Publications by authors named "Eleonora Savi"

20 Publications

  • Page 1 of 1

SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media.

Clin Mol Allergy 2020 31;18:13. Epub 2020 Jul 31.

IRCCS Oasi Maria S.S., Troina & Fondazione Mediterranea G.B. Morgagni, Catania, Italy.

Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.
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http://dx.doi.org/10.1186/s12948-020-00128-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395340PMC
July 2020

Urticaria: recommendations from the Italian Society of Allergology, Asthma and Clinical Immunology and the Italian Society of Allergological, Occupational and Environmental Dermatology.

Clin Mol Allergy 2020 6;18. Epub 2020 May 6.

5Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy.

Background: Urticaria is a disorder affecting skin and mucosal tissues characterized by the occurrence of wheals, angioedema or both, the latter defining the urticaria-angioedema syndrome. It is estimated that 12-22% of the general population has suffered at least one subtype of urticaria during life, but only a small percentage (estimated at 7.6-16%) has acute urticaria, because it is usually self-limited and resolves spontaneously without requiring medical attention. This makes likely that its incidence is underestimated. The epidemiological data currently available on chronic urticaria in many cases are deeply discordant and not univocal, but a recent Italian study, based on the consultation of a national registry, reports a prevalence of chronic spontaneous urticaria of 0.02% to 0.4% and an incidence of 0.1-1.5 cases/1000 inhabitants/year.

Methods: We reviewed the recent international guidelines about urticaria and we described a methodologic approach based on classification, pathophysiology, impact on quality of life, diagnosis and prognosis, differential diagnosis and management of all the types of urticaria.

Conclusions: The aim of the present document from the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) is to provide updated information to all physicians involved in diagnosis and management of urticaria and angioedema.
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http://dx.doi.org/10.1186/s12948-020-00123-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201804PMC
May 2020

A prevalent exposure to male dog is a risk factor for exclusive allergic sensitization to Can f 5: An Italian multicenter study.

J Allergy Clin Immunol Pract 2020 Jul - Aug;8(7):2399-2401. Epub 2020 Mar 12.

Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy; Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome "Tor Vergata," Rome, Italy.

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http://dx.doi.org/10.1016/j.jaip.2020.02.041DOI Listing
March 2020

IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper.

World Allergy Organ J 2020 Feb 25;13(2):100080. Epub 2020 Feb 25.

Campus Charite Mitte, Klinik fur Dermatologie & Allergologie, Berlin, Germany.

Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both and . It discusses skin tests, challenges, and serological and cellular tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.
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http://dx.doi.org/10.1016/j.waojou.2019.100080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044795PMC
February 2020

Neuronal contact guidance and YAP signaling on ultra-small nanogratings.

Sci Rep 2020 02 28;10(1):3742. Epub 2020 Feb 28.

NEST, Istituto Nanoscienze-CNR and Scuola Normale Superiore, Piazza San Silvestro 12, Pisa, 56127, Italy.

Contact interaction of neuronal cells with extracellular nanometric features can be exploited to investigate and modulate cellular responses. By exploiting nanogratings (NGs) with linewidth from 500 nm down to 100 nm, we here study neurite contact guidance along ultra-small directional topographies. The impact of NG lateral dimension on the neuronal morphotype, neurite alignment, focal adhesion (FA) development and YAP activation is investigated in nerve growth factor (NGF)-differentiating PC12 cells and in primary hippocampal neurons, by confocal and live-cell total internal reflection fluorescence (TIRF) microscopy, and at molecular level. We demonstrate that loss of neurite guidance occurs in NGs with periodicity below 400 nm and correlates with a loss of FA lateral constriction and spatial organization. We found that YAP intracellular localization is modulated by the presence of NGs, but it is not sensitive to their periodicity. Nocodazole, a drug that can increase cell contractility, is finally tested for rescuing neurite alignment showing mild ameliorative effects. Our results provide new indications for a rational design of biocompatible scaffolds for enhancing nerve-regeneration processes.
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http://dx.doi.org/10.1038/s41598-020-60745-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048778PMC
February 2020

Galactose α-1,3-galactose phenotypes: Lessons from various patient populations.

Ann Allergy Asthma Immunol 2019 06 26;122(6):598-602. Epub 2019 Mar 26.

Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Virginia.

Objective: To review published studies on galactose α-1,3-galactose (α-gal), a carbohydrate epitope found on proteins and lipids in nonprimate mammals and present in foods (particularly organ or fat-rich red meat) and medications, where it causes delayed-onset and immediate-onset anaphylaxis.

Data Sources: A literature search for the terms galactose α-1,3-galactose and α-gal using PubMed and Embase was performed.

Study Selections: Studies on α-gal were included in this review.

