A large number of allergens have been discovered but we know little about their potential to induce inflammation (allergenic activity) and symptoms. Nowadays, the clinical importance of allergens is determined by the frequency and intensity of their IgE antibody binding (allergenicity). This is a rather limited parameter considering the development of experimental allergology in the last 20 years and the criteria that support personalized medicine. Now it is known that some allergens, in addition to their IgE antibody binding properties, can induce inflammation through non IgE mediated pathways, which can increase their allergenic activity. There are several ways to evaluate the allergenic activity, among them the provocation tests, the demonstration of non-IgE mediated pathways of inflammation, case control studies of IgE-binding frequencies, and animal models of respiratory allergy. In this review we have explored the current status of basic and clinical research on allergenic activity of indoor allergens and confirm that, for most of them, this important property has not been investigated. However, during recent years important advances have been made in the field, and we conclude that for at least the following, allergenic activity has been demonstrated: Der p 1, Der p 2, Der p 5 and Blo t 5 from HDMs; Per a 10 from P. americana; Asp f 1, Asp f 2, Asp f 3, Asp f 4 and Asp f 6 from A. fumigatus; Mala s 8 and Mala s 13 from M. sympodialis; Alt a 1 from A. alternata; Pen c 13 from P. chrysogenum; Fel d 1 from cats; Can f 1, Can f 2, Can f 3, Can f 4 and Can f 5 from dogs; Mus m 1 from mice and Bos d 2 from cows. Defining the allergenic activity of other indoor IgE antibody binding molecules is necessary for a precision-medicine-oriented management of allergic diseases.
Introducción: en varias poblaciones se ha evidenciado un deterioro de la calidad de vida y de la capacidad funcional en pacientes con artritis reumatoide. Estos aspectos son importantes para tener en cuenta en el manejo de la enfermedad, pues en algunos casos han sido complementarios en la toma de decisiones sobre los enfoques y conductas terapéuticas. Hasta ahora, en el departamento de Bolívar, Colombia, se desconoce el grado de afectación de la calidad de vida asociada a esta condición de salud.
Objetivo: describir la afectación de la calidad de vida del paciente diagnosticado con artritis reumatoide en el departamento de Bolívar y establecer relaciones con sus características sociodemográficas y de severidad de la enfermedad.
Métodos: se hizo uso de las escalas HAQ-DI y EQ-5D-3L, así como de la escala DAS28-VSG para la medición de la actividad clínica de la enfermedad.
Resultados: el 77,1% de los pacientes indicó afectación en su calidad de vida con predominio de afectación moderada, siendo más frecuente el dolor/malestar (57,1%), y menos común el cuidado personal (40%). La afectación de la calidad de vida se correlacionó con la actividad clínica de la enfermedad y el nivel de incapacidad funcional. La actividad clínica de la enfermedad fue el predictor más importante de la incapacidad funcional medida por HAQ-DI.
Conclusión: en esta muestra representativa de pacientes con artritis reumatoide del departamento de Bolívar, se presenta una importante afectación en la calidad de vida.
Background: We had previously identified an IgE-binding low molecular weight component in the house dust mite Blomia tropicalis, identified by Edman degradation as ubiquitin. After cloning its sequence from a cDNA library, we found the protein as 100 % identical to the human orthologous. Objective: Since autoimmune responses has been linked to asthma severity, we aimed to characterize the immunological response to ubiquitin in asthmatic patients and its relationship with symptoms severity. Methods: The recombinant molecule was produced in Escherichia coli and further purified by affinity chromatography and anion exchange FPLC. Specific IgE, IgG1 and IgG4 levels were detected by ELISA in 244 asthmatic patients and 80 healthy controls. Severity of asthma symptoms were assessed by a physician. Lung function was measured by spirometry. Association between clinical indicators of disease severity and antibody responses to ubiquitin was analyzed by multivariate logistic regression. Lymphocyte proliferation assay was performed using CFSE-dilution assay (n = 3). Results: Frequency of IgE, IgG1, IgG4 to ubiquitin in asthmatic patients were 15.5 %, 16.8 % and 36.1 %, respectively, and in controls 6.25 %, 23.8 % and 26.3 %. Specific-IgE correlated moderately with IgG1 (Spearman-rho = 0.4, p < 0.001) and lightly with IgG4 (Spearman-rho = 0.24, p < 0.001 ) in asthmatic patients, but not in controls (Spearman-rho = 0.056, −0.101; p = 0.62, p = 0.37). A positive IgE or IgG1 test to ubiquitin was associated with emergency room attendance (aOR = 2.28, 95 % CI = 1.14-4.61, p = 0.021) adjusted by age, gender and socioeconomical class. No associations were found with severe dyspnea, hospitalization or lung function outcomes. In the two patients with the highest IgG1 or IgE levels, T cell proliferation (CD4+ or CD8+) was not detected in ubiquitin-stimulated cultures; however, a dose-dependent positive result was observed for B cells. No proliferation was detected in the healthy control. Conclusions: This work suggests the association of autoantibody response to ubiquitin with an indicator of asthma severity.
Glutathione-S transferases (GSTs) are part of a ubiquitous family of dimeric proteins that participate in detoxification reactions. It has been demonstrated that various GSTs induce allergic reactions in humans: those originating from house dust mites (HDM), cockroaches, and helminths being the best characterized. Evaluation of their allergenic activity suggests that they have a clinical impact. GST allergens belong to different classes: mu (Blo t 8, Der p 8, Der f 8, and Tyr p 8), sigma (Bla g 5 and Asc s 13), or delta (Per a 5). Also, IgE-binding molecules belonging to the pi-class have been discovered in helminths, but they are not officially recognized as allergens. In this review, we describe some aspects of the biology of GST, analyze their allergenic activity, and explore the structural aspects and clinical impact of their cross-reactivity.
Intestinal helminthiasis are a common public health problem in developed and developing countries. It is thought that they can influence pregnancy by causing gestational anemia. The aim of this study was to determine if there is a relationship between helminth infection and gestational anemia. A structured review of scientific literature was conducted through active search in the electronic databases MEDLINE® and LILACS® until December 2021, following 2020 PRISMA statement. The studies were reviewed independently by two authors, extracting the most relevant information from each study. Cross-sectional studies, case-control and ecological studies were included, with no date or language limit. Randomized clinical trials were excluded. A total of 38 studies were included in the systematic review. The study populations of all studies belonged to low- and middle-income countries: 28 studies from Africa, 6 from Asia, 3 from Latin America and 1 from Oceania. Overall, the average prevalence of gestational anemia among the included studies was 40% (95% CI 34-46%). Hookworm was the predominant species detected in most studies (19/38; 50%), followed by Ascaris lumbricoides (15/38; 39.5%). Gestational anemia was positively associated with A. lumbricoides (OR 1.86, 95% CI 1.12-3.08) and hookworms (OR 3.09, 95% CI 1.99-4.78). Prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk during meta-regression (p=0.5182). The results of this review indicate that there is a statistically significant association between helminthiasis and gestational anemia. Although hookworm is the main species associated with the outcome, prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk. The impact of other species needs to be defined given the expected bias that arises from polyparasitism when defining comparison groups.
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