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Caruso C, Ciasca G, Baglivo I, Di Santo R, Gasbarrini A, Firinu D, Bagnasco D, Passalacqua G, Schiappoli M, Caminati M, Canonica GW, Heffler E, Crimi C, Intravaia R, Basile V, Marino M, Colantuono S, Del Giacco S. Immunoglobulin free light chains in severe asthma patient: Could they be a new biomarker? Allergy 2024. [PMID: 38425088 DOI: 10.1111/all.16082] [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: 08/03/2023] [Revised: 01/31/2024] [Accepted: 02/08/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Increasing evidence is available about the presence of increased serum concentration of immunoglobulin (Ig) free light chains (FLCs) in both atopic and non-atopic inflammatory diseases, including severe asthma, providing a possible new biomarker of disease. METHODS We analyzed clinical and laboratory data, including FLCs, obtained from a cohort of 79 asthmatic subjects, clinically classified into different GINA steps. A control group of 40 age-matched healthy donors (HD) was considered. Particularly, HD have been selected according to the absence of monoclonal components (in order to exclude paraproteinemias), were tested for total IgE (that were in the normal ranges) and were negative for aeroallergens specific IgE. Moreover, no abnormality of common inflammatory markers (i.e., erythrocyte sedimentation rate and C-reactive protein) was detectable. RESULTS FLC-k levels were significantly increased in the asthmatic population, compared to the control group. Despite the absence of statistically significant differences in FLC-λ levels, the FLC-k/FLC-λ ratio displayed remarkable differences between the two groups. A positive correlation between FLC-κ and FLC-λ levels was found. FLC- λ level displayed a significant negative correlation with the FEV1 value. Moreover, the FLC-κ /FLC- λ ratio was negatively correlated with the SNOT-22 score and a positive correlation was observed between FLCs and Staphylococcus Aureus IgE enterotoxins sensitization. CONCLUSIONS Our findings confirmed the role of FLCs in asthma as a potential biomarker in an inflammatory disease characterized by different endotypes and phenotypes. In particular, FLC-κ and FLC-k/FLC-λ ratio could be a qualitative indicator for asthma, while FLC-λ levels could be a quantitative indicator for clinical severity parameters.
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Affiliation(s)
- C Caruso
- UOSD DH Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Ciasca
- Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - I Baglivo
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Di Santo
- Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - A Gasbarrini
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - D Bagnasco
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - M Schiappoli
- Allergy and Asthma Unit, Verona University Hospital, Verona, Italy
| | - M Caminati
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy
| | - G W Canonica
- Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - E Heffler
- Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - C Crimi
- Respiratory Medicine Unit, Policlinico "G. Rodolico-San Marco" University Hospital, Catania, Italy
| | - R Intravaia
- Unit of Cardiology, University Hospital Paolo Giaccone, University of Palermo, Palermo
| | - V Basile
- Clinical Pathology Unit and Cancer Biobank, Department of research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Marino
- Sezione di Patologia Generale, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - S Colantuono
- UOSD DH Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Adami G, Caminati M, Senna G, Fassio A, Schiappoli M, Idolazzi L, Viapiana O. Eosinophilic Granulomatosis With Polyangiitis and Cardiac Involvement: A Case Report. J Investig Allergol Clin Immunol 2019; 28:285-286. [PMID: 30073971 DOI: 10.18176/jiaci.0270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G Adami
- Rheumatology Unit, Verona University, Verona, Italy
| | - M Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - G Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - A Fassio
- Rheumatology Unit, Verona University, Verona, Italy
| | - M Schiappoli
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - L Idolazzi
- Rheumatology Unit, Verona University, Verona, Italy
| | - O Viapiana
- Rheumatology Unit, Verona University, Verona, Italy
