11^th International Conference on Allergy, Asthma & Clinical Immunology September 07-08, 2017 Edinburgh, Scotland

Biography:

Benjamin Wong completed his MD at University of Toronto, Canada. He subsequently completed Post-graduate training in Internal Medicine and Subspecialist training in Allergy and Clinical Immunology. He is a Consultant at North York General Hospital. For more than 10 years, he has been the Chair of the Section of Allergy and Clinical Immunology of the Ontario Medical Association. He has been the Chair and Co-chair of the Allergy Update, an annual symposium in Ontario where international researchers gather and participate in furthering the field of allergy and clinical immunology. At a national level, he serves as a member of the Board of Examiners of the Royal College of Physicians and Surgeons of Canada.

Abstract:

Allergy and clinical immunology is an exciting and ever changing field, providing allergists and clinical immunologists increasing and unique opportunities to work with multiple medical subspecialties and interdisciplinary personnel. Beta-lactam allergy has been a major focus in the field of drug allergy in part due to its ubiquitous use, implications for health care resource utilization, and increased awareness of antimicrobial stewardship. This presentation highlights work done at a community academic teaching hospital affiliated with the University of Toronto, Canada, over the past few years. Practical cases and management of penicillin allergy, opportunities for interdisciplinary collaborations with medical subspecialists and pharmacists, development of a practical clinical pathway with decision algorithms, patient history refinement on electronic medical records, as well as point-of-care management guide for non-allergists will be discussed. Research opportunities including utilization of point of care beta-lactam allergy skin testing (BLAST) and the standardized use of state of the art electronic order sets for oral challenges and desensitization will also be highlighted. 

Biography:

Luiz Werber-Bandeira is the Head of Clinical and Experimental Immunology Unit - Santa Casa de Misericórdia do Rio de Janeiro, Brazil. He has a degree in Medicine; completed his Post-doctorate in Immuno-Genetics and; PhD in Medicine-Immunology-Dermatology at Federal University of Rio de Janeiro. He is also specialized in Clinical Immunology-Allergy at Federal University of Rio de Janeiro. He is reorganizer of the clinical and experimental immunology unit - Santa Casa da Misericórdia, Rio de Janeiro. 

Abstract:

Primary cutaneous T cell lymphomas (CTCLs) are characterized by hyper proliferation of malignant CD4+ T cells with primary localization on the skin. The common characteristics are the migration of the malignant mature T-lymphocytes into the epidermis, with hyper proliferation of malignant CD4+ T cells and epidermotropism. Sézary syndrome (SS) is the leukemic variant. It was established that CTCLs arise from a clonal expansion of CD4+ T cells with an identical rearrangement of the T cell receptor. The purpose of this study was to evaluate the immunomodulation effect of photo chemotherapy-A [psoralen plus ultraviolet A (PUVA)]. Pre- and post-PUVA punch skin biopsies of nine patients were stained immunohistochemically for CD34+, CD8+, CD7+, CD16+, CD56+, CD1a+, Bcl2+, p53+, CD45RA+, and CD45RO+ cells. The results showed a pre-PUVA cells/mm² without significant difference among expansive or reactive cells. Post-PUVA analysis showed a significant decrease in the mean of expansive-reactive cells. PUVA was immunomodulated decreasing cellular infiltrate. These findings could contribute to the comprehension of how PUVA acts. We achieved ectoscopic clearance of the lesions, although post-PUVA, there still was a mononuclear pathological infiltrate. This result demonstrates that the PUVA treatment should only be withheld when the histological analysis is normal.

Biography:

Gennaro Maietta graduated from Faculty of Medicine of the University of Florence in 1981 and he received Post-graduate degree in Clinical Immunology and Allergology at School of Immunology of Prof. Ricci in 1984. During his Postgraduate course, he focused his interests in “Thyroid autoimmunity and in thyroid stimulating antibodies detection on FTRL5 cells”. He became the Head of Allergy Unit of Public Health department in City of Lecce (Italy) and the Head of the Laboratory of Immunology of Pignatelli Institute in the same city. He is interested in Basophils and their role in allergic disease. He is member of EAACI and of AAIITO (Italian Allergy and Immunology Society) and, he is the coordinator of the regional section of AAIITO in Apulia. 

