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Table of contents A1 Characterization of the immunoallergic profile towards the proteins of the wheat flour in Cuban population Raúl Lázaro Castro Almarales, Mary Carmen Reyes Zamora, Beatriz Tamargo, Damaris Torralba Averoff, Raysa Cruz, Yunia Oliva Diaz, Mirta Alvarez Castello, Alexander Ciria, Alexis Labrada, Maytee Mateo A2 Are peanuts causing food allergy in Cuba? Maytee Mateo, Damaris Torralba Averoff, Raysa Cruz, Yunia Oliva Diaz, Mirta Alvarez Castello, Alexander Ciria, Mary Carmen Reyes Zamora, Beatriz Tamargo, Alexis Labrada A3 Prick test and immunoallergic profile to soy allergens in Cuban population Omar Herrera, Maytee Mateo, Raysa Cruz, Mirta Alvarez Castello, Alexander Ciria, Raúl Lázaro Castro Almarales, Mary Carmen Reyes Zamora, Alexis Labrada A4 Skin sensitization and immunoallergic profile to hen's egg in Cuban population José Severino Rodríguez Canosa, Raysa Cruz, Maytee Mateo, Mirta Alvarez Castello, Alexander Ciria, Raúl Lázaro Castro Almarales, Mary Carmen Reyes Zamora, Alexis Labrada A5 Sensitization to three domestic mites in patients with adverse food events to shellfish Mirta Alvarez Castello, Raúl Lázaro Castro Almarales, Alexis Labrada, Biocen A6 Diagnostic efficacy by skin prick test with allergenic extracts of legumes in Cuban patients Yamilet Ibizate Novales, Ilonka Estruch Fajardo, Alexis Labrada, Maytee Mateo, Armando Ginard A7 Baked egg goods without wheat flour carry an increased risk of reaction Bruce Lanser, Anna Faino, Erwin Gelfand, Pia Hauk A8 Prevalence, incidence and associated risk factors of adverse reaction to food in Cuban infants - a population-based prospective study Silvia Venero Fernández, Julia Urbina, Mirta Alvarez Castello, Raúl Lázaro Castro Almarales, Ramón Suárez Medina, Hermes Fundora Hernández, John Britton, Andrew William Fogarty A9 Microbiome in ice machines and assessing the plasma nanotechnology in breaking the biofilm and improving air quality Nabarun Ghosh, Clinton Ross Bell, Chandini Revanna, Constantine Saadeh, Jeff Bennert, Danius Bouyi, Mitsy Veloz, Nelofar Sherali A10 Characteristics of patients with food allergy in health public service Magna Coelho A11 Allergic rhinitis and asthma index increased in Texas panhandle and AHPCO and plasma nanotechnology as solutions Nabarun Ghosh, Jeff Bennert, Danius Bouyi, Constantine Saadeh, Clinton Ross Bell, Mitsy Veloz, Chandini Revanna, Nelofar Sherali A12 Antigen-specific T follicular helper cells mediate peanut allergy in mice Joseph J. Dolence, Takao Kobayashi, Koji Iijima, Hirohito Kita, Hirohito Kita, Ashli Moore, James Krempski A13 Production of recombinant Mal d 3, a major apple allergen, in Pichia Pastoris, to investigate the impact of the food matrix and post-translational modifications on Mal d 3 immuno-reactivity Roberta Aina, Riccardo Asero, Sabine Pfeifer, Pawel Dubiela, Merima Bublin, Christian Radauer, Piotr Humeniuk, Karin Hoffmann-Sommergruber A14 Reaction to sports drink: no whey! Whey allergy in absence of clinical cow’s milk allergy Frank Eidelman, Ves Dimov, Charl Khalil A15 Food allergy on Tumblr: focus on teenage audience may increase educational impact Ves Dimov, Frank Eidelman, Charl Khalil A16 Changes in IgE levels following one-year immunizations in two children with food allergy Alice E. W. Hoyt, Peter Heymann, Alexander Schuyler, Scott Commins, Thomas Platts-Mills A17 IgE and IgG4 antibodies to cow's milk components in children with eosinophilic esophagitis: higher specific IgG4 antibodies and IgG4:IgE ratios compared with subjects with IgE-mediated food allergy Alexander Schuyler, Patrice Kruszewski, John Russo, Lisa Workman, Thomas Platts-Mills, Elizabeth Erwin, Anubha Tripathi A18 Frequency of Sensitization to Food Allergens in Patients with Rhinitis and Asthma in the National Medical Center La Raza “Dr. Antonio Fraga Mouret”, Mexico City Gabriela Yvette Castellanos, Elizabeth Mendieta, Martín Becerril-Angeles