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Caminati M, Senna G, Segala N, Bacchini M, Stefanizzi G, Bovo C, Schiappoli M, Canonica GW, Passalacqua G. Evaluation of asthma control in the pharmacy: an Italian cross-sectional study. Eur Ann Allergy Clin Immunol 2019; 49:225-230. [PMID: 28884990 DOI: 10.23822/eurannaci.1764-1489.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background. In Western countries a large proportion of asthmatic patients remain uncontrolled, despite the availability of effective drugs. An involvement of pharmacies / pharmacists in asthma management has been suggested in guidelines, since this could provide a relevant support. Objective. The present cross-sectional study aimed at assessing the level of asthma control, by using ACT questionnaire, in the community pharmacies in the County of Verona, North East of Italy. Methods. A call for participation was sent by Verona Pharmacists' Association to all the pharmacies located in the Verona municipality. Patients with a medical prescription and an asthma exemption code were recruited in pharmacies. They were asked to fill the ACT questionnaire and to answer some additional questions on asthma treatment, smoke habits and comorbidities. Results. Thirty-seven community pharmacies recruited 239 patients. According to the ACT score, more than 50% of patients had a controlled asthma but 20% of them were totally uncontrolled and 12% were using oral steroid. Only 2.9% of patients had received an asthma action plan. Asthma was intermittent in 17.6% of patients, mild persistent in 13.8%, moderate persistent in 63.1% and severe in 5.4%. Discordance was observed between the self-perceived asthma control and objective parameters, when available. Of note, in the severe asthma group, most patients had an ACT > 20. Conclusion. This is the first Italian pharmacy-based study on asthma control. A better asthma control was recorded in this study in comparison with other trials, but about 50% of patients were insufficiently controlled. The community pharmacies can play a relevant role in the preliminary assessment of asthma control by using easy and not time consuming tools, such as ACT.
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Affiliation(s)
- M Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy. E-mail:
| | - G Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - N Segala
- Pharmacists' Association, Verona, Italy
| | | | - G Stefanizzi
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - C Bovo
- Medical Direction, Verona University and General Hospital, Verona, Italy
| | - M Schiappoli
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - G W Canonica
- Allergy and Respiratory Diseases, IRCCS San Martino-IST, University of Genoa, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino-IST, University of Genoa, Italy
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Guarnieri G, Bonadonna P, Olivieri E, Schiappoli M. Occupational Asthma Induced by Exposure to Quinoa. J Investig Allergol Clin Immunol 2019; 29:451-452. [PMID: 31283525 DOI: 10.18176/jiaci.0432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G Guarnieri
- Occupational Medicine, Department of Cardiologic, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - P Bonadonna
- Allergy Unit and Asthma Center, Hospital and University of Verona, Verona, Italy
| | - E Olivieri
- Allergy Unit and Asthma Center, Hospital and University of Verona, Verona, Italy
| | - M Schiappoli
- Allergy Unit and Asthma Center, Hospital and University of Verona, Verona, Italy
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5
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Ridolo E, Caminati M, Martignago I, Melli V, Salvottini C, Rossi O, Dama A, Schiappoli M, Bovo C, Incorvaia C, Senna G. Allergic rhinitis: pharmacotherapy in pregnancy and old age. Expert Rev Clin Pharmacol 2016; 9:1081-9. [PMID: 27177184 DOI: 10.1080/17512433.2016.1189324] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Allergic rhinitis (AR) affects 20-30% of women in reproductive age and may worsen during pregnancy. About 10% of the elderly suffer from AR, and it could be under-diagnosed in these patients. Many drugs are currently available, however AR treatment during pregnancy and old age represents a challenging issue. AREAS COVERED A review of the literature on the topic has been performed. Expert commentary: In pregnancy, drug avoidance should be carefully balanced with the need for AR optimal control. Topical drugs are suggested as a first approach. The safety and tolerability profile of second-generation antihistamines is well supported. If allergen immunotherapy (AIT) is ongoing and well tolerated, there is no reason for stopping it. AIT initiation in pregnancy is not recommended. For elderly patients, no specific concerns have been highlighted regarding topical treatments, except from nasal decongestionants. Second generation antihistamines are generally well tolerated. Old age should not preclude AIT.
