The roles of toll like receptor 3, 7 and 8 in allergic rhinitis pathogenesis

Publication date: Available online 3 February 2018
Source:Allergologia et Immunopathologia
Author(s): A. Golshiri-Isfahani, M. Amizadeh, M.K. Arababadi
Allergic rhinitis, as an allergic and nasal hypersensitivity disease, is associated with the inflammation of nasal mucosa. It appears that innate immune receptors are the important risk factors in the pathogenesis of the inflammatory disease. Toll-like receptors (TLRs) are the most important receptors of innate immunity; their crucial roles in the recognition of allergens and subsequently pathogenesis of allergic diseases have been evaluated recently. TLR3, 7 and 8 are the intracellular members of the innate immune receptors and recognize intracellular single and double strand RNAs. This review article collected the investigations regarding the roles of TLR3, 7 and 8 in the allergic rhinitis pathogenesis.



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Assessment of IL-31 levels and disease severity in children with atopic dermatitis

Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): D. Ozceker, M. Bulut, A. Celik Ozbay, F. Dilek, M. Koser, Z. Tamay, N. Guler
Introduction and objectivesAtopic dermatitis is a chronic, relapsing, highly pruritic, inflammatory skin disease characterized by typical localization with increasing prevalence of 10–20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective.The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively.Material and methodsOne hundred thirty-five children were enrolled in the study in total, 70 children with diagnosis of atopic dermatitis and 65 healthy children in control group. Data on demographic features (age, gender, family history of atopy) and laboratory values of serum eosinophil, total IgE, IgM, IgA, IgG levels and skin prick test results were collected through patient files. The disease severity was assessed by SCORAD index. IL-31 levels were measured with human IL-31 ELISA kit.ResultsThe statistical analysis showed that IL-31 level was significantly higher in AD patients than in the control group (AD vs CG, p 0.0001). There was no significant difference in IL-31 levels between the three subgroups divided according to the SCORAD severity score (p:0.27).ConclusionIL-31 levels were significantly higher in AD patients compared to control group but irrelevant to the disease severity.



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Knowledge on asthma, food allergies, and anaphylaxis: Assessment of elementary school teachers, parents/caregivers of asthmatic children, and university students in Uruguaiana, in the state of Rio Grande do Sul, Brazil

Publication date: Available online 12 January 2018
Source:Allergologia et Immunopathologia
Author(s): M. Urrutia-Pereira, L.P. Mocellin, R.B. de Oliveira, L. Simon, L. Lessa, D. Solé
IntroductionAllergic diseases have become an increasingly common reality in the last years, extending beyond the family context.ObjectiveAssessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil.Method577 individuals (PC – N=111; EST – N=177; US – N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis.ResultsAlthough PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students.ConclusionDespite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.



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Is vitamin D level associated with the natural course of atopic dermatitis?

Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): M. Dogru
Introduction and objectivesAtopic dermatitis (AD) is a chronic inflammatory disease of the skin. Apart from its well-known role on calcium metabolism, vitamin D is reported to affect skin functions. The study aims were to: compare the vitamin D levels of children with AD and healthy children; investigate the relationship between the severity of AD and vitamin D levels; and investigate the effect of vitamin D on the natural course of AD.Patients or materials and methodsSixty-nine patients with AD were enrolled. Seventy healthy children were assigned as control group. Clinical and demographic features of groups were recorded. The skin prick test, eosinophil counts, immunoglobulin (Ig) E levels and serum 25 OH cholecalciferol (25OHD3) levels were measured. After at least 4 years of follow-up, patients were re-evaluated for natural course of AD.ResultsMean 25OHD3 level was lower in patient group vs. control group; 19.86±6.7ng/mL (min–max: 6.8–40) vs. 24.07±9.08ng/mL, respectively, (p=0.002). Mean 25OHD3 levels, and vitamin D status were significantly different between AD severity groups. (p<0.05). In terms of vitamin D status in the pairwise comparison, vitamin D deficiency was greater in children with severe and moderate AD groups (respectively, p=0.005, p=0.018). In Tukey's post hoc analysis for 25OHD3 level, the 25OHD3 levels of severe AD are significantly lower than mild or moderate AD (respectively, p=0.001, p=0.026). There was a negative correlation between 25OHD3 levels and severity of AD (r=−0.480; p=0.001). In patients reassessed after 4 years: age, the age of AD onset, vitamin D deficiency, SCORAD level and severe AD were higher in the persistent group vs. remission group, 25OHD3 levels were higher in the remission group vs. persistent group (p<0.05).ConclusionsMean vitamin D levels were lower in patients with AD. A negative correlation between vitamin D levels and disease severity was documented. Vitamin D may affect the natural course of atopic dermatitis. There is a need for more comprehensive studies in this regard.



