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Biomedical subjects

C K Naspitz

Publications and source records attributed to C K Naspitz.

120 records · Page 7Linked to original sources
PubMedDate not supplied

Cutaneous sensitivity to six mite species in asthmatic patients from five Latin American countries.

The prevalence of positive skin prick tests to the mite species Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis, Chortoglyphus arcuatus, Lepidoglyphus destructor and Aleuroglyphus ovatus was determined in 297 asthmatic adults and children living in seven cities of five Latin American countries. A standardized protocol and a common battery of extracts were used at each site. The mean wheal diameters were measured after 15 min, and those > or = 3 mm were considered positive. Sensitization to D. pteronyssinus varied from 60.7% in Cartagena to 91.2% in São Paulo; to D. farinae from 53.3% in Córdoba to 97.2% in Caracas; to A. ovatus from 26.6% in Bogotá to 71.2% in São Paulo; to B. tropicalis from 46.5% in Mexico City to 93.7% in São Paulo; to C. arcuatus from 33.3% in Mexico City to 75% in São Paulo; and to L. destructor from 30% in Mexico City to 76.2% in São Paulo. This study reported the results of skin test sensitivities in both children and adults. The studies from São Paulo and Córdoba were confined to children and thus could be compared; there was a significantly higher prevalence of cutaneous sensitivity to mite allergens in the children of São Paulo than in those of Córdoba (p < 0.001 for all mite species). Cutaneous sensitivity to mite allergens is very common in young and adult asthmatics in Latin America, in areas both at sea level and at high altitudes. Environmental control measures should be reinforced in the treatment of asthmatics in Latin America.

Adolescent↗
PubMedDate not supplied

Interleukin-4 and soluble CD23 serum levels in asthmatic atopic children.

IL-4 is an essential mediator of IgE synthesis; it also upregulates the expression of the low affinity receptor for IgE (CD23) and its release in soluble form (sCD23). The involvement of IL-4 and sCD23 on the IgE synthesis control has been observed in experimental studies. IL-4 and sCD23 serum levels in asthmatic atopic children were determined in order to investigate a possible correlation between these factors and IgE levels. IL-4, total sCD23 and Dermatophagoides pteronyssinus specific IgE were determined in the serum of 19 asthmatic atopic children (aged 7 to 14) and in 13 age-matched controls. Since sCD23 may present an age-dependent variation, sCD23 and IL-4 serum levels were evaluated in 20 "wheezy babies." IL-4 serum levels were significantly higher in patients as compared to controls, whereas there was no significant difference between them concerning sCD23 levels. sCD23 levels were, however, significantly higher among "wheezy babies" as compared to atopic and nonatopic children. There was no correlation between IL-4 and sCD23 serum levels, nor between any of these factors and IgE levels in all groups. In conclusion, the enhanced IL-4 levels suggest that atopic patients have a preferential activation of Th2 subset. CD23 expression is markedly influenced by age.

Adolescent↗
PubMedDate not supplied

Comparative performance for immediate hypersensitivity skin testing using two skin prick test devices.

Fifty-five patients were skin-tested by Multi-Test (M) and needle prick test (NPT) to compare the reproducibility of the methods. We used 6 allergenic extracts: Dermatophagoides pteronyssinus, Dermatophagoides farinae, dog epithelium, cat pelt, American cockroach and mixed molds. A glycerosaline and a positive control (histamine 1 mg/ml) were performed in both methods. Statistically significant differences in histamine and Dermatophagoides farinae wheal reactions between the two methods (M > NPT) were found, with no differences with the other allergenic extracts. We concluded that the two methods are similar with respect to determining the immediate hypersensitivity, but the Multi-Test is better accepted by children.

Adolescent↗
PubMedDate not supplied

Non-specific nasal provocation in children with chronic allergic rhinitis.

