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Propuesta de estrategia preventiva para el asma bronquial: estudio de gemelos / A proposal of a preventive strategy for bronchial asthma
Resumen
El Asma Bronquial es una enfermedad crónica con herencia multifactorial, que constituye un problema de salud en todo el mundo, con una tendencia a incrementar su morbimortalidad. Con el objetivo de proponer una estrategia de prevención para esta enfermedad se realizó una investigación epidemiológica, analítica, y transversal (sobre gemelos y Asma Bronquial) incluido como parte del programa de desarrollo de la Genética Médica en Cuba en el municipio de Pinar del Río, provincia Pinar del Río (Cuba). Esta permitió hacer una caracterización clínica-epidemiológica y genealógica de la enfermedad en gemelos con al menos, un miembro afecto e identificar que los factores genéticos contribuyen en un 72%, al origen del Asma Bronquial en este medio, determinado por los estudios de concordancia y cálculo de su heredabilidad, teniendo en cuenta que la mayoría de los gemelos comparten el mismo ambiente. En el contexto de la investigación fue elaborada y propuesta una Estrategia de Salud dirigido a la prevención y mejora de la calidad de vida de las personas que padecen Asma Bronquial, contando para ello con los recursos que aporta el Sistema de Salud en Cuba y el apoyo de la sociedad organizada.
Palabras clave: ASMA BRONQUIAL/prevención, ENFERMEDADES RESPIRATORIAS, GEMELOS, ESTRATEGIA.
ABSTRACT
Bronchial Asthma is a chronic disease with multifactorial inheritance that constitutes a health problem all over the world, having an increasing morbidity and mortality rate. Aimed at suggesting a strategy for the prevention of this disease an epidemiological, analytical and cross-sectional research (about bronchial asthma and twins) was conducted and included as a part of the program for the development of Medical Genetics in Cuba, Pinar del Rio municipality (Cuba). This research allowed making a clinical-epidemiological and genealogical characterization of this disease, with at least one member affected as well as to identify that genetic factors contribute with 72% of the disease origin in this environment, determining it by means of the studies of concordance and inheritance; taking into consideration that the majority of the twins share the same environment. During the research a Health Strategy was created aimed at preventing and improving the quality of life of people who suffer from Bronchial Asthma, supported on the resources of the Cuban Health System and the organization of the society.
Key words: ASTHMA, prevention, RESPIRATORY TRACT DESEASES, TWINS, STRATEGY.
Referencias
Negrín Villavicencio J A. Asma bronquial. Aspectos básicos para un tratamiento integral según la etapa clínica. La Habana: Editorial Ciencias Médicas; 2004
Dirección Nacional de Registros Médicos y Estadística. Registro nacional de gemelos 2006. Ministerio de Salud Pública: Ciudad de La Habana. 2007; 1.7.
Skadhauge LR, Chistsen K, Kyvik KO, Sigsgaard T. Genetic and environmental influence on asthma: a population.based study of 11,688 Danish twin pairs. Eur Respir J. 2006; 13: 8.14.
The Collaborative Study on the Genetics of Asthma. A genome.wide search for asthma susceptibility loci in ethnically diverse populations. Nat Genet. 2006; 7:125.129.
Genoma Genome.Wide searchfor asthma susectibility loci in ethnically diverse populations. The Collaborative Study on the Genetic of Asthma. Nat Genet .2005; 15: 389.2.
Ulrik CS, Kok.Jensen A. Different bronchodilating effect of salmeterol and formoterol in an adult asthmatic. Eur Respir J .2005; 7:1003.5.
Wjst M. Specific IgE- one gene fits all? German Asthma Genetics Group. Clin Exp Allergy .2006; 29 Supl 4:5.10.
Weiss St, Speizer FE. Epidemiology and natural history. En: Weiss EB, Stein M, Little Brown. Bronchial asthma mechanisms and therapeutics 3.ª ed. Boston: Little, Brown and company. 2003; 15.21.
