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Scribante A, Pascadopoli M, Bergomi P, Licari A, Marseglia GL, Bizzi FM, Butera A. Evaluation of two different remineralising toothpastes in children with drug-controlled asthma and allergic rhinitis: a randomised clinical trial. Eur J Paediatr Dent 2024; 25:1. [PMID: 38357755 DOI: 10.23804/ejpd.2024.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
AIM To compare the efficacy of two remineralising toothpastes in children suffering from asthma and allergic rhinitis after a 6-month study. METHODS 40 patients aged between 6-14 years with enamel demineralisations were enrolled for the study at the Unit of Dental Hygiene of the University of Pavia (Italy). The following indices were collected: Schiff air index (SAI), plaque index (PI), bleeding on probing (BoP), salivary pH, Basic Erosive Wear Examination (BEWE), susceptibility index (SI) for hard and soft tissues' pathologies, and decayed missing filled teeth (DMFT). After mechanical debridement with piezoelectric instrumentation and glycine powder, patients were equally divided into two groups: Group 1 using a toothpaste with zinc hydroxyapatite, and Group 2 using a toothpaste containing calcium sodium phosphosilicate. The toothpaste had to be used twice a day. The time frames of the study were: baseline (T0), after 1 month (T1), after 3 months (T2), after 6 months (T3). CONCLUSION The tested toothpastes can be proposed for home use in children with asthma and allergic rhinitis as they significantly reduced dental sensitivity and periodontal indices.
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Affiliation(s)
- A Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy - Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - M Pascadopoli
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - P Bergomi
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Licari
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy - Paediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G L Marseglia
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy - Paediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F M Bizzi
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - A Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
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De Amici M, Barocci F, Barzaghi CE, Sacchi L, De Silvestri A, Licari A, Caimmi S, Marseglia A, Testa G, Torre C, Marseglia GL. Impact of individual molecular components in determining primary sensitization to latex. Immunobiology 2023; 228:152320. [PMID: 36621307 DOI: 10.1016/j.imbio.2022.152320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/01/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
Allergy to natural rubber latex emerged as one of the main allergies at the beginning among some professional groups and the general population. Sensitization and development of latex allergy have been attributed to exposure to products containing residual latex proteins. The prevailing cross-reactivity of latex proteins with other food allergens is of great concern. Numerous purified allergens are currently available, which greatly help in patient management, thus determining their specific profile. We conducted a multicenter study to investigate changes, from the ROC analysis, in the characteristics of patients with latex allergy by measuring its major protein components. Sensitization to latex proteins is crucial because it highlights the cross reactivity to inhalants (pollen) and food (fruit). It is very essential in an accurate and specific clinical setting.
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Affiliation(s)
- M De Amici
- Immuno-Allergology Laboratory of Clinical Chemistry and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Barocci
- Medicine Unit Laboratory, ASST Rhodense Garbagnate Milanese, Rho, Italy.
| | - C E Barzaghi
- Allergology Clinic, ASST Rhodense Garbagnate Milanese, Rho, Italy
| | - L Sacchi
- Laboratory for Biomedical Informatics "Mario Stefanelli", Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
| | - A De Silvestri
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica - Fondazione IRCCS Policlinico san Matteo, Pavia, Italy
| | - A Licari
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Caimmi
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Testa
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Torre
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G L Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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3
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Tosca MA, Schiavetti I, Marseglia GL, Ciprandi G. The gender effect in children and adolescents with asthma: practical outcomes from the "ControL'Asma" study. Eur Ann Allergy Clin Immunol 2021; 55:141-143. [PMID: 34612027 DOI: 10.23822/eurannaci.1764-1489.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M A Tosca
- Allergy Center, Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - I Schiavetti
- Department of Health Science, University of Genoa, Genoa, Italy
| | - G L Marseglia
- Pediatrics Clinic, Department of Pediatrics, Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - G Ciprandi
- Allergy Clinic, Department of Outpatients, Casa di Cura Villa Montallegro, Genoa, Italy
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4
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Ciprandi G, Licari A, Tosca MA, Marseglia GL. Levodropropizine in children: over thirty years of clinical experience. J BIOL REG HOMEOS AG 2021; 35:15. [PMID: 34355551 DOI: 10.23812/21-176-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | - A Licari
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - M A Tosca
- Pediatric Allergy Center, Istituto Giannina Gaslini, Genoa, Italy
| | - G L Marseglia
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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5
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De Amici M, Barocci F, Licari A, Caimmi S, Marseglia A, Testa G, Torre C, Marseglia GL. Latex allergy: advantages of molecular diagnostics during coronavirus. J BIOL REG HOMEOS AG 2021; 35:1145-1149. [PMID: 34127177 DOI: 10.23812/21-09-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M De Amici
- Immuno-Allergology Laboratory of Clinical Chemistry and Pediatric Clinic, Foundation IRCCS Policlinic San Matteo, Pavia, Italy
| | - F Barocci
- Medicine Unit Laboratory, ASST Rhodense Garbagnate Milanese, Rho, Italy
| | - A Licari
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - S Caimmi
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Testa
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Torre
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G L Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Marseglia GL, Benazzo M, Biasci P, Blasi F, Cricelli C, Doria M, Leonardi S, Peroni DG, Scaglione F, Ciprandi G. OM-85 in the prevention of respiratory infections: State-of-the-art and future perspectives in clinical practice. J BIOL REG HOMEOS AG 2021; 35:847-863. [PMID: 34155874 DOI: 10.23812/21-147-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Respiratory infections (RI) significantly burden patients, their families, and society. Respiratory infection recurrence (RRI) usually depends on a defect of the immune response, which can be more or less transient and/or selective. In particular, children, older people, heavy smokers, and patients with chronic diseases, characterized by an inadequate immune response, may be at risk of developing RRI. In this context, OM- 85 could represent a valuable option in the management of RRI. OM-85 is a bacterial lysate containing the extracts of some common pathogens, including Branhamella catarrhalis, Klebsiella pneumoniae, Klebsiella ozaenae, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, and Staphylococcus aureus. Methodologically rigorous studies have documented the mechanism of action, efficacy, and safety of OM-85. OM-85 enhances the natural and acquired immune response through multifaceted mechanisms. Substantial evidence has shown that OM-85 can prevent respiratory infections, reduce the number of COPD exacerbations, and shorten the disease duration at home or in hospital. OM-85 can enhance the effectiveness of the 'flu vaccination without affecting the vaccine tolerability. The preventive use of OM-85 can reduce the use of antibiotics, contributing to contrast antibiotic resistance and saving the high cost of chronic respiratory diseases. Further studies should define the ideal candidate to OM-85 treatment.
