Particularities of allergy in the Tropics

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Abstract

Allergic diseases are distributed worldwide and their risk factors and triggers vary according to geographical and socioeconomic conditions. Allergies are frequent in the Tropics but aspects of their prevalence, natural history, risk factors, sensitizers and triggers are not well defined and some are expected to be different from those in temperate zone countries. The aim of this review is to investigate if allergic diseases in the Tropics have particularities that deserve special attention for research and clinical practice. Such information will help to form a better understanding of the pathogenesis, diagnosis and management of allergic diseases in the Tropics. As expected, we found particularities in the Tropics that merit further study because they strongly affect the natural history of common allergic diseases; most of them related to climate conditions that favor permanent exposure to mite allergens, helminth infections and stinging insects. In addition, we detected several unmet needs in important areas which should be investigated and solved by collaborative efforts led by the emergent research groups on allergy from tropical countries.

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The online version of this article (doi:10.1186/s40413-016-0110-7) contains supplementary material, which is available to authorized users.

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Most cited references 474

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Association of asthma with serum IgE levels and skin-test reactivity to allergens.

B Burrows, F Martinez, M Halonen … (1989)

We investigated the association of self-reported asthma or allergic rhinitis with serum IgE levels and skin-test reactivity to allergens in 2657 subjects in a general-population study. Regardless of the subjects' status with respect to atopy or their age group, the prevalence of asthma was closely related to the serum IgE level standardized for age and sex (P less than 0.0001), and no asthma was present in the 177 subjects with the lowest IgE levels for their age and sex (greater than 1.46 SD below the mean). The log odds ratio increased linearly with the serum IgE level after we controlled for possible confounders and the degree of reactivity to skin tests. In contrast, allergic rhinitis appeared to be associated primarily with skin-test reactions to common aeroallergens, independently of the serum IgE level. We conclude that asthma is almost always associated with some type of IgE-related reaction and therefore has an allergic basis, although not all the allergic stimuli that cause asthma appear to have been included in the battery of common aeroallergens we used to assess atopic status. These findings challenge the concept that there are basic differences between so-called allergic ("extrinsic") and nonallergic ("intrinsic") forms of asthma.

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The allergy epidemics: 1870-2010.

Thomas A.E. Platts‐Mills (2015)

Before the first description of hay fever in 1870, there was very little awareness of allergic disease, which is actually similar to the situation in prehygiene villages in Africa today. The best explanation for the appearance and subsequent increase in hay fever at that time is the combination of hygiene and increased pollen secondary to changes in agriculture. However, it is important to remember that the major changes in hygiene in Northern Europe and the United States were complete by 1920. Asthma in children did not start to increase until 1960, but by 1990, it had clearly increased to epidemic numbers in all countries where children had adopted an indoor lifestyle. There are many features of the move indoors that could have played a role; these include increased sensitization to indoor allergens, diet, and decreased physical activity, as well as the effects of prolonged periods of shallow breathing. Since 1990, there has been a remarkable increase in food allergy, which has now reached epidemic numbers. Peanut has played a major role in the food epidemic, and there is increasing evidence that sensitization to peanut can occur through the skin. This suggests the possibility that changes in lifestyle in the last 20 years could have influenced the permeability of the skin. Overall, the important conclusion is that sequential changes in lifestyle have led to increases in different forms of allergic disease. Equally, it is clear that the consequences of hygiene, indoor entertainment, and changes in diet or physical activity have never been predicted.

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Atopic dermatitis and the atopic march revisited.

S C Dharmage, S Dharmage, M C Matheson … (2014)

Atopic dermatitis (AD) has become a significant public health problem because of increasing prevalence, together with increasing evidence that it may progress to other allergic phenotypes. While it is now acknowledged that AD commonly precedes other allergic diseases, a link termed 'the atopic march', debate continues as to whether this represents a causal relationship. An alternative hypothesis is that this association may be related to confounding by familial factors or phenotypes that comanifest, such as early-life wheeze and sensitization. However, there is increasing evidence from longitudinal studies suggesting that the association between AD and other allergies is independent of confounding by comanifest allergic phenotypes. The hypotheses on plausible biological mechanisms for the atopic march focus on defective skin barrier function and overexpression of inflammatory mediators released by the skin affected by AD (including thymic stromal lymphopoietin). Both human and animal studies have provided evidence supporting these potential biological mechanisms. Evidence from prevention trials is now critical to establishing a causal nature of the atopic march. An emerging area of research is investigation into environmental modifiers of the atopic march. Such information will assist in identifying secondary prevention strategies to arrest the atopic march. Despite much research into the aetiology of allergies, little progress has been made in identifying effective strategies to reduce the burden of allergic conditions. In this context, the atopic march remains a promising area of investigation. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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Author and article information

Contributors

Luis Caraballo: +57 310 352 7373 , lcaraballog@unicartagena.edu.co

Journal

Journal ID (nlm-ta): World Allergy Organ J

Journal ID (iso-abbrev): World Allergy Organ J

Title: The World Allergy Organization Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1939-4551

Publication date (Electronic): 27 June 2016

Publication date PMC-release: 27 June 2016

Publication date Collection: 2016

Volume: 9

Electronic Location Identifier: 20

Affiliations

[ ]Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia

[ ]Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore

[ ]Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

[ ]Department of Medicine Solna, Karolinska Institutet, Translational Immunology Unit, Stockholm, Sweden

[ ]Allergy and Clinical Immunology Department, Centro Médico- Docente La Trinidad and Clínica El Avila, Caracas, Venezuela

[ ]Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt

[ ]Allergy Section, Fundación Santa Fe de Bogotá, Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia

[ ]Federal University of Parana, Rua General Carneiro, Curitiba, Brazil

[ ]Department of Allergy and Immunology, Hospital Quirón Bizkaia, Bilbao, Spain

[ ]Department of Pediatrics, Graduate Program on Allergology, University of Antioquia, Medellín, Colombia

[ ]Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Barcelona, Spain

Article

Publisher ID: 110

DOI: 10.1186/s40413-016-0110-7

PMC ID: 4924335

PubMed ID: 27386040

SO-VID: e66b8d3e-4398-40ff-ac38-d60132eec373

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 4 November 2015

Date accepted : 25 May 2016

Funding

Funded by: Colciencias

Award ID: 406-2011 and 515-2012

Award Recipient : Luis Caraballo

Custom metadata

ScienceOpen disciplines: Immunology

Keywords: the tropics,allergy,asthma,rhinitis,atopic dermatitis,helminthiases,papular urticaria,anaphylaxis,house dust mite,natural history,allergens

Data availability:

ScienceOpen disciplines: Immunology

Keywords: the tropics, allergy, asthma, rhinitis, atopic dermatitis, helminthiases, papular urticaria, anaphylaxis, house dust mite, natural history, allergens

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Particularities of allergy in the Tropics

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Abstract

Electronic supplementary material

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Chinese Journal of Schistosomiasis Control

Most cited references 474

Association of asthma with serum IgE levels and skin-test reactivity to allergens.

The allergy epidemics: 1870-2010.

Atopic dermatitis and the atopic march revisited.

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Contributors

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Cited by 65

Most referenced authors 5,760