Abstract:

Statement of the Problem: Specific immunotherapy (SIT) is able to modify the natural history of allergic diseases. In particular, SIT induces an immunological tolerance against the allergen and clinical control of disease. Clinical efficacy of subcutaneously SIT (SCIT) has been clearly demonstrated as well as sublingual SIT (SLIT), but we need to identify biological markers for SIT in the attempt to reveal patients with high risk of adverse reactions, to monitor the therapy outcome and to predict relapses after SIT discontinuation. We know that both SCIT and SLIT induce a sudden increase of the basophil sensitivity in the first weeks of immunotherapy followed by a gradual decrease over some months. The purpose of this study is to evaluate if Basophil Activation Test (BAT) can monitor the progressive desensitization of the patient during SIT.

Methodology: Patients between 18 and 60 years old allergic to wall pellitory or grass were enrolled in the study. Some of them were treated with SCIT, while others preferred to be treated with SLIT. BAT was performed at the beginning of the treatment and during pollen season for two years. BAT was performed with specific allergen at different concentrations in attempt to evaluate basophil activation as CD-sens (allergen concentration able to induce 50% of maximum activation). SIT outcome was evaluated clinically by using a VAS score.

Findings: BAT showed a higher and earlier reduction of CD-sens in patients treated with SCIT compared with SLIT treated ones. In some patients, it was not possible to observe a reduction in CD-sens. These patients had experienced persistence or worsening of clinical symptoms.

Conclusion & Significance: BAT should represent a useful tool in evaluating progressive desensitization during SIT by monitoring basophil sensitivity. CD-sens could be an interesting biomarker in deciding how long the SIT continues and when to suspend it. Probably, it could represent a biomarker in predicting clinical relapses after immunotherapy discontinuation.

Biography:

Sarah Van Nederveen-Bendien is working as a Pulmonologist in a teaching hospital in Hague, Netherlands. Her main interests include Asthma and Allergy. In 2014, she started a specialized asthma and pregnancy outpatient clinic. This resulted in a large cohort of pregnant patients with asthma. In the Netherlands, the treatment of asthma during pregnancy is still sub-optimally organized, mainly because of fear for teratogenic effects of asthma medication during pregnancy patients and doctors regularly stop or decrease medication.

Abstract:

Background: The diagnosis of asthma can be difficult to confirm. Recently, a study of Aaron et al in the JAMA showed that about 33% of adults with a physician diagnosis of asthma did not have asthma when assessed by a stepwise diagnostic algorithm. Dyspnoe during pregnancy can be a result of variable causes. In patients presenting with dyspnea during pregnancy, it is not always possible to confirm the diagnosis of asthma. Mainly because, in case of normal spirometry, performing bronchial provocation testing (BPT) during pregnancy is contra indicated.

Methods: This retrospective cohort consists of all pregnant women referred to the Asthma & Pregnancy outpatient clinic (Haga Teaching Hospital, Netherlands) from 2014 until 2017. At first consultation spirometric testing with reversibility, fractional exhaled nitric oxide (FeNO) measurement, asthma control questionnaire (ACQ), blood eosinophils and allergy testing were performed.

Results: 95 pregnant women were referred at a mean gestational age of 18 weeks. At first consultation mean ACQ was 2.1. In 63% of patients, the diagnosis of asthma was confirmed by spirometry and reversibility testing or bronchial provocation testing in combination with typical asthma symptoms, before or during the first consultation. In 37% of patients, the diagnosis of asthma could not be confirmed by spirometry or BPT; although their FeNO and blood eosinophils were lower as compared to the group with the diagnosis of asthma confirmed (table 1). In four patients, an alternative diagnosis was made OSAS (n=1), mycoplasma infection (n=2), sickle cell disease (n=1).

