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1.
PLoS One ; 15(4): e0231816, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330171

RESUMO

INTRODUCTION: Existing evidence on the relationship between childhood lower respiratory tract infections (LRTI) and the subsequent atopy development is controversial. We aimed to investigate an association between viral LRTI at <5 years and the development of atopy at > 2 years. METHODS: We conducted a search at Embase, Pubmed, Web of Science, and Global Index Medicus. We collected data from the included articles. We estimated the odds ratio and the 95% confidence intervals with a random effect model. We determined factors associated with atopy development after childhood LRTI using univariate and multivariate meta-regression analyses. We recorded this systematic review at PROSPERO with the number CRD42018116955. RESULTS: We included 24 studies. There was no relationship between viral LRTI at <5 years and skin prick test-diagnosed-atopy (OR = 1.2, [95% CI = 0.7-2.0]), unknown diagnosed-atopy (OR = 0.7, [95% CI = 0.4-1.3]), atopic dermatitis (OR = 1.2, [95% CI = 0.9-1.6]), hyperreactivity to pollen (OR = 0.8, [95% CI = 0.3-2.7]), food (OR = 0.8, [95% CI = 0.3-2.5]), or house dust mite (OR = 1.1, [95% CI = 0.6-2.2]). Although not confirmed in all studies with a symmetric distribution of the 23 confounding factors investigated, the overall analyses showed that there was a relationship between childhood viral LRTI at < 5 years and serum test diagnosed-atopy (OR = 2.0, [95% CI = 1.0-4.1]), allergic rhinoconjunctivitis (OR = 1.7, [95% CI = 1.1-2.9]), hyperreactivity diagnosed by serum tests with food (OR = 5.3, [1.7-16.7]) or inhaled allergens (OR = 4.2, [95% CI = 2.1-8.5]), or furred animals (OR = 0.6, [95% CI = 0.5-0.9]). CONCLUSION: These results suggest that there is no association between viral LRTI at < 5 years and the majority of categories of atopy studied during this work. These results, however, are not confirmed for the remaining categories of atopy and more particularly those diagnosed by serum tests. There is a real need to develop more accurate atopy diagnostic tools.


Assuntos
Asma/epidemiologia , Conjuntivite Alérgica/epidemiologia , Dermatite Atópica/epidemiologia , Infecções Respiratórias/imunologia , Rinite Alérgica/epidemiologia , Alérgenos/efeitos adversos , Animais , Asma/sangue , Asma/diagnóstico , Asma/imunologia , Criança , Conjuntivite Alérgica/sangue , Conjuntivite Alérgica/diagnóstico , Conjuntivite Alérgica/imunologia , Dermatite Atópica/sangue , Dermatite Atópica/diagnóstico , Dermatite Atópica/imunologia , Dermatophagoides pteronyssinus/imunologia , Humanos , Pólen/efeitos adversos , Pólen/imunologia , Infecções Respiratórias/virologia , Rinite Alérgica/sangue , Rinite Alérgica/diagnóstico , Rinite Alérgica/imunologia , Testes Cutâneos , Fatores de Tempo
2.
Environ Res ; 182: 109125, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32069762

RESUMO

INTRODUCTION: It is unknown if high concentration of airborne grass pollen, where subtropical grasses (Chloridoideae and Panicoideae) dominate, is a risk factor for respiratory health. Here we systematically reviewed the association between airborne grass pollen exposure and asthma emergency department (ED) presentations and hospital admissions in subtropical climates. OBJECTIVES: A systematic review was performed to identify and summarise studies that reported on respiratory health (asthma ED presentations and hospital admissions) and airborne grass pollen exposure in subtropical climates. METHODS: Searches were conducted in: MEDLINE, Web of Science, Scopus, CINAHL (EBSCO), Embase and Google Scholar databases (1966-2019). Risk of bias was assessed using a validated quality assessment tool. A meta-analysis was planned, however due to the heterogeneity in study design it was determined inappropriate and instead a narrative synthesis was undertaken. RESULTS: Nineteen studies were identified for inclusion, with a total of 598,931 asthma ED presentation participants and 36,504 asthma hospital admission participants in six countries (Australia, India, Israel, Italy, Spain, USA). The narrative synthesis found airborne grass pollen appears to have a small and inconsistent increase on asthma ED presentations (judged as: probably little effect n = 5, may have little effect n = 4, no effect n = 2 and uncertain if there is an effect n = 4) and hospital admissions (judged as: probably increase slightly n = 2 probably little effect n = 1, may have a little effect n = 1, no effect n = 3 and we are uncertain if there is an effect n = 4) in the subtropics. Furthermore, the reported effect sizes were small and its clinical relevance may be difficult to discern. CONCLUSION: Exposure to airborne grass pollen appears to have a small and inconsistent increase on asthma ED presentations and hospital admissions in the subtropics. These findings are comparable to reported observations from studies undertaken in temperate regions.


