Alergiile sezoniere
Dr. Jeana Rodica Radu
Profesor universitar - UMF "C.Davila" Catedra Alergologie - Spitalul Clinic "N.Malaxa"
Termenul de alergii sezoniere defineste un manunchi de boli alergice IgE mediate particularizate, in general, prin evolutie intermitenta, dependenta de variatiile sezoniere ale concentratiilor alergenelor ce actioneaza ca inductori ai sensibilizarii si/sau ca factori declansatori ai simptomelor clinice ce le caracterizeaza jogos casino online.
Delimitari Din punct de vedere epidemiologic, alergiile sezoniere care includ rino-conjunctivitele si astmul sezonier, reprezinta cele mai raspandite, cunoscute si investigate boli atopice.
Mult mai rar, intre alergiile sezoniere pot fi incadrate si anafilaxiile sau reactiile sistemice de diferite grade de severitate (vezi clasificarea Muller) cauzate de expunerea brutala/intempestiva la polenuri, precum si urticariile de contact cu aceste alergene, declansate in sezonul specific Bonus Fara Depunere
Etio-patogenic, alergiile sezoniere cu expresie rino-conjuctivala si bronsica sunt corelate cu expunerea la alergene a caror variatie cantitativa este dependenta de factori climatici, intre cele incriminate fiind enumerate: polenurile, dar si mucegaiurile si chiar acarienii, care pot
avea o dezvoltare accentuata sezoniera.
In clinica, si de aici uzual, termenul de alergii sezoniere se atribuie limitativ bolilor conjunctivei si cailor aeriene superioare si inferioare, provocate de expunerea si reexpunerea la polenuri. Cunoscute ca rino-conjunctivite si astm sezonier, acestea sunt denumite sub termenul generic polinoze.
Polenurile - principalele alergene in bolile sezoniere
Polenurile se prezinta sub forma de granule cu morfologie, dimensiuni si alte caracteristici specifice de specie.
Functional, granulele de polen reprezinta celulele sexuate masculine, cu rol in reproducerea plantelor cu seminte, fiind purtatoarele gametilor masculini dispersati pe gametii feminini ai altei plante din aceeasi specie.
Modalitatea de vehiculare a polenurilor diferentiaza plantele anemofile (polenizate de vant) de cele entomofile (polenizate mediat de insecte, omizi, mici animale cu blana, serpi etc.).
Principala sursa de polenuri alergizante este asigurata de plantele anemofile, ale caror granule de polen au variatii dimensionale intre 2 si 60 mm in diametru. Acestea sunt aeropurtate si dispersate pe arii extinse. Plantele entomofile nu reprezinta decat un rezervor alergenic limitat (neimportant cantitativ si cu o arie de dispersie limitata).
Polenizarea este asociata perioadei de inflorire a plantelor, caracteristica diferitelor specii. Pentru zona noastra geografica, la sfarsitul iernii (februarie) si in perioada primaverii timpurii (martie, aprilie) infloresc arborii din familia Betulaceae Betula verrucosa (mesteacan), Corylus
avellana (alun), Alnus glutinosa (arin) si unele Salicaceae - Salix caprea (un tip de salcie) si Populus deltoides (plopul).
Pentru acestea, perioada de polenizare variaza intre cateva zile pana la doua saptamani, polenurile de dimensiuni mari fiind cross reactive si emise abundent; ele induc fenomene de rino-conjunctivita.
Mai putin importante pentru sensibilizare sunt polenurile de Quercus robur (stejar), Ulmus camperi (ulm) si Platanus acelifolia (platan) iar polenul de Fagus silvatica (fag) nu produce deloc sensibilizari. Numarul indivizilor sensibilizati la polenuri de arbori timpurii nu este nici el important.
Coniferele sunt arbori care isi pastreaza frunzele pe toata durata anului; unele specii de conifere induc polenuri corelate cu alergia sezoniera. Asa sunt: Cryptomeria japonica (cedrul japonez) responsabil de polinoze manifestate in perioada februarie-aprilie, ca si Juniperus ashei (cedrul de munte) si Cupressus sempervireus (chiparosul).
