{"id":10518,"date":"2007-12-14T11:05:12","date_gmt":"2007-12-14T08:05:12","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/screening-atopie\/"},"modified":"2020-07-10T13:25:26","modified_gmt":"2020-07-10T10:25:26","slug":"screening-atopie","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/screening-atopie\/","title":{"rendered":"Screening atopie"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Screening atopie &#8211; Diagnosticul bolilor alergice<\/strong><\/span> este un proces complex la care contribuie anamneza, examenul fizic, metodele de testare \u201c<strong>in vivo<\/strong>\u201d \u015fi \u201c<strong>in vitro<\/strong>\u201d.<!--more--><span style=\"font-size: inherit;\">Reac\u0163iile alergice se pot manifesta \u00een diverse organe \u015fi la grupe de v\u00e2rst\u0103 diferite.<\/span><\/p>\n<p style=\"text-align: justify;\"><strong>Termenul de \u201calergie\u201d<\/strong> este larg utilizat \u00een lumea medical\u0103 \u015fi non-medical\u0103, adesea \u00een mod nejustificat. Demonstrarea implic\u0103rii mecanismelor imunologice este esen\u0163ial\u0103 pentru a considera manifest\u0103rile pacientului ca fiind de natur\u0103 alergic\u0103 \u015fi a le diferen\u0163ia de alte reac\u0163ii adverse la alimente \u015fi medicamente la care mecanismele imunologice nu pot fi dovedite.<\/p>\n<hr \/>\n<p style=\"text-align: center;\"><span style=\"color: #00539f;\"><strong>Defini\u0163ii ale termenilor \u015fi no\u0163iunilor de baz\u0103 \u00een alergologie<\/strong><\/span><\/p>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Atopie <\/strong>\u2013 tendin\u0163a personal\u0103 sau familial\u0103 de a produce anticorpi IgE ca r\u0103spuns la cantit\u0103\u0163i mici de alergeni, de obicei proteine, \u015fi de a dezvolta simptome tipice de astm, rinoconjunctivit\u0103 sau eczem\u0103\/dermatit\u0103. Termenul de \u201catopie\u201d descrie aceast\u0103 predispozi\u0163ie clinic\u0103 \u015fi nu trebuie folosit pentru a descrie boli.<\/p>\n<p style=\"text-align: justify;\"><strong>Alergie <\/strong>\u2013 o reac\u0163ie de hipersensibilitate ini\u0163iat\u0103 prin mecanisme imunologice. La majoritatea pacien\u0163ilor anticorpii responsabili de manifest\u0103rile alergice sunt de tip IgE, de aceea, \u00een aceste cazuri, este vorba de o alergie mediat\u0103 IgE. Mai exist\u0103 \u015fi un alt tip de alergie: alergia mediat\u0103 non-IgE. \u00cen acest tip de alergie sunt incluse boala serului, alveolita alergic\u0103 (afec\u0163iuni mediate IgG), dermatita de contact (alergie mediat\u0103 celular prin limfocitele T) etc.<\/p>\n<p style=\"text-align: justify;\"><strong>Hipersensibilitatea <\/strong>determin\u0103 simptome sau semne reproductibile \u00een mod obiectiv, ini\u0163iate de expunerea la un stimul definit, prezent \u00eentr-o cantitate tolerat\u0103 de subiec\u0163ii normali.<br \/>Termenul de \u201chipersensibilitate\u201d este folosit ca un fel de \u201cumbrel\u0103\u201d pentru a include pe l\u00e2ng\u0103 reac\u0163iile alergice \u015fi alte manifest\u0103ri la care nu s-a dovedit a fi implicat un mecanism imunologic, cum este cazul hipersensibilit\u0103\u0163ii la aspirin\u0103.<\/p>\n<p style=\"text-align: justify;\">Defini\u0163ia de mai sus nu include r\u0103spunsurile clasice la infec\u0163ie, autoimunitate sau reac\u0163iile toxice. Termenul de \u201c<strong>pseudoalergie<\/strong>\u201d trebuie abandonat.<\/p>\n<p style=\"text-align: justify;\">Revenind la atopie, aceasta este o condi\u0163ie mo\u015ftenit\u0103. De exemplu, riscul unui copil de a dezvolta o alergie mediat\u0103 IgE este de 40-60% dac\u0103 ambii p\u0103rin\u0163i sunt atopici. La copiii cu predispozi\u0163ie mare, sensibilizarea IgE \u015fi afec\u0163iunile atopice se instaleaz\u0103 precoce \u00een cursul vie\u0163ii. Fenotipul alergic se exprim\u0103 variat \u00een diferite perioade ale vie\u0163ii. Astfel, alergiile alimentare joac\u0103 un rol predominant \u00een primii ani de via\u0163\u0103. Manifest\u0103rile clinice sunt reprezentate \u00een special de dermatita atopic\u0103 \u015fi simptomele gastrointestinale. Pe m\u0103sur\u0103 ce prevalen\u0163a alergiilor alimentare scade cu v\u00e2rsta, cre\u015fte semnifica\u0163ia alergenilor inhalan\u0163i, cu instalarea simptomatologiilor de tract respirator superior \u015fi inferior. \u00cen multe cazuri, rinita alergic\u0103 poate fi considerat\u0103 un precursor al astmului bron\u015fic.