Conclusion: Since diagnosing asthma has the consequence of treating patients for a long time with medication with potential side effects, it is of importance to make maximum efforts to confirm or exclude asthma during or ideally before pregnancy. In case of normal spirometry, blood eosinophils and FeNO in combination with typical asthma symptoms could add important information when considering the diagnosis of asthma.

Biography:

Carlos Sanchez Salguero is the coordinator of the Allergy Pediatrics Section in Puerto Real University Hospital and Associate Professor of Pediatrics at the Medicine School in Cádiz (Spain). Specialist in Pediatrics since 1998. During the years 1999-2000 served as Director of Pediatrics Department in the Regional Hospital of Montilla (Córdoba). Then returns to the province of Cadiz where he was Director of the Pediatrics Department in the Regional Hospital of Villamartin. Since 2008 he moved to Puerto Real University Hospital where he was appointed Coordinator of the Allergy Pediatrics Section. Actually, his principal field of working is the Specific Oral Tolerance Induction with milk, egg and hake. He has published papers in relevant journals in the field of Pediatric Allergy. He has worked as an author in 4 books and chapters. He has authored several publications indexed in PubMed in national and international journals of prestige and more than 100 communications to national and international congresses of prestige.

Abstract:

In recent decades we have been assisting the identification, isolation and purification of a large number of allergens of different origins and, on the other hand, the application of recombinant DNA technology to the field of Pediatric Allergology for the biotechnological production of allergens with high purity and consistent quality from batch to batch, so that the use of purified allergens, natural or recombinant, is a real advance in clinical allergy.

The combination of these advances in molecular biology with those produced in nanotechnology has allowed the development of new technologies, among them the so-called microarrays. The protein microarray allows the detection of specific IgE against multiple molecules simultaneously, enabling the so-called molecular diagnosis or component diagnosis (CRD), which has a special interest in the diagnosis of food allergy as well as in the precision diagnosis of polysensitized patients.

The CRD will allow us to identify the individual patterns of sensitization to different proteins from the same allergenic source, with the possibility of identifying:

1.      Sensitization to proteins associated with an increased risk of serious reactions, such as lipid transfer proteins (LTP).

2.      Sensitization to homologous proteins in different allergenic sources with possible involvement in cross reactivity phenomena.

3.      Indicate a precise immunotherapy.

CONCLUSIONS

The microarray technology constitutes an important advance in the diagnosis of allergy, it allows us to establish an accurate molecular diagnosis, to know the patterns of sensitization that a patient presents with the own differences according to the geographical area to which it belongs and to detect sensitization to molecules responsible for cross reactivity syndromes. A clear indication of this tool is in the study of the patient polysensitized and in the precise indication of an immunotherapy.

Biography:

Giovanni Maria Traina completed his Graduation in Medicine and Surgery at University of Messina. He is Specialist in Pediatrics and Allergology Pediatrics at University of Messina, Perugia and Pavia. He is an author of over 25 scientific publications, speaker at over 50 national and international conferences.

Abstract:

Background: Pediatric sublingual immunotherapy (SLIT) has made it possible to attract many children allergic to desensitization path to inhalants. SLIT determines many compliance problems and sometimes it is difficult to fulfill. The alternative of SLIT is subcutaneous immunotherapy (SCIT), which is commonly performed subcutaneously with needle. This technique has not undergone special changes over the years and it is not without risk or inconvenience. This led to the search for alternative means of administering the vaccine, in order to reduce the discomfort for the child, expanding compliance and increase safety for medical vaccinators and especially reducing the potential risk of adverse reaction.

Aim: Aim of this study is to evaluate new route of administration subcutaneous immunotherapy hyposensitizing with device without needle, pain perceived by the patient registration with respect to that traditionally administered by needle, of any adverse events in the course of that procedure and also evaluate difficulties perceived by vaccinating with such methodical.