Results: Several species of ticks contain α-gal epitopes and possibly salivary adjuvants that promote high titer sensitization and clinical reactivity. Risk factors for α-gal syndrome include exposure to ticks of particular species. Age and sex differences seen in various cohorts possibly reflect the prevalence of these exposures that vary according to setting.

Conclusion: The reason and mechanisms for delayed onset of food-related anaphylaxis and the preponderance of abdominal reactions are not clear but may involve the kinetics of allergen digestion and processing or immunologic presentation via a different mechanism from usual immediate-type food allergy.
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http://dx.doi.org/10.1016/j.anai.2019.03.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839685PMC
June 2019

The Characteristics of Severe Chronic Upper-Airway Disease (SCUAD) in Patients with Allergic Rhinitis: A Real-Life Multicenter Cross-Sectional Italian Study.

Int Arch Allergy Immunol 2019;178(4):333-337. Epub 2019 Jan 3.

Consultant Physician of Professional Diseases Observatory, Procura della Repubblica, Turin, Italy.

Background: There are few studies regarding severe chronic upper-airway disease (SCUAD) that represents an important socioeconomic problem for the treatment of rhinitis and associated comorbidities, particularly asthma.

Objectives: The aim of our study is to evaluate the prevalence of this pathology in patients with allergic rhinitis (AR) in real life, to phenotype allergic patients with SCUAD, and to identify which factors are related to the severity of the disease.

Methods: We studied 113 patients with uncontrolled AR despite optimal adherence to therapy according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in a multicenter Italian study, analyzing comorbidity, use of additional drugs, not scheduled visits, and the number of emergency room admissions.

Results: Our data suggest that polysensitization is the only statistically significant factor correlating with SCUAD. Asthma does not seem to represent a correlating factor. An important finding is the poor use (20%) of allergy immunotherapy (AIT), although patients were suffering from AR and the ARIA guidelines recommend the use of AIT in moderate/severe AR.

Conclusions: The SCUAD population seems not to have a specific phenotype; there is a greater presence of SCUAD in polysensibilized patients, perhaps a sign of greater inflammation.
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http://dx.doi.org/10.1159/000495305DOI Listing
May 2019

Music reduces pain perception in healthy newborns: A comparison between different music tracks and recoded heartbeat.

Early Hum Dev 2018 09 2;124:7-10. Epub 2018 Aug 2.

Child and Adolescent Neurology and Psychiatry Unit, Children Hospital, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Objectives: To assess the effect of 3 musical interventions, as compared to no music, on the physiological response of healthy newborns undergoing painful medical procedures (Guthrie test and/or intramuscular antibiotic injections).

Methods: Prospective study of 80 full-term newborns, aged 1 to 3 days, randomly allocated to exposure to Mozart's Sonata for two pianos K.448, Beethoven's Moonlight Sonata, heartbeat sound recordings (70 bpm) or no music. Pain perception (evaluated using the Neonatal Infant Pain Scale), heart rate and oxygen saturation were measured 10 min before (T0), during (T1), 10 (T2) and 20 (T3) minutes after the interventions.

Results: Infants who were exposed to the three music interventions displayed a significant reduction in heart rate and in pain perception and an increase in oxygen saturation, as compared to the control group, which showed less modifications on stress measurements after painful medical procedures (F = 6.40, p = .001, partial η = 0.20).

Conclusions: Exposure to music and heartbeat sound recordings changes short-term physiological parameters in healthy newborns undergoing potentially painful procedures. The similar effect shown by the 3 interventions might be explained by the common characteristics of the sound shared by the various tracks. Further research is needed to investigate the impact of different types of music used in intervention, in order to develop guidelines and include music as a part of evidence-based strategies to promote the outcome for neonates.
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http://dx.doi.org/10.1016/j.earlhumdev.2018.07.006DOI Listing
September 2018

[New in vitro allergological diagnostic tool and its application in professional disease.]

G Ital Med Lav Ergon 2017 11;39(3):278-284

Unità operativa Dipartimentale di Allergologia Ospedale G. Da Saliceto Ausl Piacenza.

Objectives: Molecular diagnostic is a new therapeutic approach that - allows to valuate sensitization towards a single molecule in a allergenic source and to obtain relevant information on clinical features: sensitization towards molecules as alfa amylase of wheat or lipocalins of pets, Alt a 1 of alternaria spores and Hev b 6 of latex correlates with the risk to develop asthma - has a greater sensitivity in the serum IgE identification than the whole source.
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November 2017

Critical aspects in dog allergen immunotherapy (DAI). May Component Resolved Diagnosis (CRD) play a role in predicting the efficacy?

