Current Treatment Options in Allergy, Sep 19, 2023
Mastocytosis is associated with a high risk of anaphylaxis, in part due to drug hypersensitivity ... more Mastocytosis is associated with a high risk of anaphylaxis, in part due to drug hypersensitivity reactions (DHR). Drugs associated with mast cell activation include nonsteroidal anti-inflammatory drugs (NSAIDs), drugs used in the perioperative setting, including general anesthetics, neuromuscular blocking agents (NMBAs) and opiates/opioids, radiocontrast media (RCM), vaccines, and antibiotics such as quinolones and vancomycin. To protect patients against DHR and anaphylaxis, general avoidance of potential drug triggers is common practice, which often deprives patients of important drugs at times of need and limits their options. We aimed to critically review current evidence on the indications to avoid drugs in children and adults with mastocytosis. Recent data shows that general avoidance of drugs with potential mast cell activation action is not indicated in all patients with mastocytosis, but guidelines are lacking. Drugs tolerated before and after the onset of mastocytosis should not be avoided and a personalized approach is recommended to
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também... more Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também um papel importante na angiogênese, tolerância imunológica, regulação da fibrinólise, regeneração neuronal e osteoclastogênese. Localizam-se maioritariamente na pele e nas mucosas do intestino e pulmões, onde exercem uma função "sentinela". As síndromes de ativação mastocitária são caracterizadas pela ocorrência de episódios recorrentes de manifestações clínicas resultantes da libertação de mediadores mastocitários. Esta constitui-se como entidade complexa com um espectro de sintomas associados, representando um desafio diagnóstico e terapêutico. Nesta revisão, os autores pretendem apresentar uma visão geral sobre a estrutura e função dos mastócitos e sobre os critérios diagnósticos e abordagem terapêutica da síndrome de ativação mastocitária. Descritores: Mastócitos, mastocitose, síndrome de ativação mastocitária. Mast cells are the main effector cells of acute allergic response, also playing an important role in angiogenesis, immune tolerance, regulation of fibrinolysis, neuronal regeneration, and osteoclastogenesis. They are generally located in the skin and mucous membranes of the intestines and lungs, where they perform a "sentinel" function. Mast cell activation syndrome is characterized by recurrent clinical manifestations resulting from the release of mast cell mediators. This complex entity, which involves a spectrum of associated symptoms, is a diagnostic and therapeutic challenge. In this article we overview of the structure and function of mast cells, in addition to the diagnostic criteria and therapeutic approaches to mast cell activation syndrome.
Hypersensitivity reactions are an important hazard in healthcare. Modern dentistry depends on the... more Hypersensitivity reactions are an important hazard in healthcare. Modern dentistry depends on the use of drugs and materials widely known to elicit them. Such reactions are either immediate or nonimmediatethe former carries the risk of anaphylaxis, whereas the latter includes potentially fatal severe cutaneous adverse reactions. Apart from well-established immunoglobulin E-mediated immediate hypersensitivity reactions (IHRs), recent advances have shed light on the pathophysiology of other IHRs, suggesting a role for MRGPRX2-induced mast cell activation. Hypersensitivity to both drugs and metals may come as a challenge to dentists, often requiring changing to infrequently used compounds. Local anesthetics are cause for concern, but are a rare cause for IHRs. The opposite occurs with antimicrobials, as antibacterials frequently cause hypersensitivity reactions. Nonsteroidal anti-inflammatory drugs are another common cause, especially in patients suffering from asthma and/or chronic spontaneous urticaria. General anesthetics are a common cause for immediate hypersensitivity, whereas most drugs used for conscious sedation are rare elicitors. Chlorhexidine is a remarkable cause for anaphylaxis, nowadays, despite rare reports linked to rinsed formulations. Preservatives, flavors, and other compounds present in dentifrices cause both irritative and allergic contact dermatitis/mucositis. Metals, notably nickel and cobalt, are a very common cause for hypersensitivity in dentistry. Acrylates may induce contact mucositis, due to lack of proper polymerization of residuals, being an important cause for contact stomatitis and a dentistry occupational hazard. Acute reactions require a prompt treatment, especially in the presence of anaphylaxis, which should be treated using intramuscular epinephrine. Delayed type reactions with fever should be referred to tertiary urgent care facilities. Suspicion of hypersensitivity in dentistry requires a thorough allergological study and referral is mandatory in all cases.