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Affiliation(s)
- G L Marseglia
- Pediatric Clinic, Fundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - M Benazzo
- Otorhinolaryngoiatric Clinic, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - P Biasci
- Italian Federation of Pediatricians, Rome, Italy
| | - F Blasi
- Department of Pathophysiology and Transplant, University of Milan, Italy
| | - C Cricelli
- The Italian Society of General Medicine, Florence, Italy
| | - M Doria
- Italian Federation of Pediatricians, Rome, Italy
| | - S Leonardi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - D G Peroni
- Pediatric Unit, University of Pisa, Pisa, Italy
| | - F Scaglione
- Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
| | - G Ciprandi
- Casa di Cura Villa Montallegro, Genoa, Italy
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Tosca MA, Schiavetti I, Duse M, Marseglia GL, Ciprandi G. A Survey on the Management of Children with Asthma in Primary Care Setting in Italy. Pediatr Allergy Immunol Pulmonol 2021; 34:39-42. [PMID: 34143687 DOI: 10.1089/ped.2021.0031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Maria A Tosca
- Pediatrics Department, Pediatric Allergy Center, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Marzia Duse
- Pediatrics Department, Università la Sapienza, Rome, Italy
| | - G L Marseglia
- Pediatrics Clinic, Pediatrics Department, Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giorgio Ciprandi
- Outpatients Clinics Department, Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
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8
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Tosca MA, Marseglia GL, Ciprandi G, Anastasio E, Brambilla I, Caffarelli C, Chini L, Ciprandi R, De Vittori V, Duse M, Di Cicco ME, Indinnimeo L, Kantar A, Leone M, Licari A, Marinelli G, Moschese V, Olcese R, Peroni DG, Pistorio MA, Salmaso C, Silvestri M, Zicari AM. The treatment of allergic rhinitis in asthmatic children and adolescents: practical outcomes from the real-world "ControL'Asma" study. Eur Ann Allergy Clin Immunol 2020; 53:143-145. [PMID: 32914947 DOI: 10.23822/eurannaci.1764-1489.171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M A Tosca
- Allergy Center, Istituto Giannina Gaslini, Genoa, Italy
| | - G L Marseglia
- Pediatrics Clinic, Pediatrics Department, Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | | | | | | | | | | | | | - M Duse
- ControL'Asma" Study Group
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9
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Codazzi AC, Turchetti A, Apicella A, Ippolito R, Ceravolo G, Gitto E, Calabrò MP, Novara C, Casari G, Marseglia GL. Bicuspid aortic valve in children: importance of aortic shape, role of follow up and risk of aortic dilatation. J BIOL REG HOMEOS AG 2020; 34:127-129. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- A C Codazzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, U.O.S. Pediatric Cardiology, "IRCCS Policlinico S.Matteo" Pavia, Italy
| | - A Turchetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, "IRCCS Policlinico S. Matteo" Pavia, Italy
| | - A Apicella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, "IRCCS Policlinico S. Matteo" Pavia, Italy
| | - R Ippolito
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, "IRCCS Policlinico S. Matteo" Pavia, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - E Gitto
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, "G. Martino" Policlinic, Italy
| | - C Novara
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, "IRCCS Policlinico S. Matteo" Pavia, Italy
| | - G Casari
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, "IRCCS Policlinico S. Matteo" Pavia, Italy
| | - G L Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, "IRCCS Policlinico S. Matteo" Pavia, Italy
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10
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Rovida F, Cereda D, Novati S, Licari A, Triarico A, Marseglia GL, Bruno R, Baldanti F. Low risk for SARS-CoV2 symptomatic infection and early complications in paediatric patients during the ongoing CoVID19 epidemics in Lombardy. Clin Microbiol Infect 2020; 26:1569-1571. [PMID: 32535148 PMCID: PMC7289743 DOI: 10.1016/j.cmi.2020.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/06/2020] [Indexed: 01/08/2023]
Affiliation(s)
- F Rovida
- UOS Virologia Molecolare, UOC Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - D Cereda
- DG Welfare, UO Prevenzione, Lombardy Region, Milan, Italy
| | - S Novati
- Clinica di Malattie Infettive, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Licari
- Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - A Triarico
- Direzione Sanitaria, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G L Marseglia
- Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - R Bruno
- Clinica di Malattie Infettive, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Baldanti
- UOS Virologia Molecolare, UOC Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
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11
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Talarico V, Marseglia GL, Lanari M, Esposito S, Masi S, De Filippo M, Gallelli L, Licari A, Lubrano R, Zampogna S. Pediatric urticaria in the Emergency Department: epidemiological characteristics and predictive factors for its persistence in children. Eur Ann Allergy Clin Immunol 2020; 53:80-85. [PMID: 32372590 DOI: 10.23822/eurannaci.1764-1489.148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Introduction. Acute urticaria (AU) in children is a common clinical manifestation responsible for admission to the emergency department (ED). We aimed to analyze the epidemiological characteristics of AU in children and to identify predictors of both severity and progression. Material and methods. We evaluated 314 children admitted to the ED with a diagnosis of AU. We analyzed information concerning its onset, duration, severity, possible triggering factors, and the persistence of symptoms after 1, 3, and 6 months. Results. The most common etiological factors were infections (43.9%); in up to 32.4% of cases, AU was considered as idiopathic. AU was significantly most common in males and pre-school children. At the 6-month follow-up, 9.5% of children presented a persistence of urticaria, mainly those with contact (44.4%) or idiopathic (30.4%) forms. Conclusions. The AU etiology identified by history in the ED may be a significant predictor of persistence after a first attack of AU.
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Affiliation(s)
- V Talarico
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
| | - G L Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - M Lanari
- Department of Pediatric Emergency, S. Orsola Hospital, Bologna, Italy
| | - S Esposito
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - S Masi
- Department of Pediatrics, Meyer Hospital and University of Firenze, Florence, Italy
| | - M De Filippo
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - L Gallelli
- Department of Pharmacology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - A Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - R Lubrano
- Department of Pediatrics, La Sapienza University of Rome, Hospital of Latina, Latina, Italy
| | - S Zampogna
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
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12
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Chiappini E, Petrolini C, Caffarelli C, Calvani M, Cardinale F, Duse M, Licari A, Manti S, Martelli A, Minasi D, Miraglia Del Giudice M, Pajno GB, Pietrasanta C, Pugni L, Tosca MA, Mosca F, Marseglia GL. Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology. Ital J Pediatr 2019; 45:145. [PMID: 31744514 PMCID: PMC6862761 DOI: 10.1186/s13052-019-0742-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/23/2019] [Indexed: 03/16/2023] Open
Abstract
Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.
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Affiliation(s)
- E Chiappini
- SODc Malattie Infettive AOU Meyer, Dipartimento di Scienze della Salute, Università di Firenze, Firenze, Italy.
| | - C Petrolini
- Dipartimento di Scienze della Salute, Università di Firenze, Firenze, Italy
| | - C Caffarelli
- Clinica Pediatrica, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - M Calvani
- Dipartimento di Pediatria, Ospedale S. Camillo-Forlanini, Roma, Italy
| | - F Cardinale
- UOC Pediatria, Servizio di Allergologia e Pneumologia Pediatrica, Azienda Ospedaliera-Universitaria "Consorziale-Policlinico", Ospedale Pediatrico Giovanni XXIII, Bari, Italy
| | - M Duse
- Dipartimento di Pediatria, Policlinico Umberto I, Università Sapienza di Roma, Roma, Italy
| | - A Licari
- Clinica Pediatrica, Fondazione IRCCS Policlinico "S. Matteo", Università di Pavia, Pavia, Italy
| | - S Manti
- Dipartimento di Medicina Clinica e Sperimentale, Unità di Broncopneumologia Pediatrica, Università di Catania, Catania, Italy
| | - A Martelli
- UOC Pediatria, Azienda Ospedaliera G. Salvini, Ospedali di Garbagnate Milanese e Bollate, Milano, Italy
| | - D Minasi
- Unità Pediatria, Ospedale di Polistena, Reggio Calabria, Italy
| | - M Miraglia Del Giudice
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - G B Pajno
- Dipartimento di Pediatria, Unità di Allergologia, Università di Messina, Messina, Italy
| | - C Pietrasanta
- Terapia intensiva neonatale, Fondazione IRCCS "Ca' Granda", Ospedale Maggiore Policlinico; Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milano, Italy
| | - L Pugni
- Terapia intensiva neonatale, Fondazione IRCCS "Ca' Granda", Ospedale Maggiore Policlinico; Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milano, Italy
| | - M A Tosca
- Allergologia Pediatrica, Istituto Giannina Gaslini, Genova, Italy
| | - F Mosca
- Terapia intensiva neonatale, Fondazione IRCCS "Ca' Granda", Ospedale Maggiore Policlinico; Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milano, Italy
| | - G L Marseglia
- Clinica Pediatrica, Fondazione IRCCS Policlinico "S. Matteo", Università di Pavia, Pavia, Italy
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De Amici M, Ciprandi G, Caimmi S, Sacchi L, Licari A, Barocci F, Testa G, Marseglia GL. Cross reactivity between recombinant parvalbumin of carp and cod and recombinant grass molecules. J BIOL REG HOMEOS AG 2019; 33:1931-1933. [PMID: 31928595 DOI: 10.23812/19-235-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- M De Amici
- Laboratory Immuno-Allergology of Clinical Chemistry and Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, Pavia, Italy
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| | - L Sacchi
- Laboratory for Biomedical Informatics "Mario Stefanelli", Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - A Licari
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| | - F Barocci
- Laboratory Medicine Unit, ASST Rhodense, Garbagnate Milanese, Italy
| | - G Testa
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, University of Pavia, Pavia, Italy
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14
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D'Auria E, De Amici M, Licari A, Caimmi S, Mantegazza C, Zuccotti GV, Marseglia GL. Response to: Bias in the use of a SSClow/CCR3pos gate to capture basophils in chronic urticaria? Immunobiology 2019; 225:151852. [PMID: 31630898 DOI: 10.1016/j.imbio.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
A response to Chirumbolo S, Bjørklund G, and Vella A, Bias in the use of a SSClow/CCR3pos gate to capture basophils in chronic urticaria? Immunobiology, 224(3), 2019, 353-354.
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Affiliation(s)
- E D'Auria
- Department of Pediatrics, Vittore Buzzi Children's' Hospital-University of Milan, Milan, Italy
| | - M De Amici
- Department of Pediatrics and Laboratory of Immuno-Allergology Foundation IRCCS Policlinico San Matteo, Pavia, Italy.
| | - A Licari
- Department of Pediatrics, University of Pavia Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Caimmi
- Department of Pediatrics, University of Pavia Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Mantegazza
- Department of Pediatrics, Vittore Buzzi Children's' Hospital-University of Milan, Milan, Italy
| | - G V Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's' Hospital-University of Milan, Milan, Italy
| | - G L Marseglia
- Department of Pediatrics, University of Pavia Foundation IRCCS Policlinico San Matteo, Pavia, Italy
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15
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Marseglia GL, Licari A, Ciprandi G. A polycentric, randomized, double blind, parallel-group, placebo-controlled study on Lertal®, a multicomponent nutraceutical, as add-on treatment in children with allergic rhinoconjunctivitis: phase I during active treatment. J BIOL REG HOMEOS AG 2019; 33:617-622. [PMID: 30968678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Allergic rhinoconjunctivitis (AR) treatment is usually pharmacological in children, but medications are merely symptomatic, may not be completely effective, and may have relevant side effects. Thus, doctors and parents look at complementary medicine, including nutraceuticals. Lertal®, an oral nutraceutical, contains extract of Perilla, quercetin, and Vitamin D3 It has been reported that adults with AR diminished allergic symptoms and medication use during Lertal® therapy. Therefore, the current polycentric, randomized, double blind, parallel-group, placebo-controlled study aimed to evaluate the efficacy and safety of Lertal® as an add-on treatment in children with AR. In this study, 146 children (94 males and 52 females, mean age 9.1±1.88) were randomly assigned to Lertal® + standard treatment or Placebo + standard treatment and were visited at baseline (W0), and after 2 (W2) and 4 weeks (W4). Standard treatment consisted of continuous antihistaminic schedule. The primary endpoint was the Total Symptom Score (TSS - last 12 hours) change from the baseline to the end of the 4-week treatment. Both groups significantly (p less 0.0001 for both) reduced TSS (last 12 hours) after 4 weeks (% change: - 63.6% in Lertal®-group and - 60.7% in Placebo-group; p= n.s. intergroup analysis). Notably, 24 children had symptom worsening between W2 and W4: 8 in the Lertal®-group and 16 in the Placebo-group, with significant intergroup difference (p less than 0.05). All of them were poly-allergic subjects exposed to multiple allergens. There was no relevant adverse event. The present study documented that Lertal®, as add-on treatment, was able to significantly prevent the occurrence of clinical worsening and was safe in AR poly-allergic children.
