Sensitization to Blomia tropicalis (Bt) is very frequent in the tropics, and particularly in Cuba, being a significant cause of allergic asthma. Allergen immunotherapy (AIT) with Bt can be a ...therapeutic option, however, placebo-controlled clinical trials have not been reported.
To assess the therapeutic effect and safety of AIT for asthma using a standardized allergen vaccine of B. tropicalis by subcutaneous route, in allergic asthmatic patients exposed and sensitized to this mite species.
A double-blind, placebo-controlled Phase II trial was conducted in 35 adults (18 with treatment and 17 with placebo), with mild to moderate asthma, predominantly sensitized to Bt. AIT was administered subcutaneously in increasing doses from 4 to 6000 Biological Units using a locally manufactured standardized extract (BIOCEN, Cuba). Patient assessment was performed using symptom-medication score (SMS), peak expiratory flow and skin reactivity relative to Histamine as measured by skin prick test (SPT).
The 12-month treatment achieved a significant (p < 0.001) decrease of SMS. Symptom score showed only 41% (CI: 26–61) of placebo values, whereas medication was 34.5% (22.4%–63.3%). Treatment was regarded clinically effective in 67% of patients (OR 32; 95%CI: 17 to 102). The effect size on symptoms and medication was higher than has been reported with equivalent allergen dosages of D. pteronyssinus and D. siboney in Cuban asthmatic patients. Skin reactivity to Bt was also significantly reduced (p = 0.0001), increasing 148-fold the allergen threshold to elicit a positive skin test. This desensitization effect was specific to Bt and did not modify the reactivity to Dermatophagoides. The change of specific skin reactivity was significantly (p < 0.05) correlated to clinical improvement. All adverse events were local with a frequency of 2.4% of injections.
Subcutaneous AIT with Blomia tropicalis was effective and safe in asthmatic adults exposed and sensitized to this mite species in a tropical environment.
Cuban Public Registry of Clinical Trials: RPCEC00000026 (WHO International Clinical Trial Registry Platform ICTRP).
Nasal provocation test (NPT) is indicated to confirm the diagnosis of allergic rhinitis to house dust mites. Methods An open, non-randomized, controlled clinical trial was carried out in 50 patients ...with allergic rhinitis sensitized to D. siboney mite and 50 non-allergicsubjects.
Rationale A nasal allergen provocation test (NAPT) is performed to confirm the diagnosis of allergic rhinitis to house dust mite, in the situation of discrepancy between the symptoms and the results ...of skin prick test (SPT) and/or serum specific immunoglobulin E. In Cuba, sensitization to house dust mites (Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney and Blomia tropicalis) is a major cause of allergic rhinitis. Conclusions Nasal allergen provocation test with the Dermatophagoides pteronyssinus is effective and safety by the diagnosis of allergic rhinitis to this mite.
The Latin American Society of Allergy, Asthma, and Immunology (SLAAI) conducted a systematic search in the Medline and LILACS' database in order to get articles linked to 10 current questions about ...dermatitis. The assessment of the quality of the evidence and the strength of the recommendations was made through the GRADE system. The completeness and transparency of the recommendations for this clinical guide were assessed with the AGREE Reports Verification Checklist. The final document was shared with physicians, allergists, dermatologists, and pediatricians, and with patients and academic institutions such as universities and medical scientific societies for external assessment. According to the review, clinical scales should be used to measure the severity of the dermatitis, and some interventions such as the use of probiotics may benefit the patient; nevertheless, more studies are required before this management option can be used in the everyday practice. Other interventions such as dietary restrictions and the use of antihistamines seem to be well-founded only in particular cases and they should not be a general recommendation for all patients. This practical guide presents recommendations for the treatment of atopic dermatitis; these recommendations can be helpful for medical staff, patients, and health systems.
Las enfermedades alérgicas van en aumento importante en todo el mundo. La rinitis alérgica es una enfermedad inflamatoria crónica de la mucosa nasal IgE mediada, alérgeno-específica con participación ...de diversas células. Nos propusimos caracterizar la rinitis alérgica en pacientes atendidos en el Hospital Universitario “General Calixto García”. Se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, entre octubre 2016 y octubre 2017. En una muestra de 100 pacientes que cumplieron los criterios de inclusión, se realizó historia clínica alergológica empleando variables como: edad, sexo, antecedentes patológicos personales y familiares, procedencia, manifestaciones clínicas, y prueba cutánea por punción. Predominó el sexo femenino entre 30 y 39 años de edad, de área urbana, antecedentes patológicos familiares y personales de asma y conjuntivitis. La rinitis intermitente leve prevaleció en nuestro estudio, así como la sensibilidad a Dermatophagoides pteronyssinus. La tercera década de la vida fue la edad promedio de los pacientes. Se concluye que los pacientes presentaron una alta sensibilidad a Dermatophagoides pteronyssinus. La rinitis persistente leve, con la mitad de los casos, obtuvo mayor predominio por la duración de los síntomas.
The relationship between allergic respiratory diseases, sensitization and other factors was analyzed through the adjustment of multivariate logistic regressions and correlation analysis. Results ...Bakery workers showed greater frequency (20.8%) of asthma than the control group (8.3%, p = 0.006) and high sensitization values to wheat (40%), soy (34.2%) yeast (30%), and storage mites (A. siro: 45.8%, T. putrescentae: 48.3%, L. destructor: 44.2%).