Polenul de Pinus silvestris (pin), desi extrem de abundent, are si el o alergenicitate redusa.
Primavara tarzie (mai) pana la mijlocul verii (iulie) este perioada de polenizare a gramineelor de cultura si salbatice, larg raspandite la noi si puternic sensibilizante, cross reactive. Dintre acestea fac parte Povideae-le: Lolium perenne (zizania, iarba de gazon), Dactylis glomerata
(golomat, golomoz), Festuca rubra (paius rosu), Holcus lanatus, Phleum pratense (timoftica) etc.
Ierburile buruieni sunt plante salbatice, cu polenizare peranuala, dar cu varfuri sezoniere concomitente cu gramineele, iar pentru unele (ambrosia), polenizarea se face in lunile august-septembrie.
Cele mai importante ierburi alergogene sunt reprezentate de: Artemisia vulgaris si Parientaria judaica, Ambrosia artemisifolia si Ambrosia trifida, Urtica dioica (urzica mare), Rumex acetosella (macrisul marunt), Plantago lanceolata (patlagina ingusta).
Si intre polenurile de ierburi exista reactii incrucisate, care se pot extinde si la alergenele din Compositae.
Exista numeroase stari alergice, fie cu expresie multiorganica (anafilaxie), fie cu expresie in principal digestiva (sindromul oral) induse de cross reactivitatea intre polenuri si unele alimente.
Remarcabile sunt reactiile incrucisate intre:
a) arbori timpurii (betula verrucosa - mesteacan) si alte belulaceae (Corylus avellana, Alnus glutinosa) si fructe, in special - Rosaceae (mar, par, cais, piersic, capsuni, prun, kiwi), dar si nuci, migdale, alune, legume /vegetale (cartof, morcov, tomate);
b) graminee (cross reactivitate intre specii) si leguminoase (soia, mazare), arahide, graminacee cerealiere si faina de cereale;
c) ierburi/buruieni ca artemisia vulgaris si compositae (floarea soarelui, musetel), vermut, vegetale condimente (umbeliferae si alte familii): selina, pastarnac, morcov, piper alb, boia, patrunjel, arpagic, pepene galben, banana sau intre Ambrosia si Curcubitaceae (pepene verde, galben, cantalup, castravete) si banana.
Numerosi alergeni proveniti din polenuri au fost identificati, caracterizati, iar o parte si clonati.
Au fost identificati epitopii principali din grupurile I-V din Lolium perrene, Sorglum balepense, Poa pratensis ca si din numeroase alte polenuri, fiind izolat si citocromul C (grupul X).
Clonarea aminoacizilor din unele polenuri a fost utila pentru caracterizarea fenomenului de legare a epitopilor la IgE si celula T ca si la initierea imunoterapiei cu alergene recombinate.
Tabloul clinic caracteristic alergiilor sezoniere
Debutul simptomelor ce caracterizeaza alergiile sezoniere este cel mai adesea, lent progresiv. Tabloul clinic multiorganic, variaza de la discret pana la intens zgomotos, afectand frecvent conjunctiva si caile aeriene superioare.
Subiectii cu polinoza acuza: prurit oculo-nazal, faringian si chiar otic, lacrimare, injectie conjunctivala, senzatie de corp strain intraocular, uneori fotofobie, edem palpebral; la aceste semne se adauga stranuturi in salve, hidroree, blocaj nazal intermitent, tuse in accese, disfonie, wheesing izolat si dispnee in accese de tip astmatic.
Fenomenele clinice sunt corelate cu expunerea la polenuri fiind declansate cel mai adesea in aer liber.
Gravitatea tabloului clinic variaza de la o zi la alta in functie de conditiile de expunere, fiind dependenta in principal de concentratia polenurilor in mediu.
Sunt descrise cateva conditii care pot majora severitatea evolutiei, intre care importante sunt: sensibilizarea si inflamatia alergica preexistenta indusa de alergene peranuale, hiperreactivitatea bronsica nespecifica crescuta, care complica severitatea crizelor de astm sezonier, conjunctivita sicca (majoreaza rata sensibilizarii prin lipsa lacrimilor ce ar trebui sa
impiedice contactul cu granulele de polen).
