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ISSN 1405-1699 (Print)
Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2008, Number 1

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Alerg Asma Inmunol Pediatr 2008; 17 (1)

Inmunodeficiencias primarias y alergia

Méndez IJ, Bellanti JA, Ovilla MR

Language: Spanish
References: 32
Page: 14-34
PDF size: 937.43 Kb.


ABSTRACT

Most of the physicians that deal with patients with recurrent infections will have to elucidate the diagnosis among an allergic disease, immunodeficiency or the combination. Patients with primary enferimmunodeficiency (PID) and allergic disease will present recurrent infections symptoms. There are reports of the humoral immunodeficiency and atopy association. The atopy has been report in a 15-20% of the children population and may produce a chronic inflammation of the respiratory mucosa, being an important factor that triggers the recurrent infections. It has been demonstrated that a good control of the allergic symptoms decreases the frequency of the bacterial infections, but this is not the case, when the patient has immunodeficiency, so it is necessary to treat the allergic disease simultaneously.
The PID can be abnormalities such as the lack of maturation, function or growth or the immune cells system. Patients with PID, have higher risk of infections, allergies, autoimmune and neoplasic problems. The cytometry has contributed to the more complete classification in the molecular and genetic defects of the PID, with a report of more than 100 PIDs, with an increasing number of those. There are necessary elements to establish the exact diagnostics of the PIDS, such as a good clinical history, to think in the clinical possibility of an immunodeficiency and a specialized laboratory.
This article is oriented to the most recent advances in the molecular aspects of the immunodeficiencies where we analyze, the signaling defects, growth factors, development of the T lymphocytes (BL) and B lymphocytes (BL) and its surviving deficiencies in the T and B cells interaction, such as those in the two genes CD40L and CD40, the costimulators molecules ICOS y ICOS-L.
Defects of the phagocytic cells function such as the neutrophil defects, severe congenital neutropenia, leucocytes adhesion deficiency type I, LAD II deficiency, LAD II deficiency, gene CYBB link to X, deffects in the IFN-gamma receptors or its signaling transduction or the signaling transduction components (Stat1).
Complement system, and the genetic defect such as those in the genes RAG1 and RAG2 in BL and TL, Artemis and DNA IV ligase genes, RFX5, RFXAP, RFXANK, CIITA, ADA and PNP deficiency, dysregulation of the immune system with the protein immunodeficiency’s involved in the granules exocytosis, SAP deficiency, Lyst deficiency, such as the complement system defects and the immune system basis in the correlations with the clinical application. Also we describe the clinical specific laboratory tests, therapeutic indications and treatment of the patients with PIDs and allergic disease combination.


REFERENCES

  1. Primary immunodeficiency diseases. Report of a WHO scientific group. Clin Exp Immunol 1997; 109(Suppl 1): 1-28.

  2. Woroniecka M, Ballow M. Office evaluation of children with recurrent infection. Pediatr Clin North Am 2000; 47: 1211-1224.

  3. Paul ME, Shearer WT. The child who has recurrent infection. Immunol Allergy Clin North Am 1999; 19: 423-436.

  4. Ten RM. Primary immunodeficiencies. Mayo Clin Proc 1998; 73: 865-872.

  5. Cooper MA, Pommering TL, Koranyi K. Primary immunodeficiencies. Am Fam Physician 2003; 68: 2001-2008.

  6. Clark JA, Callicoat PA, Brenner NA, Bradley CA, Smith DM Jr. Selective IgA deficiency in blood donors. Am J Clin Pathol 1983; 80: 210-213.

  7. Buckley RH. Primary cellular immunodeficiencies. J Allergy Clin Immunol 2002; 109: 747-757.

  8. Segal BH, Holland SM. Primary phagocytic disorders of childhood. Pediatr Clin North Am 2000; 47: 1311-1338.

  9. Winkelstein JA, Marino MC, Johnston RB Jr, Boyle J, Curnutte J, Gallin JI et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine [Baltimore] 2000; 79: 155-169.

