Reacciones alérgicas: aspectos claves y nuevas perspectivas

Authors

  • D Duque Restrepo Facultad de Medicina; Universidad Pontificia Bolivariana, Medellín - Colombia

Keywords:

Alérgeno, ambiente, atopia, genética, reacción alérgica

Abstract

Las reacciones alérgicas son una respuesta inmune exacerbada a un alérgeno en un individuo atópico. En éstas, influyen dos factores el genético y el ambiental. Con base en lo anterior, la Organización Mundial de Alergia determinó como enfermedades alérgicas al asma, rinitis, sinusitis, conjuntivitis, anafilaxia, alergia a medicamentos, alimentos, animales, insectos y hongos, eczema, urticaria y angioedema; las cuales han aumentado en el último tiempo, convirtiéndose en un problema de salud pública con repercusiones económicas exorbitantes. Asimismo, se han dado avances tanto en el diagnóstico, cuyos pilares siguen siendo la historia clínica, la medición de inmunoglobulina E específica y pruebas cutáneas; el tratamiento y las bases genéticas, que cada vez son más relevantes en el manejo clínico de estas entidades.

 

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Author Biography

D Duque Restrepo, Facultad de Medicina; Universidad Pontificia Bolivariana, Medellín - Colombia

 

References

Cardona R, Rojas W. Capítulo 33. Mecanismos básicos de las alergias. En: Rojas W, Anaya JM, Cano LE, Gómez LM, Lopera D. 16 eds. Inmunología de Rojas. Medellin, Antioquia: CIB; 2012.

Lockett GA, Patil VK, Soto-Ramírez N, Ziyab AH, Holloway JW, Karmaus W. Epigenomics and allergic disease. Epigenomics. 2013 Dec;5(6):685-99.

Lodge CJ, Allen KJ, Lowe AJ, Dharmage SC. Overview of evidence in prevention and aetiology of food allergy: a review of systematic reviews. Int J Environ Res Public Health. 2013 Nov 4;10(11):5781-806.

Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: A meta-analysis. J. Allergy Clin. Immunol. 2007, 120, 638–646.

Rowe BH, Gaeta TJ. Chapter 27. Anaphylaxis, Acute Allergic Reactions, and Angioedema. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011. http://accessmedicine.mhmedical.com/content.aspx?bookid=348&Sectionid=40381488. Accessed January 20, 2015.

Pawankar R, Canonica GW, Holgate ST, Lockey RF. WAO White Book on Allergy 2011-2012: Executive Summary. 1 ed. Milwaukee: WAO; 2011.

Friedman NR, Scholes MA, Yoon PJ. Ear, Nose, & Throat. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds. CURRENT Diagnosis & Treatment: Pediatrics, 22e. New York, NY: McGraw-Hill; 2013. http://accessmedicine.mhmedical.com/content.aspx?bookid=1016&Sectionid=61597764. Accessed January 18, 2015.

Boyce A, Austen K. Allergies, Anaphylaxis, and Systemic Mastocytosis. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e. New York, NY: McGraw-Hill; 2015. http://accessmedicine.mhmedical.com/content.aspx?bookid=1130&Sectionid=79749806. Accessed July 03, 2015. Accessed January 29, 2015.

Braverman R. Eye. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds.CURRENT Diagnosis & Treatment: Pediatrics, 22e. New York, NY: McGraw-Hill; 2013. http://accessmedicine.mhmedical.com/content.aspx?bookid=1016&Sectionid=61596695. Accessed January 18, 2015.

Valeyrie-Allanore LL, Roujeau J. Chapter 40. Epidermal Necrolysis (Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis). In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. eds. Fitzpatrick's Dermatology in General Medicine, 8e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=392&Sectionid=41138737. Accessed January 19, 2015.

Sukasem C, Puangpetch A, Medhasi S, Tassaneeyakul W. Pharmacogenomics of drug-induced hypersensitivity reactions: challenges, opportunities and clinical implementation. Asian Pac J Allergy Immunol. 2014 Jun;32(2):111-23.

Shinkai K, Roujeau J, Stern RS, Wintroub BU. Chapter 55. Cutaneous Drug Reactions. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=331&Sectionid=40726780. Accessed January 19, 2015.

Pavlos R, Mallal S, Phillips E. HLA and pharmacogenetics of drug hypersensitivity. Pharmacogenomics. 2012 Aug;13(11):1285-306.

Lawley LP, McCall CO, Lawley TJ. Chapter 52. Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=331&Sectionid=40726777. Accessed January 18, 2015.

