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As alergias respiratórias
Abstract
As alergias respiratórias, que clinicamente compreendem asma e rinite, caracterizam-se por uma reação de hipersensibilidade tipo I, pois resultam da interação de alérgenos ambientais com anticorpos IgE específicos. São doenças multifatoriais causadas pela interação de fatores genéticos e exposição a fatores ambientais. O processo inflamatório é considerado atualmente o principal evento fisiopatológico. O diagnóstico preciso com identificação do(s) alérgeno(s) envolvido(s) (determinação de IgE específica in vivo ou in vitro), a intensidade dos sintomas, e o conhecimento da fisiopatologia são os elementos básicos para se estabelecer o melhor tratamento.Os estudos mostram que, com medicação apropriada, orientação e educação adequadas,as alergias respiratórias podem ser bem controladas com prejuízo mínimo da qualidade devida do paciente. Existem evidências clínicas, epidemiológicas e fisiopatológicas mostrando forte associação entre asma, rinite e sinusite (ou rinossinusite) e polipose nasal, o que tem levado alguns estudiosos a propor termos que indiquem a íntima inter-relação entre estes processos,como vias aéreas unidas. A OMS e outras sociedades de especialidades, implementaram a iniciativa ARIA (Allergic rhinitis and its impact on asthma) com os objetivos de avaliar melhor a inter-relação rinite/asma, transformar novos conhecimentos em recomendações para o controlee prevenção, aumentar a consciência sobre a rinite e suas consequências para a saúde pública, fazer com que o tratamento eficaz para a rinite esteja disponível e seja acessível para todos os pacientes que necessitarem.
... Pollen from trees and other vegetation contains allergenic proteins that, when inhaled, can trigger immune responses in susceptible individuals. 24 This immune response can lead to a range of respiratory symptoms, including sneezing, nasal congestion, and wheezing. 25 For individuals with preexisting respiratory conditions such as asthma or allergic rhinitis, exposure to pollen can exacerbate these conditions, leading to increased severity of symptoms and potentially necessitating medical treatment or hospitalization. ...
... 25 For individuals with preexisting respiratory conditions such as asthma or allergic rhinitis, exposure to pollen can exacerbate these conditions, leading to increased severity of symptoms and potentially necessitating medical treatment or hospitalization. 24,25 Second, in this study, we did not specify the type of respiratory diseases. The group of respiratory diseases has different etiologies and pathologies, and some may be more strongly linked to green spaces than others. ...
Background:
The potential health benefits of exposure to vegetation, or greenness, are well documented, but there are few nationwide studies in Brazil, a country facing challenges related to land-use planning, deforestation, and environmental health risks.
Objectives:
In this study, we investigated the association between greenness and hospitalizations for cardiorespiratory diseases in Brazil.
Methods:
We accessed hospital admissions data from 967,771 postal codes (a total of 26,724,624 admissions) covering Brazil for the period between 2008 and 2018. We used Normalized Difference Vegetation Index (NDVI) data from the Moderate Resolution Imaging Spectroradiometer (MODIS) to measure greenness at the postal-code level. First, we applied a quasi-Poisson regression model to estimate the association between greenness and hospitalizations for circulatory and respiratory diseases, adjusted for air pollution, weather variables, and area-level socioeconomic status. We stratified the analyzes by sex, age group, health outcome, and Brazilian regions. In the second stage, we performed a meta-analysis to estimate pooled effects across the Brazilian regions.
Results:
The national meta-analysis for the whole population, incorporating both urban and nonurban areas, showed that higher levels of greenness were associated with a lower risk of hospitalizations for circulatory diseases. An interquartile range (IQR=0.18) increase in average NDVI was associated with a 17% (95% confidence interval: 8%, 27%) lower risk of cardiovascular admissions. In contrast, there was no association found between greenness and respiratory admissions. When specifically examining urban areas, the results remained consistent with the overall findings. However, the analyses of nonurban areas revealed divergent results, suggesting that higher levels of greenness in rural regions are associated with a lower risk of hospital admissions for both circulatory and respiratory diseases.
Discussion:
The findings emphasize the importance of prioritizing the preservation and creation of green spaces in urban areas as a means of promoting cardiovascular health in Brazil. https://doi.org/10.1289/EHP13442.
The World Health Organization and various allergy, asthma, and immunology societies throughout the world met on January 27 through 29, 1997, in Geneva, Switzerland to write guidelines for allergen immunotherapy. Over the ensuing year, the editors and panel members reached a consensus about the information to include in the WHO position paper "Allergen immunotherapy: Therapeutic vaccines for allergic diseases." The historical term allergen extract was changed to allergen vaccine to reflect the fact that allergen vaccines are used in medicine as immune modifiers. The document summarizes the scientific literature and rationale for the appropriate use of such therapy to treat allergic rhinoconjunctivitis, allergic asthma, and Hymenoptera hypersensitivity. It also includes recommendations to improve safety, discusses new techniques being developed that may result in better efficacy and less risk, and offers recommendations for areas of additional and necessary research.
The molecular and cell biology of allergy - Volume 112 Issue 12 - S. T. Holgate, G. Mavroleon
Allergic rhinitis is an increasingly common disease, with a prevalence of at least 10% to 25% in the United States. Diagnostic allergy tests, such as skin tests and in vitro tests, can assist clinicians in determining whether nasal symptoms are allergic in origin. In addition, safe and effective medications are available to treat allergic rhinitis. The initial strategy should be to determine whether patients should undergo diagnostic testing or receive empirical treatment. This paper reviews the test characteristics of the history, skin tests, and in vitro tests in diagnosing allergic rhinitis from the perspective of decision thresholds. A combination of pertinent medical history features in a practice with a high baseline prevalence of allergic rhinitis justifies the common practice of empirical treatment since allergy medication has minimal toxicity and side effects. The situation is more complex when the patient needs a diagnostic test, because reported sensitivities and specificities of skin tests and in vitro tests vary widely. As a result, it is difficult to calculate the post-test probability of allergic rhinitis with any confidence. The decision to initiate diagnostic testing must rely on clinical judgment to select patients who would benefit most from determining their allergic status while minimizing unnecessary testing and medications. Diagnosing allergy to a specific antigen allows patients to avoid the allergen and makes them candidates for allergen immunotherapy, which can decrease the need for medications.
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