BackgroundExhaled breath condensate (EBC) pH is a promising biomarker of airway inflammation. Lac... more BackgroundExhaled breath condensate (EBC) pH is a promising biomarker of airway inflammation. Lack of method standardization and interstudy variability precludes its use in clinical practice. While endogenous determinants have been described, underlying mechanisms for variability are mostly unknown. Thus, we aimed to assess the association between asthma and EBC pH in children, while studying potential environmental factors for interstudy variability.MethodsA cross‐sectional analysis of exhaled breath condensates from 613 children, aged 7–12 years, was conducted. Assessments included lung function and airway reversibility, exhaled nitric oxide, allergic sensitization, and body mass index (BMI). Indoor air quality (IAQ) was assessed in children's classrooms during 5 school days. Post‐deaeration EBC pH showed a bimodal distribution, and the sample was split into acidic and alkaline groups. Regression models were constructed to assess the effects of asthma and asthma adjusted to IAQ parameters on EBC pH.ResultsFollowing adjustment to gender and BMI, asthma was significantly associated with a lower EBC pH in the acidic group. The effect of asthma on EBC pH was independent of IAQ, in both groups. In the acidic group, EBC pH was significantly affected by temperature [β = −0.09 (−0.15, −0.02)] and PM 2.5 concentration [β = −0.16 (−0.32, −0.01)], and in the alkaline group by relative humidity [β = 0.07 (0.02, 0.13)] and concentration of endotoxins [β = −0.06 (−0.1, −0.01)].ConclusionOur study shows that in addition to individual determinants such as asthma, environmental factors may influence and should be taken into consideration when interpreting EBC pH level in children.
BackgroundNonsteroidal anti‐inflammatory drugs (NSAIDs) are frequently avoided in mastocytosis, b... more BackgroundNonsteroidal anti‐inflammatory drugs (NSAIDs) are frequently avoided in mastocytosis, because of a potential increased risk for drug hypersensitivity reactions (DHRs) due to inhibition of cyclo‐oxygenase (COX), subsequent depletion of prostaglandin E2 and release of leukotrienes.ObjectivesHere, we aimed at determining the prevalence of mast cell (MC) mediator release symptoms triggered by NSAIDs in mastocytosis patients and the associated clinical and laboratory features of the disease.MethodsMedical records from 418 adults to 223 pediatric mastocytosis patients were retrospectively reviewed. Patients were classified according to tolerance patterns to NSAIDs and other COX inhibitors (COXi) and compared for epidemiological, clinical and laboratory findings.ResultsOverall, 87% of adults and 91% of pediatric patients tolerated NSAIDs and other COXi. Among adult and pediatric patients presenting DHRs, 5% and 0% reacted to multiple NSAIDs, 4% and 0.7% were single reactors, and 3% and 8% were single reactors with known tolerance to paracetamol but unknown tolerance to other COXi, respectively. Among adults, hypersensitivity to ≥2 drugs was more frequent among females (p = 0.009), patients with prior history of anaphylaxis to triggers other than NSAIDs or other COXi and Hymenoptera venom (p = 0.009), presence of baseline flushing (p = 0.02), baseline serum tryptase ≥48 ng/ml (p = 0.005) and multilineage KIT mutation (p = 0.02). In contrast, tolerance to NSAIDs and other COXi was more frequent among males (p = 0.02), in patients with anaphylaxis caused by Hymenoptera venom (p = 0.02), among individuals who had skin lesions due to mastocytosis (p = 0.01), and in cases that had no baseline pruritus (p = 0.006). Based on these parameters, a score model was designed to stratify mastocytosis patients who have never received NSAIDs or other COXi apart from paracetamol, according to their risk of DHR.ConclusionsOur results suggest that despite the frequency of MC mediator related symptoms elicited by NSAIDs and other COXi apart from paracetamol is increased among mastocytosis patients versus the general population, it is lower than previously estimated and associated with unique disease features. Patients that tolerated NSAIDs and other COXi following disease onset should keep using them. In turn, adults with unknown tolerance to such drugs and a positive score should be challenged with a preferential/selective COX‐2 inhibitor, while the remaining may be challenged with ibuprofen.
