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Hereditary Angioedema (HAE) is a rare and disabling disease for which early diagnosis and effective therapy are critical. This revision and update of the global WAO/EAACI guideline on the diagnosis and management of HAE provides up-to-date guidance for the management of HAE. For this update and revision of the guideline, an international panel of experts reviewed the existing evidence, developed 28 recommendations, and established consensus by an online DELPHI process. The goal of these recommendations and guideline is to help physicians and their patients in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2), by providing guidance on common and important clinical issues, such as: 1) How should HAE be diagnosed? 2) When should HAE patients receive prophylactic on top of on-demand treatment and what treatments should be used? 3) What are the goals of treatment? 4) Should HAE management be different for special HAE patient groups such as children or pregnant/breast feeding women? 5) How should HAE patients monitor their disease activity, impact, and control? It is also the intention of this guideline to help establish global standards for the management of HAE and to encourage and facilitate the use of recommended diagnostics and therapies for all patients.

Background: The transfer factor (TF) is the dialyzable extract of leukocytes with cellular immunity transfer properties. Its use has spread in the treatment of a wide range of immunologic, infectious, and even oncological diseases. However, important aspects in their protein profile, component concentrations, and a well-defined action mechanism are not completely unknown. Objectives: To analyze the protein profiles of different transfer factors marketed in Mexico. Methods: 6 TF marketed in Mexico were obtained and analyzed, quantifying protein with thaze Bradford method, by high-performance liquid chromatography (HPLC), and polyacrylamide gel electrophoresis (SDS-PAGE). All samples were analyzed in duplicate. Results: The total protein concentrations of all TF analyzed are less than 0.2 mg/mL. The chromatographic profiles showed differences in some TF. The protein concentration was 6 to almost one thousand times lower compared to reports by some manufacturers. Conclusion: Almost all transfer factors marketed in Mexico lack a labeling and health record that meets the official standards. [ABSTRACT FROM AUTHOR]

Introduction: Profilins are small ubiquitous proteins of 12-19 kDa involved in actin dynamics. These proteins are found in all eukaryotic organisms studied to date. Profilins have aminoacid sequences and tridimensional structure highly conserved. Allergic patients to pollen frequently have symptoms of allergy when ingestion of plant-derived foods like fruits, vegetables, seeds, among others. This phenomenon is known as latexpollen-fruit allergy and it's the main cause of oral allergy syndrome (OAS) which is attributed to the cross-reactivity. Allergens shared between different sources theses are called panallergens for example are profilins which representing at least 20% of all pollen allergic patients. This cross-reactivity is results from the high amino acid sequence identity of profilin from plants, which is between 70% and 85%, this may explain the exacerbation symptoms of allergic patients to profilins from plants. Objectives: We described some characteristics which show us the important participation of the profilins in the sensitization of people allergic, especially to plants, fruits and pollen. Methods: We looked research aminoacid sequences of all allergenic profilins reported to date and these were analyzed. Conclusions: Profilins are important allergens that are underrated in clinical practice and contribute to cross-reactivity in sensitized individuals by profilins from other sources. [ABSTRACT FROM AUTHOR]

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background: Immunotherapy has been practiced since over a hundred years. The exact composition of the immunotherapy concentrate, with which the patient is treated, depends partly on the results of the skin prick tests applied to the allergic patient. As such, the effectiveness of the immunotherapy depends heavily on the quality of the skin prick test. The detailed recommendations for the realization of the skin prick tests have evolved and changed over the years, leading to multiple variations in its application in Mexico. Objective: We tried to get a picture of the daily practice patterns of the members of CMICA and CoMPedIA concerning the application of skin prick tests. materials and methods: A questionnaire was sent in various occasions to all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunología y Alergia (CoMPedIA). The results are presented descriptively and by calculation of the frequency/percentages of intervals of replies, in the case of numerical responses. Results: A response rate of 61 (17%) was obtained of the College members, showing consistency in some replies but a wide variation in others, for example in the time certain medication has to be suspended before the execution of the skin prick test. Comparing the replies obtained with recent recommendations in international publications, some discrepancy can be detected. Conclusions: In some aspects of the survey there is coincidence of the skin test practices among the participants; however, in other items there is an important variation. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of microplastics (MPs) on human health., Data Source: The authors conducted a non-systematic review of articles published in English, Portuguese, French, and Spanish in the last decade in the following databases: PubMed, Google Scholar, EMBASE, and SciELO. The keywords used were: microplastics OR nanoplastics OR marine litter OR toxicology OR additives AND human health OR children OR adults., Data Summary: MPs are a group of emerging contaminants that have attracted scientific interest and societal attention in the last decade due to their ubiquitous detection in all environments. Humans can primarily be exposed to MPs and nanoplastics via oral and inhalation routes, but dermal contact cannot be overlooked, especially in young children. The possible toxic effects of plastic particles are due to their potential toxicity, often combined with that of leachable additives and adsorbed contaminants., Conclusions: Unless the plastic value chain is transformed over the next two decades, the risks to species, marine ecosystems, climate, health, economy, and communities will be unmanageable. However, along with these risks are the unique opportunities to help transition to a more sustainable world.