Materials & Methods: Our team together with that of Allergology Hospital Bambino Gesù in Rome has completed a first study, aimed precisely to assess the pain perceived by the patient and safety for the patient and for the operator, with interesting results. For this purpose, 36 patients were recruited and evaluated with oculorhinitis and/or bronchial asthma grass, aged between 5 and 18 years, which were administered under the skin of the arms, polymerized with glutaraldehyde extracted by grasses, with device without needle and with traditional SCIT with needle. They were recorded with dedicated VAS scale, the perceived pain, any adverse reactions and difficulty of the procedure by the vaccinator.

Results: All patients completed the study which provided 432 doses of AIT SCIT grasses, of which 216 with device without the needle. The perceived pain was significantly lower than that of immunotherapy administered by needle. In none of them, are adverse events of any grade occurred. It has highlighted the need for adequate training of the performer to better use the device without the needle. Changes made to the device have however solved these problems completely.

Conclusions: Vaccination with needleless device has several advantages and guarantees, compared to conventional administration SCIT, best welcome especially by children. This is important, to be able to start early immunotherapy, as recommended by the most recent studies, in order to prematurely change the natural evolution of allergic inflammation. The new technique provides a much higher safety for both the vaccinator that for the vaccinated, with a better acceptance by the patient of the procedure and thus a better and wider adherence to immunization programs. Just for the inoculation technique, such practice may allow a better distribution of the subcutaneous vaccine, with a broader recruitment of Langerhans cells by the antigen and thus a better immunological response. 

Biography:

Gilbert Glady has completed his MD at the age of 27 years from Strasbourg University of Medicine and postdoctoral studies from Besançon and Paris-Nord Universities of Medicine. He got during all these years an expertise in immunology and immunogenetics and developed also interest for alternative medicines. So he becames at 2010 the creator of the BI(G)MED method and director of EBMA, the european association for training the medical profession at the BI(G)MED. He has participated in numerous international congresses in the field of immuno-allergology, infectiology and oncology with posters and oral presentations. 

Abstract:

Oral immunotherapy has become a recognized method and validated by numerous publications, and its use has developed in the current practice of an allergy clinic. It has also been identified as likely to result in fewer adverse reactions than other conventional treatments administered by the systemic route. We propose an innovative and even revolutionary methodology by some aspects still little known in common allergology, which allows a soft and progressive regulation of the main molecular disorders involved at an immunogenetic level in the pathophysiological mechanisms of the various allergic diseases currently listed. For this purpose, we first resort to a regulation taking place at the epigenetic level thanks to the introduction in our therapeutic methodology of microRNAs used for their remarkable posttranscriptional regulatory action. All components of our cures are prepared in high dilutions to avoid any noxious side effects and administered per sublingual way. But the Bio Immuno(G)en Medicine - BI(G)MED in shortcut - is also holistic in that it does not just act in a regulating way on the immunogenetic mechanisms involved directly in the genesis of allergic diseases, but also search for neutralizing infectious, viral and bacterial and even fungal agents, which have a pernicious influence on the course of clinical allergic phenomena. To achieve this result the BI(G)MED uses a wide range of biological tests to measure the patient's reaction potential at the immunogenetic level and the impact of infectious agents in direct interaction with the immune system. The description of clinical cases of my private practice with their therapeutic modalities will make it possible to highlight the regulatory properties of this new method referring to the self-regulation potential inherent in cellular homeostasis.

Biography:

Dimitrios Balomenos received his PhD of Rutgers University, NJ. And continued his postdoctoral training at the Scripps Research Institute (La Jolla, Ca) and in the Department of Immunology and Oncology of CNB/CSIC in Madrid,Spain. In 2002 he was awarded an independent group research contract and from 2010 he is a tenured group leader at CNB/CSIC. Major discoveries include the absolute requirement of IFN-gamma for Systemic Lupus Erythematosus pathogenesis, (D. Balomenos et al, J. Clin. Invest. 1997), the discovery of p21-dependent pathways for regulation of T cell tolerance and autoimmunity (D. Balomenos et al, Nat. Med. 2000), and the requirement for p21 in reprogramming of M1-to-M2 macrophages, though the regulation of p50/p50 NF-kB and IFN-beta expression (Rackov et al, J. Clin Invest 2016). The group focuses in understanding how p21 and other molecules restrain extreme immune responses and discover p21 molecular patners that control ecssessive infalmmation and might harbor potential treatment capacity.