Assuntos
Serviço Hospitalar de Emergência , Admissão do Paciente , Pólen , Austrália , Humanos , Índia , Israel , Itália , Admissão do Paciente/estatística & dados numéricos , Poaceae , Pólen/efeitos adversos , Espanha
3.
Geospat Health ; 14(2)2019 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-31724384

RESUMO

This study focuses on the risk of pollen allergy due to paper mulberry (Broussonetia papyrifera L.), an Asian invasive plant species now common in large parts of the world. Pollen plays a key role in the pathogenesis of respiratory allergic diseases, particularly rhinitis and asthma, and Islamabad, a major metropolitan city, is severely affected by allergy owing to B. papyrifera pollen. Due to its seasonality and other relationships with climatic variables, we used remote sensing to monitor the trend of pollen count. We also mapped the localisation of patients affected by pollen allergy using geographic information systems. The maximum likelihood algorithm was applied to SPOT-5 satellite imagery for land use/land cover classification. Temporal analysis of remotely sensed data revealed an increasing trend of paper mulberry density towards the southern and south-western part of Islamabad. Although not evident during rainfall, a clear positive correlation was found between patient count and pollen count. Field survey data and hotspot spatial analysis of allergy patients revealed that residents of Shakerperiyan and Lok Virsa areas (Sectors H-8, I-8, I-9, G-8, G-7 and G-6 in Islamabad) had more pronounced symptoms compared to residents of other sectors. The methodology adopted used in this study can be used to map the distribution of similar invasive species in other parts of the country.


Assuntos
Broussonetia , Avaliação do Impacto na Saúde , Espécies Introduzidas , Pólen/efeitos adversos , Sistemas de Informação Geográfica , Humanos , Paquistão , Plantas
4.
Yonsei Med J ; 60(10): 960-968, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31538431

RESUMO

PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3%), apple (22.2%), walnut (22.2%), pine nut (18.5%), peach (14.8%), and ginseng (14.8%). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95% confidence interval (CI), 1.25-10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95% CI, 1.79-15.53; p=0.003), timothy (OR, 11.8; 95% CI, 2.70-51.64; p=0.001), or ragweed (OR, 3.18; 95% CI, 1.03-9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95% CI, 1.15-1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.


Assuntos
Anafilaxia/etiologia , Hipersensibilidade Alimentar/complicações , Pólen/efeitos adversos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Análise Multivariada , Fatores de Risco , Síndrome
5.
Anticancer Res ; 39(8): 4511-4516, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366553

RESUMO

BACKGROUND/AIM: Gluconacetobacter hansenii (G. hansenii) is an acetic acid bacterium of vinegar production. Its anti-allergic effect on mice upon oral administration was examined. MATERIALS AND METHODS: The amount of LPS was measured by the Limulus reaction. Mice were sensitized by peritoneal and intranasal administration of cedar pollen and alum followed by oral administration of 30 or 150 mg/kg of heated G. hansenii cells. Pollen was administered intranasally to evaluate nasal symptoms, and at 8 weeks, IgE and IL-10 levels in blood were measured by ELISA. RESULTS: The amount of LPS in dried bacterial cells was 10.4±3.3 mg/g. In the cedar pollinosis model of mice, a significant reduction was observed in nose scratching of both groups administered with the bacterial cells (30, 150 mg/kg). CONCLUSION: G. hansenii contains LPS, and its oral administration showed an anti-allergic effect by a significant mitigation of the symptoms in a pollen allergy mouse model.


Assuntos
Antialérgicos/administração & dosagem , Gluconacetobacter/imunologia , Pólen/efeitos adversos , Rinite Alérgica Sazonal/prevenção & controle , Ácido Acético/química , Administração Oral , Alérgenos/efeitos adversos , Animais , Antialérgicos/imunologia , Modelos Animais de Doenças , Humanos , Imunoglobulina E/imunologia , Camundongos , Rinite Alérgica Sazonal/microbiologia , Rinite Alérgica Sazonal/patologia
6.
Sante Publique ; S1(HS): 35-42, 2019 May 13.
Artigo em Francês | MEDLINE | ID: mdl-31210489

RESUMO

OBJECTIVE: Many research papers have addressed the beneficial qualities of forests in promoting mental and physical health. However, we should also be clear that forest environments could have detrimental effects. Some of them, which are of allergic nature, have hitherto been largely neglected. METHODS: A comprehensive literature search has allowed us to achieve an initial synthesis on this matter. The emphasis was on temperate forests, especially on French forests. RESULTS: Anemophilous pollen from deciduous trees is the major factor causing respiratory allergies in connection with forests. The risks are focused between mid-winter and late spring. Ash, hornbeam and birch pollen and, more incidentally, oak and beech pollen induce allergic reactions not only in the forests, but also at great distances. As a result of its high humidity and because decaying organic matter is very abundant, the forest environment presents also a breeding ground for mould growth. Accordingly, fungal spores can lead to allergic manifestations recalling pollinosis. Lastly, the "other" allergies mainly include contact dermatitis symptoms, which affect wood workers first and foremost. However, the pine processionary moth, whose zone of infestation is rapidly spreading northwards and whose setae contain several relevant allergens, represents one particular case. CONCLUSION: Allergic reactions observed in forests or originating in forests are sufficiently frequent to justify to set up a wide-reaching system for aerobiological and epidemiological monitoring.