Hess MR, Hess SP. Chapter 249. Skin Disorders Common on the Trunk. In:Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds.Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011.http://accessmedicine.mhmedical.com/content.aspx?bookid=348&Sectionid=40381736. Accessed January 18, 2015.

Kaplan AP. Chapter 38. Urticaria and Angioedema. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. eds. Fitzpatrick's Dermatology in General Medicine, 8e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=392&Sectionid=41138735. Accessed January 18, 2015.

Austen K. Chapter 317. Allergies, Anaphylaxis, and Systemic Mastocytosis. In:Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=331&Sectionid=40727118. Accessed January 18, 2015.

Disease. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=331&Sectionid=40726778. Accessed January 18, 2015.

Sampson HA, Munoz-Furlong A, Campbell RL, et al: Second symposium on the definition of anaphylaxis: a summary report—Second National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network Symposium. J Allergy Clin Immunol 117: 391, 2006.

Lewis LM. Angioedema: etiology, pathophysiology, current and emerging therapies. J Emerg Med. 2013 Nov;45(5):789-96.

Cianferoni A, Spergel JM. Food allergy: review, classification and diagnosis. Allergol Int. 2009 Dec;58(4):457-66.

Bonadonna P, Lombardo C, Zanotti R. Mastocytosis and allergic diseases. J Investig Allergol Clin Immunol. 2014;24(5):288-97.

Global Iniciative for Asthma. Global Strategy for Asthma Management and Prevention 2014. Available from: www.ginaasthma.org. Accessed December 10, 2014.

Laemmle-Ruff I, O'Hehir R, Ackland M, Tang ML. Anaphylaxis - identification, management and prevention. Aust Fam Physician. 2013 Jan-Feb;42(1-2):38-42.

Siracusa A, Folletti I, Gerth van Wijk R, Jeebhay MF, Moscato G, Quirce S, Raulf M, Ru€eff F, Walusiak-Skorupa J, Whitaker P, Tarlo SM. Occupational anaphylaxis – an EAACI task force consensus statement. Allergy 2015; 70: 141–152.

Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013 Oct 23;310(16):1721-9.

Arnold JJ, Williams PM. Anaphylaxis: recognition and management. Am Fam Physician. 2011 Nov 15;84(10):1111-8.

Simons FE, Ardusso LR, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, Sanchez-Borges M, Senna GE, Sheikh A, Thong BY, Worm M; World Allergy Organization. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol. 2013; 162(3):193-204.

Muraro A, Roberts G, Worm M, Bil_o MB, Brockow K, Fern_andez Rivas M et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy 2014;69:1026–1045.

Worm M, Babina M, Hompes S. Causes and risk factors for anaphylaxis. J Dtsch Dermatol Ges. 2013 Jan;11(1):44-50.

Worm M, Edenharter G, Ruëff F, Scherer K, Pfohler C, Mahler V, Treudler R, Lang R, Nemat K, Köhli A, Niggemann B, Hompes S. Symptom profile and risk factors of anaphylaxis in central Europe. Allergy 2012; 67: 691–8.

Calvani M, Cardinale F, Martelli A, Muraro A, Pucci N, Savino F, Zappala D, Panetta V. Risk factors for severe pediatric food anaphylaxis in Italy. Pediatr Allergy Immunol 2011; 22: 813–9.

Iribarren C, Tolstykh IV, Miller MK, Eisner MD. Asthma and the prospective risk of anaphylactic shock and other allergy diagnoses in a large integrated health care delivery system. Ann Allergy Asthma Immunol 2010; 104: 371–7.

Brockow K, Ring J. Update on diagnosis and treatment of mastocytosis. Curr Allergy Asthma Rep 2011; 11: 292–9.

Levinson W. Hypersensitivity (Allergy). In: Levinson W. eds. Review of Medical Microbiology and Immunology, 13e. New York, NY: McGraw-Hill; 2014. http://accessmedicine.mhmedical.com/content.aspx?bookid=1023&Sectionid=57053512. Accessed January 25, 2015.

Greidinger EL. Chapter 15. The Immune System. In: Janson LW, Tischler ME. eds. The Big Picture: Medical Biochemistry. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=397&Sectionid=39898622. Accessed January 11, 2015.

Manning KD, Winawer NH, Murali MR. Chapter 237. Allergy and Anaphylaxis. In: McKean SC, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. eds. Principles and Practice of Hospital Medicine. New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/content.aspx?bookid=496&Sectionid=41304230. Accessed January 29, 2015.

Kondo Y, Urisu A. Oral allergy syndrome. Allergol Int. 2009 Dec;58(4):485-91.