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Affiliation(s)
- E Ridolo
- a Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - M Caminati
- b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy
| | - I Martignago
- a Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - V Melli
- a Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - C Salvottini
- c Department of Molecular Medicine , University of Pavia , Pavia , Italy
| | - O Rossi
- d Allergy Unit , Azienda Ospedaliera Universitaria Careggi , Firenze , Italy
| | - A Dama
- b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy
| | - M Schiappoli
- b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy
| | - C Bovo
- e Medical Direction , Verona University Hospital , Verona , Italy
| | - C Incorvaia
- f Allergy/Pulmonary Rehabilitation , ICP Hospital , Milano , Italy
| | - G Senna
- b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy
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Schiappoli M, Dama AR, Passalacqua G, Le Pera C, Senna G. The role of nasal endoscopy in the prescription of allergen immunotherapy. Eur Ann Allergy Clin Immunol 2013; 45:150-151. [PMID: 24067342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Indexed: 06/02/2023]
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Schiappoli M, Lombardo C, Bortolami O, Caruso B, Senna G. IgE to staphylococcal enterotoxins are undetectable in sera from patients with nasal polyposis. Eur Ann Allergy Clin Immunol 2012; 44:251-252. [PMID: 23441443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Nasal polyposis is a frequent disease, sometime associated with asthma and non steroidal anti-inflammatory drugs intolerance. Staphylococcus aureus colonization can play a pathogenetic role in same cases by a severe eosinophilic inflammation, which can suggest new therapeutic approaches. Staphylococcus aureus colonization has been demonstrated by local specific enterotoxins IgE dosage in polyps homogenates. This study demonstrate lack of detection of serum enterotoxins specific IgE to staphylococcal in patients with nasal polyposis, compared with healthy subjects.
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Senna GE, Makatsori M, Schiappoli M, Dama AR. Subcutaneous allergen specific immunotherapy: best clinical practice as cornerstone for future development. Eur Ann Allergy Clin Immunol 2011; 43:135-140. [PMID: 22145249] [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: 05/31/2023]
Abstract
Allergen subcutaneous immunotherapy is a long lasting treatment which can modify the natural history of allergic respiratory diseases. Recommended administration is required for a minimum of three years. During this long term therapy the daily management is based on two crucial points, discussed in this review, such as the prevention and the treatment of side effects and the improvement and follow-up of patient adherence. This review specifically focuses on subcutaneous immunotherapy.
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Affiliation(s)
- G E Senna
- Allergy Unit, Verona General Hospital, Italy.
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Bonadonna P, Pagani M, Bircher A, Scherer K, Caruso B, Cocco C, Schiappoli M, Senna G, Lombardo C. Skin Test Predictive Value On The Proton Pump Inhibitors Allergy. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Bonadonna P, Zanotti R, Pagani M, Caruso B, Perbellini O, Colarossi S, Olivieri E, Dama A, Schiappoli M, Senna G, Antico A, Passalacqua G. How much specific is the association between hymenoptera venom allergy and mastocytosis? Allergy 2009; 64:1379-82. [PMID: 19627274 DOI: 10.1111/j.1398-9995.2009.02108.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The preferential association of mastocytosis with hymenoptera sting reactions is well known, but there is no data on the prevalence of clonal mast cell disorders in subjects with severe systemic reactions due to foods or drugs. METHODS Patients with food- or drug-induced severe systemic reactions, including anaphylaxis, and increased serum tryptase were studied for the presence of mastocytosis, and compared with a population of patients with hymenoptera allergy. The aetiological role of foods or drugs was assessed according to current recommendations. Systemic reactions were graded in severity according to the procedure described by Mueller. Serum tryptase was considered increased if the level was >11.4 ng/ml. Subjects with increased tryptase had dermatological evaluation and Bone marrow(BM) aspirate-biopsy, which included histology/cytology, flow cytometry and detection of KIT mutations. RESULTS A total of 137 subjects (57 male, mean age 42 years) were studied. Of them, 86 proved positive for drugs and 51 for foods. Overall, out of 137 patients, only nine (6.6%) had a basal tryptase >11.4 ng/ml, and only two (1.5%) were diagnosed with mastocytosis. This was clearly different from patients with hymenoptera allergy, where 13.9% had elevated tryptase and 11.1% had a clonal mast cell disorder. CONCLUSION The association of clonal mast cell disorders with hymenoptera allergy seems to be more specific than that with food- or drug-induced systemic reactions.