Assuntos
Alérgenos/efeitos adversos , Florestas , Hipersensibilidade , Pólen/efeitos adversos , Humanos , Estações do Ano
7.
Medicina (Kaunas) ; 55(6)2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31159395

RESUMO

Background and Objectives: Zea m 1 is a pollen allergen, which is present in maize, is accountable for a type I hypersensitivity reaction in all over the world. Several effective medications are available for the disorder with various side effects. Design and verification of a peptide-based vaccine is a state-of-art technology which is more cost effective than conventional drugs. Materials and Methods: Using immunoinformatic methods, the T cell epitopes from the whole structure of this allergenic protein can be predicted. Worldwide conserved region study among the other pollen allergens has been performed for T cell predicted epitopes by using a conservancy tool. This analysis will help to identify completely conserved HLA (human leukocyte antigen) binding epitopes. Lastly, molecular docking study and MHC-oligopeptide complex binding energy calculation data are applied to determine the interacting amino acids and the affinity of the epitopes to the class II MHCmolecule. Results: The study of criteria-based analysis predicts the presence of two epitopes YVADDGDIV and WRMDTAKAL on this pollen allergen. Conclusions: The T cell epitopes identified in this study provide insight into a peptide-based vaccine for a type I hypersensitivity reaction induced by Zea m 1 grass pollen allergenic protein.


Assuntos
Epitopos de Linfócito T/imunologia , Pólen/imunologia , Zea mays/efeitos adversos , Alérgenos/efeitos adversos , Humanos , Imunização , Pólen/efeitos adversos , Zea mays/imunologia
8.
Artigo em Russo | MEDLINE | ID: mdl-31095125

RESUMO

THE RATIONALE: The clinical course of bronchial asthma (BA) largely depends on the environmental conditions. One of the biological factors of the environmental pollution is the plant pollen. The presence of plant pollen in the air exerts the negative influence on the human health via specific (allergenic) and non-specific effects. AIM: The objective of the present study was to evaluate the influence of the aeropalinological factors of the aerial environment of the Southern Coast of the Crimea (SCC) on the results of the spa and health resort-based treatment (SRT) of the patients with bronchial asthma (BA). MATERIAL AND METHODS: The study involved 168 patients presenting with BA including 119 (70.83%) women and 49 (29.17%) men; all of them were residents of the Crimea who underwent SRT while staying at the SCC during the period from 2011 to 2013. The average age of the patients was 52.94±11.78 years. The examination of all the patients included a questionnaire survey, general medical inspection, physical examination, complete blood cell count, analysis of sputum cytology, external respiration function testing, and the assessment of the disease control with the use of the Asthma Control Test (ACT) and the Asthma Control Questionnaire (ACQ). The duration of treatment was 21 days. The drug treatment of all the patients was carried out in accordance with the generally recognized protocols for the management of asthma. Four groups of patients were formed depending on the periods of plant dusting at the Southern Coast of the Crimea, viz. cypress (n=51), pine (n=24), ragweed (n=29), and cedar (n=47); in addition, one more group of patients was distinguished who resided at SCC outside the periods of these plants dusting (n=17). RESULTS: After the completion of the spa and health resort-based treatment, the highest frequency of the absence of cough (62.5%) and dry rales in the lungs (87.5%) was revealed in the patients treated during the pine dusting period (the cough and dry rales in lungs were absent in 31.0-49.0% and 55.3-79.3% of the cases respectively during the dusting seasons of other plants of interest). The aeropalinological factors were shown to have no significant influence on the values of the parameters obtained with the use of the general blood tests and the analysis of sputum cytology. The best characteristics of the external respiration function were documented in the patients who had been treated during the pine dusting period. At the end of the SRT, no significant differences were found as regards the results of the ACQ and AST tests between the patients of the groups being compared. Nor was there a significant dependence of the dynamics of the clinical, laboratory, and functional indicators achieved as a result of SRT on the magnitude of the aeropalinological factors at the Southern Coast of the Crimea. The worst immediate effectiveness of SRT was inherent in the patients suffering from bronchial asthma who had been treated during dusting of the ragweed. CONCLUSIONS: Certain results of the spa and health resort-based treatment of the patients presenting with BA under conditions of the Southern Coast of the Crimea depend on the character and composition of the aeropalynologic factors in this region. Specifically, the treatment based at a health resort facility during the dusting period of the pine leads to the achievement of the best clinical and functional status of the patients in comparison with those treated during the cypress, ragweed, and cedar dusting periods, or in the absence of dusting of these plants. The worst immediate effectiveness of SRT was documented in the BA patients who had been treated during the ragweed dusting period.