Background: The transfer factor (TF) is the dialyzable extract of leukocytes with cellular immunity transfer properties. Its use has spread in the treatment of a wide range of immunologic, infectious, and even oncological diseases. However, important aspects in their protein profile, component concentrations, and a well-defined action mechanism are not completely unknown., Objectives: To analyze the protein profiles of different transfer factors marketed in Mexico., Methods: 6 TF marketed in Mexico were obtained and analyzed, quantifying protein with thaze Bradford method, by high-performance liquid chromatography (HPLC), and polyacrylamide gel electrophoresis (SDS-PAGE). All samples were analyzed in duplicate., Results: The total protein concentrations of all TF analyzed are less than 0.2 mg/mL. The chromatographic profiles showed differences in some TF. The protein concentration was 6 to almost one thousand times lower compared to reports by some manufacturers., Conclusion: Almost all transfer factors marketed in Mexico lack a labeling and health record that meets the official standards.

Introduction: Profilins are small ubiquitous proteins of 12-19 kDa involved in actin dynamics. These proteins are found in all eukaryotic organisms studied to date. Profilins have aminoacid sequences and tridimensional structure highly conserved. Allergy patients to pollen frequently have symptoms of allergy when ingestion of plant-derived foods like fruits, vegetables, seeds, among others. This phenomenon is known as latex-pollen-fruit allergy and it's the main cause of oral allergy syndrome (OAS) which is attributed to the cross-reactivity. Allergens shared between different sources theses are called panallergens for example are profilins which representing at least 20% of all pollen allergic patients. This cross-reactivity is results from the high amino acid sequence identity of profilin from plants, which is between 70% and 85%, this may explain the exacerbation symptoms of allergic patients to profilins from plants., Objective: We described some characteristics which show us the important participation of the profilins in the sensitization of people allergic, especially to plants, fruits and pollen., Methods: We looked research aminoacid sequences of all allergenic profilins reported to date and these were analyzed., Conclusions: Profilins are important allergens that are underrated in clinical practice and contribute to cross-reactivity in sensitized individuals by profilins from other sources.

Background: Mites are the most common cause of respiratory allergy. Sensitization to house dust mites is estimated at 30%. Families Euroglyphus and Dermatophagoides, are the most important. Recently, storage mites, from the families Acaridae and Glyciphagidae, have become more important as a cause of allergic respiratory diseases., Objective: The aim of this study was to identify sensitization to house dust and storage mites by skin tests in adult patients with allergic respiratory diseases., Methods: This is a descriptive study in patients with asthma and/or allergic rhinitis, with the approval of the local research committee 2009-3601-46. Patients underwent skin prick tests, with seven standardized extracts of mites (IPI ASACR). The results were analyzed with descriptive statistics., Results: A total of 150 patients, 109 women and 41 men, with an average age 31 years (±11) were studied. The more common allergic diseases in this group of patients were: asthma and rhinitis 72 and 26%, respectively, and asthma plus rhinitis 3.2%. Positive skin tests for Dermatophagoides pteronyssinus and Dermatophagoides farinae were 82.1% 71.5%, respectively, and for storage mites: A. siro 51.7%, Tyrophagus 47.4%, Glycyphagus 47.7%, B. tropicalis 39.7% and Lepidoglyphus 39.1%. Storage mites produced greater sensitization than house dust mites, 32% vs 10%., Conclusions: The results show that adult patients with respiratory allergy, in southern Mexico City, have a higher rate of sensitization to storage mites than the one reported in the literature.