<\/p>\n<p style=\"text-align: justify;\">Unele persoane care nu pot fi \u00eencadrate ca fiind \u201catopice\u201d scap\u0103 sensibiliz\u0103rii la alergeni obi\u015fnui\u0163i \u00een copil\u0103rie \u015fi adolescen\u0163\u0103, dar dezvolt\u0103 o alergie mediat\u0103 IgE mai t\u00e2rziu, atunci c\u00e2nd sunt expuse la doze mari de alergeni, adesea \u00een prezen\u0163a unor adjuvan\u0163i cum ar fi fumul de \u0163igar\u0103. Aceast\u0103 situa\u0163ie este \u00eent\u00e2lnit\u0103 cel mai adesea \u00een cazul alergiilor profesionale. \u00cen cazul alergiilor la venin de insecte \u015fi la unele medicamente sunt implicate tot mecanisme mediate IgE, dar sunt afectate \u00een aceea\u015fi m\u0103sur\u0103 \u015fi persoanele atopice \u015fi cele non-atopice<sup>1<\/sup>.<\/p>\n<hr \/>\n<p style=\"text-align: justify;\">\u00cen ceea ce prive\u015fte <span style=\"color: #00539f;\"><strong>investiga\u0163iile de laborator<\/strong><\/span> \u00een afec\u0163iunile alergice sunt disponibile mai multe tipuri de teste:<\/p>\n<ul>\n<li style=\"text-align: justify;\">teste pentru screening-ul atopiei : Phadiatop \u015fi Phadiatop Infant ;<\/li>\n<li style=\"text-align: justify;\">teste pentru diverse amestecuri de alergeni : praf amestec, fungi amestec, polen graminee etc.;<\/li>\n<li style=\"text-align: justify;\">teste pentru alergeni individuali: lapte de vac\u0103, gluten, frunz\u0103 de tutun etc.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Testele <a href=\"\/shop\/testul-phadiatop\/\"><strong>Phadiatop <\/strong><\/a>\u015fi <a href=\"\/shop\/testul-phadiatop-infant\/\"><strong>Phadiatop Infant<\/strong><\/a> diferen\u0163iaz\u0103 bolile atopice de afec\u0163iunile non-atopice. Dup\u0103 efectuarea anamnezei \u015fi a examenului fizic, solicitarea unui test Phadiatop constituie prima etap\u0103 a diagnosticului de laborator, care ofer\u0103 informa\u0163ii despre statusul atopic al pacientului.<\/p>\n<p style=\"text-align: justify;\">Reactivii folosi\u0163i sunt alc\u0103tui\u0163i dintr-un amestec echilibrat de alergeni relevan\u0163i (\u00een func\u0163ie de v\u00e2rsta pacientului) care reac\u0163ioneaz\u0103 cu anticorpii IgE specifici din serul pacientului.<br \/>Phadiatop \u015fi Phadiatop Infant demonstreaz\u0103 prezen\u0163a alergiei atopice la alergeni obi\u015fnui\u0163i, relevan\u0163i pentru adul\u0163i \u015fi respectiv pentru copiii cu v\u00e2rste \u00eentre 0-4 ani.<br \/>Efectuate la copii, adolescen\u0163i sau adul\u0163i, testele r\u0103spund foarte eficient la \u00eentrebarea: <strong>\u201cEste posibil ca simptomele pacientului s\u0103 se datoreze unei alergii?\u201d<\/strong>.<\/p>\n<p style=\"text-align: justify;\"><strong>Un test Phadiatop ofer\u0103 un r\u0103spuns obiectiv Da sau Nu:<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">un rezultat pozitiv demonstreaz\u0103 prezen\u0163a alergiei atopice; medicul va continua investigarea alergologic\u0103 recomand\u00e2nd teste mai specifice pentru a confirma agentul etiologic;<\/li>\n<li style=\"text-align: justify;\">un rezultat negativ indic\u0103 faptul c\u0103 simptomele nu sunt produse de alergeni obi\u015fnui\u0163i, inhalan\u0163i \u00een cazul testului Phadiatop \u015fi inhalan\u0163i + alergeni alimentari \u00een cazul testului Phadiatop Infant.