Diagnosticul alergiilor sezoniere
Diagnosticul alergiilor sezoniere este bazat pe un trepied ce consta din:
- anamneza
- determinarea tipurilor si concentratiei de polenuri in mediu
- teste de identificare a alergenelor sezoniere (dozare IgE specifice in vitro sau teste de provocare in vivo - testare cutanata, de regula prin intepatura, teste prick) sau conjunctivale - aplicarea extractelor standardizate in sacul conjunctival intern si determinarea cantitatii de lacrimi si a proteinelor/mediatorilor continuti in acestea, in
paralel cu monitorizarea conjunctivitei/rinitei induse, provocari nazale si bronsice pe cale naturala prin expunere (in camp/parc) si monitorizarea simptomelor induse, urmarirea raspunsului la tratament.
Tratamentul bolilor alergice sezoniere
Tratamentul bolilor alergice sezoniere este complex, durata aplicarii lui ca si diversitatea schemei terapeutice fiind dependente de:
- durata expunerii la polenuri si de agresivitatea acestora
- interesarea mono/pluriorganica
- gradul de severitate evolutiva
- posibile asocieri morbide, ce necesita tratamente incompatibile cu unele procedee terapeutice (ca incompatibilitatea intre imunoterapia cu vaccinuri alergenice si tratamentul cu beta-blocante si inhibitorii enzimei de conversie a angiotensinei)
- complianta la terapie a individului afectat.
Planul terapeutic al alergiilor sezoniere impune:
- asigurarea mijloacelor de evitare partiala/totala a alergenelor
- modularea raspunsurilor celulelor implicate in inflamatia alergica indusa de polenuri prin folosirea stabilizatorilor de membrana celulara
- farmacoterapia antimediatori (antihistaminice, antileucotriene)
- farmacoterapie antiinflamatorie (nesteroidiana si - in cazuri exceptional severe - steroidiana)
- imunoterapia cu vaccinuri alergenice/vaccinuri recombinante, aplicata pre-sezonier sau peranual.
Profilaxia contactului cu polenurile este dintre cele mai dificile interventii limitative de contact. Ea include:
- evitarea in sezon a activitatilor in aer liber, cel putin in orele de densificare polenica;
- circulatia cu geamurile masinii inchise si cu folosirea aerului conditionat cu filtre inalt performante;
- folosirea ochelarilor/mastilor de protectie, atunci cand expunerea in aer liber este obligatorie;
- spalarea conjunctivei bulbare si mucoasei nazale pentru eliminarea granulelor depolen.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
Comentarii (212)
coachstore 30 Decembrie, 2011 - 10:25
If you need to acquire the focus, you need to sustain the christian louboutin uk, which with stylish components that will immediately concoct you appreciably more attracting and outstanding.There are different kinds of crossbody bags within marketplace nowadays. Even so it is not possible to beat the timeless design jointly with traditional elegance of the Bags at the christian louboutin.Beautiful Designer Handbags!The following christian louboutin sale have always been a majestic choice,which are cost-effective.Most importantly,they will help you to get out of the commom.christian is one of the most distinguished leather brand all over the world. You can find many wonderful cheap christian louboutin uk sale on our christian Factory Stores.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
coachstore 30 Decembrie, 2011 - 10:23
coach factory outlet has new coach laptop bags in listing. No matter which style do you want, we can provide it for you.If people began to create a certain coach handbags, this fashionable line will be a coach. It will remind people of happy time when they like coach factory store.It may be a good helper for me.Coach Madison Handbags and Coach Poppy Bags are viewed among probably the most newsworthy among the particular coach factory stores so far.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
coachstore 30 Decembrie, 2011 - 10:20
Coach handbags from the coach factory online are popular now because of the colorful fabric. It is fashionable and beautiful. You can see the opening of the bag like wave, which is its special design.Coach handbags and purses at the coach factory outlet with new designs make them have the most outstanding and eye-catching advantage among other brands goods.coach factory outlet online offer New Signature bags which is a the newest cool creation from Coach. The look is positively upscale. Gorgeous lightly textured black leather, beautiful for any season.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
coachstore 30 Decembrie, 2011 - 10:17