Background: Immunotherapy is the only recognized causal treatment for allergies. It is prepared on an individual basis, based on the patient's clinical history and the result of the skin prick test (SPT). An adequate composition of the allergens with which to test the patient is crucial for an optimal diagnosis., Objective: To know allergens used in tests in allergy practices in Mexico., Materials and Method: A national survey among all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras Especialistas en Inmunología Clínica y Alergia (COMPEDIA) was carried out. In a second phase respondents were asked to send in the composition of a routine SPT in their clinic. The results are presented descriptively and the frequency is calculated by which certain allergen is tested in the interviewed practices., Results: A survey response rate of 61 (17%) was obtained and 54% showed their SPT content. Weeds' representation in the SPT seems adequate; Atriplex is tested in all allergy practices. Some trees that show cross-reactivity might be eliminated from the SPT, but 20% doesn't test for Cynodon nor Holcus, and 25% doesn't for important allergens as cat, dog and cockroach. House dust and tobacco are still tested with certain frequency., Conclusions: The selection of which allergens to test in a SPT is based on multiple data, that change continuously with new investigations and discoveries. Our specialty is the most indicated--and obligated--to adjust constantly to these changes to have the best diagnostic tool to detect specific allergies.

Background: Immunotherapy has been practiced since over a hundred years. Since the first applications up today changes have occurred in the preparation, dose and duration of the treatment, as well as in the extracts used. Guidelines have been published in Mexico and other countries to try to unify these practice patterns of immunotherapy., Participants and Methods: By means of a questionnaire, sent in various occasions to all members of the Colegio Mexicano de Inmunología Clínica y Alergia (CMICA) and of the Colegio Mexicano de Pediatras, Especialistas en Inmunología y Alergia (CoMPedIA) we tried to get a picture of the daily practice patterns of immunotherapy in the allergist's office. Results will be presented in a descriptive manner., Results: A response rate of 61 (17%) was obtained from the College members. For immunotherapy allergists use locally made and imported extracts, generally mixed in their office (20% over 10 allergens in one bottle). Eighty percent adds bacterial vaccine at some point and 60% uses sublingual immunotherapy. Most use Evans without albumin as diluent, don't routinely premedicate, reach maintenance treatment after more than six months and 46% recommends a maximum duration of immunotherapy of two years or less., Conclusions: We present a diagnosis on the current situation of practice patterns concerning allergen immunotherapy among the members of both Mexican colleges of allergists. The methods used by the allergists for indication, preparation and administration are quite diverse.

Objective: To determine the association among meconium aspiration syndrome, parental atopy and asthma symptoms in children younger than two years., Material and Methods: One hundred thirty six children who had suffered meconium aspiration syndrome were followed from birth to they were two years old. CONTROL GROUP included 136 healthy children without meconium aspiration syndrome., Results: Group of children with meconium aspiration syndrome: The average hospital stay in neonatal intensive care unit was of 5.91 +/- 4.44 days and were given 65.5 +/- 16.6 hours of oxygen. Prevalence of asthma symptoms during the last year was of 41.2%; 35.7% had family history of allergies (p = NS). The average age at the beginning of asthma symptoms was of 12.64 +/- 6.96 months; 78.6% of children were male., Control Group: 30.9% had wheezing episodes during the last 12 months; 28.6% were male; 38.1% had family history of allergies (p = NS). The average age at the beginning of asthma symptoms was of 15.57 +/- 6.05 months., Conclusion: Aspiration of meconium seems to be an important risk factor of the early beginning of asthma symptoms in children younger than two years. Data shows that the prevalence of asthma symptoms was higher in case group than in control group. Asthma symptoms risk increases in children with aspiration meconium syndrome and family background of allergies.

Among the allergic disorders we emphasize the inflammatory diseases of the inferior respiratory tract by their incidence, repercussion in daily activities, and by their high cost of medical attention. For their treatment, they require more than one inhaled or systemic drug. Current medicines tend to have adverse or secondary effects, such as: osteoporosis, type 3 diabetes mellitus, tremor or tachycardia. New medicines are being developed with less adverse or secondary effects, and much more selective and specific in the molecules involved in the allergic disease's physiopathology. Among them we find pascolizumab, which inhibits the differentiation made to Th2, as well as the citokines production. Other drugs are: mepolizumab, monoclonal antibody antiCD23, and the selective inhibitor of IgE (AJP13358) Rhu-Mab-E25. Currently, they are being developed some new drugs, such as SB-207499 (SKB) and LAS 31025, which are selective inhibitors of fosfodiesterase. Within the currently studied medicines that offer high specificity to inhibit the synthesis of interleukines we emphasize the presence of humanized monoclonal antibodies antireceptor IL-4. The anti IL-5 (SB-240563) is administered in asthmatic patients to reduce eosinofilia in expectoration. Tosilate of suplatast is a selective IL-4 and IL-5 inhibitor. Ramatroban (BAY or 3405) is an antagonist of the tromboxane A2 receptor, which reduces the inflammatory process of the nasal mucose without hemodynamic effects. Immunotherapy with peptides avoids the response of IgE by the allergen, without mast cell degranulation.