Assuntos
Asma/terapia , Poluição Ambiental/efeitos adversos , Pólen/efeitos adversos , Adulto , Feminino , Estâncias para Tratamento de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Resultado do Tratamento , Ucrânia
9.
Int J Mol Sci ; 20(10)2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31096561

RESUMO

Pollinosis is sub-diagnosed and rarely studied in tropical countries. Cashew tree pollen has been reported as an allergen source although the knowledge of its immunoglobulin E (IgE)-reactive molecules is lacking. Therefore, this work aimed to identify IgE-reactive molecules and provide a proteomic profile of this pollen. From the 830 proteins identified by shotgun analysis, 163 were annotated to gene ontology, and a list of 39 proteins filtered for high confidence was submitted to the Allfam database where nine were assigned to allergenic families. Thus, 12 patients from the northeast of Brazil with persistent allergic rhinitis and aggravation of symptoms during cashew flowering season were selected. Using a 2D-based approach, we identified 20 IgE-reactive proteins, four already recognized as allergens, including a homolog of the birch isoflavone-reductase (Bet v 6). IgE-reactivity against the extract in native form was confirmed for five patients in ELISA, with three being positive for Bet v 6. Herein, we present a group of patients with rhinitis exposed to cashew tree pollen with the first description of IgE-binding proteins and a proteomic profile of the whole pollen. Cashew tree pollen is considered an important trigger of rhinitis symptoms in clinical practice in the northeast of Brazil, and the elucidation of its allergenic molecules can improve the diagnostics and treatment for allergic patients.


Assuntos
Alérgenos/imunologia , Anacardium/química , Imunoglobulina E/imunologia , Pólen/efeitos adversos , Pólen/química , Rinite Alérgica Sazonal/induzido quimicamente , Adolescente , Adulto , Idoso , Alérgenos/química , Animais , Antígenos de Plantas/efeitos adversos , Antígenos de Plantas/química , Antígenos de Plantas/genética , Antígenos de Plantas/imunologia , Betula/metabolismo , Brasil , Proteínas de Transporte/análise , Proteínas de Transporte/imunologia , Criança , Pré-Escolar , Reações Cruzadas/imunologia , Dermatophagoides farinae , Dermatophagoides pteronyssinus , Feminino , Humanos , Masculino , Proteínas de Plantas/efeitos adversos , Proteínas de Plantas/química , Proteínas de Plantas/genética , Proteínas de Plantas/imunologia , Pólen/genética , Proteômica , Rinite Alérgica Sazonal/imunologia , Testes Cutâneos
10.
Health Promot Chronic Dis Prev Can ; 39(4): 136-141, 2019 Apr.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-31021065

RESUMO

Pollen allergies are a major source of seasonal allergic rhinitis in North America. This type of rhinitis affects 17% of adults in Quebec, a marked increase in the last 30 years. Ragweed (Ambrosia artemisiifolia L.) pollens are responsible for 50% to 90% of rhinitis cases. Climate change has played a significant role in the increased prevalence of seasonal allergic rhinitis over the last few decades. In 2015, the Quebec government put in place a strategy to tackle this problem, the Stratégie québécoise de réduction de l'herbe à poux et des autres pollens allergènes [Quebec strategy to reduce ragweed and other allergenic pollens]. Based on solid evidence, the Strategy advocates for co-operation between stakeholders and the integration of control measures into the maintenance practices of municipalities and other large public and private landowners. This article presents the scientific data underpinning the Strategy and initial successes of the action taken under the Strategy.


Assuntos
Mudança Climática , Exposição Ambiental/efeitos adversos , Saúde Ambiental , Promoção da Saúde/organização & administração , Hipersensibilidade/etiologia , Pólen/efeitos adversos , Ambrosia/efeitos adversos , Ambrosia/imunologia , Canadá/epidemiologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Pólen/imunologia , Prevalência , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Quebeque , Rinite Alérgica Sazonal/epidemiologia , Medição de Risco
11.
BMC Plant Biol ; 19(1): 155, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023241

RESUMO

BACKGROUND: Ambrosia artemisiifolia L. is one of the most important sources of allergenic pollen in many regions of the world. Its health impact increased over the last decades and is expected to further increase in consequence of climate change. However little information is available on the specific role played by temperature on allergy rising. The aim of this work was to evaluate the effect of temperature on A. artemisiifolia growth, flowering and pollen allergenicity, the major plant functional traits influencing the prevalence and severity of pollinosis. RESULTS: Plants were grown in controlled conditions at three thermal regimes: "Low" (LT: 18-14 °C light-dark), "Intermediate" (IT: 24-20 °C light-dark) and "High" (HT: 30-26 °C light-dark). During plant development, plant vegetative and reproductive morpho-functional traits were measured and, at the end of plant life-cycle, mature pollen was collected and analyzed for its allergenic properties by slot blot, 1D- and 2D-western blot (by using a pool of sera from ragweed-allergic patients) and liquid chromatography-tandem mass spectrometry. A. artemisiifolia showed a great development plasticity leading to a broad temperature tolerance. Shoot architecture, growth rate, number of male inflorescence and pollen allergenicity were temperature-responsive traits. Pollen allergenicity increased in parallel with temperature and differences were related to allergen synthesis and Amb a 1-IgE-binding. Flavonoids whose concentration in pollen decreased with the increase of temperature, were recognized as the cause of the negligible Amb a 1-IgE binding in LT pollen. CONCLUSIONS: Results show that temperature governs plant development and pollen allergenicity influencing the temporal and spatial magnitude of subject exposure to allergens.


