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Biomedical subjects

M Fernández Rivas

Publications and source records attributed to M Fernández Rivas.

6 recordsLinked to original sources
PubMed2005

Retrospective study of tolerance to short initiation schedules in subcutaneous immunotherapy.

With the aim of evaluating tolerance to new shorter initiation schedules in subcutaneous immunotherapy everyday clinical practice, a study was carried out using Pangramin Plus with initiation periods between 3 (Cluster) and 6 (Plus) weeks. All the information was processed retrospectively and both systemic (SR) and local (LR) adverse reactions occurring between September 2002 and February 2003 were recorded. A total of 353 patients (261 Plus and 91 Cluster) were included and 2,886 doses were administered (2,166 in initiation and 720 in maintenance). Of these, 800 were with Grass mix extract, 1,141 Grass mix + Olea, 273 Olea, 73 Dermatophagoides mix and 599 Dermatophagoides pteronyssinus. As regards adverse reactions (AR), 2.8% of patients showed SR and 4.8% LR, 1.2% of doses caused some type of reaction (SR and LR in 0.3% and 0.9%, respectively). The initiation schedule, first dose or allergens resulted in no significant differences in the frequency of adverse reactions. The Grass mix extract showed the highest frequency of AR. Sixty-seven percent of SR and 68% of LR were delayed. 64% of these reactions resolved spontaneously while the rest responded favourably to treatment. Adrenaline was administered on one occasion for immediate asthma. There were no cases of anaphylactic shock, hospitalisation or life-threatening situations. Pangramin Plus tolerance, therefore, can be classified as good, similar to conventional schedules, but with the benefits of shorter initiation schedules.

Allergens↗
PubMed1990

Stinging insect allergy: sensitization to vespids in Madrid and surroundings. Cross-reactivity study.

The study comprised 28 patients from the centre of Spain (Madrid and surroundings) who had suffered systemic reactions when stung by vespids. Specific IgE antibodies to Vespula spp. and Polistes spp. venoms were measured by RAST. All patients had positive RAST to Vespula venom and half of them also had positive RAST to Polistes venom. A patient can be sensitive to both venoms due to either a clinical sensitization to both venoms, or common antigenic determinants. To differentiate these states we used a RAST inhibition assay. We could inhibit Polistes RAST with either Polistes or Vespula venom to a similar degree. Inhibition of Vespula RAST was possible with Vespula venom, but only to a limited degree with Polistes venom. Direct RAST and RAST inhibition studies indicate that in our geographic region sensitization to Vespula venom is more common than to Polistes venom and Polistes might have cross-reactivity in our patients.

Adolescent↗
PubMedDate not supplied

[Cross-reactivity between fruit and vegetables].

Vegetable foods are the most frequent cause of food allergy after the age of 5 years. The most commonly implicated foods are fruit and dried fruits, followed in Spain by legumes and fresh garden produce. In patients allergic to fruit and garden produce, multiple sensitizations to other vegetable products, whether from the same family or taxonomically unrelated, are frequent, although they do not always share the same clinical expression. Furthermore, more than 75 % of these patients are allergic to pollen, the type of pollen varying in relation to the aerobiology of the area. The basis of these associations among vegetable foods and with pollens lies in the existence of IgE antibodies against "panallergens", which determines cross-reactivity. Panallergens are proteins that are spread throughout the vegetable kingdom and are implicated in important biological functions (generally defense) and consequently their sequences and structures are highly conserved. The three best-known groups are allergens homologous to Bet v 1, profilins, and lipid transfer proteins (LTP). Allergens homologous to Bet v 1 (major birch pollen allergen) constitute a group of defense proteins (PR-10), with a molecular weight of 17 kDa, which behave as major allergens in patients from northern and central Europe with allergy to vegetables associated with birch pollen allergy. In these patients, the primary sensitization seems to be produced through the inhalation route on exposure to birch pollen. The symptomatology characteristically associated with sensitization to this family of allergens is oral allergy syndrome (OAS). Profilins are highly conserved proteins in all eukaryotic organisms and are present in pollen and a wide variety of vegetable foods. They have a molecular weight of 14 kDa and present a high degree of structural homology as well as marked cross-reactivity among one another. The presence of anti-profilin IgE broadens the spectrum of sensitizations to vegetable foods detected through skin tests and/or in vitro tests but whether it correlates with the clinical expression of food allergy is unclear.LTPs are the most commonly implicated allergens in allergy to Rosaceae fruits in patients from the Mediterranean area without birch pollen sensitization. LTPs are a family of 9kDA polypeptides, widely found in the vegetable kingdom and implicated in cuticle formation and defense against pathogens (PR-14). They are thermostable and resistant to pepsin digestion, which makes them potent food allergens and explains the frequent development of systemic symptoms (urticaria, anaphylaxis) in patients allergic to Rosaceae fruits in Spain. LTPs have also been identified in other vegetable foods and in pollens and a marked degree of cross-reactivity among them has been demonstrated, which may explain (together with profilin) the frequency of individuals sensitized to vegetable foods in the Mediterranean area.

Allergens↗
PubMedDate not supplied

Effect of nifedipine on skin prick tests.

The immediate skin test due to interaction between allergen and mast cell bound IgE is one of the cornerstones in the clinical allergy workup. The release of histamine and other mediators from basophils and mast cells depends on the influx of Ca2+ into these cells when stimulated. The aim of this study was to evaluate the effect of common therapeutic doses of nifedipine (NFD), one of the calcium channel blockers, on the allergen skin tests. We prick tested 23 grass sensitive individuals with 7 different grass pollens at three times: at basal conditions (T0), 30 min. after having taken 20 mg of NFD s. l. (T1), and 17 of them after a week of receiving twice a day 20 mg of a NFD retard form (T2). The wheal surface obtained for each substance (allergen, histamine) at T0 was considered as basal value and compared with the one obtained at T1 and T2 for the same substance by the Wilcoxon's test. We found a significant increase in the wheal surfaces, both with allergen and histamine, at T1 and T2. In contrast to what could be expected, common therapeutic doses of NFD produce a discrete but statistically significant increase of the PT. Factors such as arteriolar vasodilation could be implicated. The increase of the allergen prick test and the increase of the histamine prick test both at T1 and T2 were not statistically different. Therefore, we do not think it necessary to stop NFD before allergen skin testing.

Adolescent↗