ALLERGY AND IMMUNOLOGY- OVERWIEV

ARZU DIDEM YALCIN, MD. University of Medical Science Internal Medicine, Allergy and Clinical Immunology. ANTALYA TRAINING AND RESEACRH HOSPITAL

Konuşma planı

0 1. Çevre bakanlığı ile ortak yaptığımız polenizasyon ve iklim değişimine bağlı Astım Seyri üzerine projelerimiz.Bulgularımızın sonucuna bağlı olarak ne gibi önlemler alınabilir?

0 2. Antalyadaki Astım Prevalansı çalışmalarımız.

0 3. ITU Mimarlik fakültesi ile ortaklaşa yapılan Astımlı Hastalara yönelik Sağlıklı kentsel tasarım projemizin sonuçları ve hastalara Önerilerimiz.

0 The prevalence of asthma, allergic rhinitis, and allergic eye disease is 8.2%, 10.8% and 7.5%, respectively, in Antalya, a city on the south coast of Turkey .

0 In Antalya, high levels of pollen allergens occured mostly from April to June. During these months meteorological conditions of the city are windy with low humidity, without rain, and lukewarm temperatures, all of which are contributing factors for seasonal allergies.

1. Yalcin AD,et al Prevalance of allergic asthma, rhinitis and conjunctivitis in over 16 year old individuals in

Antalya . Turkiye Klinikleri J Med Sci 2010; 30(3):888-94.

(2009- IPCRG World Conference,SPAIN, ORAL PRESENTATION).

2. Yalcin AD, et al.Pollen aero allergens and the climate in Mediterranean region and allergen sensitivity in allergic rhinoconjunctivitis and allergic asthma patients. Med Sci Monit 2013;19(2):102-10.

(2012-WORLD ASTMA, CANADA ,ORAL PRESENTATION).

3. Yalcin AD, et al. Evaluation Of Patients Receiving Spesific Immunotherapy In Antalya.

(2011- IPCRG World Conference, HOLLAND, ORAL PRESENTATION)

0 Several studies have investigated the association between pollen exposure and asthma emergency admissions, but only two have investigated the effect of airborne allergens on consultations for Allergic rhinitis.

0 This is study is a project of Environmental Ministery .

0 We evaluated the effects of climate change and airbone pollination. on the clinic cases of allergic rhinoconjunctivitis and allergic asthma patients. A year Later, we evaluated the same effects again. We searched for whether there was a change in the monthly clinic visits according to the climate change.

Table I. Demographics for the patient group (n=866)

Number of

patients

Percentage

% SEX

Male 294 33.9

Female 572 66.1

AGE

10-19 179 20.7

20-29 192 22.2

30-39 203 23.4

40-49 155 17.9

50-59 83 9.6

60+ 54 6.2

CLINICAL VISIT NUMBERS PER MONTH

January 59 6.8

February 92 10.6

March 86 9.9

April 104 12.0

May 152 17.6

June 127 14.7

July 55 6.4

August 40 4.6

September 48 5.5

October 24 2.8

November 40 4.6

December 39 4.5

Table II. Skin prick test results for patients (n=866) and % positivity to different allergens.

Test x ± SD (mm) Minimum maximum

size(mm)