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Affiliation(s)
- G L Marseglia
- Pediatrics Clinic, Pediatrics Department, Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - A Licari
- Pediatrics Clinic, Pediatrics Department, Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
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16
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Poddighe D, Mathias CB, Brambilla I, Marseglia GL, Oettgen HC. Importance of basophils in eosinophilic asthma: the murine counterpart. J BIOL REG HOMEOS AG 2018; 32:335-339. [PMID: 29685015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Several experimental studies in mice showed that basophils participate in the initiation of Th2 adaptive immune response, in addition to the effector phase. However, the role of basophils in allergic airway inflammation is less clear. The aim of this experiment was to assess the importance of basophils in recruiting inflammatory cells and, in particular, eosinophils in a murine model of asthma induced by Aspergillus fumigatus allergens. Additionally, bronchial reactivity was evaluated. Basophil depletion resulted in a reduction of inflammatory cells in the airways and eosinophil recruitment was significantly impaired. Also bronchial reactivity seemed to be impaired in basophil-depleted mice, but the result was not statistically significant. According to these preliminary data, basophils seem to influence the local eosinophilic response of allergic asthma.
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Affiliation(s)
- D Poddighe
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
- Department of Pediatrics, Università degli Studi, Pavia, Italy
| | - C B Mathias
- Department of Pharmaceutical and Administrative Sciences, College of Pharmacy, Western New England University, Springfield, MA, USA
| | - I Brambilla
- Department of Pediatrics, Università degli Studi, Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Università degli Studi, Pavia, Italy
| | - H C Oettgen
- Department of Medicine, Boston Childrens Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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17
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Di Cara G, Panfili E, Marseglia GL, Pacitto A, Salvatori C, Testa I, Fabiano C, Verrotti A, Latini A. Association Between Pollen Exposure and Nasal Cytokines in Grass Pollen-Allergic Children. J Investig Allergol Clin Immunol 2017; 27:261-263. [PMID: 28731413 DOI: 10.18176/jiaci.0161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G Di Cara
- Università degli Studi di Perugia, Dipartimento di Scienze Chirurgiche e Biomediche, Perugia, Italy
| | - E Panfili
- Università degli Studi di Perugia, Dipartimento di Scienze Chirurgiche e Biomediche, Perugia, Italy
| | - G L Marseglia
- Unità di Pediatria Generale e Specialistica,Dipartimento di Scienze Clinico-Chirurgiche Diagnostiche e Pediatriche, Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy
| | - A Pacitto
- Università degli Studi di Perugia, Dipartimento di Scienze Chirurgiche e Biomediche, Perugia, Italy
| | - C Salvatori
- Università degli Studi di Perugia, Dipartimento di Scienze Chirurgiche e Biomediche, Perugia, Italy
| | - I Testa
- Università degli Studi di Perugia, Dipartimento di Scienze Chirurgiche e Biomediche, Perugia, Italy
| | - C Fabiano
- U.O.S.D. Pediatria D.U. e Pronto Soccorso Pediatrico, Dipartimento Materno Infantile, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - A Verrotti
- U.O.S.D. Pediatria D.U. e Pronto Soccorso Pediatrico, Dipartimento Materno Infantile, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - A Latini
- Università degli Studi di Perugia, Dipartimento di Scienze Chirurgiche e Biomediche, Perugia, Italy
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18
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Chiappini E, Lo Vecchio A, Garazzino S, Marseglia GL, Bernardi F, Castagnola E, Tomà P, Cirillo D, Russo C, Gabiano C, Ciofi D, Losurdo G, Bocchino M, Tortoli E, Tadolini M, Villani A, Guarino A, Esposito S. Recommendations for the diagnosis of pediatric tuberculosis. Eur J Clin Microbiol Infect Dis 2016; 35:1-18. [PMID: 26476550 DOI: 10.1007/s10096-015-2507-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 10/07/2015] [Indexed: 01/10/2023]
Abstract
Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease.
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Abstract
Specific immunotherapy (SIT) is the only treatment able to modify the natural history of the allergic subjects. Several aspects of the immunopathological response modified by SIT have been investigated; the first parameter historically studied was the production of allergen-specific antibodies. An increase of allergen-specific IgG4 and a decrease of IgE appear after SIT. A shift from Th2-polarized immune response toward Th1-oriented pattern has been reported after SIT. More recently, a crucial role for a subpopulation of T cells has been evidenced: T regulatory cells (Treg). Allergic patients have a defect of Tregs. SIT is able of inducing a specific Treg response. Sublingual immunotherapy is an alternative route of administration for SIT. Recent evidence shows that SLIT is also able of inducing a Treg response as detected by IL- 10 production.
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Affiliation(s)
- G Ciprandi
- Dipartimento Patologie Testa-Collo, Azienda Ospedaliera Universitaria "San Martino", Genova, Italy.
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20
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Ciprandi G, Comite P, Mussap M, De Amici M, Quaglini S, Barocci F, Marseglia GL, Scala E. Profiles of Birch Sensitization (Bet v 1, Bet v 2, and Bet v 4) and Oral Allergy Syndrome Across Italy. J Investig Allergol Clin Immunol 2016; 26:244-248. [PMID: 27470643 DOI: 10.18176/jiaci.0041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Birch allergy (BA) is a common pollinosis caused by the allergens Bet v 1, Bet v 2, and Bet v 4. Oral allergy syndrome (OAS) is frequently associated with BA. A gradient of sensitization to birch allergen across Europe has been reported. Therefore, this study aimed to investigate the birch sensitization profile, including OAS, across Italy. METHODS We performed a retrospective study of 854 patients (391 males, mean age 35.9 years, range 18-93 years): 196 patients were recruited in Genoa, 188 in northern Italy, 359 in central Italy, and 111 in southern Italy. Serum IgE to Bet v 1, Bet v 2, and Bet v 4 was assessed, and OAS was analyzed. RESULTS With respect to the geographical path Genoa-North-Center-South, the frequency of sensitization to Bet v 1 decreased significantly (P<.0001) from Genoa (95.41%) to southern Italy (58.56%). The frequency of sensitization to Bet v 2 increased significantly (P<.0001) from Genoa (6.12%) to southern Italy (52.25%). The frequency of Bet v 4 also increased significantly (P=.0002) from Genoa (6.12%) to southern Italy (14.41%). The distribution of patients with OAS differed significantly across the areas (P<.0001), the most marked difference ranging between 33.5% in Genoa and 76.9% in northern Italy. The frequency of birch allergens correlated with OAS in central Italy only. CONCLUSIONS The present study demonstrated a significant difference between sensitization to birch and its clinical expression across Italy.
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Affiliation(s)
- G Ciprandi
- Allergy Department, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - P Comite
- Laboratory Medicine Department, IRCCS-AOU San Martino, Genoa, Italy
| | - M Mussap
- Laboratory Medicine Department, IRCCS-AOU San Martino, Genoa, Italy
| | - M De Amici
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - F Barocci
- Immunohematology and Transfusion Medicine Unit, Rho, Italy, A.O. G. Salvini, Garbagnate Milanese, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - E Scala
- Experimental Allergy Unit, IDI-IRCCS, Rome, Italy
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21
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Verrotti A, Laino D, Rinaldi VE, Suppiej A, Giordano L, Toldo I, Margari L, Parisi P, Rizzo R, Matricardi S, Cusmai R, Grosso S, Gaggero R, Zamponi N, Pavone P, Capovilla G, Rauchenzauner M, Cerminara C, Di Gennaro G, Esposito M, Striano P, Savasta S, Coppola G, Siliquini S, Operto F, Belcastro V, Ragona F, Marseglia GL, Spalice A. Clinical dissection of childhood occipital epilepsy of Gastaut and prognostic implication. Eur J Neurol 2015; 23:241-6. [PMID: 26498733 DOI: 10.1111/ene.12840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/03/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to describe the clinical and electrical features and the long-term evolution of childhood occipital epilepsy of Gastaut (COE-G) in a cohort of patients and to compare long-term prognosis between patients with and without other epileptic syndromes. METHODS This was a retrospective analysis of the long-term outcome of epilepsy in 129 patients with COE-G who were referred to 23 Italian epilepsy centres and one in Austria between 1991 and 2004. Patients were evaluated clinically and with electroencephalograms for 10.1-23.0 years. The following clinical characteristics were evaluated: gender, patient age at seizure onset, history of febrile seizures and migraine, family history of epilepsy, duration and seizure manifestations, circadian distribution and frequency of seizures, history of medications including the number of drugs, therapeutic response and final outcome. RESULTS Visual hallucinations were the first symptom in 62% and the only manifestation in 38.8% of patients. Patients were subdivided into two groups: group A with isolated COE-G; group B with other epileptic syndromes associated with COE-G. The most significant (P < 0.05) difference concerned antiepileptic therapy: in group A, 45 children responded to monotherapy; in group B only 15 children responded to monotherapy. At the end of follow-up, the percentage of seizure-free patients was significantly higher in group A than in group B. CONCLUSIONS Childhood occipital epilepsy of Gastaut has an overall favourable prognosis and a good response to antiepileptic therapy with resolution of seizures and of electroencephalogram abnormalities. The association of typical COE-G symptoms with other types of seizure could be related to a poor epilepsy outcome.
