Alérgenos de animais de estimação: relevância clínica e implicações em ambientes domésticos e ocupacionais
Pet allergens: clinical relevance and implications in domestic and occupational environments
Clóvis E. S. Galvão, Cinthya Covessi Thom-de-Souza, Ernesto Akio Taketomi, Keity Souza Santos, Laura Maria Lacerda Araujo, Luisa Karla Arruda, Priscila Megumi Takejima, Rafaella Amorim Gaia Duarte, Stella Arruda Miranda
Resumo
A sensibilização a alérgenos de animais de estimação representa um problema crescente de saúde pública, especialmente em ambientes urbanos. Cães e gatos continuam sendo as principais fontes de alérgenos intradomiciliares, com destaque para as proteínas Can f 1 e Fel d 1, respectivamente. Outros animais com pelo, como cavalos, coelhos, porquinhos-da-índia, roedores e hamsters, também podem desencadear reações alérgicas relevantes, incluindo casos de alergia ocupacional. A reatividade cruzada entre alérgenos de diferentes espécies, como lipocalinas e albuminas séricas, contribui para a complexidade do diagnóstico e manejo clínico. O diagnóstico envolve a correlação entre a história clínica e a detecção de IgE específica por meio de testes cutâneos ou sorológicos. No entanto, limitações na padronização e na sensibilidade dos extratos alergênicos disponíveis dificultam a acurácia diagnóstica, principalmente no caso dos alérgenos caninos. A imunoterapia com alérgenos (ITA) tem mostrado benefícios clínicos mais consistentes em pacientes alérgicos a gatos, embora sua eficácia em relação a cães ainda seja limitada. Abordagens alternativas, como o uso de anticorpos monoclonais anti-Fel d 1, vacinas experimentais e rações modificadas, vêm sendo investigadas. O controle ambiental permanece desafiador, dada a persistência dos alérgenos em ambientes contaminados e sua dispersão passiva. Estratégias como a remoção de carpetes e higienização frequente são recomendadas, embora seus efeitos nem sempre sejam clinicamente significativos. Conclui-se que, além de medidas de prevenção e controle, é urgente o desenvolvimento de testes diagnósticos padronizados e extratos alergênicos de alta qualidade, especialmente para aplicação segura e eficaz da imunoterapia.
Palavras-chave
Abstract
Sensitization to pet allergens is an increasing public health concern, particularly in urban areas. Dogs and cats remain the main sources of indoor allergens, with Can f 1 and Fel d 1 being the most clinically relevant proteins. Other fur-bearing animals, such as horses, rabbits, guinea pigs, rodents, and hamsters, may also trigger significant allergic reactions, including occupational allergy. Crossreactivity among allergens from different species-especially lipocalins and serum albumins-adds complexity to both diagnosis and clinical management. Diagnosis relies on clinical history and the detection of specific IgE through skin prick tests or in vitro assays. However, limitations in the standardization and sensitivity of available allergen extracts-particularly for dog allergens-reduce diagnostic accuracy. Allergen immunotherapy (AIT) has shown more consistent clinical benefits in cat-allergic patients, while the efficacy of AIT for dog allergens remains limited. Alternative strategies approaches, such as monoclonal anti-Fel d 1 antibodies, experimental vaccines, and modified pet diets, are currently under investigation. Environmental control remains a challenge due to the persistence of allergens in contaminated environments and their passive dissemination via clothing and surfaces. Measures such as carpet removal and frequent cleaning are advised, although they may not always result in clinically significant improvement. In conclusion, in addition to preventive and symptomatic approaches, there is an urgent need for standardized diagnostic tools and high-quality allergen extracts-particularly for dog allergens-to enable the safe and effective implementation of AIT.
Keywords
Referências
1. Curin M, Hilger C. Allergy to pets and new allergies to uncommon pets. Allergol Select. 2017;1(2):214-22. https://doi.org/10.5414/ALX01842E. PMid:30402618.
2. Chan SK, Leung DYM. Dog and cat allergies: current state of diagnostic approaches and challenges. Allergy Asthma Immunol Res. 2018;10(2):97-105. https://doi.org/10.4168/aair.2018.10.2.97. PMid:29411550.
3. Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional por Amostra de Domicílios: animais de estimação [Internet]. Rio de Janeiro: IBGE; 2013 [citado 2023 ago 3]. https://biblioteca.ibge.gov.br/visualizacao/livros/liv94074.pdf
4. Brasil. Ministério da Agricultura, Pecuária e Abastecimento – MAPA. População de animais de estimação no Brasil [Internet]. Brasília: MAPA; 2023 [citado 2023 ago 3]. http://www.agricultura.gov.br/assuntos/camaras-setoriais-tematicas/documentos/camarastematicas/insumos-agropecuarios/anosanteriores/ibge-populacaode-animais-de-estimacao-no-brasil-2013-abinpet-79.pdf
5. Tribuna de Jundiaí. Mundo Pet: gatos podem superar cães como animais de estimação no Brasil, diz estudo [Internet]. Jundiaí; 9 set 2019 [citado 2023 ago 3]. https://tribunadejundiai.com.br/mais/mundo-pet/gatos-podem-superarcaes-como-animais-deestimacao-no-brasil-diz-estudo
6. Rizzo MCFV, Solé D, Rizzo A, Holanda MA, Rios JB, Wandalsen NF et al. Atopic disease in Brazilian children - etiologic multicentric study. J Pediatr. 1995;71(1):31-5. https://doi.org/10.2223/JPED.699. PMid:14689033.