Hum Vaccin Immunother 2018 06 23;14(6):1438-1441. Epub 2018 Feb 23.

b Postgraduate School of Respiratory Medicine, Department of Experimental Medicine and Surgery , University of Rome "Tor Vergata" , Rome , Italy.

We hypothesize that a pivotal condition determining the efficacy of dog allergen immunotherapy (DAI) might be the mono-sensitization to dog lipocalins (Can f 1-2) in individuals not directly or indirectly exposed to other furry animals. In fact, the concomitant sensitization to lipocalins and/or albumins, especially in those patients directly exposed to furry animals, may potentially stimulate patient's airways by inducing persistent inflammation and, thus, clinical symptoms. In these conditions, it is likely that DAI alone could be inadequate to reduce airway inflammation mediated by inhalation of dog allergens in patients with simultaneous exposure to other furry animals. Can f 5 has been found as exclusive allergen in about one third of dog-sensitized individuals. Considering the presence of different allergenic materials in extract of mammalian origin, it is evident that a standard DAI is not likely to be effective in Can f 5 prevalent or mono-sensitized individuals. Moreover, we would underline the need of collecting detailed information on the possible exposures to furry animals (other than the common pets), an information that usually is neglected in clinical practice. Furthermore, a detailed clinical history exploring the real significance of dog sensitization (mono or poly-sensitization, induction of clinical symptoms after exposure etc.) should be performed before prescribing DAI. In some patients, with potential high susceptibility to animal allergens, the use of CRD is essential to verify the presence of concomitant allergic sensitization to lipocalins and/or albumins belonging to other furry animals. The availability of CRD introduced the possibility of a better targeted prescription of DAI because it might be useful for point out the primary allergens and for the exclusion of cross-reactive ones.
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http://dx.doi.org/10.1080/21645515.2018.1434383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037462PMC
June 2018

Chronic Urticaria Patient Perspective (CUPP): The First Validated Tool for Assessing Quality of Life in Clinical Practice.

J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):208-218. Epub 2017 Aug 9.

Personalized Medicine Clinic: Asthma & Allergy-Humanitas Clinical and Research Center, Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy.

Background: There is a need for validated tools to assess health-related quality of life (HRQoL) in routine clinical practice.

Objective: The aim of this study was to validate the Chronic Urticaria Patient Perspective (CUPP) for assessment of patients with chronic urticaria (CU) in clinical practice.

Methods: A provisional CUPP was developed from candidate items identified by following an iterative process in a retrospective analysis of 249 Chronic Urticaria Quality of Life Questionnaire questionnaires. The psychometric properties of the CUPP were then tested on a sample of patients enrolled in 13 Italian centers.

Results: The study population in the validation phase comprised 152 patients. The 10-item version of the CUPP showed satisfactory internal consistency (Cronbach's alpha values of 0.76 at visit 1 and 0.90 at visit 2), good criteria, and discriminative and convergent validity. Reliability was assessed in 34 patients with no changes in health (Global Rating Scale = 0 at visit 2) and was satisfactory (CCC [concordance correlation coefficient] = 0.9). Changes in CUPP scores were significantly associated with changes in Urticaria Activity Score (UAS)-Hive count (r = 0.36, P < .001), UAS-Itch severity (r = 0.48, P < .001), and UAS-Total score (r = 0.342, P < .001), all of which indicated good responsiveness. The minimal important difference was 1.5.

Conclusions: CUPP is a simple 10-question tool with good psychometric properties that provides a valid, reliable, and standardized measurement of HRQoL in patients with CU.
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http://dx.doi.org/10.1016/j.jaip.2017.06.023DOI Listing
October 2019

Which immunotherapy product is better for patients allergic to Polistes venom? A laboratory and clinical study.

PLoS One 2017 7;12(7):e0180270. Epub 2017 Jul 7.

Department of Medicine and Surgery, University of Parma, Parma, Italy.

Background: Venom immunotherapy (VIT) is highly effective in preventing allergic reactions to insect stings, but the appropriate venom must be used to achieve clinical protection. In patients with multiple positive results to venoms, molecular allergy diagnostics or CAP-inhibition may identify the causative venom. Concerning allergy to venom from Polistes spp. it has been proposed that only the European species P. dominulus should be used for VIT. However, this recommendation is not present in any international guideline. Using both laboratory and clinical data, we aimed to evaluate the reliability of this proposal.

Methods: We performed an in vitro study using CAP-inhibition to determine sensitization of 19 patients allergic to Polistes venom. The clinical study included 191 patients with positive tests to Polistes treated with VIT, 102 were treated with P. dominulus and 89 were treated with a mix of American Polistes (mAP).

