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Asma archivos - Bilastina

asma alergia y covid

ACE2 expression in allergic airway disease may decrease the risk and severity of COVID-19

By | Artículos seleccionados, Selected articles

Sunita Chhapola Shukla

Eur Arch Otorhinolaryngol. 2020 Oct 6;1-4. doi: 10.1007/s00405-020-06408-7. Online ahead of print.

At the start of the COVID-19 pandemic, allergic rhinitis, allergy, asthma, and chronic obstructive pulmonary disease were considered risk factors because they tend to aggravate during respiratory viral infections and upper respiratory tract symptoms viral infections, allergic rhinitis, and influenza overlap during COVID-19 early stages. This review aimed to revise recent studies published that do not prove that allergy and asthma are risk factors or increase severity for COVID-19.

Recent literature has not shown that airways allergic diseases are a high-risk factor or increase the severity of COVID-19. The reason is that there is a reduction in angiotensin-converting enzyme 2 (ACE2) gene expression in the nose and bronchial cells of allergic airway diseases.

Low ACE2 expression in airway cells of individuals with allergic rhinitis and allergic asthma decreases their susceptibility to COVID-19 and may not be a risk factor for severe infection. However, this is not true for the nonatopic asthma phenotype. More studies are needed to understand the impact of respiratory allergic diseases and T2 inflammatory response on COVID-19 severity and susceptibility. It is essential to continue asthma and allergic rhinitis treatments with inhaled corticosteroids, biologics, and allergen immunotherapy during the COVID-19 pandemic.

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Rinitis alérgica

Perception and control of allergic rhinitis in primary care

By | Artículos seleccionados, Selected articles

Pascal Demoly, Isabelle Bossé and Pascal Maigret

NPJ Prim Care Respir Med. 2020 Aug 20;30(1):37. doi: 10.1038/s41533-020-00195-8.

People with chronic diseases behave according to their perception of the disease, which may impact treatment results. The prevalence of allergic rhinitis is high, around 400 million people worldwide. However, it is poorly self-recognized by patients, as well as it is poorly controlled. The PETRA study’s objective was to evaluate the management of allergic rhinitis by patients and their general practitioners and to describe the relationship between disease perception, patient behavior, and treatment outcomes.

The PETRA study was a cross-sectional study that included 2001 participants between May and October 2017. The study’s main objective was to precisely identify and describe factors associated with a poor perception of the disease in people with allergic rhinitis. 201 French general practitioners selected 1929 patients for analysis (mean age: 39 years; intermittent/persistent symptoms: 46.2/52.3%). 71,7% of the participants had uncontrolled allergic rhinitis (ARCT score < 20), 53,6% had a good perception of their illness (BIPQ score < 5), and 14,1% of the patients had also been diagnosed with asthma.

A poor perception of allergic rhinitis was related to ear, nose, and throat complications, nasal pruritus, uncontrolled allergic rhinitis, and asthma. Also, there was a strong negative correlation between the BIPQ and ARCT scores: the poorer the patient’s perception, the less the disease was controlled.

In conclusion, the PETRA cohort included a high proportion of patients with moderate to severe allergic rhinitis symptoms and a low disease control level. It was shown that many patients were not satisfied with their treatment and did not perceive their disease very well. Although no causal relationship could be drawn from this study, results suggest that improving the perception of allergic rhinitis could be beneficial and lead to better control of symptoms.

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Transition of adolescents and young adults with allergy and asthma

EAACI Guideline on the effective transition of adolescents and young adults with allergy and asthma

By | Selected articles

Graham Roberts, et al.

Allergy. 2020 Jun 19. doi: 10.1111/all.14459. Online ahead of print.

Adolescents and young adults represent a large group of patients with allergic rhinitis and/or asthma. Most times their treatment is complicated due to the biological and psychosocial changes that occur as they grow. Sometimes they have difficulty in understanding the consequences of their disease, failing to take responsibility for self-management, leading to suboptimal adherence and other negative consequences. The transitional care should address the psychological, medical, educational and vocational needs of adolescents and young adults.

The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline that provides evidence-based recommendations for healthcare professionals to support the transitional care of adolescents and young adults with allergic rhinitis and/or asthma.