7. Pastorino AC, Kuschnir FC, Arruda LK, Casagrande RR, Souza RG, Dias GA et al. Sensitisation to aeroallergens in Brazilian adolescents living at the periphery of large subtropical urban centres. Allergol Immunopathol (Madr). 2008;36(1):9-16. https://doi.org/10.1157/13115665. PMid:18261427.
8. Dutra BMRS, Rosário NA Fo, Zavadniak AF. Inhalant allergens in Curitiba: a review of its clinical importance. Rev Bras Alerg Imunopatol. 2001;24(5):189-95.
9. Remes ST, Castro-Rodriguez JA, Holberg CJ, Martinez FD, Wright AL. Dog exposure in infancy decreases the subsequent risk of frequent wheeze but not of atopy. J Allergy Clin Immunol. 2001;108(4):509-15. https://doi.org/10.1067/mai.2001.117797. PMid:11590373.
10. Arshad SH, Tariq SM, Matthews S, Hakim E. Sensitization to common allergens and its association with allergic disorders at age 4 years: a whole population birth cohort study. Pediatrics. 2001;108(2):e33. https://doi.org/10.1542/peds.108.2.e33. PMid:11483843.
11. Ingram JM, Sporik R, Rose G, Honsinger R, Chapman MD, Platts-Mills TA. Quantitative assessment of exposure to dog (Can f 1) and cat (Fel d 1) allergens: relation to sensitization and asthma among children living in Los Alamos, New Mexico. J Allergy Clin Immunol. 1995;96(4):449-56. https://doi.org/10.1016/S0091-6749(95)70286-5. PMid:7560654.
12. Platts-Mills TA, Sporik R, Ingram JM, Honsinger R. Dog and cat allergens and asthma among school children in Los Alamos, New Mexico, USA: altitude 7,200 feet. Int Arch Allergy Immunol. 2009;107(1-3):301-3. https://doi.org/10.1159/000237008. PMid:7613154.
13. Dramburg S, Hilger C, Santos A, de Las Vecillas L, Aalberse RC, Acevedo N et al. EAACI molecular allergology user’s guide 2.0. Pediatr Allergy Immunol. 2023;34(Suppl 28):e13854. https://doi.org/10.1111/pai.13854. PMid:37186333.
14. Dávila I, Domínguez-Ortega J, Navarro-Pulido A, Alonso A, Antolín-Amerigo D, González-Mancebo E et al. Consensus document on dog and cat allergy. Allergy. 2018;73(6):1206-22. https://doi.org/10.1111/all.13391. PMid:29318625.
15. Sparkes AH. Human allergy to cats: a review for veterinarians on prevalence, causes, symptoms and control. J Feline Med Surg. 2022;24(1):31-42. https://doi.org/10.1177/1098612X211036793. PMid:34622710.
16. Gawlik R, Pitsch T, Dubuske L. Anaphylaxis as a manifestation of horse allergy. World Allergy Organ J. 2009;2(8):185-9. https://doi.org/10.1097/WOX.0b013e3181b2fe51. PMid:23283110.
17. Hilger C, Kler S, Arumugam K, Revets D, Muller CP, Charpentier C et al. Identification and isolation of a Fel d 1-like molecule as a major rabbit allergen. J Allergy Clin Immunol. 2014;133(3):759-66. https://doi.org/10.1016/j.jaci.2013.04.034. PMid:23763973.
18. Hilger C, van Hage M, Kuehn A. Diagnosis of allergy to mammals and fish: cross-reactive vs. specific markers. Curr Allergy Asthma Rep. 2017;17(9):64. https://doi.org/10.1007/s11882-017-0732-z. PMid:28831729.
19. Hilger C, Swiontek K, Arumugam K, Lehners C, Hentges F. Identification of a new major dog allergen highly cross-reactive with Fel d 4 in a population of cat- and dog-sensitized patients. J Allergy Clin Immunol. 2012;129(4):1149-51.e2. https://doi.org/10.1016/j.jaci.2011.10.017. PMid:22104604.
20. Jeal H, Jones M. Allergy to rodents: an update. Clin Exp Allergy. 2010;40(11):1593-601. https://doi.org/10.1111/j.1365-2222.2010.03609.x. PMid:20840394.
21. Pecquet C. New pets and allergies. Eur J Dermatol. 2012;22(1):14-22. https://doi.org/10.1684/ejd.2011.1555. PMid:22062496.