Imamura T, Kanagawa Y, Ebisawa M. A survey of patients with self-reported severe food allergies in Japan. Pediatr Allergy Immunol 2008;19:270-4.

Burks AW, Jones SM, Boyce JA, Sicherer SH, Wood RA, Assa'ad A, Sampson HA. NIAID-sponsored 2010 guidelines for managing food allergy: applications in the pediatric population. Pediatrics. 2011 Nov;128(5):955-65.

Wang J, Sampson HA. Food allergy. J Clin Invest. 2011 Mar;121(3):827-35.

Kivity S. Adult-onset food allergy. Isr Med Assoc J. 2012 Jan;14(1):70-2.

Cheng E, Souza RF, Spechler SJ. Tissue remodeling in eosinophilic esophagitis. Am J Physiol Gastrointest Liver Physiol. 2012 Dec 1;303(11):G1175-87.

Hong S, Vogel NM. Food allergy and eosinophilic esophagitis: learning what to avoid. Cleve Clin J Med. 2010 Jan;77(1):51-9.

Criado PR, Avancini J, Santi CG, Medrado AT, Rodrigues CE, de Carvalho JF.Drug reaction with eosinophilia and systemic symptoms (DRESS): a complex interaction of drugs, viruses and the immune system. Isr Med Assoc J. 2012 Sep;14(9):577-82.

Sicherer SH, Wood RA; American Academy of Pediatrics Section On Allergy And Immunology. Allergy testing in childhood: using allergen-specific IgE tests. Pediatrics. 2012 Jan;129(1):193-7.

Siles RI, Hsieh FH. Allergy blood testing: A practical guide for clinicians. Cleve Clin J Med. 2011 Sep;78(9):585-92.

Michalska-Krzanowska G. Tryptase in diagnosing adverse suspected anaphylactic reaction. Adv Clin Exp Med. 2012 May-Jun;21(3):403-8.

Kroigaard M, Garvey LH, Gillberg L, Johansson SG: Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia. Acta Anaesthesiol Scand 2007, 51, 655–670.

Harboe T, Guttormsen AB, Dybendal T: Anaphylaxis during anesthesia in Norway. Anesthesiology 2005, 102, 897–903.

Dellon ES. Diagnosis and management of eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2012 Oct;10(10):1066-78.

Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, Burks AW, Chehade M, Collins MH, Dellon ES, Dohil R, Falk GW, Gonsalves N, Gupta SK, Katzka DA, Lucendo AJ, Markowitz JE, Noel RJ, Odze RD, Putnam PE, Richter JE, Romero Y, Ruchelli E, Sampson HA, Schoepfer A, Shaheen NJ, Sicherer SH, Spechler S, Spergel JM, Straumann A, Wershil BK, Rothenberg ME, Aceves SS. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011 Jul;128(1):3-20.e6; quiz 21-2.

Dellon ES, Gonsalves N, Hirano I, Furuta GT, Liacouras CA, Katzka DA; American College of Gastroenterology. ACG clinical guideline: Evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol. 2013 May;108(5):679-92; quiz 693.

Lockett GA, Holloway JW. Genome-wide association studies in asthma; perhaps, the end of the beginning. Curr Opin Allergy Clin Immunol. 2013; 13(5):463–469.

Bønnelykke K, Matheson MC, Pers TH, et al. Meta-analysis of genome-wide association studies identifies ten loci influencing allergic sensitization. Nat Genet. 2013; 45(8):902–906.

Lee SH, Park JS, Park CS. The search for genetic variants and epigenetics related to asthma. Allergy Asthma Immunol Res. 2011; 3(4):236–244.

Manolio TA, Collins FS, Cox NJ, et al. Finding the missing heritability of complex diseases. Nature. 2009; 461(7265):747–753.

Phillips EJ, Mallal SA. Pharmacogenetics of drug hypersensitivity. Pharmacogenomics. 2010 Jul;11(7):973-87.

Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005;5:309–316.

Chung WH, Hung SI, Hong HS, et al. Medical genetics: a marker for Stevens–Johnson syndrome. Nature 2004;428:486.

Moffatt MF, Gut IG, Demenais F et al. A large-scale, consortium-based genomewide association study of asthma. N Engl J Med 2010;363:1211-21.

Li X, Howard TD, Zheng SL et al. Genome-wide association study of asthma identifies RAD50-IL13 and HLA-DR DQ regions. J Allergy Clin Immunol 2010;125:328-35.