Revista portuguesa de imunoalergologia, Dec 15, 2022
Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes inter... more Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes internados ao cuidado de outras especialidades. Métodos: Revisão dos pedidos de colaboração realizados ao serviço de IA entre janeiro de 2018 a junho de 2019, através da consulta dos processos clínicos dos doentes, com colheita de dados demográficos, motivo de internamento e do pedido de colaboração, diagnóstico imunoalergológico e orientação. Resultados: Foram identificados 177 pedidos de colaboração correspondentes a 157 internamentos de doentes com idade entre os 7 meses e os 89 anos, 52% dos quais do sexo feminino. Os pedidos mais frequentes resultaram da suspeita de reação de hipersensibilidade a fármacos (83%), seguido de pedidos para apoio na decisão terapêutica e exacerbação de asma. Os 177 pedidos originaram 446 visitas médicas de IA a internamentos (média de 2,6 visitas/ /doente). A suspeita de hipersensibilidade a fármacos foi confirmada em 64% dos casos, com diagnóstico de reações cutâneas graves em 19% e anafilaxia em 6%. A taxa de mortalidade foi de 5,1%, e 46,2% foram posteriormente avalia
Revista portuguesa de imunoalergologia, Sep 29, 2022
Chronic rhinosinusitis with and without nasal polyposis RESUMO A rinossinusite crónica, considera... more Chronic rhinosinusitis with and without nasal polyposis RESUMO A rinossinusite crónica, considerada atualmente um problema de saúde pública, é um grupo heterogéneo de doenças com etiologia multifatorial e caracteriza-se pela presença de sintomas nasossinusais caraterísticos, em associação com evidência clínica ou imagiológica de inflamação. Pode ser subdividida em rinossinusite crónica sem polipose nasal (RSCsPN) e em rinossinusite crónica com polipose nasal (RSCcPN), existindo várias patologias que podem ser consideradas subfenótipos adicionais da rinossinusite crónica. É também importante ter em conta as principais patologias que devem ser consideradas no seu diagnóstico diferencial. O tratamento médico de eleição é dirigido à inflamação nasossinusal, sendo o tratamento cirúrgico necessário nos doentes refratários ao tratamento médico ou com contraindicação à realização do mesmo. Este artigo tem por objetivo rever a informação disponível na literatura sobre a
Revista portuguesa de imunoalergologia, Mar 19, 2020
EV-endovenoso HUMARA-human androgen receptor assay IgE-imunoglobulina E IM-intramuscular LM-leuce... more EV-endovenoso HUMARA-human androgen receptor assay IgE-imunoglobulina E IM-intramuscular LM-leucemia mastocitária MCMP-mastocitoses cutâneas maculopapulares MS-mastocitose sistémica MSA-mastocitose sistémica agressiva MSA-t-mastocitose sistémica agressiva em transformação leucémica MSBD-mastocitose sistémica bem diferenciada MSI-mastocitose sistémica indolente MSNHA-mastocitose sistémica com neoplasia hematológica associada OMS-Organização Mundial de Saúde PO-per os PUVA-psoraleno com UVA REMA-Red Española de Mastocitosis SCF-stem cell factor XCIP-inativação do cromossoma X
Allergic rhinitis and asthma are two of the most common chronic respiratory diseases in developed... more Allergic rhinitis and asthma are two of the most common chronic respiratory diseases in developed countries and have become a major public health concern. Substantial evidence has suggested a strong link between respiratory allergy and upper airway dysbacteriosis, but the role of the oral bacteriota is still poorly understood. Here we used 16S rRNA massive parallel sequencing to characterize the oral bacteriome of 344 individuals with allergic rhinitis (AR), allergic rhinitis with asthma (ARAS), asthma (AS) and healthy controls (CT). Four of the most abundant (>2%) phyla (Actinobacteriota, Firmicutes, Fusobacteriota, and Proteobacteria) and 10 of the dominant genera (Actinomyces,
The Journal of Allergy and Clinical Immunology: In Practice, May 1, 2021
19 infection in patients with mast cell disorders including mastocytosis does not impact mast cel... more 19 infection in patients with mast cell disorders including mastocytosis does not impact mast cell activation symptoms,
Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também... more Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também um papel importante na angiogênese, tolerância imunológica, regulação da fibrinólise, regeneração neuronal e osteoclastogênese. Localizam-se maioritariamente na pele e nas mucosas do intestino e pulmões, onde exercem uma função "sentinela". As síndromes de ativação mastocitária são caracterizadas pela ocorrência de episódios recorrentes de manifestações clínicas resultantes da libertação de mediadores mastocitários. Esta constitui-se como entidade complexa com um espectro de sintomas associados, representando um desafio diagnóstico e terapêutico. Nesta revisão, os autores pretendem apresentar uma visão geral sobre a estrutura e função dos mastócitos e sobre os critérios diagnósticos e abordagem terapêutica da síndrome de ativação mastocitária. Descritores: Mastócitos, mastocitose, síndrome de ativação mastocitária. Mast cells are the main effector cells of acute allergic response, also playing an important role in angiogenesis, immune tolerance, regulation of fibrinolysis, neuronal regeneration, and osteoclastogenesis. They are generally located in the skin and mucous membranes of the intestines and lungs, where they perform a "sentinel" function. Mast cell activation syndrome is characterized by recurrent clinical manifestations resulting from the release of mast cell mediators. This complex entity, which involves a spectrum of associated symptoms, is a diagnostic and therapeutic challenge. In this article we overview of the structure and function of mast cells, in addition to the diagnostic criteria and therapeutic approaches to mast cell activation syndrome.
Current Treatment Options in Allergy, Sep 19, 2023
Mastocytosis is associated with a high risk of anaphylaxis, in part due to drug hypersensitivity ... more Mastocytosis is associated with a high risk of anaphylaxis, in part due to drug hypersensitivity reactions (DHR). Drugs associated with mast cell activation include nonsteroidal anti-inflammatory drugs (NSAIDs), drugs used in the perioperative setting, including general anesthetics, neuromuscular blocking agents (NMBAs) and opiates/opioids, radiocontrast media (RCM), vaccines, and antibiotics such as quinolones and vancomycin. To protect patients against DHR and anaphylaxis, general avoidance of potential drug triggers is common practice, which often deprives patients of important drugs at times of need and limits their options. We aimed to critically review current evidence on the indications to avoid drugs in children and adults with mastocytosis. Recent data shows that general avoidance of drugs with potential mast cell activation action is not indicated in all patients with mastocytosis, but guidelines are lacking. Drugs tolerated before and after the onset of mastocytosis should not be avoided and a personalized approach is recommended to
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também... more Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também um papel importante na angiogênese, tolerância imunológica, regulação da fibrinólise, regeneração neuronal e osteoclastogênese. Localizam-se maioritariamente na pele e nas mucosas do intestino e pulmões, onde exercem uma função "sentinela". As síndromes de ativação mastocitária são caracterizadas pela ocorrência de episódios recorrentes de manifestações clínicas resultantes da libertação de mediadores mastocitários. Esta constitui-se como entidade complexa com um espectro de sintomas associados, representando um desafio diagnóstico e terapêutico. Nesta revisão, os autores pretendem apresentar uma visão geral sobre a estrutura e função dos mastócitos e sobre os critérios diagnósticos e abordagem terapêutica da síndrome de ativação mastocitária. Descritores: Mastócitos, mastocitose, síndrome de ativação mastocitária. Mast cells are the main effector cells of acute allergic response, also playing an important role in angiogenesis, immune tolerance, regulation of fibrinolysis, neuronal regeneration, and osteoclastogenesis. They are generally located in the skin and mucous membranes of the intestines and lungs, where they perform a "sentinel" function. Mast cell activation syndrome is characterized by recurrent clinical manifestations resulting from the release of mast cell mediators. This complex entity, which involves a spectrum of associated symptoms, is a diagnostic and therapeutic challenge. In this article we overview of the structure and function of mast cells, in addition to the diagnostic criteria and therapeutic approaches to mast cell activation syndrome.
