Little is known about the role of molecular diagnosis in house dust mite (HDM) allergy. In this study, we investigated the association between the sensitization profile of adolescent and adult ...HDM-allergic patients and asthma in a region with high rates of exposure to HDM.
We conducted a cross-sectional study of 384 HDM-allergic patients (38.5%, males; median age, 28 years). A total of 368 patients (95.8%) had rhinitis, and 175 (45.6%) had asthma. Specific IgE (sIgE) to Dermatophagoides pteronyssinus, nDer p 1, rDer p 2, and rPen a 1 was measured in all patients. sIgE to Lepidoglyphus destructor was measured in patients (n=301) with a positive skin test result.
Significantly higher concentrations of sIgE to Der p 1 and sIgE to Der p 2 were observed in patients with asthma than in those without asthma. The proportion of asthmatic patients was higher among individuals who reacted (≥0.35 kUA/L) to both Der p 1 and Der p 2 (147/291, 50.5%) than among those who reacted to only 1 allergen (either Der p 1 or Der p 2, 18/55, 32.7%) or neither allergen (10/38, 26.3%, P=.002). Reactivity to both allergens was associated with asthma after adjusting for age and sex (OR, 2.87; 95%CI, 1.32-6.20). Higher concentrations of sIgE to L destructor were observed in patients with asthma than in patients without asthma. Tropomyosin sIgE ≥0.35 kUA/L was detected in only 6 individuals (1.6%).
L destructor may be a relevant allergen in high-exposure areas. Dual sensitization (ie, IgE to both Der p 1 and Der p 2) may help to identify HDM-allergic patients who are at risk of asthma.
Utjecaj onečišćenja zraka na razvoj astme Ocelić Bulatović, Vesna; Štajduhar, Lucija; Majdandžić, Stefania ...
Kemija u industriji; časopis kemičara i tehnologa Jugoslavije,
01/2020, Volume:
69, Issue:
1-2
Journal Article
Peer reviewed
Open access
Onečišćenje zraka globalni je problem te se smatra jednim od najčešćih nealergijskih uzročnika astme. Utjecaj onečišćenja zraka na pojavu astme, posebno kod djece, tema je mnogih znanstvenih ...istraživanja naročito na istoku svijeta s obzirom na problem onečišćenja s kojim se suočava. Ovisno o prostoru djelovanja onečišćenog zraka kojemu je čovjek izložen postoje različite onečišćujuće tvari. Tako onečišćenje zraka u vanjskom prostoru karakterizira izrazita prisutnost ozona, O3, lebdećih čestica, PM2,5 i PM10 te sumporova dioksida, SO2, dok zatvoreni prostori obiluju prisutnošću formaldehida, CH2O, dušikova dioksida, NO2 i hlapljivih organskih spojeva, VOC. Uz kontrolirano liječenje, velika pažnja se usmjerava i na klimatsko liječenje astme.
Air pollution is a global problem and is considered one of the most common non-allergen triggers of asthma. The impact of air pollution on the appearance of asthma, especially in children, is the subject of many scientific researches, especially in the eastern world due to the problem of pollution it is facing. There are different pollutants depending on the area of activity in which a person is exposed. Thus, contamination of outdoor air is characterized by the marked presence of ozone, O3, fine particles, PM2.5 to PM10 and sulphur dioxide, SO2, while indoor air with the presence of formaldehyde, CH2O, nitrogen dioxide, NO2, and volatile organic compounds, VOCs. With controlled treatment, great attention is focused on climatic treatment of asthma.
