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1.
Arerugi ; 68(9): 1141-1147, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31723111

RESUMO

We present a case of early childhood-onset pork-cat syndrome possibly due to sensitization by both cats and dogs. A 6-year-old girl was referred to our hospital because of repetitive episodes of urticaria when she consumed pork meat. The patient lived with a dog and the ground floor of her house was a veterinary clinic run by her veterinarian parents. Blood tests demonstrated high specific IgE (≥50UA/ml) against cat dander, dog dander, pork, Sus s 1, Fel d 2, Can f 1, Can f 2, and Can f 3. The skin prick test was positive for raw pork and beef. Western blotting analysis detected hot spots on 67-kDa proteins in pork meat and cat dander extract. Cross-reactivity between these two proteins was confirmed by an inhibition test. Furthermore, crossreactivity between pork meat and dog dander extract was also noted. Taken together, the diagnosis of porkcat syndrome was made, and both cats and dogs were suggested to have led to the sensitization. The patient was advised to only eat well-cooked pork, and has been followed thereafter without additional reactions. The previously reported cases of this syndrome developed during adolescence and young adulthood because a considerable period from the sensitization to the development cross-reactivity with pork meat is required. To our best knowledge, this is the youngest reported case of pork-cat syndrome among English and Japanese literatures. The nomenclature of this syndrome as pet animal-meat syndrome improves the understanding of the underlying pathogenesis of cross-reactivity between animal albumins and meat albumins.


Assuntos
Hipersensibilidade Alimentar/imunologia , Carne Vermelha , Alérgenos , Animais , Gatos , Bovinos , Criança , Reações Cruzadas , Cães , Feminino , Humanos , Imunoglobulina E/sangue , Testes Cutâneos , Suínos , Adulto Jovem
4.
J Assoc Physicians India ; 67(8): 63-65, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31562720

RESUMO

The practice of skin testing prior to administration of antibiotics in the absence of a history of allergy is non-existent in the western world. Reports on skin testing in the absence of known allergy are unheard of in the medical literature. The practice of giving a test dose prior to administration of the antibiotic is also practiced very sporadically and has no scientific basis. Despite this In India in most major institutions both in government and private hospitals , general practice set up and small and medium nursing homes, skin testing prior to administration of antibiotics remain extremely common and is even considered to be negligent if not practiced. In this review the evidence for skin testing and test dose before antibiotic administration has been examined. Based on the evidence available skin testing should be restricted to patients with a history of prior penicillin allergy for whom penicillin or other B-lactam antibiotic is the drug of choice and there is no suitable alternative.1 There is no need to do skin testing without a history of penicillin allergy even if the drug is to be administered parenterally. Test dose administration does not protect patients from anaphylactic reactions and hence the practice has no scientific basis.


Assuntos
Antibacterianos/uso terapêutico , Hipersensibilidade a Drogas/diagnóstico , Testes Cutâneos , Humanos , Índia , Penicilinas
5.
Lancet ; 394(10207): 1437-1449, 2019 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-31522849