Abstract:

Decontrolled inflammatory responses induce live-threatening disease or aggravate autoimmunity or allergy. p21 was first identified as an inhibitor of and cyclin-dependent kinase 2 inhibitor (CDK2).   However, other functions are now attributed to p21, as it orchestrates unique anti-inflammatory functions.

p21 controls NF-κB activation, macrophage activation and LPS-induced septic shock. In the absence of p21, LPS treatment leads to increased NF-κB activation, macrophage overstimulation and excessive inflammatory production. Upon extreme TLR4 activation, macrophage hyperactivation is also controlled by reprograming of hyperinflammatory microphages (M1) to a hyporesponsive status (M2-like) after a secondary LPS challenge, which is known as endotoxin tolerance. We recently reported that p21 promotes M1-to-M2 polarization, as p21^-/- macrophages showed impaired ability to reprogram. p21 shifts the balance between active p65/p50 and inhibitory p50/p50 NF‑B and promotes macrophage reprogramming by favoring DNA-binding affinity of p50/p50 homodimers, which limit IFN- production. The first association of p21 with the immune response was its identification as an autoimmunity suppressor, and it was assumed to control T cell proliferation. However, our latest findings show that lack of p21 drives lupus-like disease by augmenting the activation status of T cells The major characteristic of this hype activation is the elevated production of IFN-gamma by T cells, a major inducer of lupus autoimmunity.  Our findings point to p21 as an early regulator of T cell activation that controls mitochondrial ROS production. Finally, in agreement with effect of p21 on the excessive immune responses, p21-deficient mice developed extreme allergic asthma when subjected to the allergy-inducing OVA model, exhibiting severe pneumonitis and striking perivascular and interstitial inflammation compare to controls.  Overall p21 emerges as a global guardian of hyperresponsivess in inflammatory, autoimmune and allergic pathologies at both the macrophage and T cell levels. 

Biography:

Michele Grasso, Senior resident in Otorhinolaryngology at Department of ENT surgery, University Sapienza of Rome. Fellowship at Department of ENT and Robotic surgery, Catholique University of Louvain, Mont-Godinne, Belgium, with Prof Marc Remacle and George Lawson (2012), working on the field of laryngeal papillomatosis and CO2 Lasers. Fellowship at the ENT Department of Bergamo, with Prof Gianni Danesi (2016-2017) working on the field of lateral skull base surgery. Author of many scientific manuscripts on journals with impact factor. Attended of international congresses as speaker, and cadaver dissection surgery courses.

Abstract:

Statement of the Problem: Chronic Allergic Rhinitis (CAR) represents a worldwide emergency pathology affecting between 10% and 40% of the world population (1). Despite the number of available treatments, the prevalence of such condition is still increasing (2).

There is a need for safe treatments to help prevent/reduce the acute allergic rhinitis episodes in CRA, especially in children. The role of daily nasal detersion with isotonic saline solutions has been recognized by the health Authorities as an efficient basic treatment for CAR (3)

The aim of this review was to analyze the clinical effectiveness of an isotonic sea water solution enriched with Mn nasal spray (STERIMAR Nose prone to allergies, SNPA) in CAR.

Methodology & Theoretical Orientation: SNPA has been marketed for a long time (1999) for nasal detersion .Post-Marketing Surveillance data and previous experiences showed that use of this medical device is safe and helps relieve nasal  symptoms of CAR (4,5) while recent experience pointed out its role in reducing the recurrence rates of allergic rhinitis in CAR  patients  (6).

