (aRR, 3.81; 95% CI, 2.33-6.22) and angioedema (aRR, 4.36; 95% CI, 2.52-7.54). Conclusions and Relevance: This cohort study found that self-reported history of high-risk allergy was associated with an increased risk of self-reported allergic reactions within 3 days of mRNA COVID-19 vaccination. However, reported allergy symptoms did not impede the completion of the 2-dose vaccine protocol among a cohort of eligible health care employees, supporting the overall safety of mRNA COVID-19 vaccine.


Assuntos
Vacinas contra COVID-19/efeitos adversos , Hipersensibilidade/epidemiologia , Vacinação/estatística & dados numéricos , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos de Casos e Controles , Feminino , Humanos , Hipersensibilidade/etiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Fatores de Risco , SARS-CoV-2 , Autorrelato
9.
Georgian Med News ; (318): 105-109, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628388

RESUMO

Western countries have been challenged with an "allergy epidemic" during the last three to four decades. Interestingly, there has been a parallel increase in the incidence rates of several autoimmune disorders.The aim of our study was to evaluate antinuclear antibodies (ANA) in Georgian allergic patientspolysensitized with cross reactive allergens, in order to establish connection between allergic and autoimmune diseases in our population. Two groups of patients were included in the study: patients with atopy (group 1, n=97) and without (group 2, n=42).ImmunoCAPPhadiatop and ISAC assay platforms were used for atopy screening and polysensitization patterns evaluation. Screening for ANAs was performed by IIFA (Indirect Immunofluorescence assay) on HEp-2 cells. In general 67(69.1%) allergic patients were sensitized to at least one of the cross reactive allergen. Among allergic patients 26 (26.8%) tested positive for the presence of auto-antibodies; for non-allergic patient this value was only 1(2.4%). 18(26.9%) patients sensitized to cross reactive allergens showed positive results for ANA testing and 8(26.7%) allergic patient without cross allergen sensitization were positive for ANA. The AC-2 was only one detected pattern among non-atopic individuals (1/2.4%) and the most frequent pattern in allergic patients (19/73%). In the ANA positive group of allergic patients the atopic dermatitis (13/50%) and asthma (6/23.1%) were most frequently diagnosed. The occurrence of antinuclear antibodies is more frequent in atopic patients and associate mostly with asthma and atopic dermatitis phenotypes of allergic diseases. The most frequent coexisting ANA pattern is dense fine speckled pattern (AC-2).The occurrence of ANA antibody in atopic patients and its role in allergy remains the subject for future research.


Assuntos
Asma , Dermatite Atópica , Hipersensibilidade , Alérgenos , Anticorpos Antinucleares , Humanos , Hipersensibilidade/epidemiologia
10.
Mo Med ; 118(5): 453-459, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34658440

RESUMO

Up until about 100 years ago, the omega-6/3 ratio has been around 4:1 or less. However, the typical Western diet now provides an omega-6/3 ratio of approximately 20:1 in favor of omega-6. This predisposes to supraphysiologic inflammatory responses and perpetuates chronic low-grade inflammation. The overconsumption of linoleic acid, mainly from industrial omega-6 seed oils, and the lack of long-chain omega-3s in the diet creates a pro-inflammatory, pro-allergic, pro-thrombotic state. Reducing the omega-6/3 ratio, particularly through reductions in the intake of refined omega-6 seed oil, and increasing the intake of marine omega-3s, either through dietary means or supplementation, may be an effective strategy for reducing inflammation, allergies, and autoimmune reactions.