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Severino M, Bonadonna P, Bilò MB, Cortellini G, Mauro M, Schiappoli M, Macchia D, Campi P, Manfredi M, Passalacqua G. Safety and efficacy of immunotherapy with Polistes dominulus venom: results from a large Italian database. Allergy 2009; 64:1229-30. [PMID: 19416139 DOI: 10.1111/j.1398-9995.2009.02030.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M Severino
- Allergy and Respiratory Diseases, Department of Internal Medicine, Padiglione Maragliano, Genoa 16132, Italy
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Schiappoli M, Ridolo E, Senna G, Alesina R, Antonicelli L, Asero R, Costantino MT, Longo R, Musarra A, Nettis E, Crivellaro M, Savi E, Massolo A, Passalacqua G. A prospective Italian survey on the safety of subcutaneous immunotherapy for respiratory allergy. Clin Exp Allergy 2009; 39:1569-74. [PMID: 19486027 DOI: 10.1111/j.1365-2222.2009.03286.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Subcutaneous immunotherapy is effective for the treatment of respiratory allergy, and it is largely used in Italy, but no systematic safety assessment has been carried out so far. OBJECTIVE To assess prospectively the safety of injection immunotherapy in a multicentre, real-life survey. METHODS Eleven Italian allergy departments recorded the clinical characteristics of systemic reactions (SRs) due to immunotherapy. Vaccines were prescribed according to guidelines; only standardized depot extracts were used. SRs were graded according to the EAACI recommendations, and were classified as immediate or delayed. RESULTS One thousand seven hundred and thirty-eight patients (847 males, age range 5-71) received immunotherapy from eight different manufacturers, for a total of 2038 courses (300 patients received two extracts). A total of 60 785 injections were given over a mean immunotherapy duration of 3 years. Overall, 95 reactions were observed in 57 patients (3.28%), corresponding to 4.7% of the courses and 1.56/1000 injections. Twenty-five patients experienced more than one adverse event. There were 34 grade 2, 60 grade 3 and one grade 4 reactions and no fatality. SRs occurred more frequently in patients with asthma than in patients with rhinitis alone (4.1% vs. 1.1%), and were equally distributed between the build-up and the maintenance phase. Ragweed and grass extracts caused significantly more side effects than other allergens. CONCLUSION In this large prospective study, the rate of SRs was low, thus confirming that injection immunotherapy has an acceptable risk/benefit ratio when prescribed and carried out according to recommendations.
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Affiliation(s)
- M Schiappoli
- Allergy Unit, Verona General Hospital, Verona, Italy
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Bonadonna P, Schiappoli M, Dama A, Olivieri M, Perbellini L, Senna G, Passalacqua G. Is hymenoptera venom allergy an occupational disease? Occup Environ Med 2008; 65:217-8. [DOI: 10.1136/oem.2007.036400] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Caruso B, Bonadonna P, Severino MG, Manfredi M, Dama A, Schiappoli M, Rizzotti P, Senna G, Passalacqua G. Evaluation of the IgE cross-reactions among vespid venoms. A possible approach for the choice of immunotherapy. Allergy 2007; 62:561-4. [PMID: 17441797 DOI: 10.1111/j.1398-9995.2007.01353.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hymenoptera venom allergy can be effectively cured with specific immunotherapy, thus the correct identification of the allergen is essential. In the case of multiple skin and serum positivities it is important to know if a cross-reaction among venoms is present. We studied by CAP-inhibition assays the degree of cross-reactivity between Vespula vulgaris and Polistes dominulus. METHODS Serum samples were obtained from consecutive patients with a clinical history of grade III-IV reactions to hymenoptera sting and with nondiscriminative skin/CAP positivity to both Vespula and Polistes. Inhibition assays were carried out with a CAP method, incubating the sera separately with both venoms and subsequently measuring the specific immunoglobulin E (IgE) to venoms themselves. RESULTS Forty-five patients (33 male, mean age 40 years, age range 12-74, total serum IgE 242 +/- 168 kU/l) were included. Their specific IgE to Vespula and Polistes were 12.03 +/- 5.70 kU/l and 10.7 +/- 2.0 kU/l (P = NS), respectively. At the CAP-inhibition assays, in 25 patients a >75% heterologous inhibition by P. dominulus venom against V. vulgaris-specific IgE was found. In six subjects V. vulgaris venom effectively inhibited the P. dominulus-specific IgE. In the remaining 14 cases the CAP-inhibition test provided intermediate and not discriminative results. CONCLUSION In 31/45 patients, the double sensitizations to venoms were probably the result of cross-reactions and the CAP-inhibition allowed identifying the true double sensitizations. This approach may be helpful for the correct prescription of immunotherapy in the case of V. vulgaris and P. dominulus double positivity.
