Search

Introduction Pollens are an important source of allergens that trigger rhinitis or asthma. The allergenic extracts of pollens used to diagnose and treat allergies contain different allergenic antigens. Isolated allergenic proteins are employed in in vitro assays, skin tests and allergenic-specific immunotherapy. Calcium-binding allergens are clinically relevant antigens, and their allergenicity can be affected by Ca2+ binding. In this work, a calmodulin was identified as an allergen from Amaranthus palmeri pollen, an important source of pollinosis in Europe, Asia and North America. Materials and methods Allergenic calmodulin from A. palmeri pollen was isolated by size-exclusion chromatography and reverse-phase chromatography and identified by mass spectrometry. Sensitization to isolated calmodulin was evaluated by skin prick tests in patients with allergy to A. palmeri pollen. Results Size-exclusion chromatography yielded two fractions that were recognized by the IgE of patients allergic to A. palmeri pollen. Mass spectrometry analysis of the fractions from reverse-phase chromatography showed peptide sequences that identified a calmodulin. Skin prick tests showed that the isolated calmodulin was recognized by 56% of patients allergic to A. palmeri pollen. Conclusion A. palmeri pollen calmodulin could be a clinically relevant allergen in patients sensitized to this source.

Asthma continues to be one of the most frequent chronic respiratory diseases in our country. New methods for diagnosis and treatment have been described; accordingly, the international guidelines were renewed.To create a national platform for the development of updated guidelines, solidly based on evidence: Comprehensive Asthma Management (Spanish acronym: MIA).MIA uses the ADAPTE method. The MIA development group consists of experts in pulmonology-allergology-methodology and representatives of 13 institutions and societies of specialties that manage asthma. The international reference guidelines (selected with AGREE-II): GINA 2020, GEMA 5.0, BTS/SIGN 2019 and ATS/ERS consensus document 2014-2019 on severe asthma. MIA covers suspected asthma, diagnosis, treatment, and special groups. Key clinical questions were formulated on treatment steps 1-3, biomarkers and severe asthma.Based on evidence, safety, cost and local reality, the core group developed responses. Through a Delphi process the broad MIA development group suggested adjustments until consensus was reached.A document was generated with multiple figures and algorithms, solidly based on evidence about asthma management, adjusted for Mexico with a broad base among different societies that participated in its development. It does not include guidelines for acute asthma.Antecedentes: El asma sigue siendo una patología respiratoria crónica frecuente en México. Se han descrito nuevos métodos para el diagnóstico y tratamiento conforme se renuevan las guías internacionales. Objetivo: Crear la plataforma nacional Manejo Integral del Asma (MIA), para el desarrollo de lineamientos actualizados con base en evidencia. Métodos: Se utilizó el método ADAPTE. El grupo de desarrollo de MIA estuvo integrado por expertos en neumología, alergología y metodología y representantes de 13 instituciones y sociedades de especialidades que manejan asma. Las guías internacionales de referencia (seleccionadas con AGREE-II) fueron GINA 2020, GEMA 5.0, BTS/SIGN 2019 y consenso ATS/ERS 2014-2019. En MIA se aborda sospecha de asma, diagnóstico, tratamiento y grupos especiales. Se formularon preguntas clínicas clave sobre tratamiento en los pasos 1 a 3, biomarcadores y asma grave. Resultados: Con base en evidencia, seguridad, costo y realidad local, el grupo nuclear desarrolló respuestas. Mediante proceso Delphi, el grupo amplio de desarrollo sugirió ajustes hasta que se logró el consenso. Conclusión: El documento generado contiene múltiples figuras y algoritmos, está sólidamente basado en evidencia acerca del manejo del asma y fue ajustado para México con participación de diferentes sociedades para su desarrollo; no se incluyeron lineamientos para la crisis asmática.

Mexico 2009 faced the H1N1VI influenza pandemic, a complex immunologic and clinical host response, whose defense mechanisms have yet to be identified. Lack of information on clinical an immunological features in pediatric population with H1N1VI, delay detection of patients at risk of contracting it. This study aims to identify specific immunologic and/or clinical features of pediatric patients with H1N1VI in a federal Hospital in Mexico City. Methods Single-center, observational, non-experimental, prospective trail from September to October 2009, for pediatric patients arriving to Emergency room of Juarez Hospital, with suspicion of H1N1VI, needing to be younger than 17 years, and agree and sign the consent form by tutor. Samples obtained were peripheral blood, and pharyngeal exudate. From blood LS, Cytokine levels, and routine measurements (CBC, BCH) were investigated; the pharyngeal sample underwent PCR study to viral genetic material. Complementary studies such as arterial blood gases or Torax radiography were realized as needed. Results 32 patients participated. PCR results confirmed 18 cases (56%), 1 patient resulted positive for SII. The average age was 9 years old; 12 (67%) were female, and 6 (33%) were male. The mean amount of days from symptom onset to receiving medical attention was 2.5 days. Main symptoms and signs were fever, malaise, cough, rhinorrhea, and headache. Associated risk factors included malnutrition and tobacco exposure. It was demonstrated an elevation of IL-8, followed by IL-6, IL-12 and IL-10. Blood analysis proved no significant findings, though cases of neutrophilia and leukopenia were detected. Conclusions Limited resources, restricted participation from all the possible H1N1VI patients, thus biasing results due to small sample size; however, the obtained data is consistent with existing reports, nevertheless the information is not enough to establish standardized recommendations. Further collaboration among centers, is needed to identify features that can prompt H1N1VI early identification and prevention in pediatric population.