Allergotoxicology: Research of Pollutant Influence on the Development of Allergic Reactions

Alergotoksikologija je znanstvenoistraživačko područje koje se bavi ispitivanjem utjecaja polutanata (onečišćivača zraka) na nastanak alergijskih reakcija i bolesti. Ispitivanja su prvobitno bila usmjerena na polutante vanjskih prostora, a u novije vrijeme sve više na polutante unutarnjih prostora u kojima ljudi provode većinu vremena. Polutanti po svojoj prirodi mogu biti krute, tekuće ili plinovite čestice, koje se razlikuju s obzirom na veličinu, sastav i izvor iz kojeg nastaju. S obzirom na izvor mogu biti biološkog i nebiološkog podrijetla. Polutanti koji su predmet suvremenih istraživanja s gledišta nastanka alergijskih bolesti su respirabilne krute čestice, ozon, dušični oksidi i bioaerosoli. Mehanizam djelovanja polutanata ovisi o veličini čestica, njihovoj topljivosti i mjestu ulaska u organizam. Dosadašnja ispitivanja su pokazala da različite čestice uvjetuju različite imunosne i neimunosne odgovore u organizmu. Interakcija polutanata i alergena može se zbivati izvan eksponirane osobe, tj. sa samim alergenom ili u eksponiranoj osobi na sluznicama i koži. Polutanti mogu biti nosioci alergena i mogu interferirati na različitim nivoima u nastanku alergijske reakcije. U ovom prikazu razma raju se dosadašnja saznanja o mehanizmima djelovanja polutanata na alergene, na imunosni sustav izloženih osoba na osnovi epidemioloških populacijskih istraživanja, kliničkih studija ekspozcije u kontroliranim uvjetima i eksperimentalnih testnih sistema in vivo i in vitro.Allergotoxicology studies the infl uence of pollutants on the development of allergic reactions and diseases. At the beginning, the research was focused on outdoor air pollutants, while recently it turns to the indoor environment, mainly because people this is where people spend most of their time. Air pollutants may be solid, soluble, or gaseous particles in nature, and they can differ in size, structure, and sources. Pollutants can be of biological or nonbiological origin. Currently interesting air pollutants include particulate matter, ozone, nitrogen oxides, and bioaerosols. The mechanisms of pollutant activity depend on the particle size, solubility, site of deposition, and specifi c chemical properties. Recent studies have shown that different pollutants provoke different immunological and nonimmunological responses in exposed persons. Interaction between air pollutants and allergens can take place outside the exposed person i.e. with allergen itself, or inside the organism on mucous membranes and skin. Pollutants may be the carriers of allergens and may exacerbate allergic reactions and diseases. This review presents recent views about the mechanisms of pollutant activity on allergens and immune system response in exposed persons, based on epidemiological population studies, clinical studies of exposure under controlled conditions, and experimental tests in vitro and in vivo

Prevalence and causes of vision loss in Latin America and the Caribbean in 2015: magnitude, temporal trends and projections

Objective To estimate the prevalence and causes of blindness and vision impairment for distance and near in Latin America and the Caribbean (LAC) in 2015 and to forecast trends to 2020. Methods A meta-analysis from a global systematic review of 283 cross-sectional, population-representative studies from published and unpublished sources from 1980 to 2014 in the Global Vision Database included 17 published and 6 unpublished studies from LAC. Results In 2015, across LAC, age-standardised prevalence was 0.38% in all ages and 1.56% in those over age 50 for blindness; 2.06% in all ages and 7.86% in those over age 50 for moderate and severe vision impairment (MSVI); 1.89% in all ages and 6.93% in those over age 50 for mild vision impairment and 39.59% in all ages and 45.27% in those over 50 for near vision impairment (NVI). In 2015, 117.86 million persons were vision impaired; of those 2.34 million blind, 12.46 million with MSVI, 11.34 million mildly impaired and 91.72 million had NVI. Cataract is the most common cause of blindness. Undercorrected refractive-error is the most common cause of vision impairment. Conclusions These prevalence estimates indicate that one in five persons across LAC had some degree of vision loss in 2015. We predict that from 2015 to 2020, the absolute numbers of persons with vision loss will increase by 12% to 132.33 million, while the all-age age-standardised prevalence will decrease for blindness by 15% and for other distance vision impairment by 8%. All countries need epidemiologic research to establish accurate national estimates and trends. Universal eye health services must be included in universal health coverage reforms to address disparities, fragmentation and segmentation of healthcar