 Findings: A 14-day treatment of SNPA significantly improved nasal ventilation-secretion, headache and sinus pain in 54 children affected by CAR (4). One to two month treatment in 20 children with CAR showed an improvement in nasal ventilation-obstruction and rhinorrhea (5). A 5-month course of STERIMAR nasal detersion demonstrated significant reduction of the recurrence rates of Acute Allergic Rhinitis episodes (fig 1) and improvement in the Quality Of Life (QOL) (6)

Conclusion & Significance: SNPA could help improve QOL, recurrences and signs and symptoms of CAR. These results, if confirmed in double-blind, randomized, controlled clinical trials, could represent a new, safe and less expensive approach for managing CAR in adults and children.

Biography:

Olga Britanova completed her PhD at Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Science in 2003. She has been working in Laboratory of Genomics of Adaptive Immunity headed by Prof. D Chudakov, since 2008. Previously, her research was focused on the study of the molecular pathways during embryonic development of the mammalian cerebral cortex. She investigated the role of the transcription factor Satb2 in determination of the cell fate identity of cortical neurons. Her scientific interests are focused on Molecular Immunology. Particularly, she has developed PCR-based techniques for TCR and BCR profiling analysis.

Abstract:

The immunosenescence alterations in the T cell immunity contribute to deficiencies in response to vaccination, in protecting from various infections and increases risk of cancer development and autoimmune diseases.  One of the hallmarks of age-related processes is shrinking diversity of TCR repertoire which, on the cellular level, is associated with loss of naïve T cells and expansion of the memory and effector T cell populations. Implementing quantitative TCR repertoire profiling, we investigated changes in diversity and architecture of human TCR repertoires starting from umbilical cord blood to centenarian blood samples. Besides the overall reduction in the TCR repertoire diversity with age, we found that TCR diversity and percentage of naive CD4+ cells in males decreases significantly faster by the age of 40 compared to females. This gender difference disappears in more elderly individuals.  Remarkably, percentage of naive T cells within CD4 pool stably decreases with age but remains unexpectedly high in the oldest cohort (>75 y.o.) comparing to the ratio in CD8+ compartment.  It might indicate a possible association between high percentage of naive CD4+ cells and longevity. Despite the fact that naive CD4+ cells have low survival capacity than naive CD8+, the homeostatic machinery maintains   naive CD4+ pool diverse with age. Additionally, our analysis showed that functional TCR repertoires are more similar in the youth, and this similarity gradually decreased with age. These phenomena might be explained by enrichment of public clonotypes among naive T cells, including clones that originate from fetal period. Further analysis of sorted naive CD8 TCR repertoires across different age groups revealed that naive CD8 repertoires were more similar among young compared to aged donors. Identification of mechanisms driving ageing of TCR repertoire might shed light on vulnerability of elderly to infections, autoimmune disease and cancer development.

Biography:

Fabrício Prado Monteiro has his expertise in evaluation and passion in improving the health and immunology. He is a Medical director at Institute of allergy and immunology of West Bahia, Brazil & Specialist in Allergology & Immunology (since 2006, by ASBAI). Specialist in Pediatrics (since 2004, by SBP) Master and Doctorate (U.C.E.S / ARG) in Admistration and Economics (management) in health (public and private) Investigate the impact of legislation, regulations and policies on population health; He has built work model after years of experience in research, evaluation, teaching and attention in pediatrics and clinical allergy and immunology, both in hospital and education institutions.

Abstract:

Introduction: The beta glucuronidase is an agent stimulant of the immune system and has a desensitizing action under normal pH. This substance has an important role as immune response modifier that stimulates the expression of adhesion molecules by antigen-presenting cells in contact with lymphocytes and vice versa in the intra cellular space and acts on the balance shift TH2/TH1 responses. Method with proven security, without cases of deaths to this date and large scale in Brazil since the early of the 90’s was considered. However, there are few available randomized double-blind studies. Therefore, scientific elucidation is essential. New evidences brought by new and validated clinical studies will allow us to confirm that this therapeutic method can be more effective and safer for the immune compromised patients and with hypersensibility not only type I of Gell and Coombs.