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">La copiii mici (0-4 ani) sensibilizarea alergic\u0103 este \u00een mod obi\u015fnuit legat\u0103 de alergeni alimentari cum ar fi: oul, laptele de vac\u0103, soia \u015fi arahidele \u015fi mai pu\u0163in de alergeni inhalan\u0163i. Totu\u015fi, s-a demonstrat c\u0103 anticorpii IgE specifici alergenilor inhalan\u0163i, cum ar fi acarienii din praful de cas\u0103 \u015fi perii de animale, apar precoce \u00een cursul vie\u0163ii la persoanele predispuse la atopie \u015fi pot avea valoare predictiv\u0103. \u0162in\u00e2nd cont de aceste date, Phadiatop Infant ofer\u0103 posibilitatea test\u0103rii la un complex de alergeni obi\u015fnui\u0163i, at\u00e2t alimentari c\u00e2t \u015fi inhalan\u0163i. Acest test este recomandat copiilor mici (0-4 ani) care prezint\u0103 clinic wheezing \u015fi\/sau eczem\u0103, cu scopul de a detecta atopia.<br \/>Atopia la copil constituie un factor de risc pentru dezvoltarea astmului bron\u015fic. De aceea este foarte important\u0103 demonstrarea prezen\u0163ei acestei condi\u0163ii pentru monitorizare \u015fi tratament adecvat.<\/p>\n<p style=\"text-align: justify;\">Dac\u0103 testul Phadiatop Infant este pozitiv, medicul va continua investigarea alergologic\u0103 pentru a detecta alergenul\/alergenii r\u0103spunz\u0103tori de simptome, solicit\u00e2nd determinarea de anticorpi IgE specifici pentru: lapte de vac\u0103, albu\u015f de ou, arahide, acarienii din praful de cas\u0103, p\u0103r de pisic\u0103, p\u0103r de c\u00e2ine.<br \/>\u00cen situa\u0163ii speciale se va recurge la testarea polenurilor (graminee, ierburi, arbori).<\/p>\n<p style=\"text-align: justify;\">La copii peste 5 ani \u015fi adul\u0163i se recomand\u0103 testul Phadiatop care demonstreaz\u0103 prezen\u0163a anticorpilor IgE la cei mai obi\u015fnui\u0163i alergeni inhalan\u0163i din mediu.<br \/>Sensibilitatea \u015fi specificitatea testului Phadiatop este de 93% \u015fi, respectiv, 89%.<\/p>\n<p style=\"text-align: justify;\">Men\u0163ion\u0103m c\u0103 testele Phadiatop, \u00een ciuda eficacit\u0103\u0163ii lor clinice satisf\u0103c\u0103toare, nu pot fi folosite efectiv \u00een scop de screening pe o popula\u0163ie neselec\u0163ionat\u0103. Pe de alt\u0103 parte, testele reprezint\u0103 un instrument de diagnostic eficient, de prim\u0103 alegere, la pacien\u0163ii suspecta\u0163i ca fiind atopici \u00een baza predispozi\u0163iei genetice \u015fi a istoricului familial.<\/p>\n<p style=\"text-align: justify;\">Dup\u0103 eviden\u0163ierea statusului atopic se poate trece la testarea IgE specifice unor grupuri de alergeni sau a unor alergeni individuali<sup>2<\/sup>.<\/p>\n<p>\u00a0<\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><p><strong>Analize medicale disponibile \u00een laboratoarele Synevo:<\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/imunoglobulina-ige\/\">Imunoglobulina IgE<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>230 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9421\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9421\"\r\n                                data-product_sku=\"IM29\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><\/div><\/div><p><strong><small>Bibliografie<\/small><\/strong><\/p><p><small>1. S.G.O. Johansson, et al. A Revised Nomenclature for Allergy: An EAACI Position Statement from the EEACI Nomenclature Task Force. In European Journal of Allergy and Clinical Immunology, sept. 2001, 56: 813-824.<br>2. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2006. Ref Type: Catalog.<\/small><\/p><hr class=\"wp-block-separator\"\/><p>Teste disponibile \u00een <strong>laboratorul Synevo<\/strong>: <\/p><p>Testul<a href=\"\/shop\/testul-phadiatop-infant\/\" class=\"rank-math-link\"> Phadiatop Infant<\/a>\/ Testul <a href=\"\/shop\/testul-phadiatop\/\" class=\"rank-math-link\">Phadiatop<\/a> \u2013 Teste alergologice &#8220;in vitro&#8221;<\/p><p><a href=\"\/shop\/imunoglobulina-ige\/\" class=\"rank-math-link\">Imunoglobulina E (IgE)<\/a><\/p><p><\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[902],"class_list":["post-10518","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-teste-alergologie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10518","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10518"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10518"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}