RESUMO

BACKGROUND: Dietary avoidance is recommended for peanut allergies. We evaluated the sustained effects of peanut allergy oral immunotherapy (OIT) in a randomised long-term study in adults and children. METHODS: In this randomised, double-blind, placebo-controlled, phase 2 study, we enrolled participants at the Sean N Parker Center for Allergy and Asthma Research at Stanford University (Stanford, CA, USA) with peanut allergy aged 7-55 years with a positive result from a double-blind, placebo-controlled, food challenge (DBPCFC; ≤500 mg of peanut protein), a positive skin-prick test (SPT) result (≥5 mm wheal diameter above the negative control), and peanut-specific immunoglobulin (Ig)E concentration of more than 4 kU/L. Participants were randomly assigned (2·4:1·4:1) in a two-by-two block design via a computerised system to be built up and maintained on 4000 mg peanut protein through to week 104 then discontinued on peanut (peanut-0 group), to be built up and maintained on 4000 mg peanut protein through to week 104 then to ingest 300 mg peanut protein daily (peanut-300 group) for 52 weeks, or to receive oat flour (placebo group). DBPCFCs to 4000 mg peanut protein were done at baseline and weeks 104, 117, 130, 143, and 156. The pharmacist assigned treatment on the basis of a randomised computer list. Peanut or placebo (oat) flour was administered orally and participants and the study team were masked throughout by use of oat flour that was similar in look and feel to the peanut flour and nose clips, as tolerated, to mask taste. The statistician was also masked. The primary endpoint was the proportion of participants who passed DBPCFCs to a cumulative dose of 4000 mg at both 104 and 117 weeks. The primary efficacy analysis was done in the intention-to-treat population. Safety was assessed in the intention-to-treat population. This trial is registered at ClinicalTrials.gov, NCT02103270. FINDINGS: Between April 15, 2014, and March 2, 2016, of 152 individuals assessed, we enrolled 120 participants, who were randomly assigned to the peanut-0 (n=60), peanut-300 (n=35), and placebo groups (n=25). 21 (35%) of peanut-0 group participants and one (4%) placebo group participant passed the 4000 mg challenge at both 104 and 117 weeks (odds ratio [OR] 12·7, 95% CI 1·8-554·8; p=0·0024). Over the entire study, the most common adverse events were mild gastrointestinal symptoms, which were seen in 90 of 120 patients (50/60 in the peanut-0 group, 29/35 in the peanut-300 group, and 11/25 in the placebo group) and skin disorders, which were seen in 50/120 patients (26/60 in the peanut-0 group, 15/35 in the peanut-300 group, and 9/25 in the placebo group). Adverse events decreased over time in all groups. Two participants in the peanut groups had serious adverse events during the 3-year study. In the peanut-0 group, in which eight (13%) of 60 participants passed DBPCFCs at week 156, higher baseline peanut-specific IgG4 to IgE ratio and lower Ara h 2 IgE and basophil activation responses were associated with sustained unresponsiveness. No treatment-related deaths occurred. INTERPRETATION: Our study suggests that peanut OIT could desensitise individuals with peanut allergy to 4000 mg peanut protein but discontinuation, or even reduction to 300 mg daily, could increase the likelihood of regaining clinical reactivity to peanut. Since baseline blood tests correlated with week 117 treatment outcomes, this study might aid in optimal patient selection for this therapy. FUNDING: National Institute of Allergy and Infectious Diseases.


Assuntos
Arachis , Dessensibilização Imunológica/métodos , Hipersensibilidade a Amendoim/terapia , Proteínas de Plantas/administração & dosagem , Administração Oral , Adolescente , Criança , Dessensibilização Imunológica/efeitos adversos , Método Duplo-Cego , Feminino , Gastroenteropatias/etiologia , Humanos , Imunoglobulina E/sangue , Masculino , Hipersensibilidade a Amendoim/diagnóstico , Hipersensibilidade a Amendoim/imunologia , Proteínas de Plantas/efeitos adversos , Testes Cutâneos , Resultado do Tratamento
6.
Int J Nanomedicine ; 14: 5381-5396, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31409994

RESUMO

Background: Tacrolimus (TCR), also known as FK-506, is a biopharmaceutics classification system (BCS) class II drug that is insoluble in water because of its high log P values. After dermal application, TCR remains in the stratum corneum and passes through the skin layers with difficulty. Purpose: The objectives of this study were to develop and evaluate solid lipid nanoparticles (SLNs) with thermosensitive properties to improve penetration and retention. Methods: We prepared TCR-loaded thermosensitive solid lipid nanoparticles (TCR-SLNs) with different types of surfactants on the shell of the particle, which conferred the advantages of enhancing skin permeation and distribution. We also characterized them from a physic point of view and performed in vitro and in vivo evaluations. Results: The TCR contained in the prepared TCR-SLN was in an amorphous state and entrapped in the particles with a high loading efficiency. The assessment of ex vivo skin penetration using excised rat dorsal skin showed that the TCR-SLNs penetrated to a deeper layer than the reference product (0.1% Protopic®). In addition, the in vivo skin penetration test demonstrated that TCR-SLNs delivered more drug into deeper skin layers than the reference product. FT-IR images also confirmed drug distribution of TCR-SLNs into deeper layers of the skin. Conclusion: These results revealed the potential application of thermosensitive SLNs for the delivery of difficult-to-permeate, poorly water-soluble drugs into deep skin layers.


