157 research outputs found
Diagnosis and Management of Grain-Induced Asthma
Grain-induced asthma is a frequent occupational allergic disease mainly caused by inhalation of cereal flour or powder. The main professions affected are bakers, confectioners, pastry factory workers, millers, farmers, and cereal handlers. This disorder is usually due to an IgE-mediated allergic response to inhalation of cereal flour proteins. The major causative allergens of grain-related asthma are proteins derived from wheat, rye and barley flour, although baking additives, such as fungal α-amylase are also important. This review deals with the current diagnosis and treatment of grain-induced asthma, emphasizing the role of cereal allergens as molecular tools to enhance diagnosis and management of this disorder. Asthma-like symptoms caused by endotoxin exposure among grain workers are beyond the scope of this review. Progress is being made in the characterization of grain and bakery allergens, particularly cereal-derived allergens, as well as in the standardization of allergy tests. Salt-soluble proteins (albumins plus globulins), particularly members of the α-amylase/trypsin inhibitor family, thioredoxins, peroxidase, lipid transfer protein and other soluble enzymes show the strongest IgE reactivities in wheat flour. In addition, prolamins (not extractable by salt solutions) have also been claimed as potential allergens. However, the large variability of IgE-binding patterns of cereal proteins among patients with grain-induced asthma, together with the great differences in the concentrations of potential allergens observed in commercial cereal extracts used for diagnosis, highlight the necessity to standardize and improve the diagnostic tools. Removal from exposure to the offending agents is the cornerstone of the management of grain-induced asthma. The availability of purified allergens should be very helpful for a more refined diagnosis, and new immunomodulatory treatments, including allergen immunotherapy and biological drugs, should aid in the management of patients with this disorder
Etiopatogenia, factores de riesgo y desencadenantes de asma
págs.: 27-48Capítulo incluido en el libro: Asma y alergia: la epidemia del siglo XXI. Manuel Alcántara Villar (Coordinador). Sevilla: Universidad Internacional de Andalucía, 2012. ISBN 978-84-7993-227-5. Enlace: http://hdl.handle.net/10334/359
Asma ocupacional
págs.: 321-337Capítulo incluido en el libro: Asma y alergia: la epidemia del siglo XXI. Manuel Alcántara Villar (Coordinador). Sevilla: Universidad Internacional de Andalucía, 2012. ISBN 978-84-7993-227-5. Enlace: http://hdl.handle.net/10334/359
Estrategia diagnóstica y tratamiento actual en el asma de control difícil
págs.: 233-247Capítulo incluido en el libro: Asma y alergia: la epidemia del siglo XXI. Manuel Alcántara Villar (Coordinador). Sevilla: Universidad Internacional de Andalucía, 2012. ISBN 978-84-7993-227-5. Enlace: http://hdl.handle.net/10334/359
Sensitization profiles to purified plant food allergens among pediatric patients with allergy to banana.
Banana fruit allergy is well known, but neither immunoglobulin E recognition patterns to purified plant food allergens nor true prevalences of putative banana allergens have been established. This study aimed to characterize β-1,3-glucanase and thaumatin-like protein (TLP) as banana allergens, testing them, together with other plant food allergens, in 51 children with allergic reactions after banana ingestion and both positive specific IgE and skin prick test (SPT) to banana. Banana β-1,3-glucanase and TLP were isolated and characterized. Both banana allergens, together with kiwifruit TLP Act d 2, avocado class I chitinase Pers a 1, palm pollen profilin Pho d 2 and peach fruit lipid transfer protein (LTP) Pru p 3, were tested by in vitro and in vivo assays. Banana β-1,3-glucanase (Mus a 5) was glycosylated, whereas banana TLP (Mus a 4) was not, in contrast with its homologous kiwi allergen Act d 2. Specific IgE to both banana allergens, as well as to peach Pru p 3, was found in over 70% of sera from banana-allergic children, and Mus a 4 and Pru p 3 provoked positive SPT responses in 6 of the 12 tested patients, whereas Mus a 5 in only one of them. Both peptidic epitopes and cross-reactive carbohydrate determinants were involved in the IgE-binding to Mus a 5, whereas cross-reactivity between Mus a 4 and Act d 2 was only based on common IgE protein epitopes. Profilin Pho d 2 elicited a relevant proportion of positive responses on in vitro (41%) and in vivo (58%) tests. Therefore, Mus a 4 and LTP behave as major banana allergens in the study population, and profilin seems to be also a relevant allergen. Mus a 5 is an equivocal allergenic protein, showing high IgE-binding to its attached complex glycan, and low in vivo potency