Assuntos
Ambrosia/fisiologia , Pólen/efeitos adversos , Característica Quantitativa Herdável , Temperatura , Alérgenos/imunologia , Flavonoides/análise , Germinação , Imunoglobulina E/metabolismo , Desenvolvimento Vegetal , Pólen/imunologia , Ligação Proteica , Rutina/metabolismo , Sementes/crescimento & desenvolvimento
12.
Ann Allergy Asthma Immunol ; 123(1): 70-80, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31009701

RESUMO

BACKGROUND: Although 5-grass pollen sublingual immunotherapy has a good safety profile in controlled clinical trials, additional safety information among pediatric patients in a real-world setting would be useful. OBJECTIVE: To further document the safety of 5-grass tablet among children aged 5 to 9 years with allergic rhinoconjunctivitis (ARC). METHODS: This multicenter, observational study included allergy immunotherapy-naïve 5- to 9-year-old children with grass pollen-induced ARC prescribed with 5-grass tablet daily (3-day dose escalation to 300 index of reactivity [IR]). Patients were followed up daily for safety and tolerability over the first 30 treatment days. Adverse events (AEs) and adverse drug reactions (ADRs) were analyzed descriptively. RESULTS: Three hundred seven children (mean age, 7.1 years) were enrolled. Fifty-eight percent were confirmed as polysensitized, and 36% had mild-to-moderate asthma. Of 307 patients, 233 (76%) reported AEs, and 173/307 (56%) reported ADRs, most frequently mild application-site reactions (throat irritation, oral pruritus, oral paresthesia). Sixteen of 307 (5.2%) patients withdrew because of ADRs. In 143 of 173 (83%) patients, ADRs first occurred within 1 week of starting treatment. More than half of the ADRs lasted less than 2 days, and ADRs resolved spontaneously in 161 of 173 (93%) patients. Recurrences of ADRs were reported in 45 of 173 (26%) patients and were also mainly application-site reactions. No notable differences were found in ADRs related to whether patients had asthma at inclusion. Neither epinephrine use nor admission to intensive care unit was reported. CONCLUSION: The safety profile of 5-grass tablet in pediatric ARC patients aged 5 to 9 years was consistent with safety findings in older patients, most ADRs being at the application site and mild to moderate. ClinicalTrials.gov identifier: NCT02295969; EUPAS registration number: 8104.


Assuntos
Conjuntivite Alérgica/tratamento farmacológico , Conjuntivite Alérgica/imunologia , Poaceae/imunologia , Pólen/efeitos adversos , Pólen/imunologia , Comprimidos/efeitos adversos , Comprimidos/uso terapêutico , Administração Sublingual , Alérgenos/imunologia , Asma/imunologia , Criança , Pré-Escolar , Dessensibilização Imunológica/métodos , Feminino , Humanos , Masculino , Rinite Alérgica Sazonal/imunologia , Imunoterapia Sublingual/efeitos adversos , Imunoterapia Sublingual/métodos
13.
J Occup Health ; 61(1): 128-134, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30698335

RESUMO

BACKGROUND: Anaphylaxis is a severe and potentially fatal type of allergic reaction and is characterized by the rapid development of symptoms in the respiratory and circulatory systems, possibly leading to death if not treated properly. Occupational anaphylaxis, which does not exhibit significant differences in pathogenesis from the nonoccupational form, develops in response to work-related triggers. However, the onset of occupational anaphylaxis can also be triggered by other factors. Therefore, an unexpected episode may occur due to exposure to a previously sensitized antigen or cross-reaction in the occupational environment, even if the direct trigger has been removed. Accordingly, it is difficult to diagnosis and treat such cases and ensure avoidance of potential triggers. CASE PRESENTATION: An adult male patient developed anaphylaxis following exposure to grass antigens while replacing and burying sewer pipes at a theme park. He later developed cross-reactivity to other grains. Despite symptomatic treatment, his total serum level of allergen-specific immunoglobulin E (Ig E) antibodies continuously increased, and thus, he was admitted with severe hypersensitivity, at which time his serum levels of Ig E antibodies specific for Bermuda grass, wheat, and rice had also increased. CONCLUSION: In Korea, Bermuda grass is rarely seen and is generally found in athletic fields or theme parks. Following exposure to this relatively rare grass, our patient exhibited new anaphylactic responses to various external antigens. Therefore, we attribute his severe anaphylaxis to sensitization caused by Bermuda grass exposure and cross-reactive hypersensitivity to other grains.


