Early atopic disease and early childhood immunization--is there a link?

BACKGROUND: There are frequent concerns about early immunizations among the parents of children at heightened risk for atopy. The study assessed the effect of vaccine immunization before the first birthday on eczema severity and allergic sensitization in the second year of life. METHODS: A total of 2184 infants, aged 1-2 years, with established atopic dermatitis and a family history of allergy, from 97 study centres in 10 European countries, South Africa and Australia were included. Exposure to vaccines (diphtheria, tetanus, pertussis, polio, Haemophilus influenzae Type B, hepatitis B, mumps, measles, rubella, varicella, BCG, meningococci and pneumococci) and immunization dates were recorded from immunization cards. Immunoglobulin E (IgE) was determined by RAST and eczema severity was assessed by scoring atopic dermatitis (SCORAD). RESULTS: Immunization against any target was not associated with an increased risk of allergic sensitization to food or inhalant allergens. Varicella immunization (only 0.7% immunized) was inversely associated with total IgE > 30 kU/l (OR 0.27; 95% CI 0.08-0.87) and eczema severity (OR 0.34; 95% CI 0.12-0.93). Pertussis immunization (only 1.7% nonimmunized) was inversely associated with eczema severity (OR 0.30; 95% CI 0.10-0.89). Cumulative received vaccine doses were inversely associated with eczema severity (P = 0.0107). The immunization coverage of infants before and after the onset of atopic dermatitis was similar. CONCLUSION: In children at heightened risk for atopy, common childhood immunization in the first year is not associated with an increased risk of more severe eczema or allergic sensitization. Parents of atopic children should be encouraged to fully immunize their children

Anafilaxia associada à vacina contra sarampo, caxumba e rubéola Anafilaxia asociada a la vacuna contra sarampión, varicela y rubéola Anaphylaxis associated with the vaccine against measles, mumps and rubella

Estudo do tipo caso-controle cujo objetivo foi descrever os casos e as causas de anafilaxia associada à vacina contra sarampo, caxumba e rubéola. Foram estudados 22 casos notificados em crianças de Curitiba, PR, durante Campanha Nacional de Vacinação de 2004, que apresentaram manifestações mucocutâneas. Para o controle, foram selecionadas 66 crianças vizinhas dos casos, que não apresentaram sintomatologia após a aplicação vacinal. Foram realizadas dosagens séricas de anticorpos para os antígenos vacinais, IgE total e específicas para diversos alérgenos, e testes cutâneos. A resposta vacinal foi adequada, a dosagem de IgE específica e os testes cutâneos mostraram que os alérgenos potenciais constituintes da vacina e a atopia não foram relacionados às reações anafiláticas. Os testes cutâneos com a vacina e o dextrano foram positivos somente nos casos, sugerindo sensibilização por algum componente residual da vacina e possível reação cruzada com o dextrano.<br>Estudio del tipo caso-control cuyo objetivo fue describir los casos y las causas de anafilaxia asociada a la vacuna contra sarampión, varicela y rubéola. Fueron estudiados 22 casos notificados en niños de Curitiba, Sureste de Brasil, durante Campaña Nacional de Vacunación de 2004, que presentaron manifestaciones mococutáneas. Para el control, fueron seleccionados 66 niños vecinos de los casos, que no presentaron sintomatología posterior a la aplicación vacunal. Fueron realizadas dosificaciones séricas de anticuerpos para los antígenos vacunales, IgE total y específicas para diversos alérgenos, y pruebas cutáneas. La respuesta vacunal fue adecuada, la dosificación de IgE específica y las pruebas cutáneas mostraron que los alérgenos potenciales constituyentes de la vacuna y la atopia no fueron relacionados a las reacciones anafilácticas. Las pruebas cutáneas con la vacuna y el dextrano fueron positivas solamente en los casos, sugiriendo sensibilización por algún componente residual de la vacuna y posible reacción cruzada con el dextrano.<br>A case-control study was carried out aiming to describe the cases and causes of anaphylaxis associated with the vaccine against measles, mumps and rubella. A total of 22 reported cases in children who showed mucocutaneous manifestations, during the Campanha Nacional de Vacinação (Brazilian Vaccination Campaign), conducted in the city of Curitiba, Southern Brazil, in 2004, were studied. In addition, 66 children, who were next to these cases and did not show a symptomatology after the vaccine was applied, were selected. Serum measurements of antibodies for vaccine antigens and total IgE, specific IgE antibody measurements for several allergens, and skin tests were performed. Vaccine response was adequate, specific IgE measurement and skin tests showed that potential allergens in vaccines and atopy were not associated with anaphylactic reactions. Skin tests with the vaccine and dextran were positive in the cases exclusively, suggesting sensitization to certain residual components of the vaccine and possible cross-reaction with dextran

Immunological evaluation of allergic respiratory children with recurrent sinusitis

The objective of this study was to evaluate humoral immunity of allergic respiratory children with chronic/recurrent sinusitis. Twenty-seven allergic respiratory (persistent mild/moderate asthma and persistent allergic rhinitis) children (7-15-year old) with chronic or recurrent sinusitis were evaluated. Patients had symptoms and abnormal computer tomography scan even after two adequate treatments (long-lasting antibiotics, decongestants, and short-term oral corticosteroids). clinical examination, sweat test, total blood cell count, measurement of serum levels of: total and specific IgE, immunoglobulins (G, M, A), IgG subclasses, antibodies to Haemophilus influenza type b (IgG anti-Ps Hib) and pneumococcal serotypes (IgG anti-Ps 1, 3, 5, 6B, 9V, and 14) before and after active immunization (Act-Hib (R) and Pneumo23 (R), Aventis Pasteur SA, Lyon, France), Rubella neutralizing antibody titers and human immunodeficiency virus antibodies. Specific IgE to inhalant allergens higher than class III were observed in 24/27 patients. One patient had IgA plus IgG2 deficiency and other an IgG3 deficiency. Eight and 12 of 27 patients had IgG2 and IgG3 serum levels below 2.5th percentile, respectively. Immunological responses to protein and polysaccharide antigens were normal in all patients. Although our patients have been appropriately treated of their allergic diseases, they persisted with chronic/recurrent sinusitis and 60% of them had a documented osteomeatal complex blockade. in spite of the diagnosis of IgA plus IgG2 deficiency and an isolated IgG3 deficiency, in all patients an adequate response to Ps antigens was observed. Primary and/or secondary humoral immunodeficiency seems not to be the main cause of chronic/recurrent sinusitis in patients with respiratory allergic disease.Univ São Paulo, Escola Paulista Med, Dept Pediat, Div Rheumatol Allergy & Clin Immunol, São Paulo, BrazilFed Univ Ceara, Fac Pharm, Dept Clin & Toxicol Anal, Fortaleza, Ceara, BrazilUniv São Paulo, Dept Immunol, São Paulo, BrazilLouisiana State Univ, Dept Pediat, New Orleans, LA USAUniv São Paulo, Escola Paulista Med, Dept Pediat, Div Rheumatol Allergy & Clin Immunol, São Paulo, BrazilWeb of Scienc