L.A. Watanabe

Interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms in persistent IgE-mediated cow's milk allergy

OBJECTIVES: The aim of this cross-sectional study was to evaluate whether interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms were associated with persistent IgE-mediated cows milk allergy in 50 Brazilian children. The diagnostic criteria were anaphylaxis triggered by cows milk or a positive double-blind, placebo-controlled food challenge. Tolerance was defined as the absence of a clinical response to a double-blind, placebo-controlled food challenge or cows milk exposure. METHOD: The genomic DNA of the 50 patients and 224 healthy controls (HCs) was used to investigate five IL10 gene polymorphisms (-3575A/T, -2849A/G, -2763A/C, -1082G/A, -592C/A) and one TGFβ1 polymorphism (-509C/T). RESULTS: Among the five IL10 polymorphisms analyzed, homozygosis for the G allele at the -1082 position was significantly higher in the patients compared with the healthy controls (p = 0.027) and in the persistent cows milk allergy group compared with the healthy controls (p = 0.001). CONCLUSIONS: Homozygosis for the G allele at the IL10 -1082G/A polymorphism is associated with the persistent form of cows milk allergy.

Obesidade e asma: associação ou epifenômeno?

OBJECTIVE To relate obesity and asthma by comparing gender, age, initial classification of asthma, clinical control, basal forced expiratory volume in one second (FEV1) and forced expiratory flow between 25 and 75% (FEF25-75%) with rates of body mass index (BMI) in asthmatic adolescents. METHODS Cross-sectional study involving 120 asthmatics patients (1.9 male: 1 female) with a mean age of 14.1 years (9 to 20.1 years of age), classified according to asthma severity and control, and evaluated by spirometry using their basal FEV1 and FEF25-75%. The data were described by frequency, mean and standard deviation or median and range and analyzed by ANOVA, unpaired t test, Fischers exact test, Kruskal-Wallis and Pearsons correlation, considering significant p<0.05. RESULTS There was no difference between gender in relation to the initial classification and the level of asthma control; 91.7% (100 cases) received initial classification as persistent and 106 cases (88.3%) were partially or totally controlled. There was no statistical difference between controlled patients and the others in relation to BMI. No significant correlations were found between zBMI and FEV1 and between zBMI and FEF25-75%, analyzing all patients and only patients with overweight or obese. CONCLUSIONS In this study, no significant correlation was found between overweight/obesity and asthma using clinical, anthropometric and spirometric parameters.OBJETIVO: Evaluar la asociacion entre obesidad y asma por la comparacion entre edad, genero, clasificacion inicial y control del asma, valores de volumen espiratorio forzado en el primer segundo (VEF1) y flujo espiratorio forzado entre 25 y 75% basal (FEF25-75%) con los indices de masa corporal (IMC) en adolescentes asmaticos. METODOS: Estudio transversal implicando a 120 pacientes (1,9M:1F) asmaticos con mediana de edad de edad de 14,1 anos (9 a 20,1 anos), clasificados respecto al control y gravedad del asma, y evaluados por la espirometria utilizando su VEF1 y FEF25-75% basales. Estos datos fueron descriptos por la frecuencia, promedios y desviaciones estandar o medianas y variacion y analizados por las pruebas de ANOVA, prueba t no pareada, Prueba exacto de Fisher, Kruskal-Wallis y por la correlacion de Pearson considerandose significantes valores de p<0,05. RESULTADOS: No hubo diferencia entre los generos respecto a la clasificacion inicial del asma y el nivel de control. Recibieron clasificacion inicial persistente 91,7% (100 casos), siendo que 106 casos (88,3%) estaban parcial o totalmente controlados. No hubo diferencia estadistica entre los pacientes controlados y los restantes respecto al IMC. No se encontraron correlaciones significantes entre zIMC y VEF y entre zIMC y FEF25-75% al analizar todos los pacientes y solamente los pacientes con sobrepeso u obesos. CONCLUSIONES: En este estudio, no fue encontrada correlacion significante entre sobrepeso/obesidad y asma, utilizandose parametros clinicos, antropometricos y espirometricos.

