Immune Polarization in Allergic Patients: Role of the Innate Immune System

Allergens come into contact with the immune system as components of a very diverse mixture. The most common sources are pollen grains, food, and waste. These sources contain a variety of immunomodulatory components that play a key role in the induction of allergic sensitization. The way allergen molecules bind to the cells of the immune system can determine the immune response. In order to better understand how allergic sensitization is triggered, we review the molecular mechanisms involved in the development of allergy and the role of immunomodulators in allergen recognition by innate cells.

Estudio de las din��micas de p��rdida de peso corporal en los programas de ejercicio f��sico y nutrici��n = Study of the dynamics of body weight loss in exercise and nutritional programs

Introducci��n. La obesidad puede definirse como una enfermedad metab��lica cr��nica de origen multifactorial, lo que provoca trastornos o problemas f��sicos y psicol��gicos a la persona, con patolog��as asociadas que limitan la esperanza de vida y deterioran la calidad de la misma, siendo determinante para sus ��reas sociales y laborales. Este trastorno metab��lico cr��nico se caracteriza por una acumulaci��n excesiva de energ��a en el cuerpo en forma de grasa, lo que lleva a un aumento de peso con respecto al valor esperado por sexo, edad y altura. La gesti��n y el tratamiento de la obesidad tienen objetivos m��s amplios que la p��rdida de peso e incluyen la reducci��n del riesgo y la mejora de la salud. Estos pueden ser alcanzados por la p��rdida modesta de peso (es decir, 10.5% del peso corporal inicial), la mejora del contenido nutricional de la dieta y un modesto incremento en la actividad f��sica y condici��n f��sica. La dieta es uno de los m��todos m��s populares para perder peso corporal. El ejercicio es otra alternativa para perder peso corporal. El aumento de ejercicio provoca un desequilibrio cuando se mantiene la ingesta cal��rica. Tambi��n tiene ventajas, como la mejora del tono muscular, la capacidad cardiovascular, fuerza y flexibilidad, aumenta el metabolismo basal y mejora el sistema inmunol��gico. Objetivos. El objetivo de esta tesis es contribuir en un estudio de intervenci��n para aclarar la evoluci��n del peso corporal durante una intervenci��n de dieta y ejercicio. Para ello, se evaluaron los efectos de la edad, sexo, ��ndice de masa corporal inicial y el tipo de tratamiento en las tendencias de p��rdida de peso. Otro objetivo de la tesis era crear un modelo de regresi��n lineal m��ltiple capaz de predecir la p��rdida de peso corporal despu��s del periodo de intervenci��n. Y, por ��ltimo, determinar el efecto sobre la composici��n corporal (peso corporal, ��ndice de masa corporal, la masa grasa, y la masa libre de grasa) de las diferentes intervenciones basadas en ejercicios (fuerza, resistencia, resistencia combinada con fuerza, y las recomendaciones de actividad f��sica (grupo control)) en combinaci��n con dieta de adultos con sobrepeso y obesidad, despu��s de la intervenci��n, as�� como los cambios de la composici��n corporal 3 a��os m��s tarde. Dise��o de la investigaci��n. Los datos empleados en el an��lisis de esta tesis son parte del proyecto ���Programas de Nutrici��n y Actividad F��sica para el tratamiento de la obesidad��� (PRONAF). El proyecto PRONAF es un estudio cl��nico sobre programas de nutrici��n y actividad f��sica para el sobrepeso y la obesidad, desarrollado en Espa��a durante varios a��os de intervenci��n. Fue dise��ado, en parte, para comparar diferentes tipos de intervenci��n, con el objetivo de evaluar su impacto en las din��micas de p��rdida de peso, en personas con sobrepeso y obesidad. Como dise��o experimental, el estudio se bas�� en una restricci��n cal��rica, a la que, en algunos casos, se le a��adi�� un protocolo de entrenamiento (fuerza, resistencia, o combinado, en igualdad de volumen e intensidad). Las principales variables para la investigaci��n que comprende esta tesis fueron: el peso corporal y la composici��n corporal (masa grasa y masa libre de grasa). Conclusiones. En esta tesis, para los programas de p��rdida de peso en personas con sobrepeso y obesidad con un 25-30% de la restricci��n cal��rica, el peso corporal se redujo significativamente en ambos sexos, sin tener en cuenta la edad y el tipo de tratamiento seguido. Seg��n los resultados del estudio, la p��rdida de peso realizada por un individuo (hombre o mujer) durante los seis meses puede ser representada por cualquiera de las cinco funciones (lineal, potencial, exponencial, logar��tmica y cuadr��tica) en ambos sexos, siendo la cuadr��tica la que tiende a representarlo mejor. Adem��s, se puede concluir que la p��rdida de peso corporal se ve afectada por el ��ndice de masa corporal inicial y el sexo, siendo mayor para las personas obesas que para las de sobrepeso, que muestran diferencias