Assuntos
Derme/metabolismo , Lipídeos/química , Nanopartículas/química , Tacrolimo/farmacologia , Temperatura Ambiente , Administração Cutânea , Animais , Varredura Diferencial de Calorimetria , Derme/efeitos dos fármacos , Liberação Controlada de Fármacos , Irritantes/toxicidade , Nanopartículas/ultraestrutura , Tamanho da Partícula , Coelhos , Ratos Sprague-Dawley , Absorção Cutânea/efeitos dos fármacos , Testes Cutâneos , Espectroscopia de Infravermelho com Transformada de Fourier , Tensoativos/química , Difração de Raios X
7.
Orv Hetil ; 160(33): 1311-1318, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31401863

RESUMO

Introduction and aim: The aim of our research is to evaluate and compare commonly performed diagnostic tests, and to examine the psychological disorders induced by this food allergy. Children with symptoms suggesting cow's milk protein allergy were included in this study (n = 47). Blood and saliva samples were collected from the participants. Parents were asked to fill in a questionnaire constructed by the research team (containing the DSM-5 symptoms checklist about attention deficit hyperactivity disorder). Method: One of the most widely used diagnostic tool is the skin allergy test, which was performed in 47 subjects (n = 47, mean age: 7.36 years); only 2 children showed positive test result for cow's milk. Lymphocyte transformation test was observed to be positive in 8 children (17%), 4 subjects demonstrated questionable results. In our sub-study about psychological symptoms (n = 43, mean age: 7.88 years), the score was according to the attention deficit hyperactivity disorder symptom checklist before the diet (6.88, SD: 4.43) and showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p = 0.001). Scores of children with sleep disorder (10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p = 0.009). Salivary cortisol levels did not show significant changes before and after elimination diet. Results: According to our data, skin allergy testing and lymphocyte transformation test are not reliable diagnostic tools for establishing the diagnosis. Conclusion: We conclude that a significant improvement in clinical symptoms can only be achieved with a strict elimination diet. Orv Hetil. 2019; 160(33): 1311-1318.


Assuntos
Alérgenos/imunologia , Imunoglobulina E/imunologia , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/efeitos adversos , Animais , Bovinos , Criança , Pré-Escolar , Feminino , Hipersensibilidade Alimentar , Humanos , Imunoglobulina E/sangue , Lactente , Recém-Nascido , Masculino , Proteínas do Leite/imunologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Testes Cutâneos/métodos
8.
Int Arch Allergy Immunol ; 180(2): 103-112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31394524

RESUMO

Within the broad category of adverse drug reactions in children, there has been a recent focus specifically on the evaluation of children with antibiotic allergy, in particular, beta-lactam allergy. The potential consequences of being labeled beta-lactam allergy are increasingly recognized. Appropriate evaluation of children with suspected reactions to antibiotics is essential as it is increasingly being recognized that the label of "penicillin allergy" is associated with adverse health and economic outcomes. This review will focus on the 3 main classes of antibiotics reported to cause allergic reactions in children: beta lactams (penicillin derivatives and cephalosporins), macrolides, and sulfonamides. This article is a narrative review of the prevalence, diagnosis, and management of different types of antibiotic allergies in children. Our review reveals that antibiotic allergy is often overreported and not appropriately diagnosed in the pediatric age groups. There is a recent shift in the diagnostic paradigm from the use of skin tests and if negative challenges to the use of challenge only in the pediatric age group. Larger studies to establish the usefulness and safety of this new approach as well as updated guidelines are needed.


Assuntos
Hipersensibilidade a Drogas/imunologia , Macrolídeos/imunologia , Testes Cutâneos/métodos , Sulfonamidas/imunologia , beta-Lactamas/imunologia , Anafilaxia/imunologia , Criança , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/epidemiologia , Humanos , Lactente
9.
Artigo em Chinês | MEDLINE | ID: mdl-31434369

RESUMO

Objective: To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region. Methods: A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis. Results: A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ(2)=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ(2)=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ(2)=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area. Conclusions: The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.