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Affiliation(s)
- B Caruso
- Laboratory of Clinical Chemistry and Haematology, Verona General Hospital, Verona, Italy
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Affiliation(s)
- G Senna
- Allergy & Respiratory Diseases, Department of Internal Medicine, Padiglione Maragliano, L go R Benzi 10 16132, Genoa, Italy
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Senna G, Bonadonna P, Schiappoli M, Leo G, Lombardi C, Passalacqua G. Pattern of use and diagnostic value of complementary/alternative tests for adverse reactions to food. Allergy 2005; 60:1216-7. [PMID: 16076315 DOI: 10.1111/j.1398-9995.2005.00875.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- G Senna
- Allergy and Respiratory Diseases, Department of Internal Medicine, Padiglione Maragliano, L.go R. Benzi 10, 16132 Genoa, Italy
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Passalacqua G, Compalati E, Schiappoli M, Senna G. Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases. Monaldi Arch Chest Dis 2005; 63:47-54. [PMID: 16035564 DOI: 10.4081/monaldi.2005.657] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The use of Complementary/Alternative Medicines (CAM) is largely diffused and constantly increasing, especially in the field of allergic diseases and asthma. Homeopathy, acupuncture and phytotherapy are the most frequently utilised treatments, whereas complementary diagnostic techniques are mainly used in the field of food allergy-intolerance. Looking at the literature, the majority of clinical trials with CAMS are of low methodological quality, thus difficult to interpret. There are very few studies performed in a rigorously controlled fashion, and those studies provided inconclusive results. In asthma, none of the CAM have thus far been proved more effective than placebo or equally effective as standard treatments. Some herbal products, containing active principles, have displayed some clinical effect, but the herbal remedies are usually not standardised and not quantified, thus carry the risk of toxic effects or interactions. None of the alternative diagnostic techniques (electrodermal testing, kinesiology, leukocytotoxic test, iridology, hair analysis) have been proved able to distinguish between healthy and allergic subjects or to diagnose sensitizations. Therefore these tests must not be used, since they can lead to delayed or incorrect diagnosis and therapy.
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Affiliation(s)
- G Passalacqua
- Allergy & Respiratory Diseases, Department of Internal Medicine, University of Genoa, Italy.
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Bonadonna P, Schiappoli M, Senna G, Passalacqua G. Delayed selective reaction to clavulanic acid: a case report. J Investig Allergol Clin Immunol 2005; 15:302-4. [PMID: 16433214] [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: 05/06/2023] Open
Abstract
Clavulanic acid, an inhibitor of beta-lactamases, is widely used for antimicrobial therapy in association with beta-lactam antibiotics. Despite this, very few adverse reactions to the molecule have been described so far. We report a case of not-immediate reaction to clavulanic acid in a young adult who previously tolerated it. The patient complained of generalized itchy erythema two days after completing a course of amoxicillin-clavulanate therapy, and had no previous clinical history of adverse reactions to drugs. Intradermal and skin prick tests with beta-lactam determinants were negative, as well as the oral tolerance test with amoxicillin. Since no commercial preparation of clavulanic acid alone is available, we performed intradermal and skin prick test with the association amoxicillin-clavulanate, that elicited a delayed (24 and 48 hours) response. IgE-mediated reactions to clavulanic acid are rare, since this molecule is poorly allergenic. Based on the onset time and the specificity of the response we hypothesize that a delayed (possibly T-cell mediated) reaction has occurred.