The coach factory outlet has been in business for many years. You can log in to find more information about its products and services.in the market you definitely can find various colorways that are designed in as well as the high quality that applied in. For most of you would like to come. So just come to our coach factory outlet online store to choose one.Cheap replica Coach Handbags'style synchronous with the official coach factory store, all the pictures of discount replica coach Handbags are taken in kind.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
mikejision 27 Decembrie, 2011 - 07:27
And when I move, the draped silk fabric flows with me and if by occasion, my dress or blouse North face outlet store does expose some part of body - my skin is highlighted by the contrast of the silk fabric.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
North 9 Decembrie, 2011 - 03:42
Most jackets are wind-resistant and durable for you to wear to stand the cold windy days. Owning the North Face Sale, you do not have to stay bloated all winter long. The pockets on the front of the North Face Clearance are able to keep your hands warm when in the open air. The North Face Outlet in our site is dedicated to providing all customers the best-quality jackets.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
North 9 Decembrie, 2011 - 03:41
<p>Most jackets are wind-resistant and durable for you to wear to stand the cold windy days. Owning the <a href="http://www.jacketsonlinesale.org">North Face Sale</a>, you do not have to stay bloated all winter long. The pockets on the front of the <a href="http://www.jacketsonlinesale.org">North Face Clearance</a> are able to keep your hands warm when in the open air. The <a href="http://www.jacketsonlinesale.org">North Face Outlet</a> in our site is dedicated to providing all customers the best-quality jackets.</p>
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
chenee 6 Decembrie, 2011 - 03:12
Amongst Coach Outlet Online by far the most preferred accessories of females are handbags or cheap coach purses. Coach Factory Online coach factory outlet undoubtedly are a symbolic representation of sophistication, coach factory online offer fashion and quality on coach factory. Coach Factory, the usual high-end, coach factory outlet online luxury, sexy and famous, as "a symbol of status and wealth", Coach Outlet Online are loved and enjoyed by females a lot coach factory outlet. Brand Coach Factory become coach factory rich coach outlet consumer darling of high society coach outlet online. The business community louis vuitton handbags outlet has always been to close more than coach outlet store online elegant fashion gucci backpack. An appropriate instance coach outlet online may be the coach handbags outlet situation that coach outlet online store was definitely produced to get paired with the bag. Coach Outlet is a well-known American producer Coach Factory Outlet at home and abroad coach outlet. Coach outlet online store is most on the runway possibilities had been sized for essentials only. If you are a lady who must hold your whole coach factory outlet store lifestyle in your handbag, Cheap Coach Purses shows various bags and purses for you. Acquiring a symbol of fashion Coach Outlet Online, a cool and glamour Coach Outlet can make a distinction in the character of a lady. Becoming accessible Coach Outlet Store Online in distinctive designs and colors makes Coach Factory Online Store the very first substitute of these girls Coach Factory Store who wish to possess a matching Coach Factory Outlet Store with every single outfit of theirs. Coach Outlet Canada share and network in the trend has been the first choice for shopping from Coach outlet store online. If you want to be in the front of fashion world with high quality cheap coach bags, then you can choose to come to Coach Factory Online. Nowadays, Coach Factory Outlet Online almost become the key word of vogue, owning some fabulous Coach Outlet Online likely to be the dreams of lots of young ladies. During the past many years, Coach Factory Outlet Online was seen as one of the most famous and competitive Coach Factory online ware designer and manufacturer Coach Factory Outlet. Welcome to choose from Coach Outlet Online! The Coach Factory Online is one of the elegant New Discount Coach Handbags. Coach outlet online is not only easy to take for small enough when you go out Coach Outlet, but it is has many pocket space Coach Factory Outlet Online which are very useful for you, and convenient. Made of luxurious leather coach factory, the Coach Factory Outlet Online are not only durable and practical, but also cute coach factory outlet enough to carry as an ornamental! It is convenient for you.This color is generous,it is suit for the middle-aged ladies mainly. If you are planing to buy a Handbag on coach factory store, don't hesitate, Coach Outlet Store Online are your first choice.