Assuntos
Rinite Alérgica/epidemiologia , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Feminino , Pradaria , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Rinite Alérgica/diagnóstico por imagem , Testes Cutâneos
10.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 164-169, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465184

RESUMO

Background: The link between upper and lower airways is recognized clinically as a "unique airway". Subclinical spirometric abnormalities have been observed in patients with rhinitis without asthma, which could be proportional to rhinitis severity. Objectives: To investigate possible subclinical alterations in lung function and bronchodilator reversibility in children and adolescents with allergic (AR) and non-allergic rhinitis (NAR) without asthma, according to the clinical grade of rhinitis classified by ARIA (Allergic Rhinitis and Its Impact on Asthma). Methods: In a cross-sectional analytical study, we included patients aged 5 to 18 years with symptoms of AR and NAR without asthma. Spirometry was performed by flow-volume curve and we analyzed the abnormalities in respiratory function and bronchodilator response in relation to clinical grade of rhinitis by ARIA using an adjusted logistic model. Results: We studied 193 patients; 42 (21.7%) had some spirometric abnormalities. Patients with moderate-severe persistent rhinitis had greater impairment of lung function compared to the other grades of rhinitis (p=0.009). This defect was associated with both frequency (p=0.03) and severity of rhinitis (p=0.04) but not with atopic status (p=0.28). A positive bronchodilator response was more frequent in grades moderate-severe of rhinitis than in mild forms (p=0.04). Conclusion: Abnormalities of lung function was more prevalent in moderate-severe persistent rhinitis and was associated with the frequency and severity of rhinitis but not to atopic status. The bronchodilator reversibility was observed in patients with intermittent and persistent moderate-severe rhinitis.


Assuntos
Albuterol/uso terapêutico , Broncodilatadores/uso terapêutico , Pulmão/fisiopatologia , Rinite/complicações , Rinite/tratamento farmacológico , Adolescente , Alérgenos/administração & dosagem , Alérgenos/classificação , Argentina , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Pulmão/efeitos dos fármacos , Masculino , Rinite/diagnóstico , Rinite Alérgica/complicações , Rinite Alérgica/diagnóstico , Rinite Alérgica/tratamento farmacológico , Índice de Gravidade de Doença , Testes Cutâneos , Espirometria
11.
Ther Umsch ; 75(1): 29-31, 2019 07.
Artigo em Alemão | MEDLINE | ID: mdl-31282838

RESUMO

Drug allergy in children: more often suspected than real Abstract. Adverse drug reactions are frequent in the pediatric population. However, only a small proportion of all adverse reactions are drug allergic reactions. About 10 % of the parents report a suspected drug allergy in their children. Even though, no accurate epidemiological data are available, studies suggested that as few as 10 % of those reported an allergy really are. The most common drug allergy among children is a drug hypersensitivity to antibiotics, especially to betalactam antibiotics.In children, one of the major difficulty in the diagnosis of drug allergies, and especially to antibiotics, is the differentiation of maculopapular eruption as an allergic reaction from a viral exanthema, which is very common among children. Therefore, a high number of children are inappropriately labeled as "drug allergic". In case of suspicion of an allergy, it is recommended to perform a complete allergy workup.


Assuntos
Antibacterianos/efeitos adversos , Hipersensibilidade a Drogas , Exantema , Antibacterianos/imunologia , Criança , Hipersensibilidade a Drogas/diagnóstico , Humanos , Testes Cutâneos , Viroses/diagnóstico , Viroses/patologia
12.
J Med Microbiol ; 68(9): 1314-1319, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31274404

RESUMO

Introduction. Current intradermal tuberculin skin tests for latent tuberculosis infection (LTBI) based on purified protein derivative (PPD) have poor specificity.Aims. Developing a better skin test antigen as well as a simple skin patch test may improve and facilitate diagnostic performance.Methodology. Defined recombinant antigens that were unique to Mycobacterium tuberculosis (MTB), including two potential latency-associated antigens (ESAT-6 and Rv2653c) and five DosR-encoded latency proteins (Rv1996, Rv2031c, Rv2032, DevR and Rv3716c), were used as diagnostic skin test reagents in comparison with a standard PPD. The performance of the skin tests based on the detection of delayed-type hypersensitivity (DTH) reaction in guinea pigs sensitized to MTB and M. bovis bacille Calmette-Guérin (BCG) vaccine was evaluated.Results. The latency antigens Rv1996, Rv2031c, Rv2032 and Rv2653c and the ESAT-6 protein elicited less reactive DTH skin responses in MTB-sensitized guinea pigs than those resulting from PPD, but elicited no response in BCG-vaccinated guinea pigs. The remaining two latency antigens (DevR and Rv3716c) elicited DTH responses in both groups of animals, as did PPD. The reactivity of PPD in BCG-vaccinated guinea pigs was greater than that of any of the selected skin test reagents. Using stronger concentrations of selected skin test reagents in the patch test led to increased DTH responses that were comparable to those elicited by PPD in guinea pigs sensitized with MTB.Conclusion. Transdermal application of defined purified antigens might be a promising method for LTBI screening.