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Affiliation(s)
- A Verrotti
- Department of Paediatrics, University of Perugia, Perugia, Italy
| | - D Laino
- Department of Paediatrics, University of Perugia, Perugia, Italy
| | - V E Rinaldi
- Department of Paediatrics, University of Perugia, Perugia, Italy
| | - A Suppiej
- Paediatric Neurology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - L Giordano
- Paediatric Neuropsychiatric Division, Spedali Civili, Brescia, Italy
| | - I Toldo
- Paediatric Neurology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - L Margari
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, 'Aldo Moro' University of Bari, Bari, Italy
| | - P Parisi
- NESMOS Department, Chair of Paediatrics, Paediatric Headache Centre, Paediatric Sleep Centre and Child Neurology, Faculty of Medicine and Psychology, Sant'Andrea Hospital, 'Sapienza University', Roma, Italy
| | - R Rizzo
- Section of Child Neuropsychiatry, Department of Paediatrics, University of Catania, Catania, Italy
| | - S Matricardi
- Departement of Paediatrics, University of Chieti, Chieti, Italy.,Department of Paediatric Neuroscience, Foundation IRCCS Neurological Institute 'C. Besta', Milano, Italy
| | - R Cusmai
- Neurology Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Roma, Italy
| | - S Grosso
- Paediatric Neurology-Immunology and Endocrinology Unit, University of Siena, Siena, Italy
| | - R Gaggero
- Paediatric Unit, San Paolo Hospital, Savona, Italy
| | - N Zamponi
- Child Neuropsychiatry Unit, Polytechnic University of the Marche, Ancona, Italy
| | - P Pavone
- Unit of Paediatrics and Paediatric Emergency 'Costanza Gravina', University-Hospital 'Vittorio Emanuele, Policlinic', University of Catania, Catania, Italy
| | - G Capovilla
- Department of Child Neuropsychiatry, Epilepsy Centre, C. Poma Hospital, Mantova, Italy
| | - M Rauchenzauner
- Department of Paediatrics, Medical University Innsbruck, Innsbruck, Austria
| | - C Cerminara
- Paediatric Neurology, Department of Neurosciences, Tor Vergata University of Rome, Roma, Italy
| | | | - M Esposito
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Centre for Childhood Headache, Second University of Naples, Napoli, Italy
| | - P Striano
- Paediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 'G. Gaslini' Institute, Genova, Italy
| | - S Savasta
- Department of Paediatrics, Pavia University Foundation, IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Coppola
- Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Salerno, Italy
| | - S Siliquini
- Child Neuropsychiatry Unit, Polytechnic University of the Marche, Ancona, Italy
| | - F Operto
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, 'Aldo Moro' University of Bari, Bari, Italy
| | - V Belcastro
- Neurology Unit, Department of Neuroscience, 'Sant'Anna' Hospital, Como, Italy
| | - F Ragona
- Department of Paediatric Neuroscience, Foundation IRCCS Neurological Institute 'C. Besta', Milano, Italy
| | - G L Marseglia
- Department of Paediatrics, Pavia University Foundation, IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Spalice
- Child Neurology, Chair of Paediatrics, II Faculty of Medicine, University of Rome, Roma, Italy
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22
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Filippelli M, Lionetti E, Pulvirenti A, Gennaro A, Lanzafame A, Marseglia GL, Salpietro C, Rosa ML, Leonardi S. New approaches in hepatitis B vaccination for celiac disease. Immunotherapy 2015; 6:945-52. [PMID: 25313572 DOI: 10.2217/imt.14.64] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Celiac disease (CD) is a gluten-induced immune-mediated disorder that has been associated with a defective response to the hepatitis B virus (HBV) vaccination. This unresponsiveness could lead to a world health problem, because non-responder patients could represent a reservoir of HBV-susceptible people that will persist as healthy carriers, leading to the diffusion of the disease. This article presents a literature review of both intramuscular (IM) and intradermal (ID) routes for boosters in celiac patients. We used PubMed database and generated the odds ratio (OR) of the response on the basis of electronic searches of clinical trials. Although our results confirm the positive response of celiac patients to IM vaccination, the ID route seems to be better than the conventional one, since it could provide a saving in cost and a greater immunogenicity.
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Affiliation(s)
- Martina Filippelli
- Department of Medical & Pediatric Science, University of Catania, Catania, Italy
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23
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De Amici M, Marseglia A, Licari A, Caimmi S, Nigrisoli S, Torre C, Testa G, Marseglia GL. SERUM IMMUNOGLOBULIN IgE IN A PEDIATRIC POPULATION: A RETROSPECTIVE ANALYSIS. J BIOL REG HOMEOS AG 2015; 29:64-69. [PMID: 26638698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED Allergic sensitization is mediated by immunoglobulin E (IgE) and an increase of their total value is frequently used to complete a correct diagnosis of atopy. Serum IgE may be considered a typical biomarker for the allergic phenotype. The aim of this study was to evaluate total serum IgE, according to sensitizations and to find a cut off to discriminate between atopic and non-atopic subjects. Seven hundred and ninety-five patients were enrolled in this study. Serum levels of total IgE were measured by a fluorescence immunoassay (ImmunoCAP; ThermoFisher, Uppsala, Sweden) while specific IgE levels were measured by immunofluorometric assay (ImmunoCAP; ThermoFisher, Uppsala, Sweden). Both tests were expressed in kU/L, according to manufacturers instructions. RESULTS A difference for total IgE, according to the gender, has been found (p = 0,0012 ) with higher values for males than for females. A correlation has been found between total IgE and specific IgE, even distinguishing the population in sensitized and non-sensitized. A statistically significant difference has been found according to the presence or the absence of sensitization (p less than 0.0001) and also considering mono-sensitized and polysensitized patients (p less than 0.0001). ROC analysis has been performed to define a cut off for total serum IgE, according to sensitization and to the type of sensitization (mono-sensitization or poly-sensitization). Finally multiple regression models have been performed to describe total IgE response (positive or negative) and to predict total IgE values. Since clinical limitations are well known, total IgE provide a useful aid to define atopy, allowing the clinician to carry out further investigations in patients with total IgE values beyond normal limits.
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Affiliation(s)
- M De Amici
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Nigrisoli
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - C Torre
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - G Testa
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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24
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Licari A, Marseglia A, Caimmi S, Ricci A, Rundo B, Poddighe D, Verrotti A, Marseglia GL. EMERGING AND FUTURE THERAPIES FOR ALLERGIC RHINITIS. J BIOL REG HOMEOS AG 2015; 29:38-46. [PMID: 26634586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Allergic rhinitis (AR) is one of the most common diseases and represents a global health problem, currently affecting up to 30% of the general population, with a continuously increasing prevalence and significant comorbidities and complications. To date, the mainstay of current treatment strategies of AR includes allergen avoidance, pharmacotherapy and allergen-specific immunotherapy, as defined by Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for both adults and children. The aim of this review is to provide an update on all emerging and future therapeutic options for the treatment of AR.
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Affiliation(s)
- A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Ricci
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - B Rundo
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - D Poddighe
- Department of Pediatrics, Azienda Ospedaliera di Melegnano, Vizzolo Predabissi (MI), Italy
| | - A Verrotti
- Department of Pediatrics, University of Perugia, Perugia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Licari A, De Amici M, Marseglia A, Caimmi S, Quaglini S, Nigrisoli S, Marseglia GL. WALNUT SENSITIZATION IN PEDIATRIC AGE: A PRELIMINARY STUDY. J BIOL REG HOMEOS AG 2015; 29:150-152. [PMID: 26634601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Walnut consumption has recently become a healthy dietary habit worldwide, due to its positive benefits in reducing cholesterol levels and oxidative stress; this has resulted in an increase in individual consumption, global production and risk of developing sensitization and allergy. In general, clinical manifestations of walnut allergy are frequently severe and systemic potentially life-threatening, leading to anaphylaxis both in the pediatric and adult populations. In light of these findings, we performed a preliminary study considering the walnut native allergen and the recombinant Jug r1 in order to evaluate their role in atopic diseases.