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
Coach Outlet online 30 Noiembrie, 2011 - 08:05
Many new productsCoach Handbags Outlet
Coach Factory Outlet
Coach Factory Store
Coach Outlet Coupons have been added on Coach Outlet Online
Coach Handbags
Coach Outlet Store
Coach Factory Store Damier Graphite Bags Coach Factory Outlet Online
Coach Outlet Online Store
Coach Factory Store Online
Louis Vuitton Outlet Collection since last May, Coach Bags
Coach Factory Outlet Online
Coach Outlet Stores
Coach Factory Store including gament cover, Coach Factory Outlet Store
Coach Outlet Store
Coach Outlet Online
Louis Vuitton Outlet toilet pouch, Coach Factory Outlet Online
Coach Outlet
Coach Factory
Coach Bag steamer bag and keep-all ,Coach Factory Handbag Outlet Store
Louis Vuitton Bags
Coach Bags which extends product Coach Outlet
Coach Outlet Coupons
Coach Online Outlet
Coach Bags Outlet line for the traditionalCoach Factory Outlet Online
Coach Outlet Store Online
Coach Factory Outlet . Recently, three new pieces Coach Outlet Store Online
Coach Factory Outlet
Coach Outlet Online Store
Coach Outlet Purses have joined the classic Coach Purses Outlet
Coach Factory Store
Coach Outlet
Louis Vuitton collection. Coach Purse Outlet
Coach Outlet Store Online
Coach Outlet Stores Online
Louis Vuitton Outlet They are:Damier Graphite Discount Coach Purses
Coach Outlet Online
Coach Outlet Online Store
Coach Outlet Store MichaelCoach Factory Online
Coach Online Store
Coach Factory Outlet Online Damier Graphite Michael Coach Outlets
Coach Outlet Online Store
Coach Outlet Store
Coach Outlet Store Online is the first and only Cheap Coach Purses
Coach Outlet
Coach Purses
Coach Factory Online
Coach Factory Outlet backpack on Coach Factory Online
Coach Factory Store Online
Coach Factory Damier Collection which combines style Coach Outlet Online Store
Coach Factory Store
Coach Factory Outlet and comfort with its lightweight design. Coach Factory Outlet Online
Coach Purses Outlet Online
Louis Vuitton Although it has large size at 10.2" x 17.7" x 6.7", Coach Factory Outlet Online
Coach Outlet Online
Coach Bags On Sale
Coach Factory Outlet the sleek shape make Coach Outlet Online Store
Coach Outlet Bags
Coach Factory Online it barely hold my Lenovo SL400 with Coach Factory Outlet Online
Coach Factory
Coach Outlet Store Online
Coach Online Outlet Store 14.1 inches monitor and hard to pull it out. Cheap Coach Bags
Coach Outlet Coupon
Coach Purse Outlet Online
Coach Outlet Online Maybe a 10 inches netbook is more suitable. Coach Outlet
Coach Factory
Coach Outlet Store The Coach Outlet
Coach Outlet Stores Online
Coach Outlet Online
Coach Outlet Coupon Backpack is an ideal choice for business or travel. Coach Factory Outlet Online
Coach Outlet Handbags
Coach Outlet Stores Online There are two exterior zip pocket, Coach Purses Outlet
Coach Factory Outlet
Coach Outlet
Coach Factory Outlet Online an interior computer sleek and a cellphone pocket. Coach Outlets
Cheap Coach Bags
Coach Bags
Coach Purse Outlet It is sold for $1530.Damier Graphite Computer Coach Outlet Stores Online
Coach Purses Outlet
Louis Vuitton Outlet SleeveWith a double zip closure and a compartment Coach Online Outlet
Coach Purses Outlet
Coach Purses On Sale embossed with the Coach Factory
Coach Outlet Stores
Coach Outlet logo, Coach Purses For Cheap
Coach Outlet Store
Coach Factory Online Damier Computer Sleeve looks gorgeous. There are two sizes to choose-13 inches and 15 inches, Coach Factory Outlet
Coach Factory Outlet
Coach Outlet Stores Online
Coach Outlet Store which is enough for most laptops but Coach Outlet Store Online
Louis Vuitton Outlet