La alergia es el resultado de interacciones genéticas y ambientales, incluso de tiempo, ruta y dosis de exposición a alimentos en pacientes susceptibles. Los factores de riesgo pueden ser: 1) genéticos y 2) ambientales, y estos, a su vez, se dividen en prenatales, perinatales y posnatales. La alergia alimentaria aparece frecuentemente y depende de múltiples factores de riesgo (genéticos y ambientales), que a su vez se dividen en: factores prenatales, natales y posnatales; participan en la expresión de la enfermedad y no en todos los casos es posible la intervención clínica.

Most Latin-American countries use subcutaneous immunotherapy (SCIT) extracts from the United States and Europe and sublingual immunotherapy (SLIT) from Europe, with the exception of Argentina, Brazil, Cuba and Mexico. The number of researches on immunotherapy (IT) in Latin America has increased extensively in the last years. Only few Latin American countries have their own guidelines on IT, and, in general, the economic resources for medical research on IT are still low in the area. A global approach for the future of IT in Latin America includes to improve standardization, quality control and the production of allergen products, to develop IT guidelines and clinical investigation by the highest number of countries, to improve the regulatory status for allergens products in the area, and to expand IT accessibility for low-income patients. In Cuba, the first registered allergen vaccines were developed and registered in 2006: a standardized (in biologic units) and freeze dried product for SCIT, with a sublingual version developed in 2009. As much as 23.000 IT treatments were applied in 2011, all provided to patients free of charge. In 2012, Cuban researchers developed an IT vaccine with adjuvant for subcutaneous route, which uses Neisseria meningitidisproteoliposome as an adjuvant, added to the purified Dermatophagoides siboneymajor allergens: Der s1 and Der s2. Since December 2012, this vaccine is in Phase I clinical trial, evaluating its safety, tolerability and immunogenicity in asthmatic patients sensitized to this allergen. Cuban perspectives on IT includes to work on new indications for IT, to investigate the preventive effect and cost-effectiveness for the current vaccines, to develop new products with mixed formulas of house dust mites for SLIT, to complete the phase I and II clinical study for dust mite plus adjuvant vaccine, to develop allergen vaccines for fungi allergy and to complete the Cuban guideline for allergen IT management. Keywords: Immunotherapy, Latin America, Cuba

Las infecciones respiratorias agudas constituyen la primera causa de consultas médicas y de morbilidad, tanto en los países desarrollados como en los países en vías de desarrollo. Los niños menores de 5 años tienen algunas características fisiológicas e inmunológicas que los hacen más susceptibles para presentar estos procesos respiratorios. A pesar que las infecciones respiratorias agudas bajas concentran habitualmente la atención por su mayor complejidad, costo del tratamiento y complicaciones, son las altas las que se presentan en mayor número en la consulta ambulatoria. Por la frecuente presentación en la consulta de alergología y por la carga de ansiedad que se genera en los familiares de estos niños con infecciones respiratorias recurrentes, nos decidimos a realizar una revisión sobre algunos aspectos de interés relacionados con ellas. Nuestro objetivo es mejorar el conocimiento de estas entidades, para identificar aquellos niños con mayor riesgo de presentar recurrencia de estas infecciones respiratorias. Estas entidades, que en su mayoría son de etiología viral y curso limitado, son causa importante de uso y abuso de medicamentos, entre ellos, los antibióticos, con efectos perjudiciales en la salud de los niños.Acute respiratory infections are the first cause of visits to the physician's offices and of morbidity in the developing and developed countries. Children under 5 have some physiological and immunological characteristics that make them more susceptible to present these respiratory processes. In spite of the fact that the lower respiratory infection usually attracts the attention due to their greater complexity, cost of treatment and complications, the upper are more frequent at the outpatient department. Due to their common presentation at the allergology department and to the load of anxiety generated in the relatives of these children with recurrent respiratory infections, it was decided to make a review of some aspects of interest related to them. It was our objective to improve the knowledge of these entities to identify those children with higher risk for presenting recurrence of these respiratory infections. These entities, which are most of viral aetiology and limited course are an important cause of the use and abuse of drugs, such as antibiotics, with harmful effects for the children's health.