Hypersensitivity reactions are an important hazard in healthcare. Modern dentistry depends on the... more Hypersensitivity reactions are an important hazard in healthcare. Modern dentistry depends on the use of drugs and materials widely known to elicit them. Such reactions are either immediate or nonimmediatethe former carries the risk of anaphylaxis, whereas the latter includes potentially fatal severe cutaneous adverse reactions. Apart from well-established immunoglobulin E-mediated immediate hypersensitivity reactions (IHRs), recent advances have shed light on the pathophysiology of other IHRs, suggesting a role for MRGPRX2-induced mast cell activation. Hypersensitivity to both drugs and metals may come as a challenge to dentists, often requiring changing to infrequently used compounds. Local anesthetics are cause for concern, but are a rare cause for IHRs. The opposite occurs with antimicrobials, as antibacterials frequently cause hypersensitivity reactions. Nonsteroidal anti-inflammatory drugs are another common cause, especially in patients suffering from asthma and/or chronic spontaneous urticaria. General anesthetics are a common cause for immediate hypersensitivity, whereas most drugs used for conscious sedation are rare elicitors. Chlorhexidine is a remarkable cause for anaphylaxis, nowadays, despite rare reports linked to rinsed formulations. Preservatives, flavors, and other compounds present in dentifrices cause both irritative and allergic contact dermatitis/mucositis. Metals, notably nickel and cobalt, are a very common cause for hypersensitivity in dentistry. Acrylates may induce contact mucositis, due to lack of proper polymerization of residuals, being an important cause for contact stomatitis and a dentistry occupational hazard. Acute reactions require a prompt treatment, especially in the presence of anaphylaxis, which should be treated using intramuscular epinephrine. Delayed type reactions with fever should be referred to tertiary urgent care facilities. Suspicion of hypersensitivity in dentistry requires a thorough allergological study and referral is mandatory in all cases.
BackgroundExhaled breath condensate (EBC) pH is a promising biomarker of airway inflammation. Lac... more BackgroundExhaled breath condensate (EBC) pH is a promising biomarker of airway inflammation. Lack of method standardization and interstudy variability precludes its use in clinical practice. While endogenous determinants have been described, underlying mechanisms for variability are mostly unknown. Thus, we aimed to assess the association between asthma and EBC pH in children, while studying potential environmental factors for interstudy variability.MethodsA cross‐sectional analysis of exhaled breath condensates from 613 children, aged 7–12 years, was conducted. Assessments included lung function and airway reversibility, exhaled nitric oxide, allergic sensitization, and body mass index (BMI). Indoor air quality (IAQ) was assessed in children's classrooms during 5 school days. Post‐deaeration EBC pH showed a bimodal distribution, and the sample was split into acidic and alkaline groups. Regression models were constructed to assess the effects of asthma and asthma adjusted to IAQ parameters on EBC pH.ResultsFollowing adjustment to gender and BMI, asthma was significantly associated with a lower EBC pH in the acidic group. The effect of asthma on EBC pH was independent of IAQ, in both groups. In the acidic group, EBC pH was significantly affected by temperature [β = −0.09 (−0.15, −0.02)] and PM 2.5 concentration [β = −0.16 (−0.32, −0.01)], and in the alkaline group by relative humidity [β = 0.07 (0.02, 0.13)] and concentration of endotoxins [β = −0.06 (−0.1, −0.01)].ConclusionOur study shows that in addition to individual determinants such as asthma, environmental factors may influence and should be taken into consideration when interpreting EBC pH level in children.