Maski astmy oskrzelowej – opis przypadku Kupczyk, Maciej; Kuna, Piotr
Alergologia Polska - Polish Journal of Allergology,
April-June 2016, 2016-04-00, Volume:
3, Issue:
2
Journal Article
Peer reviewed
Severe, difficult-to-treat asthma represents a significant burden for the patient and the health system. In difficult-to-treat asthma, factors worsening asthma control may include: inadequate ...treatment plan (low therapy adherence and compliance), inappropriate inhalation technique, insufficient symptom control using the available classes of medications, incomplete response to treatment (non-responders, steroid-resistance), incorrect diagnosis of asthma or comorbidities, and environmental factors. In difficult asthma it is recommended to perform detailed diagnostics and initiate treatment of concomitant diseases, carry out differential diagnostics of conditions mimicking asthma, educate the patient as to the inhalation technique and check it, eliminate unfavorable environmental factors before current treatment is modified. We described here a case of 30-year-old woman, followed for 4 years in a specialist center, with the diagnosis of severe asthma, frequent exacerbations, hospitalizations, significant changes in lung functions, referred to be included in the program of biologic treatment that came out as tumor of the trachea.
ASTMA U DJECE GAGRO, ALENKA
Acta medica Croatica,
04/2011, Volume:
65, Issue:
2
Journal Article
Open access
Astma je najčešća kronična bolest u djece koju obilježava dugotrajna upala dišnih putova promjenjivog intenziteta praćena spontanom ili lijekovima reverzibilnom akutnom bronhokonstrikcijom. Nastanak ...astme, težina kliničke slike i učinak terapije određeni su brojnim genetskim i okolišnim čimbenicima. Astma se u djece odlikuje izrazitom heterogenošću s obzirom na moguću etiologiju, stupanj upale i oštećenja bronha, poremećaja funkcije pluća i posljedičnu kliničku prezentaciju kao i prirodan tijek bolesti koji se u nekih nastavlja i u odrasloj dobi. Opisani su i brojni čimbenici koji prisutni u ranom životu djeluju zaštitno na razvoj astme. Dosadašnje spoznaje o patofiziološkim mehanizmima alergijske reakcije kao bolesti najčešće posredovanoj Th2-limfocitima ne objašnjavaju tu heterogenost pa se u zadnjih nekoliko godina o astmi govori kao sindromu s više različitih podtipova ili endotipova definiranih novodefiniranim imunopatofiziološkim mehanizmima. Pravodobna dijagnoza i odgovarajuće liječenje preduvjet su za sprječavanje ireverzibilnih promjena dišnih putova i posljedičnog slabljenja plućne funkcije.
The role of cytokines in the accumulation of eosinophil granulocytes in inflamed tissue has been studied extensively during recent years, and these molecules have been found to participate throughout ...the whole process of eosinophil recruitment. Haematopoietic cytokines such as IL‐3, IL‐5 and GM‐CSF stimulate the proliferation and differentiation of eosinophils in the bone marrow, and the release of mature eosinophils from the bone marrow into the blood is probably promoted by IL‐5. Priming of eosinophils in the blood following, for example, allergen challenge is performed mainly by IL‐3, IL‐5 and GM‐CSF. An important step in the extravasation of eosinophils is their adhesion to the vascular endothelium. Adhesion molecules are upregulated by, e.g. IL‐1, IL‐4, TNF‐α and IFN‐γ and the same cytokines may also increase the affinity of adhesion molecules both on eosinophils and endothelial cells. Finally, a number of cytokines have been shown to act as eosinophil chemotactic factors, attracting the cells to the inflammatory focus in the tissue. Some of the most important eosinophil chemoattractant cytokines are IL‐5, IL‐8, RANTES, eotaxin, eotaxin‐2, eotaxin‐3, MCP‐3, MCP‐4 and TNF‐α. Th2 cells, mast cells and epithelial cells are important sources of proinflammatory cytokines, but in recent years, the eosinophils have also been recognized as cytokine‐producing and thereby immunoregulatory cells. The aim of this paper is to review the role of cytokines in the process of eosinophil recruitment in asthma, allergy and ulcerative colitis.
