RESUMO
Among the aeroallergens associated to asthma and allergic rhinitis, the fungi are a common cause of diagnostic and therapeutic problems. The wide variety and distribution of fungal species and the complex characterization of their allergenicity, is a complex item. The fungus extracts used to diagnose and treat sensitizations are frequently non effective, and different varieties of extracts are globally distributed. The standardization of commercial fungi extracts results extremely important as diagnostic procedure as well as to decide an efficacious and safe immunotherapy. This paper reviews important methodological steps to the standardization of fungi extracts, and finally the clinical use of these extracts.
Assuntos
Alérgenos , Asma/microbiologia , Misturas Complexas/normas , Fungos , Hipersensibilidade/microbiologia , Imunoterapia , Rinite Alérgica Perene/microbiologia , Rinite Alérgica Sazonal/microbiologia , Alérgenos/uso terapêutico , Asma/diagnóstico , Asma/terapia , Fungos/imunologia , Humanos , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/terapia , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/terapiaRESUMO
BACKGROUND: Helminth infections have been associated with reduced reactivity to aeroallergens, which could be related to interleukin 10 (IL-10) production, as reported in schistosomiasis. OBJECTIVE: To compare skin responses to aeroallergens with Der p specific IL-10 production in patients with asthma or rhinitis according to Ascaris infection status. METHODS: Cross-sectional study of 113 patients with asthma or rhinitis from a region endemic for geohelminths. Stool examinations and skin prick tests to aeroallergens were performed in all the patients. Der p specific IL-10 production was measured in the supernatant of peripheral blood mononuclear cell (PBMC) cultures of a subsample of 53 patients. RESULTS: Forty-seven patients had Ascaris in their stool samples. Skin test results were positive in 77% of Ascaris-infected patients and in 71% of uninfected individuals. Median levels of Der p specific IL- 10 in PBMC cultures of infected and uninfected patients were similar (7.8 and 8.4 pg/mL, respectively). The lack of association remained when parasite load was taken into account and when patients with evidence of previous infection were removed from the uninfected group. CONCLUSIONS: In patients with asthma or rhinitis living in an urban area endemic for geohelminths, we found no association between Ascaris infection and skin reactivity to aeroallergens. Furthermore, there was no difference in Der p specific IL-10 production by PBMCs. These negative findings indicate that different from what is observed in Schistosoma infection, Ascaris lumbricoides infection in individuals living in an urban area does not induce strong regulatory responses.