This guideline includes general recommendations on operating a clinical service for these patients, which include: starting the transition as early as 11-13 years old, using a structured, multidisciplinary approach, ensuring they fully understand their condition and have resources they can access, active monitoring of adherence and discussing any implications for further education and work.

Specific allergy and asthma transition recommendations include simplifying medication regimes and using reminders, focusing on areas where these patients are not confident and involving peers in training them. Identifying and managing psychological and socioeconomic issues impacting disease control and quality of life; enrolling the family in assisting them to undertake self-management and encouraging them to let their friends know about their allergies and asthma are also recommendations of this guideline.

National healthcare systems may need to adapt these recommendations according to each culture. If optimal care is received by adolescents and young adults, they will become expert adult patients with the knowledge and skills to manage their condition throughout their lifes.

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historia rinitis alergica

History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis

By | Selected articles

Tohidinik HR, Mallah N, Takkouche B.

Allergic rhinitis has been suspected to be a risk factor for asthma in several studies but this association is not firmly established. The objective of this study was to synthesize the evidence of the association between allergic rhinitis and the risk of asthma through a systematic review and meta-analysis.

We performed a search in Medline, Scopus, ISI Proceedings databases and other databases from inception until February 2019, followed by manual search to identify potentially relevant case-control and cohort studies that reported relative risk estimates and confidence intervals of the association between allergic rhinitis and asthma. Cross-sectional studies were excluded. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed and random effects models and quality of studies was assessed through a modified version of the Newcastle-Ottawa scale.

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Enfermedades alérgicas respiratorias ambiente tropical

Diagnosis of allergic sensitization in patients with allergic rhinitis and asthma in a tropical environment

By | Selected articles

Sánchez-Borges M, Capriles-Hulett A, Torres J, Ansotegui-Zubeldia IJ, Castillo A, Dhersy A, Monzón X. 

The aim of this study is to investigate the in vivo and in vitro responses of IgE antibodies to inhalant allergens in allergic patients with rhinitis and/or asthma.
This study confirms that mites are the main sensitizing agents in patients with respiratory allergic diseases in a tropical environment. There was a good correlation between the results of the skin tests and the results of the in vitro tests.

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enfermedades de la piel

The role of invariant T cells in inflammation of the skin and airways

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Yip KH, Papadopoulos M, Pant H, Tumes DJ.

Invariant and semi-invariant T cells are emerging as important regulators of host environment interactions at barrier tissues such as the airway and skin. In contrast to conventional T cells, invariant natural killer T (iNKT) cells and mucosal associated invariant T (MAIT) cells express T cell receptors of very limited diversity.
We herein describe the current literature on iNKT and MAIT cells in allergic and non-allergic skin diseases (dermatitis and psoriasis) and airway diseases (asthma, chronic obstructive pulmonary disease, rhinitis, and chronic rhinosinusitis).

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vacunas alergias

2019 ARIA Care pathways for allergen immunotherapy

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Bousquet J, (…), Zuberbier T; ARIA Working Group.

Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways.

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Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

By | Selected articles

Bousquet J, (…)Okamoto Y, Wallace DV; The MASK study group.

Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.

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Nasal IgE production in Allergic Rhinitis: Impact of Rhinovirus Infection

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Ahmed Hamed, DeVon C Preston, Will Eschenbacher, Dilawar Khokhar, Lisa Workman, John W Steinke, Peter Heymann, Monica Lawrence, Manuel Soto-Quiros, Thomas AE Platts-Mills, Spencer Payne, Larry Borish (2019)

Practitioners from various specialties investigated the presence of local IgE production in the nose of allergic and non-allergic people and assessed whether it was enhanced by rhinovirus.

Initial studies were performed in patients presenting to the emergency department for allergic and non-allergic respiratory complaints. Local production of specific IgE was determined by comparing ratios of specific to total IgE concentrations between nasal and serum samples.

The analysis revealed evidence of local sIgE production to Dermatophagoides pteronyssinus and Blomia tropicalis in 30.3 and 14.6% of allergic patients, respectively. Patients with active rhinovirus infection were more than twice as likely to have local sIgE, and those with sIgE being produced were three times more likely to have an asthma exacerbation.

In conclusion, local IgE production happens in allergic rhinitis and allergic asthmatics with local IgE are more likely to develop an asthma exacerbation when infected with rhinovirus.

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