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Affiliation(s)
- A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - M De Amici
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
| | - S Nigrisoli
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Licari A, De Amici M, Nigrisoli S, Ricci A, Castagnoli R, Quaglini S, Marseglia GL. TRYPTASE AND HISTAMINE MAY SUPPORT ORAL FOOD CHALLENGE IN THE DIAGNOSIS OF ALLERGY. J BIOL REG HOMEOS AG 2015; 29:1-7. [PMID: 26634580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Allergen-specific immunoglobulin E (IgE) reactions lead to acute degranulation of mast cells and basophils and release of stored mediators, particularly tryptase and histamine, which can be measured in vitro after reactions. The aim of this study was to investigate the utility of serum tryptase and plasma histamine during oral food challenge (OFC) in 103 children with suspected food allergy, in order to support the diagnosis of a IgE-mediated reaction. Blood samples for serum tryptase and plasma histamine were collected before the OFC and after the onset of allergic symptoms or after 60 minutes from test completion. Serum tryptase and plasma histamine were measured by a fluoroenzyme immunoassay (ImmunoCAP; ThermoFisher, Uppsala, Sweden) according to the manufacturers instructions. A correlation between serum tryptase and plasma histamine distributions was observed after OFC (p=0.0035). A correlation was also observed for both serum tryptase and plasma histamine before and after OFC (p less than0.0001). Subjects with positive response to OFC had significantly higher values (p = 0.0375) of serum tryptase compared to subjects with negative response. The plasma histamine distribution showed a significant difference between measurements before and after OFC, both in the complete population (p less than 0.0001), and considering the response (negative OFC: p less than 0.0001; positive OFC: p=0.0181). The diagnostic work-up of IgE- mediated food allergy may include determination of serum tryptase and plasma histamine, in order to support the results of OFC. These markers are strongly related to the same IgE-mediated mechanism and, as they can be both easily measured, can confirm the allergic nature of a reaction in the real-life setting of food allergy.
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Affiliation(s)
- A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - M De Amici
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Nigrisoli
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Ricci
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - R Castagnoli
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Licari A, Marseglia A, Castellazzi AM, Ricci A, Tagliacarne C, Valsecchi C, Castagnoli R, Marseglia GL. ATOPIC DERMATITIS: IS THERE A ROLE FOR PROBIOTICS? J BIOL REG HOMEOS AG 2015; 29:18-24. [PMID: 26634583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that commonly presents during early childhood. In the last decades the prevalence of AD has increased, especially in western societies. This frequently relapsing inflammatory condition has a strong impact on the quality of life of patients and families. The recent advances in the understanding of this disease have paved the way for the development of new strategies for the prevention and treatment of AD. Among the new therapeutic options, there is increasing interest in the potential benefit of probiotic supplementation. It has been widely demonstrated that the human microbiota plays a fundamental role not only in the maintenance of intestinal homeostasis through the interaction between microorganisms and the innate immune system, but also in the microbiota-mediated development of adaptive immunity. In addition, several studies have demonstrated that probiotics are able to influence the composition of gut microbiota and may exert immunomodulatory effects. According to these promising results, the possible application of probiotics in the therapeutic management of allergic diseases has been investigated in many studies. In particular, a considerable body of literature has been published analyzing the effects of probiotics on patients with AD. In order to shed light on frequently conflicting results, we reviewed the data regarding the application of probiotics in AD, with the aim to provide a state-of-the-art assessment of the most important studies exploring the role of probiotics both in the prevention and treatment of AD.
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Affiliation(s)
- A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A M Castellazzi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Ricci
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - C Tagliacarne
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - C Valsecchi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - R Castagnoli
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Caimmi D, Chiron R, Tremblay F, Caimmi S, Ricci A, Licari A, Marseglia GL. CYSTIC FIBROSIS AND ANTIBIOTIC HYPERSENSITIVITY: PRESENT KNOWLEDGE AND PRACTICAL APPROACH. J BIOL REG HOMEOS AG 2015; 29:29-37. [PMID: 26634585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cystic fibrosis is one of the most common fatal genetic diseases (1 in 2500 births). The defect causing the disease is localized on the 7q31 gene, which codifies for the CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) transmembrane protein. CFTR is a chloride channel localized on the epithelial cells of the mucosa of the respiratory tract, pancreatic ducts, biliary tree, intestine, vas deferens and sweat glands. More than 2000 different mutations are currently known; some are prominent or relatively frequent, ranging from one population to another. The most frequent complications of cystic fibrosis are those affecting the bronchial tree. Patients suffer from recurrent lung infections, which involve a progressive loss of lung function. The pulmonary infections are frequent or chronic and limit the quality of life of patients. In addition to being enormously exposed to antibiotics, they have many more opportunities to develop hypersensitivity reactions to these molecules. Only a complete allergy work-up with a detailed analysis of the clinical history, skin tests and provocation test can show if the patient has actually experienced an allergic hypersensitivity reaction. Desensitization is to be considered as a treatment that may help patients benefit from antibiotic treatment in those cases in which they have a proven allergy to a certain molecule.
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Affiliation(s)
- D Caimmi
- Department of Pediatrics, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, France
| | - R Chiron
- Department of Pediatrics, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, France
| | - F Tremblay
- Department of Medicine, Pulmonary division and Cystic Fibrosis Clinic, University of Montreal Hospital Center, Montreal, Canada
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Ricci
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Licari A, Caimmi S, Bosa L, Marseglia A, Marseglia GL, Caimmi D. Rhinosinusitis and asthma: a very long engagement. Int J Immunopathol Pharmacol 2015; 27:499-508. [PMID: 25572729 DOI: 10.1177/039463201402700405] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Upper and lower airways may be considered as a unique entity, interested by coexisting inflammatory processes that share common etiopathogenic mechanisms. Previous studies have strongly demonstrated a relationship between rhinosinusitis and asthma. This has led to the introduction of the concept of United Airways, which has also been included in the WHO document Allergic Rhinitis and its Impact on Asthma (ARIA); this concept has important consequences also on the treatment of these disorders. To better summarize the evident connection between upper and lower airway disease we decided to describe it as a multilayered construction, each level pointing out more deeply the relationship between these entities.
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Affiliation(s)
- A Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - S Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - L Bosa
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - A Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - D Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Licari A, De Amici M, Nigrisoli S, Marseglia A, Caimmi S, Artusio L, Marseglia GL. Pidotimod may prevent recurrent respiratory infections in children. Minerva Pediatr 2014; 66:363-367. [PMID: 25253184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Recurrent respiratory infections (RRI) constitute a social problem for both the pharmaco-economic impact and the burden for the family. Pidotimod is a synthetic immunostimulant. The aim of this study was to evaluate the effects of pidotimod on RRI prevention in children. METHODS Globally, 100 children (49 males, mean age 4.7 ± 1.2 years) with RRI were enrolled in the study. At baseline, children were randomly assigned to the treatment with pidotimod 400 mg/die or not for two months. Children were visited at baseline, after 30 (T1) and 60 (T2) days, and at follow-up (120 days; T3). Number of children with upper and lower airways symptoms, medications use, school attendance, and paediatric visits for RRI were evaluated. RESULTS Pidotimod treatment was able of significantly reducing the number of children with upper and lower airways symptoms, and medications use, increasing school attendance, and reducing pediatric visits for RRI. CONCLUSION This study provided the evidence that pidotimod may be able of preventing RRI in children.
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Affiliation(s)
- A Licari
- Immuno‑Pneumo‑Allergy Unit Department of Pediatrics, University of Pavia, Fondazione IRCCS San Matteo, Pavia, Italy -
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Quercia O, Incorvaia C, Marseglia GL, Puccinelli P, Dell'albani I, Emiliani F, Frati F, Stefanini GF. Prevalence and incidence of reactions to insect stings in children: a reappraisal. Minerva Pediatr 2014; 66:257-260. [PMID: 25198560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The prevalence of systemic reactions (SR) to Hymenoptera stings in children was estimated in values lower than 1% in early studies but much higher in recent surveys. We evaluated the current prevalence and the incidence of SR and large local reactions (LLR) to Hymenoptera stings in children in Italy. METHODS The data on children were collected from the database of the population study on the city of Cotignola, analyzing the answers to the part of the questionnaire about Hymenoptera stings, that concerned if the subject was ever stung by apids or vespids, if there has been a SR or a LLR, and if subjects with reactions received a diagnostic evaluation and a medical treatment. RESULTS Of the population of 1035 children, 173 (16.7%) were stung at least one time by Hymenoptera. Of them, 5 had had a SR and 9 had had a LLR. This defines a prevalence of SR of 0.5% and of LLR of 0.9%. Only one reaction was severe. Of the 14 subjects with SR or LLR, 5 (35.7%) underwent a diagnostic evaluation and one (7.1%) was treated with venom immunotherapy. The incidence of SR in the subsequent 2 years was 0.09% in the first year and 0.08% in the second year. CONCLUSIONS These findings do not confirm the recent reports of an increased prevalence of Hymenoptera venom allergy in children. The incidence of SR to stings, thus far unreported for children, was very low both in the first and in the second year.