Berhman RE, Kliegman RM, Hargin AM. Nelson Tratado de Pediatria. 15 ed. Ciudad de la Habana: Editorial Ciencias Médicas.1998; 1:787.802.
International Study of Asthma and Allergies in Childhood Steering Comittee. Worldwide variation in the prevalence of symptoms of asthma allergic rhinoconjunctivitis and atopic eczema. Lancet 2007; 351: 1225.1232.
Abbas AK, Lichtmann AH: Immediate Hipersensitivity. En Abbas AK, Lichtmann AH. Cellular and Molecular Immunology, Philadelphia: Saunders Fifth edition 2006; 432.52.
Romagnani S. Immunologic influences on allergy and the Th1/Th2 balance. J Allergy Clin Immunol. 2006; 113: 395.40.
Lilly CM: Diversity of asthma: evolving concepts of patophysiology and lessons from genetics. J Allergy Clin Immunol 2005; 115 Supl 4: S526.31.
Ulham JW, Holt PG. Enviromental and development of atopy. Curr Opin Allergy Clin Immunol. 2005; 5: 167.72.
Prescott S, Macaubas C, Holt B, Smallacombe TB, Loh R, Sly PD et al. Transplacental priming of the human immune system to environmental allergens: universal skewing of initial T cell responses towards the Th2 cytokine profile. J Immunol .2006; 160: 4730.4737.
Brabäck L, Hedberg A. Perinatal risk factors for atopic disease in conscripts. Clin Exp Allergy. 2006; 28: 936.942
Björksten B. The intrauterine and postnatal environments. J Allergy Clin Immunol. 2006; 104: 1119.1127.
Von Mutius E, Nicolai T, Martinez FD. Prematurity as a risk factor for asthma in preadolescent children. J Pediatr. 2003; 123: 223.229.
Hanrahan JP, Tager IB, Segal MR, Tosteson TD, Castile RG, Van Vunakis H et al. The effect of maternal smoking during pregnancy on early infant lung function. Am Rev Respir Dis .2006; 145: 1129.1135.
Tager IB, Hanrahan JP, Tosteson TD, Castile RG, Brown RW, Weiss ST et al. Lung function, pre. and post.natal smoke exposure, and wheezing in the first year of life. Am Rev Respir Dis. 2006; 147: 811.817.
Ehrlich RI, Du Toit D, Jordaan D, Zwarestein M, Potter P, Volmink JA et al. Risk factors of childhood asthma and wheezing. Importance of maternal and household smoking. Am J Respir Crit Care Med. 2006; 154: 681.688.
Cunningham J, O`Connor GT, Dockery DW, Speizer FE. Environmental tobacco smoke, wheezing, and asthma in children in 24 communities. Am J Respir Crit Care Med .2006; 153: 218.224.
Litonjua S, Cicala C, Scharenberg AM, Kinet LP. The FceRIbeta subunit funtions as an amplifier of FceRIgamma. mediated cell activation signals. Cell.2006; 85: 985.95.
Agustin JB, Kaur B, Andreson HR, Burr M, Harkins LS, et al: Hay fever, eczema, and wheeze: anationwide UK study (ISAAC, international study of asthma and allergies childhood). Arch Dis Child. 2005; 81: 225.30.
Peat JK, Allen J, Oddy W. Beyond breast.feeding. J Allergy Clin Immunol. 2005; 104: 526.529.
Wright AL, Sherrill D, Holberg CJ, Halonen M, Martínez FD. Breast.feeding, maternal IgE, and total serum IgE in childhood. J Allergy Clin Immunol .2005; 104: 589.594.
Frischer T, Kuehr J, Meinert R, Karmans W, Urbanek R. Risk factors for childhood asthma and recurrent wheezy bronchitis. Eur J Pediatr. 2003; 152: 771.775.
Copyright (c) 2010 Eddy Llobany González Ungo, Migdalia de las Mercedes Peña Abraham, Carlos Romero Díaz, Martha Valladares Hernández
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