Assuntos
Hipersensibilidade Tardia/imunologia , Tuberculose Latente/diagnóstico , Mycobacterium tuberculosis/imunologia , Testes Cutâneos/métodos , Adesivo Transdérmico , Animais , Antígenos de Bactérias/imunologia , Vacina BCG/imunologia , Feminino , Cobaias , Indicadores e Reagentes , Mycobacterium tuberculosis/isolamento & purificação , Testes Cutâneos/normas , Tuberculina/imunologia
13.
Ther Umsch ; 75(1): 33-37, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31282835

RESUMO

The diagnosis of drug allergy is essentially based on a detailed anamnesis, involving the doctors who first treated the patient, and skin testing (prick, intradermal and epicutaneous / patch tests). In the allergological practice / clinic, provocation tests with the presumed trigger are only carried out if the indication is very clear (see articles in this issue on drug allergy children, allergies to betalactam and other antibiotics as well as analgesic intolerance). The provocation with a probably tolerable alternative is in the foreground. Unfortunately, the skin tests of certain drug groups have a low sensitivity even under optimal conditions, but very good specificity. Accordingly, positive skin tests are mostly relevant, but negative skin tests cannot rule out an allergy. In recent years, it has therefore proved successful to carry out supplementary laboratory tests in the clarification of drug allergies. The serological tests (IgE) are of little help. In contrast, the test forms based on the analysis of leukocytes (basophil activation test, BAT, and lymphocyte transformation test, LTT) have gained in importance and complement the diagnostic repertoire. In the combination of all test methods (skin test, LTT, BAT, sometimes provocation test) the trigger of a drug allergy can be defined in a good 70 % of cases and in most cases a safe therapeutic alternative can be found. In the following, we will discuss the importance of laboratory diagnostics in drug allergy.


Assuntos
Hipersensibilidade a Drogas , Testes Cutâneos , Antibacterianos , Criança , Hipersensibilidade a Drogas/diagnóstico , Humanos , Ativação Linfocitária , beta-Lactamas
14.
Rev. fac. cienc. méd. (Impr.) ; 16(1): 12-18, ene.-jun. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1023772

RESUMO

La atopia es un fenómeno biogenético y ambiental, un estado de hipersensibilidad anómala que presentan ciertos individuos ante la presencia de sustancias o condiciones que para el resto de la población son inocuas, con diversas manifestaciones clínicas de alergia aguda o crónica, sistémica u órgano- específica. En el país existe poca información sobre enfermedades alérgicas. Objetivo: describir las manifestaciones clínicas frecuentes y la condición atópica, definida a través de datos clínicos y pruebas cutáneas de alergia. Material y Métodos: se realizó un estudio observacional, descriptivo, transversal, con muestreo por conveniencia, de 50 de los 62 empleados del Centro de Salud Integral Zoé de Tegucigalpa, Honduras, de octubre 2015 a febrero 2016. A cada participante, previo consentimiento informado, se le aplicó un instrumento clínico-epidemiológico y un prick test de aero alérgenos inhalados y de alimentos frecuentes. Resultados: La población femenina fue mayoritaria (66%), con una relación mujer/varón de 2:1, 38 personas (76%) ubicadas entre los 20 y 40 años de edad. Se encontró que 23 (46%) tuvieron antecedentes familiares de atopia, 28 (56%) manifestaron el antecedente personal de rinitis, asma bronquial o dermatosis, 6 (12%) expresaron antecedente de alergia a medicamentos y 35 (70%) identificaron el polvo como principal alérgeno. La prevalencia general de atopia, medida por una prueba de prick positiva fue de 76%. Los alérgenos identificados fueron principalmente los ácaros del polvo doméstico (48%), hongos (50%) y cucaracha (polvo casero) (32%); en menor frecuencia chocolate (6%), mariscos (6%) y maíz (6%). Conclusiones: Se encontró un elevado porcentaje (76%) de enfermedad alérgica, con mayor frecuencia de hipersensibilidad a polvo, ácaros y mohos. La detección oportuna y adecuada de los alérgenos desencadenantes de enfermedades alérgicas, es necesaria para tomar medidas terapéuticas óptimas y ofrecer mejor calidad de vida a las personas que las padecen...(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Testes Cutâneos/métodos , Alérgenos , Hipersensibilidade , Consentimento Livre e Esclarecido/ética
15.
Int Arch Allergy Immunol ; 180(1): 28-36, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31189157