Assuntos
Alérgenos/imunologia , Anafilaxia/etiologia , Cynodon/imunologia , Doenças Profissionais/imunologia , Exposição Ocupacional/efeitos adversos , Pólen/imunologia , Adulto , Anafilaxia/tratamento farmacológico , Anticorpos , Reações Cruzadas , Cynodon/efeitos adversos , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Imunoglobulina E , Masculino , Oryza , Pólen/efeitos adversos , República da Coreia , Triticum
14.
J Asthma ; 56(9): 927-937, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30207818

RESUMO

Objective: To better understand how meteorological variables, air quality variables, and pollen counts collectively contribute to asthma-related emergency department visits (AREDV) and asthma-related hospitalizations (ARH) among pediatric and adult patients in the New York City borough of the Bronx. Methods: The numbers of daily adult and pediatric AREDV and ARH from 2001 to 2008 were obtained from three Bronx hospitals. After removing outliers, interpolating missing data, and standardizing variable values by scaling the data using z-scores, data were analyzed using Spearman rank tests and linear regression models for the full year and each season. Results: There were a total of 42,065 AREDV and 1,664 ARH at both Bronx hospitals. With the exception of a spring peak in AREDVs, AREDVs and ARHs follow a cyclical pattern, climbing in the fall, plateauing in the winter, dropping in the spring, and reaching a low in the summer. Among the 11 air quality, meteorological, and pollen count variables, temperature and tree pollen made the greatest contribution to AREDV with scaled coefficients of -0.337 and 0.311 respectively; equating to an additional AREDV for every 5.0-unit decrease in temperature and an additional AREDV for every 186.0-unit increase in tree pollen. These two variables were confirmed to have independent associations with AREDV prior to the data interpolation. Grass pollen was also found to have a relatively large contribution to AREDV during the summer with a scaled coefficient of 0.314, equating to an additional AREDV for every 2.3-unit increase in grass pollen. Conclusion: There are distinct peaks of increased AREDVs that are closely associated with increased tree pollen counts in the spring and decreasing temperatures in the fall. Early anticipation of these air quality, meteorological, and pollen factor changes based on ongoing surveillance could potentially guide clinical practice and minimize AREDVs in the Bronx.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/estatística & dados numéricos , Asma/terapia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adulto , Poluição do Ar/efeitos adversos , Alérgenos/efeitos adversos , Asma/etiologia , Criança , Monitoramento Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Material Particulado/efeitos adversos , Pólen/efeitos adversos , Estudos Retrospectivos , Estações do Ano , Temperatura
15.
Int J Dermatol ; 58(3): 279-282, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29873062

RESUMO

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease with a growing health concern, because of its high prevalence and associated low quality of life. The etiology of AD is multifactorial with interaction between various factors such as genetic predisposition, immune, and importantly, environmental factors. Since climate change is associated with a profound shift in environmental factors, we suggest that AD is being influenced by climate change. This review highlights the effects of ultraviolet light, temperature, humidity, pollens, air pollutants, and their interaction between them contributing to the epidemiology and pathophysiology of AD.


Assuntos
Mudança Climática , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Poluentes Atmosféricos/efeitos adversos , Humanos , Umidade , Pólen/efeitos adversos , Prevalência , Índice de Gravidade de Doença , Temperatura , Raios Ultravioleta/efeitos adversos
16.
Ocul Immunol Inflamm ; 27(4): 622-631, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29543548

RESUMO

Purpose: To compare alcaftadine and olopatadine ophthalmic solutions, and vehicle for preventing allergen-mediated conjunctivitis in Japanese subjects. Methods: Japanese cedar pollen-sensitive subjects were randomized to alcaftadine 0.25%, olopatadine 0.1%, or vehicle. Ocular itching was assessed at 3, 5 (primary outcome), 7, and 15 min post-conjunctival allergen challenge (CAC) and conjunctival hyperemia assessed at 7, 15 (secondary outcome), and 20 min post-CAC. Adverse events were monitored. Results: Overall, 240 subjects were randomized. Alcaftadine 0.25% (challenged 8 h post-dose) was significantly more effective than vehicle for prevention of itching and conjunctival hyperemia (p < 0.001) and noninferior to olopatadine 0.1% (challenged 4 h post-dose). Significantly lower hyperemia scores were observed in alcaftadine-treated than olopatadine-treated eyes at 7 and 15 min post-CAC (p ≤ 0.027). Alcaftadine and olopatadine were well tolerated; no serious adverse events were reported. Conclusion: Alcaftadine 0.25% is effective in preventing signs and symptoms of Japanese cedar pollen-induced allergic conjunctivitis.


Assuntos
Benzazepinas/administração & dosagem , Cedrus/efeitos adversos , Conjuntivite Alérgica/prevenção & controle , Imidazóis/administração & dosagem , Cloridrato de Olopatadina/administração & dosagem , Pólen/efeitos adversos , Adulto , Conjuntivite Alérgica/epidemiologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Seguimentos , Antagonistas dos Receptores Histamínicos H1/administração & dosagem , Humanos , Incidência , Japão/epidemiologia , Masculino , Soluções Oftálmicas/administração & dosagem , Estudos Retrospectivos , Estações do Ano , Resultado do Tratamento
17.
Intern Med J ; 49(1): 74-78, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29573176