En los últimos años, y con motivo de los avances que se realizan en el campo de la investigación del asma bronquial, los conceptos en su prevención han ido cambiando entre los especialistas que lo tratan. Este trabajo tiene como objetivo llevar el conocimiento básico necesario a los profesionales de la medicina, para que a cada paciente asmático, atendido por primera vez, se le determinen los alergenos desencadenantes, los factores agravantes y socioculturales que le rodean y que pueden estar afectándolo. Se aborda la sensibilización a alergenos desde la etapa embrionaria y lactancia en el niño atópico, cuándo debemos considerar a un niño con alto riesgo alérgico, los factores de riesgo más importantes, con experiencias prácticas en el Hospital Universitario “Calixto García”, y las recomendaciones para la prevención de las enfermedades alérgicas en lactantes e infantes de alto riesgo alérgico.En recent years and advances in research field of bronchial asthma, features in its prevention has been changing among specialists treating it. Aim of this paper is to transmit the basic and necessary knowledge to medicine professionals for that in each asthmatic patient treated for the first time, the triggering allergens, aggravating factors, and the surrounded sociocultural ones, affecting him be determined. Authors approach sensitivity to allergens from embryonic stage and the lactation in atopic child, when we must to consider the case of an allergic and in high risk child, the more significant risk factors, with practical experiences in “Calixto García” University Hospital, and recommendations for preventions of allergic diseases in infants and breast-fed child in high risk of allergy.

La morbilidad de las enfermedades alérgicas mediadas por el anticuerpo IgE, se ha incrementado en los últimos 40 años, y además, se han identificado a los ácaros domésticos como sus principales agentes causales. En Cuba, los ácaros más frecuentemente son: Dermatophagoides pteronyssinus (D. pteronyssinus), Dermatophagoides siboney (D. siboney) y Blomia tropicalis (B. tropicalis). En este estudio investigamos si la sensibilización a estos ácaros constituye un problema de salud en nuestra población infantil, y su relación con la exposición al polvo doméstico. Se seleccionaron 103 niños alérgicos del pueblo de Guatao, que se clasificaron según su grado de exposición al polvo doméstico. A todos se les realizó la prueba por punción cutánea por duplicado en ambos antebrazos y se utilizaron los extractos alergénicos estandarizados VALERGEN-BT Ò (Blomia tropicalis), VALERGEN-DS Ò (Dermatophagoides siboney) y VALERGEN-DP Ò (Dermatophagoides pteronyssinus), todos de producción nacional en el Centro Nacional de Biopreparados. La sensibilización fue mayor de forma significativa (pMorbidity of allergic diseases mediated by the IgE antibody has increased in the last 40 years and the house mites have been identified as their main causal agents. In Cuba, the most common mites are Dermatophagoides pteronyssinus (D. pteronyssinus), Dermatophagoides siboney (D. siboney) and Blomia tropicalis (B. tropicalis). In this study, it was investigated if the sensitization to these mites is a health problem in our infantile population and its connection with the exposure to house dust. 103 allergic children from the Guatao town were selected. All of them underwent the skin puncture test in both forearms and the VALERGEN-BT Ò (Blomia tropicalis), VALERGEN-DS Ò (Dermatophagoides siboney) and VALERGEN-DP Ò (Dermatophagoides pteronyssinus) standardized allergenic extracts, which were produced in our country by the National Centre of Biopreparations, were used. The sensitization was significantly higher (p

Se realizó un estudio con el objetivo de investigar si la sensibilización a estos ácaros ( Dermatophagoides pteronyssinus [ Dp ], Dermatophagoides siboney [ Ds ] y Blomia tropicalis [ Bt ] ) constituye un problema de salud en nuestra población infantil, pues el estudio de los problemas alérgicos ha identificado a los ácaros domésticos como los principales agentes causales de asma y otras afecciones. Se seleccionaron 32 niños alérgicos de nuestro consultorio que se clasificaron según su grado de exposición al polvo doméstico. A todos se les realizó la prueba por punción cutánea en el brazo derecho, y se utilizaron 3 extractos alergénicos estandarizados Valergen Ò ( Blomia tropicalis, Dermatophagoides siboney y Dermatophagoides pteronyssinus ) de producción nacional (BIOCEN). La prevalencia de la sensibilización fue mayor de forma significativa (pA study was conducted aimed at investigating if the sensitization to these dust mites (Dermatophagoides pteronyssinus [Dp], Dermatophagoides siboney [Ds] and Blomia tropicalis [Bt] ) is a health problem in our infantile population, since the study of the allergic problems has identified the house dust mites as the main agents causing asthma and other affections. 32 allergic children of our office were selected and classified according to their degree of exposure to house dust. All of them underwent the skin test in the right arm. 3 standardized allergenic extracts ValergenÒ (Blomia tropicalis, Dermatophagoides siboney y Dermatophagoides pteronyssinus) of national production (BIOCEN) were used. The prevalence of sensitization was significantly higher (p