BackgroundNonsteroidal anti‐inflammatory drugs (NSAIDs) are frequently avoided in mastocytosis, b... more BackgroundNonsteroidal anti‐inflammatory drugs (NSAIDs) are frequently avoided in mastocytosis, because of a potential increased risk for drug hypersensitivity reactions (DHRs) due to inhibition of cyclo‐oxygenase (COX), subsequent depletion of prostaglandin E2 and release of leukotrienes.ObjectivesHere, we aimed at determining the prevalence of mast cell (MC) mediator release symptoms triggered by NSAIDs in mastocytosis patients and the associated clinical and laboratory features of the disease.MethodsMedical records from 418 adults to 223 pediatric mastocytosis patients were retrospectively reviewed. Patients were classified according to tolerance patterns to NSAIDs and other COX inhibitors (COXi) and compared for epidemiological, clinical and laboratory findings.ResultsOverall, 87% of adults and 91% of pediatric patients tolerated NSAIDs and other COXi. Among adult and pediatric patients presenting DHRs, 5% and 0% reacted to multiple NSAIDs, 4% and 0.7% were single reactors, and 3% and 8% were single reactors with known tolerance to paracetamol but unknown tolerance to other COXi, respectively. Among adults, hypersensitivity to ≥2 drugs was more frequent among females (p = 0.009), patients with prior history of anaphylaxis to triggers other than NSAIDs or other COXi and Hymenoptera venom (p = 0.009), presence of baseline flushing (p = 0.02), baseline serum tryptase ≥48 ng/ml (p = 0.005) and multilineage KIT mutation (p = 0.02). In contrast, tolerance to NSAIDs and other COXi was more frequent among males (p = 0.02), in patients with anaphylaxis caused by Hymenoptera venom (p = 0.02), among individuals who had skin lesions due to mastocytosis (p = 0.01), and in cases that had no baseline pruritus (p = 0.006). Based on these parameters, a score model was designed to stratify mastocytosis patients who have never received NSAIDs or other COXi apart from paracetamol, according to their risk of DHR.ConclusionsOur results suggest that despite the frequency of MC mediator related symptoms elicited by NSAIDs and other COXi apart from paracetamol is increased among mastocytosis patients versus the general population, it is lower than previously estimated and associated with unique disease features. Patients that tolerated NSAIDs and other COXi following disease onset should keep using them. In turn, adults with unknown tolerance to such drugs and a positive score should be challenged with a preferential/selective COX‐2 inhibitor, while the remaining may be challenged with ibuprofen.
Revista portuguesa de imunoalergologia, Dec 15, 2022
Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes inter... more Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes internados ao cuidado de outras especialidades. Métodos: Revisão dos pedidos de colaboração realizados ao serviço de IA entre janeiro de 2018 a junho de 2019, através da consulta dos processos clínicos dos doentes, com colheita de dados demográficos, motivo de internamento e do pedido de colaboração, diagnóstico imunoalergológico e orientação. Resultados: Foram identificados 177 pedidos de colaboração correspondentes a 157 internamentos de doentes com idade entre os 7 meses e os 89 anos, 52% dos quais do sexo feminino. Os pedidos mais frequentes resultaram da suspeita de reação de hipersensibilidade a fármacos (83%), seguido de pedidos para apoio na decisão terapêutica e exacerbação de asma. Os 177 pedidos originaram 446 visitas médicas de IA a internamentos (média de 2,6 visitas/ /doente). A suspeita de hipersensibilidade a fármacos foi confirmada em 64% dos casos, com diagnóstico de reações cutâneas graves em 19% e anafilaxia em 6%. A taxa de mortalidade foi de 5,1%, e 46,2% foram posteriormente avalia
Revista portuguesa de imunoalergologia, Sep 29, 2022