Positive Result

Number of patients Percentage of patients

Positive control 11,15±3,79 1 - 24 863 99.6

Negative control 0,17±1,03 2 - 10 23 2.6

GRASS MIX 5,86±4,03 1 - 30 703 81.2

holcuslanatus 4,14±4,08 3 - 23 512 59.1

dactylisglomerata 4,75±4,40 3 – 26 594 68.6

loliumperenne 4,56±4,29 1 - 28 568 65.6

phleumpratense 3,46±3,76 3 – 21 452 52.2

poapratensis 3,54±3,92 2 – 24 459 53.0

festucapratensis 3,15±3,74 2 – 19 416 48.0

BARLEY MIX 4,09±4,20 2 - 30 516 59.6

hordeumvulgare 2,78±3,65 3 – 20 366 42.3

triticumsativum 2,61±3,54 2 – 20 351 40.5

secalecereale 2,32±3,63 2 – 22 316 36.5

avenasativa 2,32±3,35 2 – 18 319 36.8

WEED MIX 3,35±3,39 1 – 21 471 54.4

artemissiavulgaris 3,26±3,21 3 – 14 477 55.1

urticadioica 2,45±2,99 2 – 12 372 42.9

plantagolanceolata 2,65±3,15 3 – 18 396 45.7

taraxacumofficianele 2,46±3,33 3 – 20 353 40.8

TREE MIX 3,22±3,46 3 - 21 433 50.0

alnusglutinosa 2,40±3,19 3 – 18 337 38.9

corylusavellana 2,42±3,50 3 – 44 326 37.6

populusalba 2,52±3,12 3 – 13 366 42.3

salixcaprea 2,69±3,08 2 – 11 397 45.8

betulaverricosa 2,12±2.99 3 – 10 307 35.4

pinussilvestris 1,45±2,68 3 – 10 207 23.9

quereusrobur 2,58±3,03 3 – 10 386 44.6

robininapseudoacacia 0,17±1,03 2 – 10 23 2.6

oleaauropeae 3,57±3,48 3 – 18 491 56.7

EPITHELIAL ALLERGENS

dog 3,30±3,14 2 – 10 486 56.1

cat 2,91±3,26 3 – 15 415 47.9

horse 0,08±0,71 4 – 9 10 1.1

FUNGAL ALLERGENS

alternaria 3,38±3,18 2 – 18 496 57.3

aspergillusfumigatus 3,36±3,17 3 – 19 493 56.9

MITE MIX

D. pteronyssinus 3,88±3,69 3 – 36 532 61.4

D. farinae 3,95±4,54 3 – 45 517 59.7

P. germanica 0,07±0,70 4 – 11 9 1.0

P. america 0,03±0,39 3 – 8 4 0.5

Blatella germanica 2,73±3,32 3 - 35 457 52.8

AGE Corylusavellana

X±Sd (mm)

Aspergillus

fumigatus

X±Sd (mm)

Dpteronyssinus

X±Sd (mm)

Plantagolanceola

ta

X±Sd (mm)

<40 2.21±3.14 3.59±3.12 4.12±3.78 3.00±3.49

40+ 2.82±4.09 2.93±3.23 3.42±3.47 2.19±2.90

Independen

t-samples t-

test

p=0.02 p=0.004 p=0.008 p=0.001

Table V: Monthly pollination ratios

Marc

h

Ap

ril

May

Ju

ne

Ju

ly

Au

gu

st

Sep

tem

ber

Oct

ob

er

Novem

b

er

Dec

emb

er

Jan

uary

Feb

ruar

y

Tota

l

Tota

l %

Pinaceae 62.1 125.9 56.2 24.5 3.1 0.0 1.6 1.3 0.6 0.4 0.0 0.0 275.7 19.0

Cupressace

ae 84.9 8.2 2.7 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 65.3 162.2 11.2

Gramineae 0.6 4.0 202.9 78.6 51.1 22.9 13.4 1.8 0.4 0.0 0.0 0.0 375.7 25.9

Ericaceae 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.0 0.6 0.0 0.0 0.0 0.7 0.1

Chenopodi

aceae

Amarantha

ceae

0.0 0.0 0.0 7.4 17.8 3.2 0.8 3.0 0.0 0.0 0.0 0.0 32.1 2.2

Unidentifie

d 104.4 155.2 110.1 87.8 41.0 19.6 29.5 31.6 5.2 5.9 3.3 8.0 601.5 41.5

Total 252.0 293.3 372.1 199.3 113.0 45.6 45.3 37.7 6.7 6.3 3.3 73.3 1447.9 100.0

Total % 17.4 20.3 25.8 13.8 7.8 3.2 3.1 2.6 0.5 0.4 0.2 5.1 100.0

Allergens Most common on

…

%

Grass mix (n:703) May (n:115),

June(n:97)

30,2

Barley mix (n:516) May (n:94), June

(n:89)

35,5

Weed mix (n:471) May (n:71), June

(n:71)

30,1

Tree mix (n:433) May (n:77), June

(n:77)

35,6

The most commonly detected months of the allergens

YALCIN AD, BASARAN S. THE EFFECTS OF CLIMATE AND AERO ALLERGENS CHANGES IN ALLERGIC RHINOCONJUNCTIVITIS AND ALLERGIC ASTHMA PATIENTS IN

MEDITERRANEAN REGION BETWEEN 2011 AND 2012. MED SCI MONITOR 2013.