Occupational asthma could be defined as a reversible lung disorder characterized by attacks of breathing difficulty, wheezing, and cough, which are caused by various agents found in the workplace. Incidence varies from 2 to 15% in adult work population; actually there is no data for the child population. Allergic occupational asthma is due to allergic sensitization to a specific substance or material present at the workplace; non-allergic occupational asthma occurs because of the high exposure to an irritant also at the workplace. Over the past few years, more people have been diagnosed as having asthma because of some workplace exposure. The identification of occupational asthma in workers is important because early detection may lead to the control of the worker's symptoms and control of the chemicals in the workplace. In Latin America there is no data about occupational asthma, maybe for the scarce information about it or for its difficult diagnosis.

Background: Urticaria and angioedema are illnesses of easy diagnosis, but to solve them or to determine their cause is complex, as well as the therapeutic management of chronic cases., Objective: To determine the prevalence, possible precipitating factors and chronic urticaria characteristics., Material and Methods: A questionnaire was applied to 4,000 persons selected at random, from the ages of 18-50 years, women and men. We made up simple frequencies, odds ratio, confidence interval at 95%. Possible interventions from the some variables were determined through regression logistic model., Results: Chronic urticaria and angioedema prevalence was 4.8%. From the 147 sick persons, 71.4% were women (p = 0.00) 51.70% had only wheals, 10.88% angioedema alone and 37.41% of the patients with chronic urticaria also have angioedema. Potential triggering factors that we found were 18.36% drugs (p = 0.00) and 4.08% foods (p = 0.00). Family (p = 0.00) and personal allergy (p = 0.00) antecedents were documented in 55.8% and 68.70%, respectively. In 40.1% symptoms interfere with daily activities of the patients and 53.1% of patients had symptoms at night., Conclusions: Despite of being a retrospective study, the results show us that the chronic urticaria and angioedema are important health problems in the northeastern of Mexico. We can not identify the etiology, and the symptoms can disturb quality of life of the patients. Female sex, family and personal allergy antecedent could be important for these pathology presentations.

Introduction: In 1980 AIDS appeared in the USA in the homosexual community. CHARACTERISTICS OF THE VIRUS: A particle of HIV is formed by two identical RNA chains that are packed within a center of viral proteins, and surrounded by a double layer of fosfolipids derived from the cellular membrane of the host., Clinical Symptoms: It starts with a severe infection, evolving in a progressive chronic infection reaching a final phase with a T CD4+ cellular count under 200 cells per mm3, with incident infections, neoplasias, consumption syndrome, renal dysfunction, and degeneration of the central system. CONSEQUENCES IN ALLERGIC REACTION: Reactions to the use of drugs are the most frequent form of hypersensitivity caused by HIV compared to the general population. In this condition, a profile of TH2 cytocines are produced and they induce the synthesis of IgE against the drugs. IgE levels have been related to the progression of this condition., Conclusion: The increase of IgE is a risk factor to allergic reactions against these medications, as well as a severity index.

Background: Remodeling is considered a new or different reconstruction of tissues. The airway remodeling is a consequence of changes induced by endothelial cells and extra-cellular matrix as a result of chronic inflammation., Objective: To show histological changes into mucosa in patients with perennial allergic rhinitis., Material and Methods: We studied 26 patients with perennial allergic rhinitis, with evolution of 3 to 6 years, between 20 to 40 years old, without medical or immunological treatment. A turbinate biopsy was taken in all of them., Results: We found enlargement of the basal membrane in 92.3%, subepithelial fibrosis in 92.4%, neutrophils in 100% of the cases, eosinophils in 100%, lymphocytes in 100%, edema in 46.2%, fragmented reticular fibers in 19.2%, and vascular dilatation in 11.1%., Conclusion: These results suggest nasal remodeling in patients with allergic rhinitis, although more structural studies about this pathology are necessary.