Papular urticaria: A review of causal agents in Colombia

Abstract

López: análisis bioinformático y datos experimentales inéditos Todos los autores contribuyeron en igual medida a la redacción del manuscrito. La urticaria papular es una enfermedad alérgica causada por la picadura de insectos, la cual predomina en el trópico. El objetivo de esta revisión fue profundizar en sus aspectos epidemiológicos e inmunológicos, particularmente con base en datos publicados en Latinoamérica. Se hizo una revisión no sistemática mediante la búsqueda electrónica de artículos sobre la epidemiología de la urticaria papular, las características entomológicas de los agentes causales y los mecanismos inmunológicos asociados. Según los diversos reportes de centros médicos de Latinoamérica la urticaria papular es frecuente; el único estudio de prevalencia publicado indica que afecta a una cuarta parte de los niños escolares de Bogotá. Hay información sobre la relación causal entre la exposición domiciliaria a la pulga, la pobreza y la urticaria papular en Bogotá, una ciudad representativa de las altitudes andinas. No hay estudios que indaguen directamente sobre los insectos causales en zonas cálidas, aunque se sospecha clínicamente de los mosquitos Aedes aegypti y Culex quinquefasciatus. En cuanto a su patogenia, se destaca la participación de mecanismos celulares que involucran las células colaboradoras Th2, lo cual explica que sea una condición de hipersensibilidad retardada. El papel de la inmunoglobulina E (IgE) en la urticaria papular no está tan claro. Se desconocen los antígenos derivados de los insectos que causan la enfermedad, aunque se plantea que existen moléculas comunes de reacción cruzada entre los insectos, tales como el alérgeno Cte f 2 en la pulga, y sus homólogos en los mosquitos. La urticaria papular es una condición frecuente en Latinoamérica que debe investigarse en profundidad. La caracterización inmunológica de los componentes moleculares que causan esta condición puede resolver interrogantes sobre su etiología y su patogenia. Urticaria papular y sus agentes causales en ColombiaPalabras clave: urticaria; insectos; Aedes; Culex; Ctenocephalides; hipersensibilidad. doi: http://dx.doi.org/10.7705/biomedica.v36i4.3258 Papular urticaria: A review of causal agents in ColombiaPapular urticaria is a chronic allergic reaction induced by insect bites, which is common in the tropics. The objective of this review was to deepen on epidemiological and immunological aspects of this disease, focused on data published in Latin American countries. We conducted a non-systematic review of the literature through electronic search on the epidemiology of papular urticaria, the entomological characteristics of the causative agents and associated immunological mechanisms. Several reports from medical centers suggest that papular urticaria is common in Latin America. Only one epidemiological survey designed to estimate prevalence of papular urticaria has been published, reporting that about a quarter of children under six years of age is affected by this condition in Bogotá. There is evidence on the ca...

Cellular and Humoral Responses to Cte f 2, a Cat Flea Allergen, in Children with Papular Urticaria

“…This protein is phylogenetically related to other allergens from arthropods, including Sol i 3 and Ves v 5 (Table 1). Homologous proteins were also identified in the mosquito species A. aegypti and Culex quienquefasciatus , both of which are present in tropical climates and associated with skin hypersensitivity reactions [3]. We further assessed whether pAb raised in Cte f 2 immunized mice recognized the mosquito homolog Aedes Cte f 2 like and observed a weak IgG binding (online suppl.…”

“…Chronic exposure to insect bites, such as mosquito and flea species, is common in this environment, but its effects on the immune system physiology are barely known. Their salivary fluid may induce hypersensitivity reactions in the host [2, 3]. One of them is papular urticaria (PU), a common chronic skin disorder [3] characterized by a delayed hypersensitivity reaction manifested by papule type skin lesions, intense pruritus, severe secondary infections, and scarring [1].…”

“…Cte f 2 and Cte f 3 were also reported as allergens (based on IgE testing) in the WHOI/IUIS database without further details regarding their antigenic and molecular features. Cte f 2 is phylogenetically related to other insect allergens belonging to the CAP (cysteine-rich secretoryprotein/antigen-5 [Ag5]/pathogenesis related-1) superfamily of proteins [3], which are known to participate in biological processes such as reproduction, fungal virulence, cellular defense, and immune evasion [19]. The possibility of cloning and producing those antigens allows investigation of their immune effects on humans and analysis of whether share characteristics with those found in pathobiology.…”

“…Their salivary fluid may induce hypersensitivity reactions in the host [2, 3]. One of them is papular urticaria (PU), a common chronic skin disorder [3] characterized by a delayed hypersensitivity reaction manifested by papule type skin lesions, intense pruritus, severe secondary infections, and scarring [1]. PU is frequent in several tropical countries [4-6] and may be induced by Ctenocephalides felis , also known as cat flea, which may inhabit dwellings even outside of pet bodies [7, 8].…”

The Unmet Needs in Atopic Dermatitis Control in Latin America: A Multidisciplinary Expert Perspective

“…Other differential diagnoses of AD include miliaria, papular urticaria, seborrheic and contact dermatitis, ichthyosis, atypical psoriasis, cutaneous T-cell lymphoma, infective dermatitis, and primary immunodeficiencies [33][34][35]. Because some of these diseases may appear simultaneously, they can further hinder AD diagnosis [36,37].…”