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Affiliation(s)
- O Quercia
- Allergology High Specialty Unit General Medicine, Faenza Hospital Ravenna, Italy -
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Brazzelli V, Grassi S, Savasta S, Ruffinazzi G, Carugno A, Barbaccia V, Marseglia GL, Borroni G. Pompholyx of the hands after intravenous immunoglobulin therapy for clinically isolated syndrome: a paediatric case. Int J Immunopathol Pharmacol 2014; 27:127-30. [PMID: 24674688 DOI: 10.1177/039463201402700117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. It has a multifactorial etiology, including genetic determinants, allergy to metals, and id reaction; rarely it is a drug-related side effect. We report a paediatric case of pompholyx of the hands related to the intravenous immunoglobulin (IVIG) therapy for Clinically Isolated Syndrome (CIS). A 10-year-old boy, received an IVIG therapy (Venital, Kedrion Spa, Italy) at a dose of 400 mg/kg daily for five days. The fifth day of IVIG infusion, a symmetrical vesicular eruption appeared on the palms of the hands and on lateral aspects of the fingers. The lesions improved with application of topical steroids in few days. The mechanism of induction of pompholyx by IVIG therapy is unknown. A review of the Literature suggests the hypothesis that dyshidrotic eczematous reactions may be related not only to the type of IVIG, to the dose and the rates of infusion, but also to an allergic response to excipients and preservatives contained in the drug, probably elicited by an underlying neurological disease in some cases.
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Affiliation(s)
- V Brazzelli
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - S Grassi
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - S Savasta
- Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - G Ruffinazzi
- Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - A Carugno
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - V Barbaccia
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - G L Marseglia
- Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - G Borroni
- Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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Poddighe D, Mathias CB, Freyschmidt EJ, Kombe D, Caplan B, Marseglia GL, Oettgen HC. Basophils are rapidly mobilized following initial aeroallergen encounter in naïve mice and provide a priming source of IL-4 in adaptive immune responses. J BIOL REG HOMEOS AG 2014; 28:91-103. [PMID: 24750795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Chronic aeroallergen inhalation elicits the expansion of IL-4-producing Th2 cells and the production of IgE antibodies. In sensitized subjects, who have established IgE and Th2 responses, re-exposure to allergen leads to rapid recruitment of basophils, which are thought to be important effectors of late phase allergic reactions. Several investigations of responses to parasites and injected antigens have identified an additional role for basophils as innate immune effectors during initial antigen encounter in immunologically naïve hosts. These cells constitutively express IL-4 and promote Th2 polarized adaptive responses to such antigens. Their early recruitment and modulation of cellular immune responses to natural inhaled allergens in the airways has been scarcely investigated. In this study, basophils were enumerated in lung tissue, blood and spleen from BALB/c mice in the first days after inhalation of an aqueous extract of the allergen, Aspergillus fumigatus (Af). Af inhalation induced rapid increases in basophil numbers in the lung, blood and spleen. This was Rag-1-, MyD88- and IL-3-independent. The basophils expressed abundant IL-4. Their depletion during Af sensitization resulted in an attenuated induction of both IL-4 producing Th lymphocytes and specific IgE and IgG1 responses to an inhaled protein antigen, ovalbumin, which was co-administered. Our results suggest that basophils are rapidly recruited to the airways of naïve mice following initial fungal allergen exposure, produce IL-4 and influence the development of the adaptive immune response.
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Affiliation(s)
- D Poddighe
- Department of Medicine, Division of Immunology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - C B Mathias
- Department of Medicine, Division of Immunology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - E J Freyschmidt
- Department of Medicine, Division of Immunology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - D Kombe
- Department of Medicine, Division of Immunology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - B Caplan
- Department of Medicine, Division of Immunology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - G L Marseglia
- Department of Pediatrics, University of Pavia, Italy
| | - H C Oettgen
- Department of Medicine, Division of Immunology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Valsecchi C, Marseglia A, Montagna L, Tagliacarne SC, Elli M, Licari A, Marseglia GL, Castellazzi AM. Evaluation of the effects of a probiotic supplementation with respect to placebo on intestinal microflora and secretory IgA production, during antibiotic therapy, in children affected by recurrent airway infections and skin symptoms. J BIOL REG HOMEOS AG 2014; 28:117-124. [PMID: 24750797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Antibiotic therapy, especially in pediatric patients, is often associated with significant modifications of the gut microflora, which can lead to intestinal dysbiosis and influence intestinal physiology and immune system functionality. Herein we report the results from a double blind controlled clinical trial in 77 pediatric patients affected by recurrent airway infections, receiving antibiotic therapy with amoxicillin and clavulanic acid. A group was treated with an oral probiotic preparation composed of Lactobacillus paracasei ssp.paracasei CRL-431, Bifidobacterium BB-12, Streptococcus thermophilus TH-4 and a fructooligosaccharide (FOS) during and after antibiotic therapy for seven days, while the other group received placebo. The study revealed a reduction in the Clostridia population, with a contemporary increase in Bifidobacteria and Lactobacilli in fecal samples in the probiotic group and an increase in the Enterobacteria population in the placebo group. Moreover, there was a decreasing trend in secretory IgA production in the probiotic group. Some relevant, but not statistically significant probiotic supplementation effects were identified.
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Affiliation(s)
- C Valsecchi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - A Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - L Montagna
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - S C Tagliacarne
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - M Elli
- AAT (Advanced Analytical Technologies) Institute, Piacenza, Italy
| | - A Licari
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - G L Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - A M Castellazzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Salpietro C, Cuppari C, Grasso L, Tosca MA, Miraglia Del Giudice M, La Rosa M, Marseglia GL, Salpietro A, Ciprandi G. Nasal high-mobility group box-1 protein in children with allergic rhinitis. Int Arch Allergy Immunol 2013; 161:116-21. [PMID: 23343652 DOI: 10.1159/000345246] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 10/17/2012] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Allergic rhinitis (AR) is characterized by an inflammatory reaction. High-mobility group box-1 protein (HMGB1) has many characteristics similar to classic proinflammatory cytokines. No study has yet investigated its role in AR. The aim of this study was to measure HMGB1 levels in the fluid recovered from nasal lavage in children with untreated AR and in control subjects. MATERIALS The study was conducted on 104 AR subjects (48 males and 56 females, median age 10.3 ± 3.4 years) and 97 healthy children (42 males and 55 females) who were age-matched (median age 9.8 ± 4.1 years). Total serum immunoglobulin E, peripheral eosinophils and nasal symptoms assessed by visual analog scale (VAS) were considered. HMGB1 was measured using an ELISA assay. RESULTS HMGB1 levels in nasal lavage fluid were higher in AR children than in the control group (96.9 ± 19.3 vs. 9.27 ± 4.01 ng/ml; p < 0.001). There was a very strong relationship between HMGB1 levels and VAS values in AR children (r = 0.919). Considering the symptom severity assessed by VAS, there was a relationship between HMGB1 and VAS in all AR subgroups: more evident in the severe subgroup (r = 0.727). CONCLUSIONS Nasal HMGB1 has significantly increased in children with AR and is significantly related to symptom severity.
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Affiliation(s)
- C Salpietro
- UOC Genetics and Immunology Paediatrics, University of Messina, Messina, Italy
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Leonardi S, Coco A, Del Giudice MM, Marseglia GL, La Rosa M. The airway epithelium dysfunction in the pathogenesis of asthma: The evidence. Health (London) 2013. [DOI: 10.4236/health.2013.52a044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Marseglia A, Castellazzi AM, Valsecchi C, Licari A, Piva G, Rossi F, Fiorentini L, Marseglia GL. Outcome of oral provocation test in egg-sensitive children receiving semi-fat hard cheese Grana Padano PDO (protected designation of origin) containing, or not, lysozyme. Eur J Nutr 2012; 52:877-83. [PMID: 22692502 DOI: 10.1007/s00394-012-0394-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 05/29/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Lysozyme, obtained from egg white, is a potential food allergen used in the dairy industry to prevent late blowing of the loaf caused by the outgrowth of clostridial spores (Cl. butyricum and Cl. tyrobutyricum) during cheese aging. The aim of this study was to evaluate the possible correlation between egg protein allergy in pediatric age and sensitization to egg lysozyme, used for the preparation of Grana Padano cheese. METHODS The tolerability of Grana Padano cheese has been evaluated in pediatric patients allergic to egg proteins through an oral provocation test with increasing amounts of cheese containing, or not, lysozyme at 12 and 24 months of aging. RESULTS When lysozyme-sensitized children received 12-months aged and lysozyme-containing cheese, several immediate and late adverse reactions such as itching, abdominal pain, vomiting, nausea, dermatitis, rhinitis, bronchial asthma, urticaria, and angioedema were seen in 5 out of 21 subjects; only 1 out of 21 children showed an adverse reaction after challenge with 24-months-ripened lysozyme-containing cheese. CONCLUSIONS There is a possible relationship between the severity of allergic reactions and the lysozyme-specific IgE level in blood. In particular vomiting, hypotension, and abdominal pain were present when IgE level was higher than 7 kU/L. A ripening time of 24 months may reduce allergy problems when lysozyme-containing cheese is given to sensitized subjects, probably due to the hydrolysis of antigenic epitopes during aging.