  10. Sorensen RU, Moore C. Antibody deficiency syndromes. Pediatr Clin North Am 2000; 47: 1225-1252.

  11. Ballow M. Primary immunodeficiency disorders: antibody deficiency. J Allergy Clin Immunol 2002; 109: 581-591.

  12. Conley ME, Notarangelo LD, Etzioni A. Diagnostic criteria for primary immunodeficiencies. Representing PAGID (Pan- American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Clin Immunol 1999; 93: 190-197.

  13. Gaspar HB, Kinnon C. X-linked agammaglobulinemia. Immunol Allergy Clin North Am 2001; 21: 23-43.

  14. Frank MM. Complement deficiencies. Pediatr Clin North Am 2000; 47: 1339-1354.

  15. Muller SM, Ege M, Pottharst A, Schulz AS, Schwarz K, Friedrich W. Transplacentally acquired maternal T lymphocytes in severe combined immunodeficiency: a study of 121 patients. Blood 2001; 98: 1847-1851.

  16. Montoya CJ, Henao J, Salgado H et al. Phenotypic diagnosis of primary immunodeficiencies in Antioquia, Colombia, 1994-2002. Biomedica 2002; 22(4): 510-518.

  17. Buckley RH. Primary cellular immunodeficiencies. J Allergy Clin Immunol 2002; 109(5): 747-757.

  18. Staple L, Andrews T, McDonald-McGinn D, Zackai E, Sullivan KE. Allergies in patients with chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome) and patients with chronic granulomatous disease. Pediatr Allergy Immunol 2005; 16(3): 226-230.

  19. Rodríguez MR, Gasca BMR. Humoral immunodeficiencies in asthmatic children with recurrence rhinopharyngitis. Rev Alerg Mex 2000; 47(6): 204-206.

  20. de José Gómez MI, González de Dios J, Hernando de Larramendi C, Jimenez GA, Vidal LML, García HJ. [IgG2 deficiency associated with recurrent pneumonia and asthma (review of an IgG subclass)]. An Esp Pediatr 1990; 33(3): 258-264.

  21. Martin MMA. Humoral immunodeficiencies and allergic diseases]. An Esp Pediatr 1985; 23(7): 475-478.

  22. Botta E. The role of IgA in allergic disease]. Boll Ist Sieroter Milan 1982; 61(3): 185-201.

  23. Illoh OC. Current applications of flow cytometry in the diagnosis of primary immunodeficiency diseases. Archives of Pathology & Laboratory Medicine 2004; 128: 23-31.

  24. Verbsky JW, Grossman WJ. Cellular and genetic basis of primary immune deficiencies. Pediatric Clinics of North America 2006; 53(4): 203-215.

  25. Schwartz SA. Intravenous immunoglobulin treatment of immunodeficiency disorders. Pediatr Clin North Am 2000; 47: 1355-1369.

  26. Busse PJ, Razvi S, Cunningham-Rundles C. Efficacy of intravenous immunoglobulin in the prevention of pneumonia in patients with common variable immunodeficiency. J Allergy Clin Immunol 2002; 109: 1001-1004.

  27. Sacher RA, IVIG Advisory Panel. Intravenous immunoglobulin consensus statement. J Allergy Clin Immunol 2001; 108(4 Suppl): S139-146.

  28. Bonilla FA, Geha RS. Update on primary immunodeficiency diseases. J Allergy Clin Immunol 2006; 117(2 Suppl): S435-41.

  29. Notarangelo L, Casanova JL, Conley MH et al. Primary immunodeficiency diseases: An update from the International Union of Immunological Societies Primary Immunodeficiency Diseases Classification Committee Meeting in Budapest, 2005. J All Clin Immunol 2006; 117(4): 883-896.

  30. Bonilla FA, Bernstein IL, Khan DA et al. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma Immunol 2005; 94: 1-63.

  31. Gardulf A, Nicolay U, Math D et al. Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home. J Allergy Clin Immunol 2004; 114: 936-942.

  32. Berger M. Subcutaneous immunoglobulin replacement in primary immunodeficiencies. Clin Immunol 2004; 112: 1-7.




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