Case Description: A 53 year old female patient Lausivan Martins De Miranda, Caucasian, farm labourer is reported to doctor's office complaining of itching dermatological diffuse for one year and eight months, associated with urticariformes boards, angioedema on hands and lips, diffuse rash and aphonia. She is on recurrent use of doxepin 10 mg​and bilastine 20 mg without any success. She denies social addictions and makes regular use of propranolol and chronic of metformin, aldactone, furosemide and NPH insulin, due to metabolic syndrome and hypertension. No history of hospitalizations, surgeries, adverse reactions to drugs, vaccines and atopics was found. Physical examination with exanthematous and hives urticaria diffusely distributed and aphonia. Still, BMI is greater than 35. Blood tests without notable changes and Patch test with positive results are for: Nickel sulfate (+ +), cobalt chloride (+ +) and parfum mix (+ +) and diagnosis of allergic contact dermatitis as well.

Immunological Aspects & Conclusions: Patient began the immunostimulation therapy in low doses with β-glucuronidase, β glucan and nickel sulphate, bimonthly (every two months) and obtained tolerance and energy after the first three doses. After six months, there was a great reduction of emergency medications and finally a substantial increase in the quality of life without the total exclusion of the triggering chemicals contactants. Immunostimulating subcutaneous therapy as proposed in the case, according to protocol and subcutaneous administration ITA bimonthly of β glucan and β glucuronidase associated with specific antigens in low dose showed great results providing an increase of antigenic recognition because of an efficient activation of antigen presenting cells through up-regulation of their receivers. Thus, the activation and degranulation of inflammatory products that cause various clinical manifestations are minimized and regulated, with the consequent clinical improvement despite associated medications and chemical environmental exclusion. Therefore, a great alternative for immune compromised patients and with several kinds of hypersensibility should be taken.

Biography:

Bibi Alladin-Karan established the first allergy clinic in Guyana in 2014 as a Pediatric Resident who received training from a pediatric allergist from Humber River Hospital in Canada. Completed Master’s in Pediatrics in May 2016 also has an Associate Degree in Pharmacy and currently lectures four courses at University of Guyana, School of Medicine and Pharmacy.

Abstract:

Background: There is an increasing trend in allergic diseases worldwide, particularly among children. Currently, however, there are no published statistics on the burden of allergies among children in Guyana.

Aim: Aim of this study is to determine the prevalence of allergens among pediatric patients (<13 year old) in Guyana and to assess the types and possible risk factors.

Methods: A retrospective chart review was conducted among pediatric patients who were seen at GPHC Allergy Clinic during 2014 July-2016 July. A standard allergy questionnaire was completed, skin prick test (SPT) was carried out in an attempt to identify the allergen. Descriptive statistics was applied to estimate the prevalence and trends for allergens.

Results: 50 patients met inclusion criteria, 46 (92%) had SPT. Majority of cases (44.4%) were of mixed decent, nearly all of the patients were from Georgetown-Mahaica. 25 (54%) patients had a positive SPT, 60% of positive SPT were females although the gender distribution was equal in the study population, rash was the most common presenting feature (60%, p<0.05), 40% had a history of dermatitis while 36% had history of asthma. 60% of individuals who had a positive SPT were allergic to just one allergen, and two (8%) were allergic to four of more allergens. Dust mites were the most common allergen (88%) followed by peanuts (20%) and mixed fish (16%).

Conclusion: Allergies are common among children in Guyana with a prevalence of 54% in children with risk factors. Dust mites were the most common allergen. Predictors for positive SPT included history of asthma and dermatitis, and positive family history. Patients who were treated for their allergies had more control of their asthma and eczema. The results of the study will also be used to sensitize the population on the functions of the clinic.