RESUMO

BACKGROUND: Epidemic thunderstorm asthma (ETSA) refers to large-scale acute bronchospasm events associated with thunderstorm. The most serious episode ever recorded occurred in Melbourne, Australia, in November 2016, where more than 3500 patients were treated in hospitals and 10 died. Previous work has been focused primarily on patient presentations to emergency departments. The prevalence of individuals with milder, non-emergent symptoms and who may be at risk of more serious episodes in the future has not previously been explored. AIM: To characterise the nature and extent of respiratory symptoms in healthcare workers during the Melbourne ETSA event. METHODS: A survey was conducted among staff and volunteers across Eastern Health, distributed on the intranet homepage, by email and by word of mouth. Anonymous survey questions were constructed to assess prior and current diagnoses of relevance, symptoms, and demography. RESULTS: There were 515 participants (80% female, n = 411) of approximately 9000 potential respondents (~6% response rate) who completed the survey; 132 (25.6%) had symptoms suggestive of asthma during the Melbourne ETSA event, the majority of whom did not seek professional medical help. Notably, of those with ETSA-like symptoms, only 58 (43.9%) had a history of asthma, while 97 (73.5%) had a history of allergic rhinitis. Specifically, a history of allergic rhinitis (OR 2.77, P < 0.001), a history of asthma (OR 1.67, P = 0.037) and being of self-identified Asian ethnicity (OR 3.24, P < 0.001) were all strong predictors of ETSA-like symptoms. Being predominantly indoors was not protective. CONCLUSIONS: Our study provides evidence of the presence of a large cohort of sufferers during the Melbourne ETSA event of 2016 that did not come to the attention of medical services, implying a potentially hidden and significant susceptible population. Further research should help clarify the true prevalence of vulnerability in the general population, with important public health implications.


Assuntos
Asma/epidemiologia , Asma/etiologia , Epidemias/estatística & dados numéricos , Tempo (Meteorologia) , Adolescente , Adulto , Idoso , Alérgenos/efeitos adversos , Austrália/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pólen/efeitos adversos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
18.
J Asthma ; 56(5): 505-511, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29667465

RESUMO

BACKGROUND: Artemisia and Humulus pollen are the two most important aeroallergens of autumn allergies in North China. Cross-sectional data in 2001 have shown that allergic rhinitis often preceded or occurred at the same time as asthma in patients with autumn pollinosis in North China. OBJECTIVE: We used this cross-sectional data to investigate the association of serum specific IgE (sIgE) levels to Humulus and/or Artemisia pollen with the onset of asthma in patients with autumn pollen-induced allergic rhinitis. METHODS: 1096 patients with autumn pollinosis were face-to-face interviewed and underwent sIgE tests to Artemisia and Humulus. The temporal sequence of allergic rhinitis and asthma was documented. 1013 patients were positive to Artemisia and/or Humulus by sIgE. Multinomial logistic regression and survival analysis were used to examine the potential implication of sIgE levels for the progression of asthma in autumn pollen-induced allergic rhinitis. RESULTS: Of the 1013 participants with a positive sIgE test to Artemisia and/or Humulus, 563 (55.6%) had a history of allergic rhinitis which preceded or occurred at the same time as asthma. 450 (44.4%) had allergic rhinitis alone. After controlling of sex, age at onset of allergic rhinitis, and parental asthma, the risk of developing asthma increased with the levels of sIgE to both Artemisia and Humulus (p < 0.05). In Kaplan-Meier analysis, IgE classes 5-6 to Humulus or Artemisia increased the risk of asthma development (p < 0.05). CONCLUSION: Autumn pollen-induced allergic rhinitis often coexists with seasonal asthma. The incidence of asthma is more pronounced when the sIgE level was higher.


Assuntos
Alérgenos/efeitos adversos , Asma/sangue , Asma/imunologia , Imunoglobulina E/sangue , Pólen/efeitos adversos , Rinite Alérgica/imunologia , Adulto , Alérgenos/imunologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólen/imunologia , Estudos Retrospectivos , Estações do Ano
19.
J. investig. allergol. clin. immunol ; 29(1): 24-29, 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183960

RESUMO

Objectives: The incidence of eosinophilic esophagitis is unknown in our area. The aim of our study was to determine the incidence of eosinophilic esophagitis and its possible association with the most frequent absolute annual pollen counts. Methods: A descriptive retrospective multicenter observational study was designed to calculate the incidence of eosinophilic esophagitis in children aged under 15 years in the southwest region of Madrid, Spain in 2002-2013 (data were provided by the Statistics Institute of Madrid). We collected data on age, sex, clinical presentation, and date of endoscopic diagnosis. Relative risk (RR) was estimated (Stata v.11) using negative binomial regression models to assess the association between incidence and pollen counts (provided by Subiza Clinic). Results: The study population comprised 254 patients (192 male [75.6%], aged 0.5-14.99 years). The clinical presentation was esophageal impaction in 23.6%, dysphagia in 22%, gastroesophageal reflux-like symptoms in 44.9%, and other findings in 9.4%. The annual incidence from 2002 to 2013 per 100 000 children aged <15 years per year was, respectively, 0.81, 1.5, 0.37, 3.17, 3.07, 4.36, 6.87, 7.19, 8.38, 9.05, 9.14, and 9.68. The incidence of eosinophilic esophagitis increased by an average of 19% annually (RR, 1.19; 95%CI, 1.14-1.25; P<.001). In the overall analysis, the relationship between incidence and absolute annual and monthly counts during the pollen seasons of the respective pollen types was analyzed only for Platanus species, which had an RR >1 (1.17 and 1.06, respectively) (P<.05). Conclusion: The incidence of diagnosis of pediatric eosinophilic esophagitis increased by an average of 19% annually. No significant association was found between incidence and pollen counts, except for a weak association with Platanus species