Twenty-three children with chronic allergic rhinitis (Group A) and eleven normal non-atopic subjects (group C) were submitted to non-specific nasal provocation tests with histamine (0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0 and 4.0 mg/ml), and one week later with methacholine (0.025; 0.1; 0.25, 0.5; 1.0; 2.5; 5.0 and 10.0 mg/ml). Measurements of total nasal resistance were performed by active anterior rhinomanometry (Berger, S.A.) and symptoms were recorded. Challenges were carried out in the morning with all children in an acclimatized room (25 degrees C/77 degrees F). Concentrations of the tested drugs were increasingly instilled, and after 5 min were followed by total nasal resistance, FEV, and FVC measurements. Considering as positive those tests in which total nasal resistance had a 100% increase, we observed that both histamine and methacholine caused an increase in total nasal resistance as instilled drug concentration rose; histamine provocations were significantly more positive among group A than group C patients (91% sensitivity, 80.8% positive predictive value). This was not observed with methacholine (55% sensitivity, 75% positive predictive value). In neither provocation was there correlation between the concentration that induced a positive response and symptoms. There were no changes in spirometric values during the tests. Nasal provocations with histamine and methacholine are safe and well tolerated. Histamine seems to be more adequate for differentiating children with allergic rhinitis from normal controls.

Adolescent↗
PubMedDate not supplied

Methotrexate in the treatment of corticodependent asthmatic children.

Methotrexate has been used as an anti-inflammatory agent in chronic asthma. We evaluated the action of methotrexate in eight corticodependent severely asthmatic children (more than 10 mg of prednisone per day for at least one year). The patients (3 males and 5 females; aged 8 to 14 years) received a single weekly dose of 0.6 mg/kg methotrexate (maximum 25 mg) and folic acid (15 mg/day for 5 days in the week). The children were examined and had their pulmonary function test evaluated weekly. As the study progressed, the dose of prednisone was reduced and maintained till the next evaluation if the patient's symptoms were under control. After the 3rd month of treatment, we observed a significant reduction in the dose of prednisone and maintenance of the spirometric parameters. At the end of the trial, in 4 patients it was possible to reduce the basal prednisone dose 56% or more. In the remaining 4, one did not show any benefit and in the other 3, it was possible to obtain an average reduction of 40% of the basal prednisone dose. The total mean reduction was 55.9%. This oral corticoid reduction was not associated with clinical or pulmonary function deterioration, except in one patient. The patients were submitted to white blood cell count, hepatic transaminases, urine tests and other determinations at least once a month. There were no changes in biochemical tests. The side-effects were nausea, vomiting and abdominal pain. In conclusion, methotrexate given to severely corticodependent asthmatic children permitted a reduction in the daily intake of prednisone, reducing the severe side-effects of chronic corticotherapy.

Adolescent↗
PubMedDate not supplied

Lysine-vasopressin in the evaluation of the hypothalamic-pituitary-adrenal axis in children with allergic rhinitis treated with intranasal beclomethasone dipropionate or oral prednisone.

One of the complications of steroid therapy is the hypothalamic-pituitary-adrenal (HPA) axis' suppression, particularly in children where this can lead to growth suppression and other well known complications. Although there are a large number of studies on suppression of the HPA axis with the use of topical steroids, the subject is still controversial. We measured the HPA axis function in 3 groups of allergic children treated with: 1) intranasal beclomethasone dipropionate (BDP) 400 micrograms/day for 4 weeks or 2) BDP 800 micrograms/day for 4 weeks and 3) oral prednisone, 1 mg/kg/day for 2 weeks. The HPA response was obtained after lysine-vasopressin (LVP) stimulation. LVP acts on the pituitary or hypothalamus level, stimulating the whole axis. Peripheral blood samples through an intravenous line were obtained for serum cortisol measurement at zero, 30, 60, and 90 minutes after the intravenous injection of LVP, before and after the treatment period. Our results showed no suppression of the HPA axis in children medicated with BDP at either 400 micrograms/day or 800 micrograms/day. On the other hand, there was a suppression of the HPA axis after prednisone treatment (p < 0.05). During the LVP test some side effects, possibly due to systemic vasoconstriction, were noted such as abdominal pain, nausea and vomiting, and transient hypertension. In conclusion, intranasal BDP at the dose of 400 or 800 micrograms/day during 4 weeks did not induce HPA axis suppression. The LVP test is efficient to demonstrate HPA hypofunction or suppression and it produced only mild to moderate transient side effects. However, due to the side effects observed, a safer test such as urinary free cortisol (24 hours), should be used in the investigation of the HPA axis.

Administration, Intranasal↗
PubMedDate not supplied

Specific sensitization to Dermatophagoides pteronyssinus and cutaneous reactivity to histamine in Brazilian children.