Assuntos
Asma , Doenças Autoimunes , Ácidos Graxos Ômega-3 , Hipersensibilidade , Asma/epidemiologia , Asma/prevenção & controle , Dieta , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/prevenção & controle
11.
JAMA Netw Open ; 4(9): e2125524, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34533570

RESUMO

Importance: As of May 2021, more than 32 million cases of COVID-19 have been confirmed in the United States, resulting in more than 615 000 deaths. Anaphylactic reactions associated with the Food and Drug Administration (FDA)-authorized mRNA COVID-19 vaccines have been reported. Objective: To characterize the immunologic mechanisms underlying allergic reactions to these vaccines. Design, Setting, and Participants: This case series included 22 patients with suspected allergic reactions to mRNA COVID-19 vaccines between December 18, 2020, and January 27, 2021, at a large regional health care network. Participants were individuals who received at least 1 of the following International Statistical Classification of Diseases and Related Health Problems, Tenth Revision anaphylaxis codes: T78.2XXA, T80.52XA, T78.2XXD, or E949.9, with documentation of COVID-19 vaccination. Suspected allergy cases were identified and invited for follow-up allergy testing. Exposures: FDA-authorized mRNA COVID-19 vaccines. Main Outcomes and Measures: Allergic reactions were graded using standard definitions, including Brighton criteria. Skin prick testing was conducted to polyethylene glycol (PEG) and polysorbate 80 (P80). Histamine (1 mg/mL) and filtered saline (negative control) were used for internal validation. Basophil activation testing after stimulation for 30 minutes at 37 °C was also conducted. Concentrations of immunoglobulin (Ig) G and IgE antibodies to PEG were obtained to determine possible mechanisms. Results: Of 22 patients (20 [91%] women; mean [SD] age, 40.9 [10.3] years; 15 [68%] with clinical allergy history), 17 (77%) met Brighton anaphylaxis criteria. All reactions fully resolved. Of patients who underwent skin prick tests, 0 of 11 tested positive to PEG, 0 of 11 tested positive to P80, and 1 of 10 (10%) tested positive to the same brand of mRNA vaccine used to vaccinate that individual. Among these same participants, 10 of 11 (91%) had positive basophil activation test results to PEG and 11 of 11 (100%) had positive basophil activation test results to their administered mRNA vaccine. No PEG IgE was detected; instead, PEG IgG was found in tested individuals who had an allergy to the vaccine. Conclusions and Relevance: Based on this case series, women and those with a history of allergic reactions appear at have an elevated risk of mRNA vaccine allergy. Immunological testing suggests non-IgE-mediated immune responses to PEG may be responsible in most individuals.


Assuntos
Vacinas contra COVID-19/efeitos adversos , Hipersensibilidade/diagnóstico , Adolescente , Adulto , Idoso , Vacinas contra COVID-19/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos/epidemiologia , United States Food and Drug Administration/organização & administração , United States Food and Drug Administration/estatística & dados numéricos , Vacinação/efeitos adversos
13.
BMC Med ; 19(1): 214, 2021 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-34526042

RESUMO

BACKGROUND: Studies on allergy-related diseases in relation to abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) in children are few and results are contradictory. We examined the associations between childhood allergy-related diseases and adolescent AP-FGIDs in general and irritable bowel syndrome (IBS) in particular. METHOD: Prospective population-based birth cohort study of 4089 children born in Sweden 1994-1996. We analysed data from 2949 children with complete follow-up at 16 years (y) and no diagnosis of inflammatory bowel disease or coeliac disease at 12y or 16y. Asthma, rhinitis, eczema, and food hypersensitivity (FH) were assessed through questionnaires at 1-2y, 4y, 8y, 12y, and 16y. AP-FGIDs and IBS were assessed through questionnaires at 16y and defined according to the Rome III criteria. Associations between childhood allergy-related diseases and any AP-FGID and IBS and 16y respectively were examined using binomial generalized linear models with a log link function and described as relative risk with 95% confidence intervals. RESULTS: The prevalence of any AP-FGID and IBS at 16y were 12.0% and 6.0% respectively. Eczema at 1-2y, 4y, and 8y, and FH at 12y and 16y were associated with an increased risk for any AP-FGID at 16y. Asthma and FH at 12y and 16y were associated with an increased risk for IBS at 16y. The relative risk for IBS at 16y increased with increasing number of concurrent allergy-related diseases at 16y, but linear trend for relative risk was only borderline statistically significant (P for trend = 0.05). CONCLUSIONS: This prospective population-based study demonstrated positive associations between childhood allergy-related diseases and adolescent AP-FGIDs, including IBS, implicating shared pathophysiology among these disorders.