Astma i kronična opstruktivna bolest pluća vodeći su uzroci pobola i smrtnosti u cijelom svijetu čime uzrokuju značajne ekonomske i društvene posljedice. Bolesnici mogu imati klinička obilježja obje ...bolesti, a ovo stanje naziva se preklapanje astme i KOBP-a. Prevalencija astme i KOBP-a uvelike varira zbog razlika u dijagnostičkim metodama koje se koriste, kriterijima i analitičkim pristupom prikupljanja podataka. Prevalenciju je moguće izračunati ako se provede istraživanje udjela oboljelih na reprezentativnom uzorku stanovnika te prema tome napravi procjena. Druga mogućnost dobivanja epidemioloških podataka je temeljem redovitog praćenja zabilježenih posjeta pojedinim zdravstvenim djelatnostima pod tom dijagnozom i praćenjem smrtnosti, kao i usporedbom tog pokazatelja s drugim državama. Hrvatska se po vrijednostima dobno-standardiziranih stopa smrtnosti od astme i KOBP-a nalazi u razini drugih tranzicijskih država, ali i nekih razvijenih europskih država. S obzirom na navedeno svakako treba nastaviti i pojačati mjere primarne, ali i ostalih razina prevencije što uključuje aktivno promicanje nepušenja, odvikavanje od pušenja, provođenje zdravog načina života i pravovremenu dijagnozu i liječenje.
Izloženost duhanskom dimu je rizični čimbenik za nastanak ili pogoršanje mnogih poremećaja, uključujući astmu. Cilj ovog istraživanja
je ustvrditi pogoršava li pasivno pušenje u djece vrijednosti ...spirometrijskih i alergijskih parametara mjerenih iz krvi. Provedeno
je retrospektivno istraživanje parova u razdoblju od 2011. do 2013. godine, u Alergološkoj ambulanti Klinike za dječje bolesti KBC-a
Split. U istraživanje je uključeno 60-ero djece u dobi od 5 do 18 godina s dijagnozom astme (postavljenom prema GINA smjernicama
iz 2006. godine), koje smo podijelili u dvije skupine: 36-ero djece čiji su ukućani pušili i 24-ero kojoj su ukućani bili nepušači. Analizi rani
su parametri krivulje protok-volumen: PEF, FVC, FEV1, FEF25, FEF50 i FEF75 prije i poslije obavljenog bronhodilatacijskog testa sa dva
udaha salbutamol (Ventolin) spreja, 100 μg po udahu; alergijski markeri iz krvi: ukupna konc. IgE-a u serumu, apsolutni i relativni
broj eozinofi la u krvi te broj eozinoifi la u brisu nosa. Podatci su prikupljeni od roditelja putem upitnika te uvidom u elektroničku medicinsku
dokumentaciju. Nije dokazana statistički značajna razlika između skupine djece izložene pasivnom pušenju i kontrolne
skupine u promatranim vrijednostima. Broj pušača u kućanstvu također nije pokazao značajan utjecaj na spomenute vrijednosti.
Pronađena je značajna razlika u vrijednosti ECP-a između skupine djece čiji su ukućani pušili u domu i one kojoj su ukućani pušili
izvan njega (P = 0,009). Broj na dan popušenih cigareta u domu statistički značajno korelira s relativnim brojem eozinofi la u krvi
(P = 0,048). Pasivno pušenje nije se pokazalo povezanim s brojem alergena na koje je dijete alergično.
We present the case of 20-year-old woman with the short history of severe course of asthma since its beginning. The patient met the inclusion criteria to omalizumab therapy in the program reimbursed ...by Polish Health Fund, so we expected that this therapy will enable to improve asthma control in the patient and decrease the dose of oral steroids or completely withdraw them. However within twelve weeks of therapy, the day of omalizumab application had to be rescheduled many times because of infectious asthma exacerbations. Moreover, in between exacerbations, asthma remained uncontrolled in spite of the very high doses of inhaled steroids and bronchodilators. Only on the day of last omalizumab injection, the patient reported better condition, and we observed improvement in spirometry and questionnaires score. We hoped that patient started to respond to the therapy. In the twelfth week of therapy, the patient reported that she became pregnant and had to be excluded from the therapeutical program. From the patients’ findings, high eosinophil count in peripheral blood as well as in broncho-alveolar lavage fluid were remarkable and chronic sinusitis preceded asthma diagnose.
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