RESUMO
BACKGROUND: Allergic rhinitis is the most common atopic reaction to allergens and may persist for many years if not treated. It is never lethal, though it may cause morbidity. The IgE synthesis is regulated by inheritance, antigen exposition and cytokines; specially Th2 cells, through secretions of the IL4 e IL5 that favor IgE production and inflammation rich in eosinophils. OBJECTIVE: To determine the difference of IgG4 serum levels, gamma interferon, and interleukins of patients with allergic rhinitis, with and without immunotherapy, and healthy patients. MATERIAL AND METHODS: In an observational, transversal, prospective, comparative and open study 82 (100%) patients were recruited and divided into three groups. Group 1 included 15 patients with allergic rhinitis diagnosis and positive skin tests without immunotherapy; group 2, 15 patients with allergic rhinitis diagnosis and positive skin tests with immunotherapy; group 3, 52 healthy patients. RESULTS: IL-4, IL-5, IL-6 and IL-12 values were higher in both groups of allergic rhinitis, compared with healthy group. There were differences in the IL-5 concentrations that were less in patients with allergic rhinitis and vaccine than in those without vaccine. The values of IgG4 and gamma interferon did not vary and were not found in the studied groups. CONCLUSION: The present study proved the existence of significant differences, showed increments in the interleukin values among healthy and allergic patients, despite allergic rhinitis is a local phenomenon. It is probable that the above is related to the genetic tendency to produce a Th2 cytokines pattern which is a characteristic of allergy. Allergen immunotherapy modified significantly the IL-5 levels as well as the other studied interleukins.
Assuntos
Dessensibilização Imunológica , Imunoglobulina G/sangue , Interleucinas/sangue , Rinite Alérgica Perene/sangue , Rinite Alérgica Sazonal/sangue , Adulto , Estudos Transversais , Feminino , Humanos , Interferon gama/sangue , Interleucina-12/sangue , Interleucina-4/sangue , Interleucina-5/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rinite Alérgica Perene/terapia , Rinite Alérgica Sazonal/terapia , Testes Cutâneos , Células Th2/metabolismoRESUMO
BACKGROUND: Since year 3000 BC, pollenology (science that studies allergens) was already known. In the year 49 BC, Herodotus recognized the first case of hay fever, Jacob Constant (17th century) described the first case of allergic rhinitis and related it to "something" (allergens) that roses emitted. Charles Backley (1873) proved the ability of the skin to determine allergic reactions to allergens. Today, it is well-known that allergens are able to react with environmental exposure, plants and pollens. OBJECTIVE: To know the most common allergens in allergic patients who are admitted into a tertiary care hospital. MATERIAL AND METHODS: 3,172 electronic expedients of registered allergic patients were examined. Only 356 fulfilled the inclusion criteria. Five groups of allergens were studied: group 1 (pollens), 2 (fungus), 3 (inhaled allergens), 4 (food) and 5 (other allergens), the value of seric IgE was registered too. RESULTS: The main allergens that were found are: 156 (43.8%) Amaranthus palmeri, 163 (45.5%) Candida albicans, 262 (73.6%) dust mite, 33 (9.3%) chicken and 4 (1.2%) apple/pineapple. The main diseases were: 254 (71.3%) allergic rhinitis, 52 (14.6%) asthma-rhinitis, 39 (11%) asthma and 63 (17.6%) others, the value of seric IgE was minimum of 1 and maximum of 9,620 Ul/dL. CONCLUSIONS: Allergens affecting patients are not different of what is reported in world-wide literature; however, it is of great significance to know this and take it as a guideline to achieve clinical improvement with the use of an appropriate immunotherapy.