Coach Outlet Store Online leaves few space for the must-have accessories Coach Handbags Factory Outlet
Coach Outlet Store Online
Coach Outlet Online such as power line and mouse. Whatever, priced at US$650 and US$700 respectively, It won't Coach Purses Outlet Online
Coach Factory Outlet Store
Coach Factory Online impress any sober technical geeks and for those fashionistas, they care nothing but logos Coach Outlet
Louis Vuitton
Coach Outlet
Coach Outlet Online Store .Damier Graphite Camera BagMeasuring at 8.6" x 15.3" x 9.4", the stylish Damier Camera Bag can offer Coach Factory Store Online
Coach Factory Outlet
Coach Store Online
Coach Factory Outlet good protection for small andCoach Outlet Online
Coach Factory Store Online
Coach Handbag Outlet medium sized cameras with many Coach Online Outlet Store
Coach Purse Outlet compartments for accessories. Coach Bags Outlet
Coach Outlet Store Online
Coach Factory Outlet Online It can be carried and shouldered by a handle and a detachable strap. Coach Online Factory Store
Coach Outlet Stores But the retail price is US$2250 which Coach Factory Store Online
Coach Outlet Store Online
Louis Vuitton is higher than most cameras. I doubt if any professional Coach Factory Outlet
Coach Factory Store Online photographers will be interested in it.Visit Handbag Comment [http://handbagcomment.com] for Daily Reviews on Trendy Handbags Coach Purses
Coach Factory Outlet Online Gucci Review for Professional Reviews on Gucci Handbags, Clothes, Fragrance
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
supratkshoes 24 Noiembrie, 2011 - 08:40
Green Bay Packers Jerseys
A.J. Hawk Jerseys
Aaron Kampman Jerseys
Aaron Rodgers Jerseys
Al Harris Jerseys
B.J. Raji Jerseys
Bart Starr Jerseys
Brandon Jackson Jerseys
Brett Favre Jerseys
Charles Woodson Jerseys
Clay Matthews Jerseys
Donald Driver Jerseys
Greg Jennings Jerseys
James Starks Jerseys
Jermichael Finley Jerseys
John Kuhn Jerseys
Jordy Nelson Jerseys
Nick Barnett Jerseys
Nick Collins Jerseys
Paul Hornung Jerseys
Randall Cobb Jerseys
Ray Nitschke Jerseys
Reggie White Jerseys
Ryan Grant Jerseys
Tramon Williams Jerseys
William Henderson Jerseys
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
eemmaa 14 Noiembrie, 2011 - 08:46
Coach Factory Online custom made Coach Handbags Outlet are among probably the most Louis Vuitton Outlet Online well-known custom made accessories. If you are acquainted Coach Outlet Online with many handbag brands, you are optimistic to know the producer Coach Outlet Online. Coach Outlet Online is typically a recognize which stands for style trend. This could be typically a stunning recognize for countless individuals in style bags and purses industry. Reduce price Nike Dunk producer enjoys the terrific reputation for delivering good good quality Coach Outlet Online Store and aesthetic layout bags and Cheap Coach Purses at the same time to other Coach accessories from Coach Factory Outlet Store. Have you experienced any attention in Coach Purses Outlet? Louis Vuitton Bags Outlet presently are usually used by typically each and every and every other female you research around. And if you as well desire to research best Coach Outlet and reflect your assortment of most latest fashion, you need to purchase a decent and sensible Coach Outlet Online that is effortlessly obtainable inside the market. You will should hunt near to an ideal offer of stores to acquire just one you ordinarily longed for. You also really feel gratified if you have the worth for the income you spend for Cheap Gucci Handbags. Anyway, you will appear throughout the Coach Factory Outlet and understand its reliability and utility. Welcome to order!
