Francisco José Passos Soares

Sensibilização a alérgenos inalantes e alimentares em crianças brasileiras atópicas, pela determinação in vitro de IgE total e específica: Projeto Alergia (PROAL)

OBJECTIVE To determine the frequency of sensitization to inhalant and food allergens in children seen at Brazilian allergy services. PATIENTS AND METHODS Total and specific IgE serum levels to inhalant and food allergens (RAST, UniCAP - Pharmacia) were measured in 457 children accompanied in pediatric allergy services and in 62 control children age matched. RAST equal or higher than class 1 was considered as positive (R+). RESULTS Frequency of R+ was significantly higher among atopics (361/457, 79%) when compared to controls (16/62, 25.8%). There were no differences according to gender. The frequency of R+ to all allergens evaluated was higher among atopics when compared to controls. Significantly higher total IgE serum levels were observed among the atopics with R+ in comparison to those with R-. The frequency of R+ to main inhalant allergens were: D. pteronyssinus = 66.7% x 14.5% (p < 0.05), D. farinae = 64.5% x 17.8% (p < 0.05), B. tropicalis = 55.2% x 19.4% (p < 0.05), cockroach = 32.8% x 9.7% (p < 0.05), and cat = 12% x 8.1%. In relation to food allergens we observed: fish = 29.5% x 11.3% (p < 0.05), egg = 24.4% x 4.8% (p < 0.05), cows milk = 23.1% x 3.2% (p < 0.05), wheat = 20% x 8.1% (p < 0.05), peanuts = 14% x 4.8% (p < 0.05), soy = 11.8% x 4.8% (p < 0.05), and corn = 10.6% x 4.8% (p < 0.05). With respect of age, food allergen sensitization predominates in young children whereas the inverse occurs with inhalant allergens. CONCLUSIONS There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization, mainly in infants.

Evaluation of Beta-Adrenergic Function in Normal and Asthmatic Children

Low levels of serum glucose have been observed in atopic individuals after a subcutaneous injection of epinephrine. This less than normal hyperglycemia could be evidence of partial beta-adrenergic blockade in atopy. We compared the basal values of glucose with those obtained after 30 and 60 minutes of a subcutaneous injection of epinephrine 1/1000 (0.006 ml/kg; maximum of 0.3 ml) in normal and atopic asthmatic children (mild, moderate, and severe). The glucose-oxidase method was used for the determination of glucose levels in peripheral blood. Glucose serum levels in normal children were significantly higher at 30 and 60 minutes compared with basal values. In patients with mild and moderate asthma, significantly higher values were observed only at 30 minutes. In severe asthmatics, the glucose levels at 30 minutes were not different from the basal values, but higher than those observed at 60 minutes. Comparison among the four groups showed significant differences between the nonatopic normal children and the severe asthmatic children at 30 and 60 minutes. The moderate asthmatic children showed significantly lower levels when compared with nonatopic normal children at 30 minutes.