RESUMO

BACKGROUND: Clinically meaningful specific IgE determination is an important step in the diagnosis of allergic diseases. While patient's history and skin prick tests are available during the medical visit, most IgE immunoassays require hours to several days to be available. Recent developments in the field of nanofluidic technology open new horizons for point-of-care management of this unmet medical need. OBJECTIVE: This study aimed to compare IgE diagnostic agreement between a nanofluidic assay (abioSCOPE®) and a laboratory reference method (Phadia Laboratory System®) in a real-world clinical setting. METHODS: Sera from 105 patients whose routine allergy diagnostic workup required a blood sampling were used to compare the novel nanofluidic IgE assay to a reference method in a blind manner for a panel of five respiratory allergens. To assess the agreement between methods, patient records were reviewed by four independent experts to establish the final diagnosis. Experts were blinded to the IgE serological method used, but had access to patient history, skin prick tests, and blood test results. RESULTS: Analytic agreement between the two methods was 81% for the tested panel of allergens (ranging from 77 to 89%). The overall agreement in clinical diagnosis decision taken by the expert panel was 94.6% with the nanofluidic IgE assay when compared to the reference method. CONCLUSION: The nanofluidic IgE assay, as determined through an evaluation based on clinical history, skin prick tests, and IgE measurement, is a valuable tool for allergy experts to identify patients' sensitization patterns at the point of care, and for routine IgE diagnostic workup.


Assuntos
Imunoensaio/métodos , Imunoensaio/normas , Imunoglobulina E/imunologia , Dispositivos Lab-On-A-Chip , Nanotecnologia/métodos , Adolescente , Adulto , Idoso , Alérgenos/imunologia , Feminino , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Imunoglobulina E/sangue , Masculino , Pessoa de Meia-Idade , Padrões de Referência , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Testes Cutâneos , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-31174696

RESUMO

The analysis of haptoglobin (Hp) serum concentration is a very sensitive, but non-specific, indicator of inflammation or infection. Methods to accurately diagnose infection in vivo in wildlife are usually constrained by low sensitivity due to the effects of stress on individual immune response and the challenging logistics of performing tests in the wild. Firstly, we sought to determine serum Hp concentration in red deer (Cervus elaphus) naturally infected with bovine tuberculosis (TB). Secondly, we assessed the complementary diagnostic value of serum Hp levels in conjunction with the cervical comparative skin test (CCT) performed in a subsample (n = 33). Serum Hp concentrations were significantly higher in TB-infected individuals (based on the presence of macroscopic lesions confirmed by culture) compared to those uninfected. In addition, serum Hp significantly changed with the type of animal handling, with captured and handled animals showing higher levels of Hp than hunted animals. Four out of 6 TB positive individuals that tested negative to the CCT (false negatives) showed Hp levels higher than the 95th percentile of healthy animals. These findings indicate that an acute phase response develops in animals with TB. In this paper, we demonstrate for the first time that an acute phase protein can provide a complementary assessment for specific diagnosis tests in wild species.


Assuntos
Cervos/imunologia , Haptoglobinas/imunologia , Tuberculose Bovina/sangue , Tuberculose Bovina/diagnóstico , Animais , Anticorpos Antibacterianos/sangue , Biomarcadores/sangue , Bovinos , Cervos/microbiologia , Ensaio de Imunoadsorção Enzimática , Mycobacterium bovis , Testes Cutâneos/métodos
17.
Int Arch Allergy Immunol ; 179(4): 297-303, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31091525

