Factores ambientales, nutricionales y de estilo de vida asociados con asma y atopia em uma zona rural de Ecuador. / Factors environmental, nutritional lifestyle y Asociados y con atopic asthma in a rural area of ​​Ecuador.

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

16/06/2011

RESUMO

The aim of this study was to investigate the effect of environmental, anthropometric and lifestyle factors on asthma and atopy in a rural area of Ecuador. We carried out a crosssectional study in order to identify children and adolescents with and without wheeze in the past year to be included in a case-control study. Initially, an exploratory study was conducted to identify if different factors (socioeconomic, environmental, family, lifestyle, helminth infection) would be associated with atopic and non-atopic wheeze in this rural area. The results showed that non-atopic wheezing phenotype is more common in this area and a different pattern of risk factors for atopic and non-atopic wheezing were observed. This result might suggest that different underlying mechanisms might be involved. Some studies in rural and urban poor areas in Latin America have shown that asthma is not mostly attributed to atopy. Similarly, dissociation between allergen-specific IgE and skin test reactivity has been observed, so we tested the hypothesis that in our population, helminth infections may be modifying these associations. The results highlight a complex relationship between helminths, asthma and atopy. It was noted that the association between markers of atopy was weaker in patients with presence of sensitization to Ascaris and the association between skin test and wheeze was attenuated in subjects with active infection with Ascaris and / or Trichuris. Additionally, anti-Ascaris IgE, but no active infection, increased risk of wheeze regardless of specific IgE to allergens. Finally, a new hypothesis suggests that the adoption of new lifestyles would be leading to an increase in asthma and atopy. Thus, we decided to study overweight as a marker of recent changes in lifestyle patterns which in turn would be associated with asthma and atopy. The presence of skin test and specific IgE to allergens was 1.85 and 2.20 times higher in children with overweight than in children with normal weight /deficit. However, the effect on wheeze was through a non-atopic mechanism. Although these results need to be confirmed by longitudinal studies, they will certainly contribute to a better understanding of the mechanisms of non-atopic asthma in rural areas which have been poorly understood.

ASSUNTO(S)

allergen-specific ige skin test reactivity infecciones parasitárias sibilo reatividade cutânea geohelmintos excesso de peso wheeze geohelminths overweight ecuador asma saude publica ige específica para alérgenos equador

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