0 The aim of this study is to emphasize urban and health relationship by being healthy in urban life, describing “healthy urban parameters” especially in urban areas dominated by climate. During the period of March 2011 and February 2012, we examined 982 patients with allergic rhinoconjunctivitis and allergic asthma.

0 In Antalya during March, 2010 and February, 2011 number of clinical visits were 12%, 17.6% in April and May consequently. A year later nurber of clinical visits were found as 11% in both months. We concluded that there was a significant decrease in the number of monthly clinical visits in April and May compared to the previous year. We assumed that, evaluating synchronized climate reports, the factor for this is the declining of wind speed.We think this might be correlated with wind speed .

Dincer E, Cevik O, Yalcin AD. Healthy City Research from both clinical and urban planning perspectives: Antalya Case as a a Mediteranian Coastal City.

(2013-EAACI, Italy).

0 300 controlled allergic asthma patients were studied. 51% of the controlled patients are having allergic symptoms less than 5 years. 17% of the patients complained about highway, 6% of the patients complained about agricultural areas, %5 of the patients complained about industrial areas and 1% of the patients complained about tourism areas as urban facilities. 42% of the studied patients live in high-income (wealthy) residential areas though 28% of the patients live in low-income residential areas. 44% of the patients live in houses which have 100-150m² living area, 32% of the patients live in houses which have 80-100m² living area. 59% of the buildings were built before less than 15 years and 95% of the buildings are concrete. 45% of the patients work in tourism areas, 7% of them work in industrial areas and 5% of the patients work in agricultural areas. 28% of the studied patients are either not working or housewives.

We found profession, building age, building type and building material have effects on allergens which patients are sensitive to. The older the

building are, the more symptoms are seen in patients with allergic rhinoconjunctivitis and allergic asthma.

0 Patients who live in buildings which are older than 20 years, have allergic symptoms for medium (p:0.016) and long (p: 0.049) term. Patients who live in buildings which are 0-10 years old have allergic symptoms in fall (p:0.009) and Winter (p: 0.000), and patients who live in buildings which are 0-15 years old have allergic symptoms in Summer (p:0.009). Patients who live in wood houses have allergic symptoms mostly in Winter (p: 0.000). While patients who are disturbed by noise have allergic symptoms for short (p: 0.031) and medium (p:0.026) terms, long term patients are commonly disturbed by cockroaches (p: 0.023) and wall cracks (p: 0.025) in their living areas. Moreover smoking has an effect on allergic symptoms for short (p: 0.027) and long (p:0.002) term patients.

Bilgilendirme kartları örneklerimiz

PROF.DR. LUDWIG G. STRAUSS, Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Im Neuenheimer Feld 280, 69120,

Heidelberg, Germany.

Thank you

Prof. Dr. Tse Wen CHANG, Ph.D. (Taiwan)

Prof.Dr. Philipp Albert Shnabel(Germany)

Prof. Dr. Saadet GUMUSLU, Ph.D.

Prof. Dr. Reginald M GORCZYNSKI, MD, PhD. (Canada)

Prof.Dr. Olcay YEGIN, MD.

Prof. Dr. Ludwig G. STRAUSS, MD (Germany)

Prof.Dr. Felix HERTH, MD, PhD. (Germany)

Gizem Esra PARLAK MSc.

Dr. Atil BISGIN, MD, PhD (Sweden)

Prof. Dr. Hasan Huseyin POLAT, MD.

Dr. Emel SAHIN, PhD.

Assoc. Prof. Dr. Sukran KOSE, MD.

Nilgün (Sekretary)

Arzu Didem Yalcin ,MD adidyal@yahoo.com

Dünya Astım Günü Etkinliğimiz

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