entre sexos s��lo en la condici��n de sobrepeso. Adem��s, es posible calcular el peso corporal final de cualquier participante involucrado en una intervenci��n utilizando la metodolog��a del proyecto PRONAF s��lo conociendo sus variables iniciales de composici��n corporal. Adem��s, los cuatro tipos de tratamientos tuvieron resultados similares en cambios en la composici��n corporal al final del per��odo de intervenci��n, con la ��nica excepci��n de la masa libre de grasa, siendo los grupos de entrenamiento los que la mantuvieron durante la restricci��n cal��rica. Por otro lado, s��lo el grupo combinado logra mantener la reducci��n de la masa grasa (%) 3 a��os despu��s del final de la intervenci��n. ABSTRACT Introduction. Obesity can be defined as a chronic metabolic disease from a multifactorial origin, which leads to physical and psychological impacts to the person, with associated pathologies that limit the life expectancy and deteriorate the quality of it, being determinant for the social and labor areas of the person. This chronic metabolic disorder is characterized by an excessive accumulation of energy in the body as fat, leading to increased weight relative to the value expected by sex, age and height. The management and treatment of obesity have wider objectives than weight loss alone and include risk reduction and health improvement. These may be achieved by modest weight loss (i.e. 5���10% of initial body weight), improved nutritional content of the diet and modest increases in physical activity and fitness. Weight loss through diet is one of the most popular approaches to lose body weight. Exercise is another alternative to lose body weight. The increase of exercise causes an imbalance when the caloric intake is maintained. It also has advantages such as improved muscle tone, cardiovascular fitness, strength and flexibility, increases the basal metabolism and improves immune system. Objectives. The aim of this thesis is to contribute with an interventional study to clarify the evolution of the body weight during a diet and exercise intervention. For this, the effects of age, sex, initial body mass index and type of treatment on weight loss tendencies were evaluated. Another objective of the thesis was to create a multiple linear regression model able to predict the body weight loss after the intervention period. And, finally, to determine the effect upon body composition (body weight, body mass index, fat mass, and fat-free mass of different exercise-based interventions (strength, endurance, combined endurance and strength, and physical activity recommendations group (control group)) combined with diet in overweight and obese adults, after intervention as well as body composition changes 3 years later. Research Design. The data used in the analysis of this thesis are part of the project "Programs of Nutrition and Physical Activity for the treatment of obesity" (PRONAF). The PRONAF project is a clinical trial program about nutrition and physical activity for overweight and obesity, developed in Spain for several years of intervention. It was designed, in part, to compare different types of intervention, in order to assess their impact on the dynamics of weight loss in overweight and obese people. As experimental design, the study was based on caloric restriction, which, in some cases, added a training protocol (strength, endurance, or combined in equal volume and intensity). The main research variables comprising this thesis were: body weight and body composition outcomes (fat mass and fat-free mass). Conclusions. In this thesis, for weight loss programs in overweight and obese people with 25-30% of caloric restriction, the body weight was significantly decreased in both sexes, regardless the age and type of followed treatment. According to the results of the study, the weight loss performed by an individual (male or female) during six months can be represented by any of the five functions (linear, power law, exponential, logarithmic and quadratic) in both sexes, being the quadratic one which tends to represent it better. In addition, it can be concluded that the body weight loss is affected by the initial body mass index and sex condition, being greater for the obese people than for the overweight one, showing differences between sexes only in the overweight condition. Moreover, it is possible to calculate the final body weight of any participant engaged in an intervention using the PRONAF Project methodology only knowing their initial body composition variables. Furthermore, the four types of treatments had similar results on body composition changes at the end of the intervention period, with the only exception of fat-free mass, being the training groups the ones that maintained it during the caloric restriction. On the other hand, only the combined group achieved to maintain the fat mass (%) reduced 3 years after the end of the intervention.