Lymphocyte Transformation Test (LTT) in allergy to benznidazole: A promising approach
Benznidazole (Bzn) from the nitroimidazole family and nifurtimox from nitrofurans family,
are drugs used as first and second line treatment for acute and chronic phases of
Chagas disease (CD). Even though skin reactions are frequent, confirmed allergy to
Bzn is rare, and there are few cases reported in the literature. Since CD treatment is
very restrained, the possibility of cross-reactivity between members of the same and
other pharmacological families highlights the importance of an adequate diagnosis that
allows alternative treatments in CD and other diseases. We report a series of 31 patients
(69% women) referred to our Allergy unit with suspected hypersensitivity to Bzn, twenty
three of them with mild reactions and eight of them with severe reactions. LTT with Bzn
was performed in 31 patients and in 8 negative controls. LTT was also performed in 25
and 20 of these patients with nifurtimox and Mtn, respectively. Twenty-one out of thirtyone
patients were Bzn prick tested, and all were negative. We obtained 2/19 positive
results on patch tests to Bzn. LTT with Bzn was positive in 22/31 patients (Sensitivity
75.9% and specificity 100%). The test was considered positive with a stimulation index
2. There was a positive result in 7/25 patients for nifurtimox and in 7/20 patients with
Mtn. After negative LTT and skin tests, oral provocation was performed in 4/9 patients,
all negative. LTT is a safe test that seems to be more useful than skin tests (prick and
patch test), particularly in severe reactions, in confirming delayed hypersensitivity to Bzn
and detecting cross reactivity with other imidazoles such as Mtn and reactivity to other
drugs like nifurtimox. Tests for these drugs need to be included in the workup of patients
with hypersensitivity to Bzn in case they are needed as an alternative treatment for CD
or to treat other frequent infectious diseases.This work was funded by FIS PI13/01768 to T
Component-resolved diagnosis of wheat flour allergy in baker's asthma.
Baker's asthma is one of the most common types of occupational asthma and its prevalence is increasing in the last years. Diagnosis of occupational asthma is complex. The poor specificity of current diagnostic approaches may be associated with insufficient purity of wheat extracts or lack of inclusion of major allergens in them. In this work, we use microarray technology to characterize the allergenic profiles of baker's asthma patients from three regions in Spain and to analyze the influence of other environmental allergens on the sensitization pattern
eosinophil derived neurotoxin and clinical outcomes with mepolizumab in severe eosinophilic asthma
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Suppressors of Cytokine Signaling 3 Expression in Eosinophils: Regulation by PGE2 and Th2 Cytokines
Asthma and nonasthmatic eosinophilic bronchitis (NAEB) are respiratory disorders characterized by a predominance of Th2 cells and eosinophilic inflammation. Suppressors of cytokine signaling (SOCS) proteins play an important role in Th2-mediated allergic responses through control of the balance between Th1 and Th2 cells, particularly, SOCS3 and SOCS5. The aim of this study was to analyze SOCS expression in human peripheral blood eosinophils from patients with asthma, NAEB and healthy controls. SOCS expression in eosinophils from subjects was demonstrated by different techniques. Results showed that expression of SOCS3 in eosinophils and CD4 T cells from patients was higher than in healthy subjects. In addition, we demonstrated that prostaglandin E2 (PGE2) and Th2 cytokines are able to upregulate SOCS3 production in eosinophils and attenuate its degranulation. In conclusion, eosinophils are able to transcribe and translate SOCS3 protein and can contribute to the regulation of the Th1/Th2 balance through SOCS3 production
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Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma.
Exposome research can improve the understanding of the mechanistic connections between exposures and health to help mitigate adverse health outcomes across the life span. The exposomic approach provides a risk profile instead of single predictors and thus is particularly applicable to allergic diseases and asthma. Under the PRACTALL collaboration between the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Allergy, Asthma, and Immunology (AAAAI), we evaluated the current concepts and the unmet needs on the role of the exposome in allergic diseases and asthma
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