The immediate hypersensitivity cutaneous test is a recognized method for etiologic diagnosis of allergic diseases. It is easily conducted, painless and can be quickly interpreted, making it deal for use with children. However, its low positivity in infants limits its use this population. The purpose of our study was to evaluate the skin reactivity to atopic and non-atopic children of different ages to increasing concentrations of histamine and to an extract of Dermatophagoides pteronyssinus (Dpt). Atopic children (A, n = 217) and non-atopic children (C, n = 198), under 15 years of age were grouped by age and administered skin prick tests. Increasing concentrations of histamine (1, 9, 81 and 243 mg/ml) and Dpt (10,000 AU/ml) were applied to the forearm. Skin reactions were recorded after 15 minutes and expressed as the mean of the largest wheal and its midpoint perpendicular diameter. Cutaneous reactions were observed in the early phases of life with a progressive increase observed in both groups. Significant differences were noted between the two groups starting at 48 months of life. As the concentration of histamine was increased, we observed a higher level of cutaneous reactivity in younger children. Comparative analysis of cutaneous reactivity to the histamine solution (1 mg/ml) and the Dpt extract showed parallelism between them and wheals with diameters larger than 3 mm after 12 months of age. We concluded that the skin prick test with Dpt is reliable in atopic children after 1 year of age. Reactivity to higher concentrations of histamine was observed after 3 months of age for all children. However, considering all age groups, the skin reactivity in atopic children to histamine (1 mg/ml) was more precocious when compared to controls.

Adolescent↗
PubMedDate not supplied

Bronchoprovocation with methacholine in children under two years old: a follow-up study.

Fifty-one wheezing babies (WB) under two years of age and 20 controls (C) within the same age range were submitted to a bronchial provocation test (BPT) with methacholine. The appearance of wheezing on pulmonary auscultation was used to determine PCW (provocative concentration of methacholine causing wheezing). For all tests, methacholine diluted in saline at increasing concentrations (0.025, 0.125, 0.25, 0.5, 1.0, 2.5, 5.0 and 10.0 mg/ml) was delivered with O2 (5 ml/min) via a face mask. Solution was inhaled through the mouth and nose during two minutes of quiet tidal breathing via a nebulizer containing a 2 ml volume. No collateral effects were observed, except for tachypnea and tachycardia. There was a statistically significant difference between the PCW for WB (2.3 mg/ml) and the PCW for C (9.2 mg/ml). A 5 mg/ml concentration of methacholine provides the clearest distinction between the WB and C groups. Indeed, we observed that 96% of WB and 25% of C demonstrated PCW below this concentration. In the WB group, those with mild symptoms had higher PCW values. When the BPT was repeated in 27 WB at an 8-month interval, statistically significant differences between the two PCV values were observed. The highest PCW values were evidenced in the second BPT. The use of BPT with methacholine could establish PCW as a parameter of bronchial hyperreactivity in infants.

Administration, Inhalation↗
PubMedDate not supplied

IgE antibodies to aeroallergens in allergic children in São Paulo, Brazil.

The sensitization to inhaled allergens was studied in 80 Brazilian children and 12 controls, aged 6 to 16 years. We performed skin tests with Alternaria alternata, cat, dog, Lolium perenne, grasses and the following domestic mites: Blomia tropicalis, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Lepidoglyphus destructor, Chortoglyphus arcutus and Aleuroglyphus ovatus. The frequencies of positive skin tests (mean diameter > or = 23 mm) were respectively 15%, 11%, 11%, 6%, 7%, 95%, 92%, 88%, 76%, 75% and 71%. The mean diameter of the wheal to domestic mites was higher to D. pteronyssinus than to B. tropicalis, L. destructor, A. ovatus and C. arcuatus (p < 0.05). The skin test results to domestic mites by regression analysis revealed highly significant correlation (p < 0.0001), suggesting considerable cross-reactivity between them. Specific IgE to each mite was determined and the results expressed as the mean of the percentage of total counts bound (% TCB). We had the highest levels of % TCB to D. farinae, followed by D. pteronyssinus, E. maynei, B. tropicalis, C. arcuatus, L. destructor and A. ovatus. The Brazilian children with asthma had more positive skin tests to domestic mites than to other inhalant allergens, and based on previous studies performed in São Paulo that have shown D. pteronyssinus and B. tropicalis as the most prevalent mite species in house dust, we assumed that IgE Ab to D. farinae reflects cross-reactivity with D. pteronyssinus in most cases. The observed high levels of IgE Ab to domestic mites stress the importance of environmental avoidance measures, decreasing the rate of sensitization or perhaps the development of symptoms of asthma in genetically predisposed children.

Adolescent↗