Las reacciones adversas por alimentos son motivo de consulta frecuente en el servicio de alergia del Hospital "Calixto García". En ocasiones su diagnóstico es complejo, y pueden requerir estudios más específicos, sobre todo, cuando los síntomas son respiratorios, como es el caso de la rinitis y el asma, o cuando existe sensibilidad a más de un alimento. Muchas veces estas reacciones adversas, luego de la ingestión de un determinado alimento nada tienen que ver con la alergia y adonde acuden inicialmente es a los médicos de atención primaria, por lo que se revisa en este artículo determinados aspectos de interés en su diagnóstico y atención, con el objetivo de mejorar el tratamiento y control de todo paciente con estas características. Finalmente se hace énfasis en la importancia de un buen interrogatorio, en las pruebas de eliminación y provocación, así como en la aparición de tolerancia a muchos alimentos en la etapa de la infancia, en la que es frecuente este comportamiento. Con este estudio se pretende difundir asimismo, el trabajo y control que debe aplicarse con dichos pacientes, al tiempo que se fomentan mejores hábitos alimentarios en la población.The adverse reactions to food are a reason for the frequent visit to the allergy service at "Calixto García" Hospital. Sometimes, its diagnosis is complex and it may require more specific studies, mainly when the symptoms are respiratory, as in the case of rhinitis and asthma, or when there is sensitivity to more than one food. Many times, these adverse reactions after the ingestion of a certain food have nothing to do with allergy and the patients initially go to see doctors at the the primary health care level, so some aspects of interest in its diagnosis and care are reviewed aimed at improving the treatment and control of every patient with these characteristics. Finally, emphasis is made on the importance of a good interview, on the tests of elimination and provocation, as well as on the appearance of tolerance to many food products during childhood, where this behavior is common. With this paper, we intend to disseminate the work and control that should be applied to such patients and to promote better food habits in the population.

La importancia de las enfermedades alérgicas, y entre ellas de la rinitis alérgica, así como su costo económico y de recursos humanos, tanto como su prevalencia, está fuera de toda duda. Esta entidad representa la sexta causa de enfermedad crónica en EE.UU. y tiene un gran impacto en la calidad de vida de los pacientes que la padecen. La rinitis alérgica es un desorden heterogéneo y su alta prevalencia es aún subdiagnosticada. Está caracterizada por uno o más de los siguientes síntomas: estornudos, picor nasal, secreción y congestión nasal. Muchos agentes están involucrados con esta entidad, entre ellos, pólenes, hongos, ácaros y animales domésticos. Atendiendo a que la rinitis y la sinusitis mantienen síntomas en común como la pérdida del olfato y la obstrucción y el drenaje nasal, se prefiere denominarla como rinosinusitis. Muchos estudios han identificado a la rinitis como un factor de riesgo para el asma, con una prevalencia entre 80 y 90 %. Esta revisión pretende repasar aspectos fundamentales de estas entidades como definición, etiología, clasificación, síntomas y tratamiento, y servir de guía para aquellos médicos que de una forma u otra tratan ambas afecciones con un impacto demostrado en la calidad de vida de los que las padecen.The importance of the allergic diseases and, among them, of allergic rhinits, as well as its economic cost, human resources involved and prevalence, is out of doubt. This entity represents the sixth cause of chronic disease in the United States and it has a great impact on the quality of life of those patients suffering from it. Allergic rhinits is a heterogenous disorder and its high prevalence is still underdiagnosed. It is characterized by one or more of the following symptoms that include sneezes, nasal itching, nasal secretion and congestion. Many agents are involved in this entity, among them, pollens, fungi, mites and domestic animals. Taking into account that rhinitis and sinusitis have common symptoms, such as loss of smell, obstruction and nasal drainage, it is preferably called rhinosinusitis. Several studies have identified rhinitis as a risk factor for asthma with a prevalence from 80 to 90 %. This review intends to go over fundamental aspects of this entities, such as definition, etiology, staging, symptoms and treatment, and to serve as a guide for those physicians that in one way or the other treat both affections with a proved impact on the patients' quality of life.