Sensibilização a alérgenos inalatórios e alimentares em crianças brasileiras atópicas pela mensuração in vitro de IgE específica, IgE total e phadiatop infant® - Projeto Alergia II

• Ano de defesa: 2017
• Autor(a) principal: Rozalem, Ana Carolina [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Hipersensitivity; Child; Immunoglobulin E; Comorbidity; Chronic disease; Hipersensibilidade; Criança; Imunoglobulina E; Comorbidade; Doença crônica
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5228517; http://repositorio.unifesp.br/handle/11600/50390

Introduction: Allergic diseases are examples of chronic non-communicable diseases present since the earliest stages of life and with a notable increase in incidence in the last decades. Its occurrence presupposes production by the immune system of immunoglobulin E (IgE) to specific proteins and the triggering of clinical symptoms when coming into contact with them. The presence of elevated total IgE (tIgE) is related to the presence of specific IgE (sIgE) and the occurrence of allergic diseases. Panels that include common allergens relevant to populations, pathologies, and age groups may be useful to exclude IgE involvement in individuals suspected of allergy and to facilitate diagnosis. Phadiatop Infant® (PhInf) is a panel with good performance, developed for the population under 5 years, which combines the most frequent allergens among the Brazilian population. Objectives: To evaluate PhInf as a screening method for allergic diseases in Brazilian children. To determine the serum levels of seIgE and sIgE to allergens constituent of PhInf in the different age groups and allergic diseases studied. Evaluate the relationship between the levels of PhInf and those of tIgE and sIgE performed. Methods: Cross - sectional study involving 11 Brazilian Pediatric Allergy Centers. Patients and controls were divided into groups according to the main disease and age group. Participants were submitted to the collection of blood for the measurement of tIgE, PhInf and sIgE for D.pteronyssinus (Dp), Cat Epithelium, Dog Epithelium, Grass Mix, Pollen Mix, Egg, Cow's Milk, Peanut and Shrimp. Values ​​of sIgE and PhInf equal to or greater than 0.35 KUA / L (or PAU / L) were considered positive. RESULTS: A total of 470 children and adolescents were divided into 5 groups of the same proportion according to the main disease: Allergic rhinitis (RA) and / or Asthma, Atopic dermatitis (AD), Food allergy (AA), Sibilant Infant and Control. There was no statistical difference of gender: 47.7% were males. The mean age was 6.3 years (range from 5 months to 18 years). Children with asthma and AD were significantly older than those with AA and LS. The mean tIgE concentration was 981kU / L, increasing with age up to 4 years, when there was no statistical difference between the subsequent age groups. Regarding the main disease, AD and Asthma had the highest levels. PhInf was positive in 72.6% of the subjects tested (n = 341) with the highest positivity ratio in AA (92.6%), AD (91.9%) and in the group of patients over 13 years of age (95 %). The agreement between PhInf positivity and any of the specific allergens reached high levels between patients (Kappa = 0.94, p <0.001) and controls (Kappa = 0.84, p <0.001). For each specific allergen, agreement was perfect between PhInf and Dp in patients older than 13 years (Kappa = 0.936, p <0.001). TIgE levels were significantly higher in the group with PhInf 0.35 (p <0.001) for all groups involved. As a diagnostic test for atopy, PhInf showed good sensitivity (S = 79%) and moderate specificity (E = 56%), however, when compared to sIgE, high S and E: 97% and 93%, respectively. Conclusions: The positivity of Phadiatop Infant® in children and adolescents allergic is high and presents an excellent correlation with the constituent allergens dosed separately. It can be said that PhInf is a useful method in screening children suspected of allergic diseases. TIgE levels in allergic patients are very high and are influenced by age, type and presence of disease are higher in patients with AD and Asthma and lower in LS and controls and increase with age progression.