Assuntos
Doença Celíaca , Gastroenteropatias , Hipersensibilidade , Síndrome do Intestino Irritável , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Adolescente , Criança , Estudos de Coortes , Feminino , Gastroenteropatias/epidemiologia , Humanos , Hipersensibilidade/epidemiologia , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/epidemiologia , Prevalência , Estudos Prospectivos , Inquéritos e Questionários
14.
Elife ; 102021 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-34550875

RESUMO

Background: Lack of early infection-exposure has been associated with increased allergy-related disease (ARD) susceptibility. In tropical Africa, little is known about which infections contribute to development of ARDs, and at which time. Methods: We used latent class analysis to characterise the early infection-exposure of participants in a Ugandan birth cohort and assessed ARDs in later childhood. Results: Of 2345 live births, 2115 children (90%) had data on infections within the first year of life while 1179 (50%) had outcome data at 9 years. We identified two latent classes of children based on first-year infection-exposure. Class 1 (32% membership), characterised by higher probabilities for malaria (80%), diarrhoea (76%), and lower respiratory tract infections (LRTI) (22%), was associated with lower prevalence of wheeze, eczema, rhinitis, and Dermatophagoides skin prick test (SPT) positivity at 9 years. Based on 5-year cumulative infection experience, class 1 (31% membership), characterised by higher probabilities for helminths (92%), malaria (79%), and LRTI (45%), was associated with lower probabilities of SPT positivity at 9 years. Conclusions: In this Ugandan birth cohort, early childhood infection-exposure, notably to malaria, helminths, LRTI, and diarrhoea, is associated with lower prevalence of atopy and ARDs in later childhood. Funding: This work was supported by several funding sources. The Entebbe Mother and Baby Study (EMaBS) was supported by the Wellcome Trust, UK, senior fellowships for AME (grant numbers 064693, 079110, 95778) with additional support from the UK Medical Research Council. LL is supported by a PhD fellowship through the DELTAS Africa Initiative SSACAB (grant number 107754). ELW received funding from MRC Grant Reference MR/K012126/1. SAL was supported by the PANDORA-ID-NET Consortium (EDCTP Reg/Grant RIA2016E-1609). HM was supported by the Wellcome's Institutional Strategic Support Fund (grant number 204928/Z/16/Z).


Assuntos
Doenças Transmissíveis/epidemiologia , Hipersensibilidade/epidemiologia , Fatores Etários , Criança , Pré-Escolar , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/imunologia , Feminino , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Hipersensibilidade/prevenção & controle , Lactente , Recém-Nascido , Análise de Classes Latentes , Masculino , Prevalência , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Uganda/epidemiologia
16.
Allergol Immunopathol (Madr) ; 49(5): 9-15, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34476916

RESUMO

INTRODUCTION: Allergic diseases could play a role of a predisposing factor for coronavirus disease 2019 (COVID-19). The aim of this study was to investigate allergic comorbidity and its association in COVID-19 patients. METHODS: Demographic data, clinical manifestations, laboratory reports, and radiologic findings, together with underlying comorbidity of patients, were studies. Allergic diseases were identified by using the standard GA2LEN questionnaire. The severity of COVID-19 was assessed by a visual analog scale (VAS) and an intensive care unit (ICU) report. RESULTS: Out of 400 COVID-19 patients admitted in the hospital, 158 (39.5%) presented with different allergic diseases, and a reverse association was observed between having allergic comorbidity and severity of COVID-19 infection (P = 0.005, relative risk = 0.96; 95% Confidence Interval (95% CI): 0.77-1.19). The respective frequency of asthma, allergic rhinitis (AR), chronic rhinosinusitis (CRS), atopic dermatitis, chronic urticaria, and food or drug allergy was 7.3%, 16%, 1.8%, 5%, 10% and 13.3%. Significantly, only AR was reversely associated with the severity of COVID-19 (P = 0.02, relative risk = 0.45; 95% CI: 0.77-1.19). Additionally, 43% of the patients presented hypoxemia, and 93.5% had chest CT scan involvement. Interestingly, patients with allergic diseases had significantly lower hypoxemia and chest CT involvement as compared with non-allergic patients (P = 0.002 and 0.003, respectively). CONCLUSION: The results of this study established that allergic diseases were not determined to be a predisposing factor for the severe acute respiratory syndrome (SARS) due to coronavirus 2 (SARS-CoV-2) infection. Significantly, AR patients developed mild clinical manifestations of COVID-19 and admitted to ICU as compared to non-AR patients.