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Affiliation(s)
- A Marseglia
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Sezione di Scienze Pediatriche, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Piazzale Golgi 9, 27100, Pavia, Italy
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Franceschini F, De Benedictis FM, Peroni DG, Marseglia GL, Caffarelli C, Crisafulli G, Indinnimeo L. Anesthesia in children with asthma and rhinitis. Int J Immunopathol Pharmacol 2012; 24:S83-90. [PMID: 22014930 DOI: 10.1177/03946320110240s312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The incidence of asthma is increasing worldwide, but morbidity and mortality are decreasing, because of improvements in medical care. Although the incidence of severe perioperative bronchospasm is relatively low in asthmatics undergoing anaesthesia, when it does occur it may be life-threatening. Preoperative assessment of asthma should include a specialized medical hystory and physical examination as well as pulmonary function testing. Potential trigger agents should be identified and avoided. In many asthmatic patients treatment with systemic corticosteroids and bronchodilators is indicated to prevent the inflammation and bronchocostriction associated with endotracheal intubation. Nonetheless, acute bronchospasm can still occur, especially at induction and emergence, and should be promptly and methodically managed.
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Pajno GB, Crisafulli G, Caminiti L, Marseglia GL, Cardinale F, Paravati F, Caffarelli C. Perioperative allergy: therapy. Int J Immunopathol Pharmacol 2012; 24:S101-4. [PMID: 22014932 DOI: 10.1177/03946320110240s314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Perioperative allergic reactions manifest in various ways. The majority of systemic reactions occur during anesthesia within minutes of intravenous induction; however, agents which are administered via other routes may cause reactions after more than 15 minutes. Anaphylaxis during anesthesia may present in many different ways and the signs and symptoms, which do not vary from those of anaphylactic reactions in general, may be masked by hypovolemia, light, deep anesthesia or extensive regional blockade. Recommendations for treatment are based on available evidence in the literature. A treatment algorithm is suggested, with emphasis on the incremental titration of adrenaline and fluid therapy as first-line treatment. Increased focus on this subject will hopefully lead to prompt diagnosis and rapid, correct treatment.
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Affiliation(s)
- G B Pajno
- Department of Pediatrics, University of Messina, Messina, Italy
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Caimmi S, Caimmi D, Cardinale F, Indinnimeo L, Crisafulli G, Peroni DG, Marseglia GL. Perioperative allergy: uncommon agents. Int J Immunopathol Pharmacol 2012; 24:S61-8. [PMID: 22014927 DOI: 10.1177/03946320110240s309] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Anesthesia may often be considered as a high-risk procedure and anaphylaxis remains a major cause of concern for anesthetists who routinely administer many potentially allergenic agents. Neuromuscular blocking agents, latex and antibiotics are the substances involved in most of the reported reactions. Besides these three agents, a wide variety of substances may cause an anaphylactic reaction during anesthesia. Basically all the administered drugs or substances may be potential causes of anaphylaxis. Among them, those reported the most in literature include hypnotics, opioids, local anesthetics, colloids, dye, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Iodinated Contrast Media (ICM), antiseptics, aprotinin, ethylene oxyde and formaldehyde, and protamine and heparins. No premedication can effectively prevent an allergic reaction and a systematic preoperative screening is not justified for all patients; nevertheless, an allergy specialist should evaluate those patients with a history of anesthesia-related allergy. Patients must be fully informed of investigation results, and advised to provide a detailed report prior to future anesthesia.
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Affiliation(s)
- S Caimmi
- Department of Pediatrics, University of Pavia, Italy.
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Miraglia Del Giudice M, Maiello N, Decimo F, Fusco N, D' Agostino B, Sullo N, Capasso M, Salpietro V, Gitto E, Ciprandi G, Marseglia GL, Perrone L. Airways allergic inflammation and L. reuterii treatment in asthmatic children. J BIOL REG HOMEOS AG 2012; 26:S35-S40. [PMID: 22691248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Recently, it has been hypothesized that the oral administration of specific live probiotic strains may have therapeutic potential in the treatment of allergic inflammation. The aim of this study was to evaluate the effect of the oral L. reuteri DSM 17938 administration (1X108CFU), in airways allergic inflammation in mild persistent asthmatic children. In this DBPC randomized study we selected 50 children (6-14 years old), affected by mild persistent asthma (GINA step 2) and allergic to HDM. At the run-in period (T-2), the children were submitted to medical examination, prick tests for the main respiratory allergens, spirometry and children asthma control test (C-ACT). We selected only the children with well controlled asthma (C-ACT >19 and FEV1> 80%). After two weeks (T0) the children were allocated into two groups, the FeNO was measured and the breath condensate was collected. Group A children were treated with the placebo (5 drops per day) and Group B children with L. reuteri (108CFU =5 drops per day) for 60 days. After the treatment period (T1), all patients were evaluated by medical examination, C-ACT, spirometry, FeNO measurement and exaled breath condensate analysis. The FeNO values showed a significant reduction (p=0,045) in L. reuteri group but not in the placebo group at the end of the treatment (T1). Furthermore, the cytokines exam showed an increase in IL-10 levels (p less than 0.05) and a significant reduction in IL-2 levels (p less than 0.05) only in L. reuteri group at T1. No significant differences in FEV1 values and C-ACT score were found in both groups. In conclusion, these data showed that L. reuteri (108 CFU) was effective in reducing bronchial inflammation in asthmatic children. No significant effect was found on FEV1 values and C-ACT score, probably because we selected children with well controlled asthma.
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Marseglia GL, De Amici M, Marseglia A, Caimmi S, Miraglia Del Giudice M, Leoni MC, Salpietro C, Leonardi S, Brambilla I, Ciprandi G. Pentraxin 3 serum levels in children with atopic dermatitis. J BIOL REG HOMEOS AG 2012; 26:S105-S108. [PMID: 22691256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PTX3 behaves as an acute-phase response protein as its blood levels rapidly and dramatically increase during endotoxic shock, sepsis, and other inflammatory and infectious conditions. Therefore, this study was designed to investigate a possible role of PTX3 in children with Atopic Dermatitis (AD). One-hundred-and-thirty-six patients (37 females, 99 males, mean age 10.4 years) were enrolled in the study. One hundred patients (74%) had only respiratory symptoms (allergic rhinitis and/or bronchial asthma); thirty-six patients (26%) showed dermatitis associated with respiratory allergy (allergic rhinitis and/or bronchial asthma). PTX3 levels were higher in children with AD and there was a significant correlation between serum PTX3 levels and SCORAD index (p-value=0.0001, rho=0.658). Therefore, this study may show that PTX3 might be a reliable marker for the severity of AD in children with respiratory allergy.
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Affiliation(s)
- G L Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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43
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Ciprandi G, Cuppari C, Salpietro A, Tosca M, Grasso L, Rigoli L, La Rosa M, Marseglia GL, Miraglia Del Giudice M, Salpietro C. Serum IL-23 in asthmatic children. J BIOL REG HOMEOS AG 2012; 26:S53-S61. [PMID: 22691251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Asthma is characterized by airway inflammation that is controlled by a complex cytokine network. The Th1/Th2 imbalance has been well documented in the pathogenesis of allergic asthma. Recently, Th17 cells and regulatory T (Treg) cells have been found to participate in the pathogenesis of allergic asthma. This study aimed at verifying whether anti-inflammatory treatment could change serum IL-4, IL-10 and IL-23 in asthmatic children. Globally, 78 children (40 males and 38 females, median age 9.3 +- 3.7 years), with asthma and monosensitized to house dust mites, were evaluated. Lung function (such as FEV1) and serum IL-4, IL-10 and IL-23 levels were measured at baseline (T0), after 4 weeks (T1) and after 12 weeks (T2) of inhaled corticosteroid (ICS) treatment. The control group consisted of 40 healthy children (22 males and 18 females) age matched. At baseline, IL-4 and IL-23 levels were higher in severe asthmatics than in control group (p less than 0.001), while serum IL-10 levels were significantly lower in group of asthmatic children as compared to healthy control group (p less than 0.001). At T2, IL-4 and IL-23 significantly diminished (p less than 0.001), while IL-10 significantly increased. There was significant relationship between FEV1 and IL-4, IL-10 and IL-23 at T0 (r=-0.784; r=-0.735 and r=-0.787, respectively). Moreover, there were correlations between FEV1 and IL-4, IL-10 and IL-23 in patients at T1 (r=-0.563; r=-0.539 and r=-0.583, respectively) and at T2 (r=-0.549; r=-0.428 and r=-0.393, respectively). The present study provided evidence that: i) serum IL-23 was up-regulated also in asthmatic children, ii) ICS treatment was able of reducing IL-23, and iii) IL-23 change well related with lung function improvement. Thus, it is presumable that IL-23 could be a suitable marker of allergic inflammation in asthma.
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
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Ciprandi G, Capasso M, Leonardi S, Lionetti E, La Rosa M, Salpietro C, Miraglia Del Giudice M, Cirillo I, Tosca M, Marseglia GL. Impaired FEF25-75 values may predict bronchial reversibility in allergic children with rhinitis or asthma. J BIOL REG HOMEOS AG 2012; 26:S19-S25. [PMID: 22691246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
FEV1 is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that FEF25-75 could be more sensitive than FEV1 to detect slight airways obstruction. Bronchial reversibility defined by positive response to bronchodilation test. The aim of the present study was to define whether an impaired FEF25-75 value (less than 65 percent of predicted) may be predictive for reversibility in a large cohort of allergic children with rhinitis or asthma. Six hundred allergic children were recruited: 300 with controlled asthma and 300 with allergic rhinitis. All of them were evaluated by performing spirometry, bronchodilation test, and skin prick test. Two predictors were significantly associated with bronchial reversibility: i) an impaired FEF25-75 value (less than 65 percent of predicted), and ii) sensitization to perennial allergens. It was more relevant in children with rhinitis (ORAdj:8.9 and 2.2 respectively). In conclusion, this study, conducted in real life, could suggest that an impaired FEF25-75 value (less than 65 percent of predicted) may be considered a reliable marker of bronchial reversibility, mainly in children with allergic rhinitis.