Obesity and asthma: association or epiphenomenon?

OBJECTIVE To relate obesity and asthma by comparing gender, age, initial classification of asthma, clinical control, basal forced expiratory volume in one second (FEV1) and forced expiratory flow between 25 and 75% (FEF25-75%) with rates of body mass index (BMI) in asthmatic adolescents. METHODS Cross-sectional study involving 120 asthmatics patients (1.9 male: 1 female) with a mean age of 14.1 years (9 to 20.1 years of age), classified according to asthma severity and control, and evaluated by spirometry using their basal FEV1 and FEF25-75%. The data were described by frequency, mean and standard deviation or median and range and analyzed by ANOVA, unpaired t test, Fischers exact test, Kruskal-Wallis and Pearsons correlation, considering significant p<0.05. RESULTS There was no difference between gender in relation to the initial classification and the level of asthma control; 91.7% (100 cases) received initial classification as persistent and 106 cases (88.3%) were partially or totally controlled. There was no statistical difference between controlled patients and the others in relation to BMI. No significant correlations were found between zBMI and FEV1 and between zBMI and FEF25-75%, analyzing all patients and only patients with overweight or obese. CONCLUSIONS In this study, no significant correlation was found between overweight/obesity and asthma using clinical, anthropometric and spirometric parameters.OBJETIVO: Evaluar la asociacion entre obesidad y asma por la comparacion entre edad, genero, clasificacion inicial y control del asma, valores de volumen espiratorio forzado en el primer segundo (VEF1) y flujo espiratorio forzado entre 25 y 75% basal (FEF25-75%) con los indices de masa corporal (IMC) en adolescentes asmaticos. METODOS: Estudio transversal implicando a 120 pacientes (1,9M:1F) asmaticos con mediana de edad de edad de 14,1 anos (9 a 20,1 anos), clasificados respecto al control y gravedad del asma, y evaluados por la espirometria utilizando su VEF1 y FEF25-75% basales. Estos datos fueron descriptos por la frecuencia, promedios y desviaciones estandar o medianas y variacion y analizados por las pruebas de ANOVA, prueba t no pareada, Prueba exacto de Fisher, Kruskal-Wallis y por la correlacion de Pearson considerandose significantes valores de p<0,05. RESULTADOS: No hubo diferencia entre los generos respecto a la clasificacion inicial del asma y el nivel de control. Recibieron clasificacion inicial persistente 91,7% (100 casos), siendo que 106 casos (88,3%) estaban parcial o totalmente controlados. No hubo diferencia estadistica entre los pacientes controlados y los restantes respecto al IMC. No se encontraron correlaciones significantes entre zIMC y VEF y entre zIMC y FEF25-75% al analizar todos los pacientes y solamente los pacientes con sobrepeso u obesos. CONCLUSIONES: En este estudio, no fue encontrada correlacion significante entre sobrepeso/obesidad y asma, utilizandose parametros clinicos, antropometricos y espirometricos.

Obesidad y asma: association or epiphenomenon?