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Evaluation of an intervention to improve the management of allergens in school food services in the city of Barcelona

Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): M. Fontcuberta-Famadas, G. Serral, M.J. López, P. Balfagón, E. García-Cid, L. Caballé-Gavaldà
BackgroundAn intervention to promote the development of an allergen control plan (ACP) and preventive measures for the management of allergens in school food services was implemented in all schools of Barcelona city over a three-year period (2013–2015) by the public health services. The present study aimed to assess changes regarding the management of food allergens in school food services in Barcelona after an intervention conducted by the public health services of the city.MethodsSchool meal operators of a random sample of 117 schools were assessed before and after the intervention using a structured questionnaire. The questionnaire collected general information on the students and their demand for special menus, and included 17 closed questions regarding the implementation of specific preventive measures for the management of allergens. Based on these 17 questions, a food safety score was calculated for each school. The improvement in these scores was evaluated.ResultsThe results showed positive increments in the percentage of implementation of 12 of the 17 preventive measures assessed. The percentage of school food services with an implemented ACP increased by 49%. Schools with external and internal food supplies increased their scores by 16.5% and 19.6%, respectively. The greatest improvements were observed in smaller food services and in schools located in districts with low gross household incomes.ConclusionsThe intervention was effective in improving school food services' management of allergens and in reducing the differences found among food services in the pre-intervention survey. We must also focus efforts on reducing socio-economic inequalities linked to the management of allergens.



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Adherence to pharmacotherapy improves school performance in children with rhinitis and asthma

Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): J. Sánchez, A. Sánchez, R. Cardona
BackgroundAdherence to pharmacotherapy reduces symptoms of asthma and rhinitis, however, little is known of its impact on school performance.ObjectiveTo evaluate the impact of pharmacotherapy in absenteeism and school performance in a child population.MethodsA cross-sectional study, carried out in eight schools. All participants and their parents were given a questionnaire assessing parameters related to respiratory diseases and pharmacotherapy. Data on school performance was obtained from the academic history of each child who participated in the study. Adherence to pharmacotherapy was classified as a correct use of therapy for more than five days per week.Results1109 children agreed to participate. Students were divided into two groups: symptomatic (36%) and asymptomatic (63%). The symptomatic group had a higher frequency of school absenteeism (1 vs. 3.1days/year/patient p<0.01) and lower academic performance (failed: 20% vs. 33% p<0.01). After dividing the symptomatic group between adherents and non-adherents to the pharmacotherapy, the group of adherents had a similar school performance to the asymptomatic group and it was significantly different from the no-adherent group.ConclusionRespiratory symptoms are associated with poor school performance and with an increase in school absenteeism, but adherence to pharmacotherapy can reduce these negative impacts in children.



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Development and characterization of an allergoid of cat dander for immunotherapy

Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): J.P. Sola, Y. Pedreño, A. Cerezo, M. Peñalver-Mellado
BackgroundAllergy to cats is a frequent cause of sensitization to indoor allergens and currently there are few alternatives to specific immunotherapy with cat native extracts. The objective is to develop and characterize a new allergoid to increase the tools available for use in clinical practice.MethodsThe allergoid cat dander extract (ACD) was developed from a native cat dander extract (NCD) by modification with glutaraldehyde, and the optimal process control was determined by SDS-PAGE, DOT BLOT and determination of free amine groups. The ACD was characterized in protein profile by SDS-PAGE, size exclusion chromatography (SEC) and peptide footprint. The allergenic profile of ACD was determined by immunoblot, IgE CAP inhibition and IgG competition ELISA. The major allergen content in NCD was obtained by the ELISA sandwich protocol and was extrapolated to ACD.ResultsThe control process determined the optimal development of the allergoid. The ACD obtained contains 182.28μg/mg of protein and 11.90μg/mg of Fel d 1. SDS-PAGE and SEC confirmed the presence of high molecular weight proteins in ACD, and the peptide footprint showed the presence of Fel d 1 and Fel d 7. The high degree of polymerization was evidenced with the determination of the reduction of lysine residues in the allergoid, resulting 91.96%. The ACD showed a significant loss of allergenicity respect to NCD, while the IgG-binding capacity was maintained.ConclusionsThe ACD obtained presents a good safety profile, so would be a good alternative for treatment of cat allergy.



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