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Affiliation(s)
- P Bonadonna
- Allergy Service, Verona General Hospital, Italy
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Senna G, Bonadonna P, Crivellaro M, Schiappoli M, Passalacqua G. Anaphylaxis due to Brazil nut skin testing in a walnut-allergic subject. J Investig Allergol Clin Immunol 2005; 15:225-7. [PMID: 16261962] [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: 05/05/2023] Open
Abstract
The diagnosis and management of nut allergy can be difficult because of the possible severity of the clinical manifestations and the cross reactivity between different species. We report a case of anaphylaxis due to skin testing in a young adult with clinically ascertained walnut allergy. After an episode of anaphylaxis due to walnut ingestion, a routine diagnostic workup was carried out, involving skin prick test with commercial extracts, prick by prick with fresh food and CAP-RAST assay for different nuts. Immediately after pricking with fresh Brazil nut, a severe episode of anaphylaxis occurred, that required epinephrine and intravenous steroids. The subject had never eaten Brazil nut before. Therefore we hypothesize a cross reactivity effect, since this phenomenon is well known for tree nuts. Our case suggests that in vivo diagnosis, especially if fresh nuts are used, should be performed only if adequate equipment to treat anaphylaxis is available.
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Affiliation(s)
- G Senna
- Allergy Service, Verona General Hospital, Verona, Italy
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Senna G, Bilò MB, Antonicelli L, Schiappoli M, Crivellaro MA, Bonadonna P, Dama AR. Tolerability of three selective cyclo-oxygenase-2 inhibitors, meloxicam, celecoxib and rofecoxib in NSAID-sensitive patients. Eur Ann Allergy Clin Immunol 2004; 36:215-8. [PMID: 15329003] [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: 04/30/2023]
Abstract
BACKGROUND Patients with aspirin-sensitive respiratory and cutaneous diseases experience cross reactions to all nonsteroidal anti-inflammatory drugs (NSAIDs) which inhibit cyclo-oxigenase (COX) enzymes. As are now available drugs which selectively inhibit COX-2, questions are raised whether cross-reactivity occurs between aspirin and these COX 2 inhibitors. OBJECTIVE The aim of this study was to evaluate the tolerability of three COX-2 inhibitors (meloxicam, celecoxib and rofecoxib) in subjects with previous pseudoallergic respiratory and cutaneous reactions to NSAIDs. METHODS 76 subjects with documented previous cutaneous and respiratory pseudoallergic reactions to aspirin and/or other NSAIDs underwent a single blind challenge with celecoxib, meloxicam and rofecoxib. RESULTS All subjects with previous respiratory reactions tolerated all drugs. Three subjects with multiple-drug induced urticaria complained of a generalized reaction after challenge (Two due to celecoxib and one due to meloxicam). Among the group of patients with NSAIDs-induced urticaria five complained of a relapse of the disease due to rofecoxib (one subject), celecoxib (two subjects and meloxicam (two subjects). CONCLUSIONS According to these results the cross-reactivity between aspirin and these COX-2 inhibitors does not occur in subjects with previous respiratory pseudoallergic reactions. A good safety profile was also demonstrated in patients with cutaneous reactions, being few reactions observed. However for this reason a controlled oral challenge with these drugs is useful for the proper management of patients sensitive to classic NSAIDs.
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Affiliation(s)
- G Senna
- Unità Operativa di Allergologia, Ospedale Civile Maggiore di Verona, Verona, Italy
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Senna G, Crivellaro MA, Bonadonna P, Dama AR, Schiappoli M. Optimal dosing of allergen immunotherapy: efficacy, safety, long-lasting effect. Eur Ann Allergy Clin Immunol 2003; 35:386-92. [PMID: 14768524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- G Senna
- Allergy Unit, Verona General Hospital, Verona, Italy
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Bonadonna P, Crivellaro M, Dama A, Guarnieri G, Schiappoli M, Senna G. [Occupational asthma induced by casein inhalation]. G Ital Med Lav Ergon 2003; 25 Suppl:192-3. [PMID: 14979145] [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: 04/29/2023]
Abstract
Reported cases of occupational asthma due to inhalation of milk proteins are rare. Our report is about the first evidence of occupational asthma in a health care worker, caused by an hidden exposure to casein, contained in a commercial dermatological powder widely used in geriatric patients treatment. The diagnosis is based on the case-history and on the positive skin prick test to a commercial and extemporary extract of the occupational allergen.