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
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45
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Leonardi S, Vitaliti G, Marseglia GL, Caimmi D, Lionetti E, Miraglia Del Giudice M, Salpietro C, Spicuzza L, Ciprandi G, La Rosa M. Function of the airway epithelium in asthma. J BIOL REG HOMEOS AG 2012; 26:S41-8. [PMID: 22691249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Asthma is traditionally defined as a chronic disease characterized by bronchial hyper-responsiveness and lung inflammation. The airway inflammation and remodelling together likely explain the clinical manifestations of asthma. The mechanisms by which the external environmental cues, together with the complex genetic actions, propagate the inflammatory process that characterizes asthma are beginning to be understood. There is also an evolving awareness of the active participation of structural elements, such as the airway epithelium, airway smooth muscle, and endothelium, in this process; these structural elements within the lung and the bone marrow serve as reservoirs for and the source of inflammatory cells and their precursors. Although often viewed as separate mechanistic entities, so-called innate and acquired immunity often overlap in the propagation of the asthmatic response. This review examines the newer information on the pathophysiologic characteristics of asthma and focuses on the role of airway epithelium in the exacerbation of the disease.
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Affiliation(s)
- S Leonardi
- Department of Pediatrics, University of Catania, Italy
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46
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Ciprandi G, Tosca MA, Cirillo I, Lionetti E, Leonardi S, Miraglia Del Giudice M, La Rosa M, Salpietro A, Capasso M, Marseglia GL. Impaired FEF25-75 may predict high exhaled nitric oxide values in children with allergic rhinitis and/or asthma. J BIOL REG HOMEOS AG 2012; 26:S27-S33. [PMID: 22691247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Allergic rhinitis and asthma are closely associated. Inflammation is a common pathological characteristic shared by both disorders. The measure of the fractional concentration of exhaled nitric oxide (FeNO) may be considered a surrogate marker for airway inflammation. Forced expiratory flow between 25 and 75 percent of vital capacity (FEF25-75) has been previously demonstrated to be able to predict BHR and bronchial reversibility. The aim of this study was to evaluate whether impaired FEF25-75 values may be related to FeNO values in a pediatric cohort of allergic subjects. 850 children with allergic rhinitis, allergic asthma, or both, were evaluated. Bronchial function (FEV1, FVC, and FEF25-75), FeNO, and sensitizations were assessed. Bronchial function and FeNO were significantly different in the 3 groups (p less than 0.001). A strong inverse correlation between FeNO and FEV1was found in patients with rhinitis, asthma and asthma with rhinitis (r= -0.72, r=-0.70 and r= -0.70, respectively). Impaired FEF25-75 values (such as less than 65 percent of predicted) were significantly associated with high FeNO levels (such as =34 ppb). In conclusion, this study provided evidence that FEF25-75 is strongly and inversely related with FeNO and FEF25-75 may predict high FeNO levels in children with allergic rhinitis, asthma or both.
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
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47
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Ciprandi G, Fenoglio G, Kalli F, De Amici M, Leonardi S, Miraglia Del Giudice M, Salpietro C, La Rosa M, Caimmi S, Marseglia GL. Patients with oral allergic syndrome to apple have intense proliferative response to BET V 1. J BIOL REG HOMEOS AG 2012; 26:S113-S117. [PMID: 22691258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Patients with pollen allergy may frequently present an additional food-related allergy (Oral Allergic Syndrome, OAS), as consequence of cross-reactivity between pollen allergens (mainly birch, hazelnut, alder, mugwort) and vegetable allergens. The aim of this study was to evaluate the effect on Bet v 1-induced T cell proliferation exerted by the presence of OAS in birch patients. Fourteen allergic patients were evaluated (6 males, mean age 35.8 years). All of them were monosensitized to birch and suffered from allergic rhinitis: 4 had also OAS to apple. Proliferation of peripheral mononuclear cells was evaluated using Bet v 1 and non-specific stimuli. OAS had higher proliferation than non-OAS patients. In addition, there were significant relationships between immunological and clinical parameters in OAS patients. This study evidences that OAS characterizes a more severe form of birch allergy: as OAS patients had higher SI, circulating eosinophils, and IgE levels. Thus, this study confirms the previous report and underlines the relevance of measuring recombinant birch allergen as higher values may suggest a reliable prediction of OAS.
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
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48
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Ciprandi G, De Amici M, Quaglini S, Labò E, Castellazzi AM, Miraglia Del Giudice M, Marseglia A, Bianchi L, Moratti R, Marseglia GL. Tetanus toxoid IgE may be useful in predicting allergy during childhood. J BIOL REG HOMEOS AG 2012; 26:S119-S123. [PMID: 22691259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hypersensitivity reactions after immunization with tetanus toxoid are occasionally observed in atopic and non-atopic individuals. High IgE levels in infancy may predict subsequent allergy. The aims of this study were: i) to evaluate the role of specific IgE to tetanus toxoid in children in response to tetanus immunization and the possible factors associated with specific IgE levels, and ii) to investigate the correlation between specific IgE levels to tetanus toxoid and the late development of allergy (up to 12 years). Initially, 278 healthy infants (152 males and 126 females, aged 12 months) living in an urban city were screened for serum total IgE and specific IgE to tetanus toxoid, after having obtained informed consent from parents. After 12 years, 151 children could be evaluated. Total IgE summed with tetanus specific IgE were significantly associated with allergy at 12 years. In conclusion, this study demonstrates that serum total IgE and tetanus specific IgE may be predictive of subsequent allergy onset.
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
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Caimmi D, Matti E, Pelizzo G, Marseglia A, Caimmi S, Labò E, Licari A, Pagella F, Castellazzi AM, Pusateri A, Parigi GB, Marseglia GL. Nasal polyposis in children. J BIOL REG HOMEOS AG 2012; 26:S77-S83. [PMID: 22691254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Nasal polyposis is a chronic inflammatory disease affecting the nasal cavity and the paranasal sinuses. It is a relatively common disease, occurring in 1-4 % of the general population, but it is rarely described in the pediatric population. Most of the published series include children presenting with other underlying systemic diseases, mainly cystic fibrosis. The aim of the present study was to describe the characteristics of the patients suffering from nasal polyposis, evaluated at the Pediatric Clinic of the University of Pavia (Italy) over the last 17 years. 56 consecutive pediatric patients referring to our Pediatric Department had a diagnosis of nasal poyposis over the last 17 years. All children underwent allergy evaluation, nasal endoscopy, CT scan of the paranasal sinus, and Functional Endoscopic Sinus Surgery. The mean age of the present cohort was of 11.8 years and most of the patients were male. 50% of the patients presented with unilateral, polyposis, mostly with a diagnosis of antrochoanal polyp. 4 patients presenting with bilateral polyposis suffered from cystic fibrosis. Main symptoms at diagnosis included nasal obstruction, snoring and rhinorrhea 32% of the patients presented at least a positivity to skin prick test, for major inhalant and food allergens. Nasal polyposis in children could represent an alert sign for other underlying systemic diseases. Nasal endoscopy should therefore be prescribed when a diagnosis is suspected. To properly treat a patient presenting with nasal polyposis, it is necessary to integrate medical and surgical skills through a multidisciplinary approach.
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Affiliation(s)
- D Caimmi
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, 2-27100 Pavia PV, Italy
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50
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Marseglia GL, Caimmi S, Marseglia A, Pagella F, Ciprandi G, La Rosa M, Leonardi S, Miraglia Del Giudice M, Caimmi D. Occult sinusitis may be a key feature for non-controlled asthma in children. J BIOL REG HOMEOS AG 2012; 26:S125-S131. [PMID: 22691260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Sinusitis is frequently associated with asthma. The diagnosis and management of patients with asthma associated with sinusitis are often challenging, though sometimes unsatisfactory. Detection and treatment of sinusitis in asthmatics may lead to a better control of asthma symptoms. Most of the studies regarding the relationship between sinusitis and asthma have been conducted in adults. The aim of the present study was to evaluate the presence of sinusal comorbidity in children with un-controlled asthma both clinically and through nasal endoscopy after the first 6 months of treatment. The present study included 294 consecutive asthmatic children (97 males, mean age 7.3 years). Asthma diagnosis, severity assessment and treatment were performed according to GINA guidelines. Twenty-one patients with non-controlled asthma presented with endoscopic features of sinusitis, but without any clinical sign or symptom. We defined such condition occult sinusitis. Not only overt sinusitis, but also occult sinusitis could be a significant comorbidity in asthmatic patients. For this reason, it may be beneficial to determine the presence of sinus inflammation in children with non-controlled asthma, even when they do not present clinical signs or symptoms of upper airways involvement.
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Affiliation(s)
- G L Marseglia
- Department of Paediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy.
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