Alergia a Cupresáceas en la población del Vallés Occidental

Abstract

Allergy to pollens, or hay fever, is the inflammation of the nasal mucosa and / or conjunctival and / or bronchial as a result of sensitization to pollen allergens. To diagnose allergy to pollens is necessary to perform a medical history, intraepidermal skin tests with commercial extracts of pollens allergens and in vitro studies to demonstrate the IgE sensitization. To make more precise the etiological diagnosis of hay fever we should perform molecular diagnostic tests and specific allergen exposure, such as specific nasal provocation._x000D_ Currently, pollinosis has great clinical impact and its prevalence has increased, estimated at 40% in Europe. Nationally it has been found pollen of Cupressaceae as a major allergen and observed an increase in the number of patients polysensitized._x000D_ The objectives of this study were:_x000D_ • Determine the annual incidence of sensitization to pollen of Cupressaceae in the population of Western Vallés with symptoms compatible with respiratory allergy._x000D_ • To describe the clinical features and molecular allergenic profile of patients with sensitization to pollen of Cupressaceae in the area of Vallés Occidental._x000D_ • Comparative study of detection of sensitization by skin test to different pollen extracts used: Cupressus sempervirens, Cupressus arizonica and Juniperus ashei._x000D_ • To determine the sensitivity and specificity of specific IgE to different pollen extracts of Cupressaceae tested and the allergens Cup 1 and Cry j 1._x000D_ • Determine the predictive ability of the presence of symptoms due to pollen of Cupressaceae by specific nasal challenge with pollen of Juniperus ashei._x000D_ _x000D_ _x000D_ _x000D_ The results and conclusions of this study points out that the annual incidence of sensitization to pollen of Cupressaceae by skin testing in the population of Western Vallés with symptoms compatible with respiratory allergy is 15.1%._x000D_ Patients sensitized to cypress pollen study were characterized as mostly asymptomatic, have a high frequency of polysensitization, a predominance of male gender in the pediatric population and a prolonged time of exposure to cypress pollen to develop sensitization._x000D_ Raising the profile of individual allergens revealed that the patients were mainly sensitized to Cup 1 and Cry j 1 and polysensitization was mainly at the expense of genuine sensitization to other pollen sources. Sensitization to profilin and polcalcinas was low._x000D_ Papules induced by the pollen extract Cupressus sempervirens are lower than those induced by Juniperus ashei and Cupressus arizonica and, in adults, Cupressus arizonica extract induces papules greater than Juniperus ashei._x000D_ The sensitivity and specificity of IgE specific to different extracts and molecular allergens tested is less than 70% in the population studied._x000D_ The specific nasal provocation test with Juniperus ashei pollen has high sensitivity but low specificity except for the concentration of 1 IR in the study population._x000D_ The recommendations from this study for clinical practice are: perform the diagnosis of in vivo sensitization to pollen cypress with 2 extracts (Cupressus arizonica and Juniperus ashei) to increase sensitivity, making determinations in vitro of specific IgE to pollen of Cupressus arizonica, individual Cup 1 allergen and CCD-bearing proteins as, for example, Phl p 4, Pl 2 or Jug r 2. Finally, despite the low specificity shown, you can raise the testing PNE in cases where the clinical symptoms and the in vitro results not conclude the diagnosis.

Date of Award	30 Nov 2016
Original language	Undefined/Unknown
Awarding Institution	Vall d'Hebron University Hospital (HUVH)
Supervisor	Victòria Cardona Dahl (Director), Olga Luengo Sánchez (Director) & Albert Selva O Callaghan (Tutor)