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Biomedical subjects

J C García-Robaina

Publications and source records attributed to J C García-Robaina.

9 recordsLinked to original sources
PubMed2004

Olerance of a cluster schedule with a house dust mite extract quantified in mass units: multicentre study.

The standardisation of allergenic extracts in micrograms of the major allergen has encouraged the search for new treatment schedules, with the purpose of shortening the number of visits and doses required to reach the maintenance dose without eliciting a greater risk of adverse reactions for the patients. With this objective, a prospective multicentre pharmacovigilance study was designed that included 200 patient with allergic rhinoconjunctivitis and/or allergic asthma sensitised to mites (Dermatophagoides pteronyssinu and/or farinae). The dose increment period was carried out using a cluster schedule, where the optimal dose wa reached after 4 visits, administering two doses in each visit. The duration of the study was 5 months and a total o 1902 doses were administered. At the end of the trial, 31 adverse reactions in 23 patients were recorded. Six of these were systemic (0.3% of t administered doses) recorded in 6 patients (3% of the sample). One was an immediate reaction (grade 1) and delayed (4 mild and 1 moderate). Two were asthmatic exacerbations, 2 cutaneous reactions, 1 rhinitis and 1 an unspecific symptom (not IgE-mediated). Two appeared upon administration of the first vial and the remaining 4 after administration of the third cluster. Therefore, the schedule tested presents an adequate tolerance profile, suggesting savings (compared to th conventional schedule of 13 doses per patient) of 1800 visits and 1000 treatment doses in the whole study.

Adolescent↗
PubMed1997

Sensitization to Blomia kulagini in a general population of a subtropical region of Spain (Canary Islands).

The Blomia genus has been described as allergenic in man. The present study aimed to assess the prevalence of B. kulagini sensitization in a large population of allergic subjects without occupational exposure in a subtropical region (Canary Islands, Spain). Secondarily, a new standardized B. kulagini extract was evaluated. The study population comprised 207 patients. RAST for B. kulagini was positive in 76.2% of patients, and 47 of them were selected for the biologic standardization. When the prick test was performed with the nonstandardized extracts, results were positive in 76.6%, whereas when the test was repeated with the standardized extract, sensitivity rose to 95.7%. The conjunctival provocation test was positive in 78.3% of 46 evaluated patients. The bronchial provocation test was positive in 18 sensitized patients and negative in five controls. In conclusion, B. kulagini is an important cause of sensitization among the occupationally unexposed population of the studied area and should be included in allergy diagnostic tests. For reliable prick tests, the use of standardized extracts is mandatory.

Adolescent↗
PubMed1997

The natural history of Apis-specific IgG and IgG4 in beekeepers.

BACKGROUND: Most published studies on changes of specific IgG or its subclasses as a response to stimuli by allergens have been performed on patients under immunotherapy. There are few reports analysing the response to immunoglobulins in patients exposed to allergens in their natural habitats. OBJECTIVE: The aim of this work was to discover the natural history of Apis specific IgG (IgG-ap) and IgG4 (IgG4-ap) levels in beekeepers from the Canary Islands. METHODS: We studied 242 beekeepers (Bks). We used a questionnaire and measured total IgE and seric Apis specific IgE (IgE-ap), IgG-ap and IgG4-ap against Apis mellifera venom. RESULTS: All Bks had IgG-ap and IgG4-ap. IgE-ap was positive in 160 Bks (65.6%), but only 92 (37.6%) Bks were considered sensitized. IgG-ap and IgG4-ap showed significant correlation (r = 0.84); IgE did not correlate with IgG-ap or IgG4-ap. There was no seasonal variation in IgG-ap or IgG4-ap. The group of sensitized Bks had significantly lower IgG-ap and IgG4-ap levels (P < 0.05). The groups with longer beekeeping activity showed significantly higher levels of IgG-ap and IgG4-ap (P < 0.001). Bks with locals reactions had significantly higher IgG-ap and IgG4-ap than Bks who reported systemic reactions (P < 0.05). CONCLUSION: Our study showed that IgG-ap and IgG4-ap appear to increase in Bks, either according to their beekeeping experience or in subjects with local reactions after bee stings.

