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Doenças alérgicas respiratórias na ilha da Madeira
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As alergias respiratórias, que incluem a asma e a rinite, são patologias de extrema importância na área da saúde, uma vez que apresentam uma prevalência elevada na população mundial, afetando várias faixas etárias e ambos os géneros, e representando uma relevante parcela dos gastos da saúde. Além disso, são patologias com um grande impacto na qualidade de vida dos pacientes, apresentando elevadas taxas de morbilidade e mortalidade. Apesar da ideia empírica de que a prevalência de doenças alérgicas respiratórias na Madeira é superior à verificada em Portugal continental, vários estudos demonstraram precisamente o contrário. As patologias alérgicas respiratórias são doenças de origem multifatorial, em que existe uma interação entre fatores ambientais e genéticos, que contribuem para o seu desenvolvimento e progressão. Alguns fatores desencadeantes foram estudados, nomeadamente a poluição atmosférica, a concentração de pólenes e fungos no ambiente, o clima e os fatores genéticos. Verificou-se que a Madeira apresenta concentrações atmosféricas de pólenes e fungos inferiores às registadas em Portugal continental, bem como, uma prevalência inferior dos polimorfismos genéticos da IL4 e IL4-RP2 associados ao desenvolvimento de alergias respiratórias. Relativamente à poluição atmosférica demonstrou-se que as concentrações de NO2 foram superiores na ilha da Madeira comparativamente às restantes regiões do país, o que pode explicar o agravamento dos sintomas referidos empiricamente por alguns pacientes, uma vez que a poluição foi associada a formas mais graves da patologia, mas não se comprovou que aumentasse a prevalência da mesma. Os dados do clima parecem ser os únicos que não estão de acordo com a prevalência encontrada, uma vez que a Madeira revelou ter condições meteorológicas favoráveis ao desenvolvimento de pólenes, no entanto não é isso que se verifica, pelo que são necessários mais estudos para esclarecer a situação.
Respiratory allergies, which include asthma and rhinitis, are pathologies of extreme importance in the health field, since they have a high prevalence in the world population, affecting several age groups and both genders, and representing a relevant amount of costs for health care. In addition, they are pathologies with a great impact on the patients' quality of life, presenting high rates of morbidity and mortality. Despite the empirical idea that the prevalence of allergic respiratory diseases in Madeira is higher than the ones found in mainland Portugal, several studies have shown the opposite. Allergic respiratory pathologies are diseases of multifactorial origin, in which there is an interaction between environmental and genetic factors that contribute to its development and progression. Some triggers were studied, namely air pollution, the concentration of pollens and fungi in the environment, climate and genetic factors. We have seen that Madeira has atmospheric concentrations of pollens and fungi lower than those recorded in mainland Portugal, as well as a lower prevalence of the genetic polymorphisms of IL4 and IL4-RP2 associated to the development of respiratory allergies. Regarding air pollution, it was shown that NO2 concentrations were higher in Madeira rather than in the rest of the country. This may explain the worsening of the symptoms referred empirically by some patients, since pollution has been associated with more severe forms of the pathology, but not proven to increase its prevalence. The climate data seem to be the only ones that are not in accordance with the prevalence found, since Madeira has shown to have favourable weather conditions for the development of pollens. However, this is not the case, so further studies are needed to clarify the situation.
Respiratory allergies, which include asthma and rhinitis, are pathologies of extreme importance in the health field, since they have a high prevalence in the world population, affecting several age groups and both genders, and representing a relevant amount of costs for health care. In addition, they are pathologies with a great impact on the patients' quality of life, presenting high rates of morbidity and mortality. Despite the empirical idea that the prevalence of allergic respiratory diseases in Madeira is higher than the ones found in mainland Portugal, several studies have shown the opposite. Allergic respiratory pathologies are diseases of multifactorial origin, in which there is an interaction between environmental and genetic factors that contribute to its development and progression. Some triggers were studied, namely air pollution, the concentration of pollens and fungi in the environment, climate and genetic factors. We have seen that Madeira has atmospheric concentrations of pollens and fungi lower than those recorded in mainland Portugal, as well as a lower prevalence of the genetic polymorphisms of IL4 and IL4-RP2 associated to the development of respiratory allergies. Regarding air pollution, it was shown that NO2 concentrations were higher in Madeira rather than in the rest of the country. This may explain the worsening of the symptoms referred empirically by some patients, since pollution has been associated with more severe forms of the pathology, but not proven to increase its prevalence. The climate data seem to be the only ones that are not in accordance with the prevalence found, since Madeira has shown to have favourable weather conditions for the development of pollens. However, this is not the case, so further studies are needed to clarify the situation.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Alergias respiratórias Asma Rinite Ilha da Madeira Otorrinolaringologia