22. Hilger C, Dubey VP, Lentz D, Davril C, Revets D, Muller CP et al. Male-specific submaxillary gland protein, a lipocalin allergen of the golden hamster, differs from the lipocalin allergens of Siberian and Roborovski dwarf hamsters. Int Arch Allergy Immunol. 2015;166(1):30-40. https://doi.org/10.1159/000371420. PMid:25765367.
23. Díaz-Perales A, González-de-Olano D, Pérez-Gordo M, Pastor-Vargas C. Allergy to uncommon pets: new allergies but the same allergens. Front Immunol. 2013;4:492. https://doi.org/10.3389/fimmu.2013.00492. PMid:24416032.
24. Corradi M, Ferdenzi E, Mutti A. The characteristics, treatment and prevention of laboratory animal allergy. Lab Anim. 2013;42(1):26-33. https://doi.org/10.1038/laban.163. PMid:23246890.
25. Jones M. Laboratory animal allergy in the modern era. Curr Allergy Asthma Rep. 2015;15(12):73. https://doi.org/10.1007/s11882-015-0575-4. PMid:26496763.
26. Chan SK, Leung D. Dog and cat allergies: current state of diagnostic approaches and challenges. Allergy Asthma Immunol Res. 2018;10(2):97-105. https://doi.org/10.4168/aair.2018.10.2.97. PMid:29411550.
27. Hemmer W, Sestak-Greinecker G, Braunsteiner T, Wantke F, Wöhrl S. Molecular sensitization patterns in animal allergy: relationship with clinical relevance and pet ownership. Allergy. 2021;76(12):3687-96. https://doi.org/10.1111/all.14885. PMid:33914361.
28. Perzanowski MS, Rönmark E, Nold B, Lundbäck B, Platts-Mills TA. Relevance of allergens from cats and dogs to asthma in the northern most province of Sweden: schools as a major site of exposure. J Allergy Clin Immunol. 1999;103(6):1018-24. https://doi.org/10.1016/S0091-6749(99)70173-9. PMid:10359880.
29. Platts-Mills JA, Custis NJ, Woodfolk JA, Platts-Mills TA. Airborne endotoxin in homes with domestic animals: implications for catspecific tolerance. J Allergy Clin Immunol. 2005;116(2):384-9. https://doi.org/10.1016/j.jaci.2005.05.012. PMid:16083794.
30. Wood RA, Chapman MD, Adkinson Jr NF, Eggleston PA. The effect of cat removal on allergen content in household dust samples. J Allergy Clin Immunol. 1989;83(4):730-4. https://doi.org/10.1016/0091-6749(89)90006-7. PMid:2708734.
31. Nageotte C, Park M, Havstad S, Zoratti E, Ownby D. Duration of airborne Fel d 1 reduction after cat washing. J Allergy Clin Immunol. 2006;118(2):521-2. https://doi.org/10.1016/j.jaci.2006.04.049. PMid:16890781.
32. Satyaraj E, Wedner HJ, Bousquet J. Keep the cat, change the care pathway: a transformational approach to managing Fel d 1, the major cat allergen. Allergy. 2019;74(Suppl 107):5-17. https://doi.org/10.1111/all.14013. PMid:31498459.
33. Thoms F, Jennings GT, Maudrich M, Vogel M, Haas S, Zeltins A et al. Immunization of cats to induce neutralizing antibodies against Fel d 1, the major feline allergen in human subjects. J Allergy Clin Immunol. 2019;144(1):193-203. https://doi.org/10.1016/j.jaci.2019.01.050. PMid:31056187.
34. Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S et al. EAACI Allergen immunotherapy user’s guide. Pediatr Allergy Immunol. 2020;31(Suppl 25):1-101. https://doi.org/10.1111/pai.13189. PMid:32436290.
35. Davidson W, Lucas S, Borish L. Update on allergy immunotherapy. Allergy Asthma Clin Immunol. 2005;1(4):161-73. https://doi.org/10.1186/1710-1492-1-4-161. PMid:20529220.
36. Dhami S, Agarwal A. Does evidence support the use of cat allergen immunotherapy? Curr Opin Allergy Clin Immunol. 2018;18(4):350-5. https://doi.org/10.1097/ACI.0000000000000457. PMid:29870462.
37. Orengo JM, Radin AR, Kamat V, Badithe A, Ben LH, Bennett BL et al. Treating cat allergy with monoclonal IgG antibodies that bind allergen and prevent IgE engagement. Nat Commun. 2018;9(1):1421. https://doi.org/10.1038/s41467-018-03636-8. PMid:29650949.
38. Shamji MH, Singh I, Layhadi JA, Ito C, Karamani A, Kouser L et al. Passive prophylactic administration with a single dose of anti-Fel d 1 monoclonal antibodies REGN1908-1909 in cat allergen-induced allergic rhinitis: a randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med. 2021;204(1):23-33. https://doi.org/10.1164/rccm.202011-4107OC. PMid:33651675.
Submetido em:
03/07/2025
Aceito em:
16/03/2026
Facebook
LinkedIn
Mendeley
StumbleUpon
Reddit
Email