Chronic rhinosinusitis with and without nasal polyposis RESUMO A rinossinusite crónica, considera... more Chronic rhinosinusitis with and without nasal polyposis RESUMO A rinossinusite crónica, considerada atualmente um problema de saúde pública, é um grupo heterogéneo de doenças com etiologia multifatorial e caracteriza-se pela presença de sintomas nasossinusais caraterísticos, em associação com evidência clínica ou imagiológica de inflamação. Pode ser subdividida em rinossinusite crónica sem polipose nasal (RSCsPN) e em rinossinusite crónica com polipose nasal (RSCcPN), existindo várias patologias que podem ser consideradas subfenótipos adicionais da rinossinusite crónica. É também importante ter em conta as principais patologias que devem ser consideradas no seu diagnóstico diferencial. O tratamento médico de eleição é dirigido à inflamação nasossinusal, sendo o tratamento cirúrgico necessário nos doentes refratários ao tratamento médico ou com contraindicação à realização do mesmo. Este artigo tem por objetivo rever a informação disponível na literatura sobre a
Revista portuguesa de imunoalergologia, Mar 19, 2020
EV-endovenoso HUMARA-human androgen receptor assay IgE-imunoglobulina E IM-intramuscular LM-leuce... more EV-endovenoso HUMARA-human androgen receptor assay IgE-imunoglobulina E IM-intramuscular LM-leucemia mastocitária MCMP-mastocitoses cutâneas maculopapulares MS-mastocitose sistémica MSA-mastocitose sistémica agressiva MSA-t-mastocitose sistémica agressiva em transformação leucémica MSBD-mastocitose sistémica bem diferenciada MSI-mastocitose sistémica indolente MSNHA-mastocitose sistémica com neoplasia hematológica associada OMS-Organização Mundial de Saúde PO-per os PUVA-psoraleno com UVA REMA-Red Española de Mastocitosis SCF-stem cell factor XCIP-inativação do cromossoma X
Allergic rhinitis and asthma are two of the most common chronic respiratory diseases in developed... more Allergic rhinitis and asthma are two of the most common chronic respiratory diseases in developed countries and have become a major public health concern. Substantial evidence has suggested a strong link between respiratory allergy and upper airway dysbacteriosis, but the role of the oral bacteriota is still poorly understood. Here we used 16S rRNA massive parallel sequencing to characterize the oral bacteriome of 344 individuals with allergic rhinitis (AR), allergic rhinitis with asthma (ARAS), asthma (AS) and healthy controls (CT). Four of the most abundant (>2%) phyla (Actinobacteriota, Firmicutes, Fusobacteriota, and Proteobacteria) and 10 of the dominant genera (Actinomyces,
The Journal of Allergy and Clinical Immunology: In Practice, May 1, 2021
19 infection in patients with mast cell disorders including mastocytosis does not impact mast cel... more 19 infection in patients with mast cell disorders including mastocytosis does not impact mast cell activation symptoms,
Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também... more Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também um papel importante na angiogênese, tolerância imunológica, regulação da fibrinólise, regeneração neuronal e osteoclastogênese. Localizam-se maioritariamente na pele e nas mucosas do intestino e pulmões, onde exercem uma função "sentinela". As síndromes de ativação mastocitária são caracterizadas pela ocorrência de episódios recorrentes de manifestações clínicas resultantes da libertação de mediadores mastocitários. Esta constitui-se como entidade complexa com um espectro de sintomas associados, representando um desafio diagnóstico e terapêutico. Nesta revisão, os autores pretendem apresentar uma visão geral sobre a estrutura e função dos mastócitos e sobre os critérios diagnósticos e abordagem terapêutica da síndrome de ativação mastocitária. Descritores: Mastócitos, mastocitose, síndrome de ativação mastocitária. Mast cells are the main effector cells of acute allergic response, also playing an important role in angiogenesis, immune tolerance, regulation of fibrinolysis, neuronal regeneration, and osteoclastogenesis. They are generally located in the skin and mucous membranes of the intestines and lungs, where they perform a "sentinel" function. Mast cell activation syndrome is characterized by recurrent clinical manifestations resulting from the release of mast cell mediators. This complex entity, which involves a spectrum of associated symptoms, is a diagnostic and therapeutic challenge. In this article we overview of the structure and function of mast cells, in addition to the diagnostic criteria and therapeutic approaches to mast cell activation syndrome.
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