OBJECTIVE To relate obesity and asthma by comparing gender, age, initial classification of asthma, clinical control, basal forced expiratory volume in one second (FEV1) and forced expiratory flow between 25 and 75% (FEF25-75%) with rates of body mass index (BMI) in asthmatic adolescents. METHODS Cross-sectional study involving 120 asthmatics patients (1.9 male: 1 female) with a mean age of 14.1 years (9 to 20.1 years of age), classified according to asthma severity and control, and evaluated by spirometry using their basal FEV1 and FEF25-75%. The data were described by frequency, mean and standard deviation or median and range and analyzed by ANOVA, unpaired t test, Fischers exact test, Kruskal-Wallis and Pearsons correlation, considering significant p<0.05. RESULTS There was no difference between gender in relation to the initial classification and the level of asthma control; 91.7% (100 cases) received initial classification as persistent and 106 cases (88.3%) were partially or totally controlled. There was no statistical difference between controlled patients and the others in relation to BMI. No significant correlations were found between zBMI and FEV1 and between zBMI and FEF25-75%, analyzing all patients and only patients with overweight or obese. CONCLUSIONS In this study, no significant correlation was found between overweight/obesity and asthma using clinical, anthropometric and spirometric parameters.OBJETIVO: Evaluar la asociacion entre obesidad y asma por la comparacion entre edad, genero, clasificacion inicial y control del asma, valores de volumen espiratorio forzado en el primer segundo (VEF1) y flujo espiratorio forzado entre 25 y 75% basal (FEF25-75%) con los indices de masa corporal (IMC) en adolescentes asmaticos. METODOS: Estudio transversal implicando a 120 pacientes (1,9M:1F) asmaticos con mediana de edad de edad de 14,1 anos (9 a 20,1 anos), clasificados respecto al control y gravedad del asma, y evaluados por la espirometria utilizando su VEF1 y FEF25-75% basales. Estos datos fueron descriptos por la frecuencia, promedios y desviaciones estandar o medianas y variacion y analizados por las pruebas de ANOVA, prueba t no pareada, Prueba exacto de Fisher, Kruskal-Wallis y por la correlacion de Pearson considerandose significantes valores de p<0,05. RESULTADOS: No hubo diferencia entre los generos respecto a la clasificacion inicial del asma y el nivel de control. Recibieron clasificacion inicial persistente 91,7% (100 casos), siendo que 106 casos (88,3%) estaban parcial o totalmente controlados. No hubo diferencia estadistica entre los pacientes controlados y los restantes respecto al IMC. No se encontraron correlaciones significantes entre zIMC y VEF y entre zIMC y FEF25-75% al analizar todos los pacientes y solamente los pacientes con sobrepeso u obesos. CONCLUSIONES: En este estudio, no fue encontrada correlacion significante entre sobrepeso/obesidad y asma, utilizandose parametros clinicos, antropometricos y espirometricos.

267 Recurrent Aanaphylaxis in Cow Milk Allergy: What Is Wrong?

Background Food allergens are one of the most important triggers of anaphylaxis in pediatric population and all efforts must be done to avoid new episodes. Objective To determine some factors associated to recurrent anaphylaxis induced by cow´s milk (CM) in pediatric patients with a previous anaphylactic episodes. Methods This is a retrospective study based on medical records from all CM anaphylactic patients, from a Brazilian reference center for food allergy. The anaphylaxis criterion used was based on the Second symposium on the definition and management of anaphylaxis. Patients and parents had received orientation regarding prevention of new episodes, including information about hidden allergens, label reading, and synonymous terms. Results It was included 53 patients (33M: 20F), median age of the first episode of anaphylaxis was 6 months (range 1–87 month) and in 56. 6% the first episode occurred until the age of 6 months. Fifty episodes were observed in 22 patients during the follow up. Twelve patients presented 2 or more episodes and 2 patients presented 6 episodes. It was not possible to detect the trigger food in 17 episodes and these situations were related to ingestion of: appetizers (4), margarine (3), bread (2), pizza (2), juice with casein (1), pasta (1), cake (1), chips (1), Italian sausage (1). Two episodes were challenged by accidentally skin contact and 2 by inhalation. Among the settings of episodes, the majority occurred at home. Other places included: school, restaurants and bakery. Conclusions This study showed that it is very difficult to reach success only with the orientations regarding anaphylaxis prevention. It is necessary to betake of other strategies to improve the measure to avoid new episodes of anaphylaxis such as: folders, visual midia and interactive activities. Furthermore, the continuous education is essential to reinforce the knowledge.