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Affiliation(s)
- P Bonadonna
- Unità Operativa di Allergologia, Ospedale Civile Maggiore di Verona
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Abstract
Carrot is frequently involved in food allergies and oral allergy syndromes, usually in association with other foods. Nevertheless, carrot alone is rarely responsible for severe systemic reactions. We report a case of anaphylactic shock due to the inadvertent ingestion of carrot as a hidden allergen contained in an ice-cream. The etiological role of carrot in provoking the symptoms was thoroughly ascertained through appropriate in vivo and in vitro assays and by excluding, through double-blind placebo-controlled challenge, the involvement of other ingredients of the food. We highlight once again the harm and risks due to hidden food allergens contained in commercial preparations and the importance of thorough patient education and information.
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Affiliation(s)
- M Schiappoli
- Allergy Service, Verona General Hospital, Verona. Italy
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Affiliation(s)
- G Senna
- Allergy and Repiratory Diseases, DIMI, Pad. Maragliano, Largo R. Benzi 10, 16132 Genoa, Italy
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Di Gioacchino M, Andreassi M, Boscolo P, Cervone M, Bavazzano P, Gravante M, Pavone G, Cavallucci E, Ramondo S, Schiappoli M, Verna N, Masci S, Amerio P, Giuliano G. [Allergic contact dermatitis to nickel: modification of receptor expression on peripheral lymphocytes of women after oral provocation tests (preliminary data)]. G Ital Med Lav Ergon 1997; 19:56-8. [PMID: 9377749] [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: 02/05/2023]
Abstract
Blood lymphocyte subset evaluation was performed before after oral challenge with 10 mg of Ni, in 9 healthy women and in 15 allergic to Ni. Following challenge, 7 allergic showed a flare up of eczema and/or urticaria. In the controls, CD4+ lymphocytes were modified 24 hours after Ni challenge: CD4+/CD44RO- "virgin" cells were reduced while CD4+/CD45RO+ "memory" cells increased. The allergic women, not sensitive to oral Ni, showed an increase of B lymphocytes after the test. On the contrary, the oral Ni reacting patients presented a reduction of monocytes 4 hours after Ni ingestion and marked reduction (ranging from 20 to 50%) of T and B lymphocytes after 24 hours. These significant T and B lymphocytes changes suggest a migration of the cells in peripheral tissues, likely skin and GUT mucosa.
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Affiliation(s)
- M Di Gioacchino
- Immunologia Clinica ed Allergologia, Centro di Medicina del Lavoro ed Ergoftalmologia, Università G. D'Annunzio. Chieti
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Pavone G, Cavallucci E, Verna N, Ramondo S, Schiappoli M, Boscolo P, Neri G, Croce A, Di Gioacchino M. Nasal Popyposis and Nsaid Hypersensitivity in Asthmatics. Int J Immunopathol Pharmacol 1996. [DOI: 10.1177/039463209600900227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | | | | | - P. Boscolo
- Occupational Medicine, University of Chieti, Italy
| | - G. Neri
- ENT Institute, University of Chieti, Italy
| | - A. Croce
- ENT Institute, University of Chieti, Italy
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Cavallucci E, Pavone G, Ramondo S, Schiappoli M, Verna N, Neri G, Croce A, Di Gioacchino M. Adverse Reactions to Ketorolac in Patients Affected by Widal's Syndrome: Case Reports. Int J Immunopathol Pharmacol 1996. [DOI: 10.1177/039463209600900225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | | | - G. Neri
- ENT Institute -University of Chieti - Italy
| | - A. Croce
- ENT Institute -University of Chieti - Italy
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Schiappoli M, Ramundo S, Verna N, Pavone G, Cavallucci E, Boscolo P, Sabbioni E, Di Gioacchino M. Immunological Effects of Trace Elements: New Trends in Research. Int J Immunopathol Pharmacol 1996. [DOI: 10.1177/039463209600900239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | | | | | - E. Sabbioni
- Environment Institute, Joint Research Centre, Ispra, Italy
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