Hunninghake GM, Lasky-Su J, Soto-Quirós ME et al. Sexstratified linkage analysis identifies a specific locus for IgE to cockroach in Costa Ricans. Am J Respir Crit Care Med 2008;177:830-6.

Tamari M, Tanaka S, Hirota T. Genome-wide association studies of allergic diseases. Allergol Int. 2013 Mar;62(1):21-8.

Esparza-Gordillo J, Weidinger S, Fölster-Holst R et al. A common variant on chromosome 11q13 is associated with atopic dermatitis. Nat Genet 2009;41:596-601.

Paternoster L, Standl M, Chen CM et al. Meta-analysis of genome-wide association studies identifies three new risk loci for atopic dermatitis. Nat Genet 2011;44:187-92.

Ramasamy A, Curjuric I, Coin LJ et al. A genome-wide meta-analysis of genetic variants associated with allergic rhinitis and grass sensitization and their interaction with birth order. J Allergy Clin Immunol 2011;128:996-1005.

Rothenberg ME, Spergel JM, Sherrill JD et al. Common variants at 5q22 associate with pediatric eosinophilic esophagitis. Nat Genet 2010;42:289-91.

Saag M, Balu R, Phillips E, Brachman P, Martorell C, Burman W, et al. High sensitivity of human leukocyte antigen-b*5701 as a marker for immunologically confirmed abacavir hypersensitivity in white and black patients. Clin Infect Dis. 2008;46:1111-8.

Jung JW, Song WJ, Kim YS, Joo KW, Lee KW, Kim SH, et al. HLA-B58 can help the clinical decision on starting allopurinol in patients with chronic renal insufficiency. Nephrol Dial Transplant. 2011 Nov;26:3567-72.

Amstutz U, Ross C, Castro-Pastrana L, Rieder M, Shear N, Hayden M, et al. HLA-A*31:01 and HLA-B*15:02 as genetic markers for carbamazepine hypersensitivity in children. Clin Pharmacol Ther. 2013;94:142-9.

Kim S-H, Lee KW, Song W-J, Kim S-H, Jee Y-K, Lee S-M, et al. Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans. Epilepsy Res. 2011;97:190-7.

Kaniwa N, Saito Y, Aihara M, Matsunaga K, Tohkin M, Kurose K. HLA-B*1511 is a risk factor for carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Japanese patients. Epilepsia. 2010;51:2461–5.

McCormack M, Alfirevic A, Bourgeois S, Farrell JJ, Kasperaviciute D, Carrington M, et al. HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans. N Engl J Med. 2011;364:1134–43.

Chantarangsu S, Mushiroda T, Mahasirimongkol S, Kiertiburanakul S, Sungkanuparph S, Manosuthi W, et al. HLA-B*3505 allele is a strong predictor for nevirapine-induced skin adverse drug reactions in HIV-infected Thai patients. Pharmacogenet Genomics 2009;19:139-46.

A, Boyce J Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM; NIAID-Sponsored Expert Panel. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report. J Allergy Clin Immunol. 2010 Dec;126(6):1105-18.

Saadeh D, Salameh P, Baldi I, Raherison C. Diet and allergic diseases among population aged 0 to 18 years: myth or reality? Nutrients. 2013 Aug 29;5(9):3399-423.

Muche-Borowski C, Kopp M, Reese I, Sitter H, Werfel T, Schäfer T. Allergy prevention. Dtsch Arztebl Int. 2009 Sep;106(39):625-31.

Syed A, Kohli A, Nadeau KC. Food allergy diagnosis and therapy: where are we now? Immunotherapy. 2013 Sep;5(9):931-44.

Gupta RS, Springston EE, Warrier MR, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011;128(1):e9–e17.

Bidad K, Nicknam MH, Farid R. A review of allergy and allergen specific immunotherapy. Iran J Allergy Asthma Immunol. 2011 Mar;10(1):1-9.

Larché M, Akdis CA, Valenta R. Immunological mechanisms of allergen-specific immunotherapy. Nat Rev Immunol 2006; 6(10):761-71.

Norman G, Faria R, Paton F, Llewellyn A, Fox D, Palmer S, Clifton I, Paton J, Woolacott N, McKenna C. Omalizumab for the treatment of severe persistent allergic asthma: a systematic review and economic evaluation. Health Technol Assess. 2013 Nov;17(52):1-342.

Published

2022-03-03

How to Cite

Duque Restrepo, D. (2022). Reacciones alérgicas: aspectos claves y nuevas perspectivas. Anales of the Faculty of Medical Sciences, 48(1), 69–82. Retrieved from https://revistascientificas.una.py/index.php/RP/article/view/2031

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Review Articles