The prevalence of asthma and allergic diseases in Cuban children is high, but little is known about adverse reactions to foods.
To determine the prevalence, incidence and risk factors for adverse ...reaction to foods in children.
Population-based cohort study carried out in Havana, Cuba, in a three-year period. Parents of 1543 children provided medical and lifestyle information from the first to the third year of age, which was collected using a questionnaire. An adverse reaction to foods was defined by medical diagnosis reported by the parents or caregivers.
Annual cumulative incidence was 5.7%, 1.9% and 0.8%, whereas annual prevalence was 5.7%, 4% and 2.5% at 1, 2 and 3 years of age, respectively; 8% of infants had experienced an adverse reaction to foods when they turned 3 years of age. Cow milk was the most commonly implicated food. Main risk factors were allergenic food consumption, use of antibiotics, factors related to the presence of allergens, maternal history of overweight during pregnancy and allergy to insect bites.
Adverse reaction to food is a significant clinical problem in children from Havana. Modifiable risk factors were identified, the understanding of which will help to direct effective intervention strategies.
A nivel mundial, los aeroalérgenos más frecuentes causantes de enfermedades alérgicas son los granos de polen anemófilos. Estos han sido capaces de desencadenar crisis que han reflejado una elevada ...morbilidad. En Cuba los estudios de sensibilización a granos de polen han sido escasos. Con el objetivo de determinar la sensibilización a granos de polen en pacientes alérgicos y su relación con la presencia de enfermedades alérgicas, se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, de marzo a junio del 2019. La muestra se constituyó de 33 pacientes con asma, rinitis, rinoconjuntivitis alérgica, dermatitis atópica y conjuntivitis alérgica. A todos los pacientes se les realizó historia clínica alergológica y prueba cutánea por punción con extractos alergénicos de: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucaliptus sp. Se aplicaron las frecuencias absolutas, porcientos, desviación estándar, promedio, edad media y test de Spearman para su análisis. La edad media de la muestra fue de 36,9 años, con predominio de mujeres. Más del 50% de los pacientes presentaron sensibilización a granos de polen; y de ellos, el 24,24% resultaron polisensibilizados. El mayor porcentaje de sensibilización fue a Cynodon dactylon. La rinitis alérgica fue la enfermedad que prevaleció en la población estudiada.
Diagnostic options for immune reactions to mosquito bites are limited. In Cuba, IgE-mediated reactions are frequently related to Culex quinquefasciatus bite.
To determine the sensitivity and ...specificity of skin prick test with two doses of standardized extract in nitrogen protein units (PNU of Culex quinquefasciatus (BIOCEN, Cuba).
An analytical study was conducted on 100 children between 2 and 15 years old. Fifty atopic patients with a history of allergy to mosquito bite and positive specific serum IgE Culex quinquefasciatus and fifty atopic patients without a history of allergy to mosquito bite and negative specific serum IgE to Culex quinquefasciatus. Skin prick tests (SPT) were performed by duplicates on the forearms of the patients. Investigated doses were 100 PNU/mL and 10 PNU/mL.
SPT with the highest concentration obtained a mean wheal size of 22.09 mm2 and for lower doses of 8.09 mm2, a statistically significant difference (p=0.001, Student's t test). Positive skin test correlated in 100% of patients with the presence of specific IgE. Testing with both doses showed a 94% of specificity and 88% of sensitivity.
The diagnostic accuracy of SPT using both doses of standardized extract was similar, which justifies its use for diagnosis of sensitization to Culex quinquefasciatus in patients with symptoms of allergy to mosquito bite.
En un complejo contexto epidemiológico nacional e internacional, de trasmisión y hospitalización por COVID-19 en población pediátrica, Cuba decidió realizar una campaña de vacunación masiva contra ...esta enfermedad en niños y adolescentes. El objetivo de este trabajo fue evaluar la seguridad del esquema heterólogo de dos dosis de SOBERANA®02 más una dosis de SOBERANA®Plus con 28 días entre ellas en niños y adolescentes, hijos de los trabajadores del Centro Nacional de Biopreparados, que pertenece a BioCubaFarma, Grupo Empresarial de las Industrias Biotecnológica y Farmacéutica de Cuba. La seguridad de las vacunas se evaluó mediante la identificación y clasificación de los eventos adversos por farmacovigilancia activa y pasiva. Se evaluaron 237 niños de ambos sexos, siendo incluidos 200 (130 con edades de 2 a 10 años y 70, de 11 a 18). Ciento noventa niños de los incluidos (95%) recibieron el esquema completo de vacunación. Se registraron un total de 121 eventos adversos, en su mayoría por farmacovigilancia pasiva, de intensidad leve y de causalidad A1 (relacionados). No ocurrieron eventos adversos graves relacionados. Las vacunas SOBERANA®02 y SOBERANA®PLUS evidenciaron un perfil de seguridad muy favorable durante su administración a niños y adolescentes, hijos de los trabajadores del Centro Nacional de Biopreparados.
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