RESUMO

BACKGROUND: Mucociliary clearance is one of the most important protective functions of the airway. Previous studies, checking the influence of allergic rhinitis (AR) on mucociliary clearance time (MCT), were made on small patient groups and brought contradictive results. OBJECTIVES: The aim of the study is to confirm whether AR in children influences MCT. METHODS: The examined group consisted of 842 AR children. A total of 96 children with no history of allergy rhinitis served as a comparative group. All patients underwent saccharin and skin prick tests and tests for blood eosinophilia, nasal eosinophilia, vitamin D3 serum concentration, total and specific IgE serum concentration. RESULTS: Nasal MCT was significantly longer in AR patients (mean ± SD: 10.5 ± 5.65 min) compared to controls (mean ± SD: 7.25 ± 4.3 min). Percentage of eosinophils in nasal smears in patients was significantly higher compared to controls and a weak, but significant positive correlation was observed between the percentage and MCT (r > 0.10, p < 0.008). Patients with intermittent and persistent moderate/ severe AR had significantly longer MCT and higher eosinophilia in nasal smears compared both to patients with intermittent and persistent mild RA and controls. No correlation was observed between MCT and: participant's age, total serum IgE, vitamin D3 serum concentration, absolute number or percentage of eosinophils in blood, prick test results or duration of illness. CONCLUSIONS: AR affects the mucociliary clearance in children, and its deterioration is related to more severe rhinitis with higher intensity of local nasal inflammation, reflected in nasal smear eosinophilia.


Assuntos
Eosinófilos/imunologia , Inflamação/imunologia , Depuração Mucociliar , Mucosa Nasal/imunologia , Seios Paranasais/imunologia , Rinite Alérgica/imunologia , Adolescente , Criança , Progressão da Doença , Feminino , Humanos , Imunoglobulina E/metabolismo , Contagem de Leucócitos , Masculino , Testes Cutâneos
18.
S Afr Med J ; 109(5): 323-327, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31131799

RESUMO

BACKGROUND: There are no previous data on tolerance development in children with atopic dermatitis (AD) and concomitant food allergy in low- and middle-income settings. OBJECTIVES: To determine the rate of tolerance acquisition to egg and peanut 5 years after diagnosing food allergies in South African (SA) children with AD, and to explore factors influencing tolerance acquisition. METHODS: Five years after first diagnosing food allergy in 37 SA children with egg and/or peanut allergy, they were reassessed for their allergies by questionnaire, skin-prick tests (SPTs) and ImmunoCAP-specific IgE (sIgE) tests (Thermo Fisher Scientific/Phadia, Sweden) to egg white, ovomucoid, peanut and Arachis hypogaea allergen 2 (Ara h 2), and incremental food challenges. RESULTS: Eighteen of 25 originally egg-allergic patients and 19 of 24 originally peanut-allergic children were followed up at a median age of 8 years and 3 months and 9 years and 6 months, respectively. A high percentage of children (72.2%) outgrew their egg allergy, and 15.8% outgrew their peanut allergy. Allergic comorbidity remained high, with asthma increasing over time, and AD remaining moderate in severity in the cohort overall. At diagnosis, sIgE egg white ≤9.0 kU/L and sIgE ovomucoid ≤2.0 kU/L were associated with tolerance development to egg 5 years later. At follow-up, sIgE egg white ≤0.70 kU/L, sIgE ovomucoid ≤0.16 kU/L, SPT egg-white extract ≤1 mm and SPT fresh egg ≤5 mm were associated with tolerance. At diagnosis, sIgE Ara h 2 ≤1.7 kU/L and SPT peanut ≤10 mm were associated with tolerance development to peanut 5 years later. At follow-up, sIgE peanut ≤0.22 kU/L, sIgE Ara h 2 ≤0.18 kU/L and SPT peanut ≤5.5 mm were associated with tolerance. CONCLUSIONS: Egg allergy was outgrown in 72.2% and peanut allergy in 15.8% of SA children 5 years after diagnosis of AD. This is in keeping with findings derived from studies in higher socioeconomic settings, and can help to guide the counselling of patients with allergies to these foods of high nutritional value.


Assuntos
Dermatite Atópica/epidemiologia , Hipersensibilidade a Ovo/complicações , Tolerância Imunológica , Hipersensibilidade a Amendoim/complicações , Criança , Pré-Escolar , Dermatite Atópica/diagnóstico , Dermatite Atópica/etiologia , Hipersensibilidade a Ovo/epidemiologia , Hipersensibilidade a Ovo/imunologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Masculino , Hipersensibilidade a Amendoim/epidemiologia , Hipersensibilidade a Amendoim/imunologia , Estudos Retrospectivos , Testes Cutâneos , África do Sul/epidemiologia , Fatores de Tempo
19.
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
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