Assuntos
COVID-19/epidemiologia , Hipersensibilidade/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , Teste para COVID-19 , Comorbidade , Feminino , Humanos , Hipersensibilidade/diagnóstico , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
18.
Allergy ; 76(11): 3276-3291, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34390006

RESUMO

Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy. Microbial therapies, such as probiotics, have been studied in the prevention and treatment of allergic diseases, but evidence remains limited due to studies with high heterogeneity, strain-dependent effectiveness, and variable outcome measures. In this review, we sketch the relation of microbiota with allergic diseases, the overuse and rationale for the use of antimicrobial agents in allergic diseases, and current knowledge concerning the use of bacterial products in allergic diseases. We urgently recommend 1) limiting antibiotic therapy in pregnancy and early childhood as a method contributing to the reduction of the allergy epidemic in children and 2) restricting antibiotic therapy in exacerbations and chronic treatment of allergic diseases, mainly concerning asthma and atopic dermatitis. Future research should be aimed at antibiotic stewardship implementation strategies and biomarker-guided therapy, discerning those patients that might benefit from antibiotic therapy.


Assuntos
Asma , Dermatite Atópica , Hipersensibilidade , Antibacterianos/uso terapêutico , Bactérias , Criança , Pré-Escolar , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/epidemiologia , Feminino , Humanos , Hipersensibilidade/tratamento farmacológico , Hipersensibilidade/epidemiologia , Lactente , Gravidez
20.
JAMA Netw Open ; 4(8): e2122255, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34463744

RESUMO

Importance: Allergic reactions among some individuals who received the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine discourage patients with allergic conditions from receiving this vaccine and physicians from recommending the vaccine. Objective: To describe the assessment and immunization of highly allergic individuals with the BNT162b2 vaccine. Design, Setting, and Participants: In a prospective cohort study from December 27, 2020, to February 22, 2021, 8102 patients with allergies who applied to the COVID 19 vaccine referral center at the Sheba Medical Center underwent risk assessment using an algorithm that included a detailed questionnaire. High-risk patients (n = 429) were considered "highly allergic" and were immunized under medical supervision. Exposures: Pfizer-BioNTech (BNT162b2) COVID-19 vaccine. Main Outcomes and Measures: Allergic and anaphylactic reactions after the first and second doses of BNT162b2 vaccine among highly allergic patients. Results: Of the 429 individuals who applied to the COVID-19 referral center and were defined as highly allergic, 304 (70.9%) were women and the mean (SD) age was 52 (16) years. This highly allergic group was referred to receive immunization under medical supervision. After the first dose of the BNT162b2 vaccine, 420 patients (97.9%) had no immediate allergic event, 6 (1.4%) developed minor allergic responses, and 3 (0.7%) had anaphylactic reactions. During the study period, 218 highly allergic patients (50.8%) received the second BNT162b2 vaccine dose, of which 214 (98.2%) had no allergic reactions and 4 patients (1.8%) had minor allergic reactions. Other immediate and late reactions were comparable with those seen in the general population, except for delayed itch and skin eruption, which were more common among allergic patients. Conclusions and Relevance: The rate of allergic reactions to BNT162b2 vaccine, is higher among patients with allergies, particularly among a subgroup with a history of high-risk allergies. This study suggests that most patients with a history of allergic diseases and, particularly, highly allergic patients can be safely immunized by using an algorithm that can be implemented in different medical facilities and includes a referral center, a risk assessment questionnaire, and a setting for immunization under medical supervision of highly allergic patients. Further studies are required to define more specific risk factors for allergic reactions to the BNT162b2 vaccine.


Assuntos
Anafilaxia/etiologia , Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Vacinação/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anafilaxia/epidemiologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/etiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Medição de Risco , SARS-CoV-2 , Adulto Jovem
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