OBJECTIVES: The aim of this cross-sectional study was to evaluate whether interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms were associated with persistent IgE-mediated cow's milk allergy in 50 Brazilian children. The diagnostic criteria were anaphylaxis triggered by cow's milk or a positive double-blind, placebo-controlled food challenge. Tolerance was defined as the absence of a clinical response to a double-blind, placebo-controlled food challenge or cow's milk exposure. METHOD: The genomic DNA of the 50 patients and 224 healthy controls (HCs) was used to investigate five IL10 gene polymorphisms (-3575A/T, -2849A/G, -2763A/C, -1082G/A, -592C/A) and one TGFβ1 polymorphism (-509C/T). RESULTS: Among the five IL10 polymorphisms analyzed, homozygosis for the G allele at the -1082 position was significantly higher in the patients compared with the healthy controls (p = 0.027) and in the persistent cow's milk allergy group compared with the healthy controls (p = 0.001). CONCLUSIONS: Homozygosis for the G allele at the IL10 -1082G/A polymorphism is associated with the persistent form of cow's milk allergy.

OBJETIVO: Descrever os dados epidemiológicos, clínicos e os fatores associados ao controle da asma em pacientes asmáticos seguidos em um ambulatório pediátrico especializado. MÉTODOS: Estudo transversal de pacientes asmáticos ambulatoriais, para os quais eram fornecidas medicações profiláticas. A classificação da asma, as etapa de tratamento e a avaliação do controle seguiram a IV Diretrizes Brasileiras para o Manejo da Asma, de 2006. Os fatores avaliados foram: outras alergias, obesidade, imunodeficiências, refluxo gastresofágico e sensibilização alérgica, sendo comparados pacientes com asma controlada ou não com relação à etapa do tratamento, à obesidade e à sensibilização alérgica. RESULTADOS: Foram analisados 300 pacientes com asma (1,38M:1F), com mediana de idade de 10,8 anos, e de início dos sintomas de 1,0 ano. A atopia estava presente em 78% dos pais e/ou irmãos. Antecedentes pessoais de doenças alérgicas ocorreram em 292 pacientes (96% rinite, 27% dermatite atópica, 18% conjuntivite alérgica, 6% alergia alimentar). Foram diagnosticados sete casos de deficiência de IgA (DIgA) e quatro de IgG2; obesidade em 37/253 (15%), sendo que sobrepeso e obesidade estiveram associados à falta de controle (p=0,023). Em 118 pacientes com multissensibilização, predominaram casos não controlados (22 (19%) casos; p=0,049; OR 1,9; IC95% 1,03-3,50). Entre os 180 casos (60%) em tratamento nas etapas 3 e 4, 122 (45%) estavam controlados e 112 (41%) parcialmente controlados. CONCLUSÕES: A rinite foi a alergia mais associada à asma e a prevalência de DIgA foi 20 vezes maior do que na população geral. O controle parcial ou total dos sintomas da asma foi obtido em 85% dos casos. Obesidade/sobrepeso e multissensibilização foram associadas à falta de controle da asma.

OBJECTIVE: To describe the epidemiological and clinical data and factors associated with asthma control of asthmatic patients followed at a pediatric reference center. METHODS: Cross-sectional study including asthmatic outpatients receiving prophylactic medications from the institution. For classification of asthma, steps of treatment and control evaluation, the IV Brazilian Guidelines for the Management of Asthma (2006) were adopted. The presence of other allergies, obesity, immunodeficiency, gastroesophageal reflux and allergic sensitization were evaluated and compared between patients with or without asthma control according to the treatment step, obesity and allergic sensitization. RESULTS: 300 patients with asthma (1.38M:1F) were included; median age=10.8 years; median age at onset of symptoms=1.0 year. Among parents and/or siblings, 78% reported atopy. Personal history showed other allergic diseases in 292 patients (96% rhinitis, 27% atopic dermatitis, 18% allergic conjunctivitis, 6% food allergy). IgA deficiency was diagnosed in seven cases and IgG2 deficiency in four. Obesity was noted in 34/233 patients (15%) and overweight/obesity were associated with asthma poor control (p<0.023). Among 118 patients multisensitizated, the frequency of poor asthma control was greater (22 (19%) cases; p=0.049, OR 1.9; 95%CI 1.03-3.50). Among the patients, 180 (60%) were treated according steps 3 and 4; 122 children (45%) were considered controlled and 112 (41%) were partially controlled. CONCLUSIONS: Allergic rhinitis was the allergic disease more associated with asthma. The prevalence of IgA deficiency was 20 times higher than in the general population. Total or partial control of asthma symptoms was obtained in 85% of the cases. Overweight/obesity and multisensitization were associated to poor asthma control.

OBJETIVO: Describir los datos epidemiológicos, clínicos y los factores asociados al control del asma en pacientes asmáticos seguidos en ambulatorio pediátrico especializado. MÉTODOS: Estudio transversal de pacientes asmáticos ambulatoriales, para los que se suministraban medicaciones profilácticas gratuitamente. La clasificación del asma, las etapas de tratamiento y la evaluación del control siguieron las IV Directrices Brasileñas para el Manejo del Asma, 2006. Los factores evaluados fueron: otras alergias, obesidad, inmunodeficiencias, reflujo gastroesofágico y sensibilización alérgica, siendo comparados pacientes controlados o no respecto a la etapa del tratamiento, obesidad y la sensibilización alérgica. RESULTADOS: Se analizaron a 300 pacientes con asma (1,38M:1F); mediana de edad de 10,8 años, mediana del inicio de los síntomas de 1,0 año. La atopía estaba presente en el 77,8% de los padres y/o hermanos. Antecedentes personales de enfermedades alérgicas ocurrieron en 292 pacientes (95,6% rinitis, 27% dermatitis atópica, 18,3% conjuntivitis alérgica, 6% alergia alimentar). Se diagnosticaron 7 casos de deficiencia de IgA (2,3% de DIgA) y 4 de IgG2; obesidad en 37/253 (14,6%), siendo que el sobrepeso y la obesidad estuvieron asociados a la falta de control (p=0,023). En 118 pacientes con multisensibilización predominaron casos no controlados (18,6% frente a 9,8%) (p=0,049; OR 1,9; IC95% 1,03-3,50). Entre los 180 casos (60,2%) en tratamiento en las etapas 3 y 4, 122 estaban controlados (45,0%) y 112 (41,3%), parcialmente controlados. CONCLUSIONES: La rinitis fue la alergia más asociada al asma y la prevalencia de DIgA fue 20 veces superior a la población general. El control parcial o total de los síntomas del asma se obtuvo en el 86,3% de los casos. Obesidad/sobrepeso y multisensibilización fueron asociadas a la falta de control del asma.