- autentifică-te sau înregistrează-te pentru a adăuga comentarii
kaizheng 16 Ianuarie, 2012 - 16:08
Louis Vuitton
Coach Outlet
Cheap Louis Vuitton
Louis Vuitton
Coach Online Outlet Store
Louis Vuitton Bag
Hermes Bags
Hermes
Coach Store Online
Hermes Wallet
Coach Outlet Store Online
Hermes Birkin
Coach Store Outlet
Coach Factory Outlet Online
www.louisvuitton.com
Burberry Bags
Prada
Louis Vuitton Purse
Louis Vuitton Bags
Louis Vuitton Purse
Burberry
Coach Outlet Online Store
Louis Vuitton Outlet
Louis Vuitton Sunglasses
coachoutlet
Hermes Bag
Coach Factory Handbag Outlet Store
Hermes
Cheap Louis Vuitton Purses
Coach Outlet Online
Coach Factory Outlet Online
Louis Vuitton Outlet
Coach Factory Outlet
Louis Vuitton Handbags
Coach Factory Online
Coach Outlet Online
Coach Outlet Store Online
Chanel Bags
Louis Vuitton
Louis Vuitton Handbag
Louis Vuitton Outlet
Coach Outlet Store Online
Louis Vuitton Handbags Authentic
Coach Purse Outlet
Louis Vuitton Outlet Online
Louis Vuitton Bags
Louis Vuitton Outlet
Coach Outlet
Louis Vuitton Bags
louis vuitton.com
Coach Outlet Online
Discount Louis Vuitton Handbags
Louis Vuitton Outlet
Coach Outlet Store
Coach Wallets
Louis Vuitton Outlet
Coach Outlet Stores
Coach Outlet Store Online
Coach Bags
Coach Online Outlet
Louis Vuitton Purses
Discount Louis Vuitton
Coach Handbags Outlet
Prada Handbags
Louis Vuitton Bag
Louis Vuitton Outlet
Coach Purses
Coach Outlet Online Store
Louis Vuitton
Louis Vuitton Handbag
Louis Vuitton Wallets
Coach Store Online
Coach Handbags
Louis Vuitton Purses
Coach Handbags
Coach Outlet Stores
Louis Vuitton Outlet
Coach Outlet Handbags
Louis Vuitton Handbags
www.burberry.com
www.coachoutlet.com
Coach Outlet Online
Coach Purses Outlet
Louis Vuitton Bags
Chanel Handbags
Coach Online Outlet
Louis Vuitton Outlet Stores
louis vuitton.com
Louis Vuitton Bags
Louis Vuitton
www.louisvuitton.com
Louis Vuitton Outlet Store
Louis Vuitton Outlet Online
Prada Bags
Coach Factory Outlet Store
www.prada.com
Coach Factory Outlet Store
Louis Vuitton Purses
Louis Vuitton Handbags
Coach Handbag Outlet Sale
Coach Outlet Stores
Prada Outlet
Louis Vuitton
Louis Vuitton Outlet Online
Louis Vuitton Handbags Outlet
Cheap Louis Vuitton Bags
Hermes Purses
Louis Vuitton Outlet
Hermes Birkin
Coach Outlet Online
Louis Vuitton Bags
Louis Vuitton Purse
Louis Vuitton Outlet Store
Louis Vuitton
Louis Vuitton 2012
Louis Vuitton Purses
Coach Outlet Store Online
Louis Vuitton Handbags
Authentic Louis Vuitton Bag
Coach Factory Handbag Outlet Store
Louis Vuitton Bags 2012
Hermes Handbags
Authentic Louis Vuitton Bags
Louis Vuitton Outlet Stores
burberry.com
Hermes Bags
Burberry Handbags
www.louisvuitton.com
Louis Vuitton Store
Coach Purse
Coach Handbag Outlet
Louis Vuitton
Coach Outlet Stores Online
Louis Vuitton Handbag Outlet
Authentic Louis Vuitton
Louis Vuitton
Coach Outlet Store
Coach Handbag Factory Outlet
Coach Handbag
Authentic Louis Vuitton Handbags
Louis Vuitton Handbags
Cheap Louis Vuitton handbags
Coach Outlet Stores Online
Louis Vuitton USA
Coach Store Online
Louis Vuitton Sale
www.louisvuitton.com