Adult↗
PubMedDate not supplied

A prospective and multicenter safety-monitoring study of a short up-dosing schedule of immunotherapy with a mass-units-standardized extract of mites.

A prospective, multicenter pharmacovigilance study was carried out to evaluate the safety of a new 7-dose treatment schedule of subcutaneous immunotherapy as opposed to the conventional 13 doses normally recommended. The study was carried out in 14 centers and included 261 patients (children and adults) with respiratory allergic disease due to sensitization to mites (Dermatophagoides pteronyssinus and/or farinae). A total of 2290 doses were administered under the direct supervision of the participating specialists. One hundred and ten reactions in 63 patients (24.1%) were recorded, representing 4.8% of the total doses administered. Most of the reactions (98) were local. Only 12 were systemic (0.5% of the administered doses) and occurred in 10 patients (3.8% of the sample). Ten reactions reverted quickly with rescue medication. The maintenance dose had to be lowered in one patient and another patient was withdrawn from the study after suffering two asthmatic crises after two consecutive doses. In view of the results obtained, we can conclude that the new schedule shows an acceptable tolerance profile and does not present a greater risk of reactions than the conventional scheme of 13 doses using an identical extract. Moreover, the new schedule represents substantial savings in the number of doses and visits required to reach the maintenance dose.

Adult↗
PubMedDate not supplied

Epidemiology of allergic reactions in beekeepers: a lower prevalence in subjects with more than 5 years exposure.

Beekeepers (Bks) represent a high allergic risk population against Hymenoptera because of their frequent exposure to bee stings. Most published studies show different percentage of sensitization and systemic reactions with to another groups of population. With the aim to know the prevalence and type of allergic reaction in Bks from the Canary Islands, 246 subjects were studied prospectively. A questionnaire was developed and skin test and specific IgE determination against Apis mellifera, Vespula and Polistes venom were performed. One hundred and twenty eight subjects had presented at least one reaction greater than merely local. In 83.5% of these subjects subsequent stings caused reactions of lesser intensity. Specific IgE in serum for Apis mellifera was positive in 126 BKs, for Vespula in 27 and for Polistes in 9. We found that the group of BKs sensitized to Apis was significantly higher among atopics BKs (p < 0.001) and with fewest years of working experience in beekeeping (p = 0.0134). This study showed that sensitization to Hymenoptera is higher in beekeepers with less than 5 years working experience and who are sensitized to another allergens.

Adult↗
PubMedDate not supplied

Extracts from various mite species contain cross-reactive and noncross-reactive IgE epitopes. A RAST inhibition study.

Previous studies have demonstrated the high incidence of Dermatophagoides, Euroglyphus, Blomia, Lepidoglyphus and Chortoglyphus spp. sensitizations in a mite-allergic population. The aim of this study was to evaluate immunological cross-reactivity among the above mentioned groups, using sera from a nonrural population allergic to mites, from a subtropical area (Canary Islands). RAST inhibition studies demonstrated significant cross-reactivity among Dermatophagoides and Euroglyphus species (> or = 65% of maximum theoretical inhibition), as also noted by other authors. Blomia kulagini demonstrated scarce cross-reactivity with Dermatophagoides, Lepidoglyphus and Chortoglyphus species (< or = 30% of maximum theoretical inhibition) and medium level with Euroglyphus maynei (45% of maximum theoretical inhibition). Chortoglyphus arquatus demonstrated high cross-reactivity levels with the other species studied. The results obtained in this study demonstrated the scarce immunological cross-reactivity between Pyroglyphidae and non-Pyroglyphidae mites, thus suggesting the polysensitization of the studied population to different mite species.

Adolescent↗