Objetivo: La incidencia de esofagitis eosinofílica es desconocida en nuestra área. El objetivo de nuestro estudio es determinar la incidencia de diagnóstico de esofagitis eosinofílica y su posible asociación con los recuentos absolutos anuales de los pólenes más frecuentes. Métodos: Se diseñó un estudio descriptivo multicéntrico retrospectivo para el cálculo de la incidencia de esofagitis eosinofílica en niños menores de 15 años en el suroeste de la Comunidad de Madrid entre 2002-2013 (datos poblacionales obtenidos del Instituto de Estadística de la Comunidad de Madrid). Se recoge de cada paciente: edad, sexo, presentación clínica y fecha de diagnóstico endoscópico. Se estimó la asociación entre la incidencia y los recuentos polínicos (aportados por la Clínica Subiza) mediante cálculo del riesgo relativo usando modelos de regresión binomial negativa (Stata v.11).Resultados: Se incluyeron 254 pacientes, 75,6% varones (n=192), de edades comprendidas entre 0,5-14,99 años. La presentación clínica fue: impactación esofágica 23,6%, disfagia 22%, síntomas sugerentes de reflujo gastroesofágico 44,9% y otros 9,4%. Las incidencias anuales desde 2002 a 2013 (nº casos/100.000 niños menores de 15 años/año) fueron respectivamente: 0,81; 1,5; 0,37; 3,17; 3,07; 4,36; 6,87; 7,19; 8,38; 9,05; 9,14 y 9,68. La incidencia de esofagitis eosinofílica se incrementó en una media anual de 19% (RR 1,19, 95% IC: 1,14-1,25, p <0,001). En nuestro estudio únicamente existió asociación (RR>1) entre la incidencia y los recuentos polínicos absolutos de Platanus spp anuales y durante los meses de máxima polinización (1,17 and 1,06, respectivamente) (p <0,05).Conclusión: La incidencia de diagnóstico de esofagitis eosinofílica en la edad pediátrica se ha incrementado en una media anual de un 19%. No se encontró una asociación estadísticamente significativa entre la incidencia y los recuentos polínicos, excepto con el Platanus spp aunque ésta fue débil


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Esofagite Eosinofílica/epidemiologia , Pólen/efeitos adversos , Transtornos de Deglutição/epidemiologia , Espanha/epidemiologia , Estudos Retrospectivos , Rinite Alérgica Sazonal/epidemiologia , Esofagite Eosinofílica/imunologia
20.
Expert Rev Clin Immunol ; 14(12): 1003-1011, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30345820

RESUMO

INTRODUCTION: Allergic rhinitis (AR) is among the most common chronic conditions affecting both children and adults. It is the cause of significant morbidity from the symptoms and interference with sleep. It results in major impairment of performance both at school and at work. In the U.S. and certain parts of Europe, ragweed pollen is a major cause of seasonal AR. In 2014, the U.S. Food and Drug Administration (FDA) approved a sublingual ragweed tablet (MK-3641) for use in adults with ragweed-induced AR. Areas covered: This paper will review the impact of ragweed-induced AR and available treatments including subcutaneous immunotherapy and studies with MK-3641. The principal search method was PubMed. Expert commentary: One dosing finding, two 28-day safety and two 52-week safety and efficacy studies have been conducted with MK-3641. The 12-U (12µg Amb a 1) tablet was the most effective. Local application site reactions were common but usually not serious. Only one, non-serious systemic reaction was reported in four safety studies. MK-3641 is a safe and effective treatment for ragweed-pollen-induced AR when treatment is initiated ≥ 12 weeks prior to the onset of the ragweed pollen season.


Assuntos
Ambrosia/imunologia , Antígenos de Plantas/administração & dosagem , Hipersensibilidade Imediata/terapia , Exposição por Inalação/efeitos adversos , Proteínas de Plantas/administração & dosagem , Pólen/efeitos adversos , Rinite Alérgica Sazonal/terapia , Imunoterapia Sublingual/métodos , Administração Sublingual , Antígenos de Plantas/efeitos adversos , Antígenos de Plantas/imunologia , Humanos , Hipersensibilidade Imediata/diagnóstico , Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade Imediata/imunologia , Proteínas de Plantas/efeitos adversos , Proteínas de Plantas/imunologia , Pólen/imunologia , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/epidemiologia , Rinite Alérgica Sazonal/imunologia , Imunoterapia Sublingual/efeitos adversos , Comprimidos , Resultado do Tratamento
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