Results: The difference in % of inhibition was significant concerning inhibition of P. dominulus sIgE by P. dominulus venom (79.8%) compared with inhibition by mAP venom (64.2%) and not significant concerning the inhibition of mAP sIgE by P. dominulus venom (80.1%) and by mAP venom (73.6%). Instead, the clinical protection from stings was not statistically different between the two kinds of venom.

Conclusion: The data from CAP inhibition would suggest that the choice of either P. dominulus venom or mAP venom for VIT is appropriate in patients with CAP inhibition higher than 70%, but the clinical data show the same odds of protection from stings using for VIT P. dominulus or mAP venom.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180270PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501507PMC
September 2017

Is allergic sensitization relevant in severe asthma? Which allergens may be culprit?

World Allergy Organ J 2017 6;10(1). Epub 2017 Jan 6.

Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.

Severe asthma is a major health concern. The allergic (IgE-mediated) form of asthma is well known from a pathogenic viewpoint. We searched the available literature to identify which allergens are most frequently associated with severe, refractory or life threatening asthma. According to the results, molds, pet dander, cockroach and ragweed were more frequently responsible for severe asthma. Thunderstorm asthma, in addition, represents a special association between allergic sensitization and an external climatic factor. A detailed knowledge of the most harmful allergens is mandatory for an appropriate diagnostic and preventive approach.
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http://dx.doi.org/10.1186/s40413-016-0138-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219672PMC
January 2017

Potential of molecular based diagnostics and its impact on allergen immunotherapy.

Asthma Res Pract 2016 2;2. Epub 2016 Jun 2.

Allergy and Respiratory Diseases, Department of Internal Medicine, IRCCS San Martino-IST-University of Genoa, Genova, Italy.

Molecular based in vitro technologies greatly changed the diagnostic approaches in allergy. At present, sensitization profiles can be dissected according to IgE subsets, which are specific for genuine or cross-reacting components and potentially dangerous or virtually harmless components. The identification of IgE in components with specific characteristics has a direct impact on the accuracy of the diagnosis (indeed, it is possible at present to not only identify the allergen derived from a given allergen source but also the family of molecules to which the patient is sensitized), on the prognosis of the patient's allergy, and on the prevention activities to be implemented. More interestingly, during the last few years, and thanks to the tools of molecular diagnostics, the indications for Allergen Immunotherapy (AIT) have also be modified, and novel strategies for the selection of the allergens to be administered have been better defined. Indeed, protocols indicating how Molecular Based Diagnosis (MBD) can be used to identify the best AIT approach have been recently published. In this review, the rationale for the use of MBD tools is discussed, and the recent strategies for the choice of allergens to be used in AIT are reported.
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http://dx.doi.org/10.1186/s40733-016-0024-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142326PMC
June 2016

Appropriateness in allergic respiratory diseases health care in Italy: definitions and organizational aspects.

Clin Mol Allergy 2016 19;14. Epub 2016 Apr 19.

Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.

In a historical period in which sustainability of the National Health Service is mandatory because of the international economical situation, the limited available resources at national level and the tendency of passing from a "population medicine" model towards the concept of "individualized medicine", the debate on appropriateness of medical and surgical procedures is of central importance. The choosing wisely campaign, started in United States in 2012 and then spread all over the world, tries to summarize which are the most inappropriate procedures for each medical and surgical speciality; as far as allergic respiratory diseases, the most relevant Italian societies and the American Academy defined the allergological procedures with the highest probability of inappropriateness. In Italy, a recent decree of the Ministry of Health defined a list of more than 200 procedures that will be considered as inappropriate in certain conditions; many of these procedures concern allergology, including allergic respiratory diseases. In this commentary we discuss the above mentioned decree and the concept of appropriateness in the field of allergic respiratory diseases, trying to figure out some practical considerations based on the current health resources available in the field of allergology in Italy.
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http://dx.doi.org/10.1186/s12948-016-0042-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837511PMC
April 2016

Comparing the ability of molecular diagnosis and CAP-inhibition in identifying the really causative venom in patients with positive tests to Vespula and Polistes species.

Clin Mol Allergy 2016 8;14. Epub 2016 Feb 8.

Allergy/Pulmonary Rehabilitation, ICP Hospital, Via Bignami 1, 20100 Milan, Italy.

Background: Cross-reactivity among Hymenoptera venoms is an important issue when prescribing venom immunotherapy (VIT). Using all venoms eliciting a positive response results in treatment excess and unjustified cost increase. The first in vitro method that helped to identify the really causative venom was RAST-inhibition, but in latest years also molecular allergy (MA) diagnostics, that detects specific sIgE to single venom allergens, was introduced. We compared the two methods in patients with double sensitization to Vespula spp. and Polistes spp.

Methods: Fifty-four patients with anaphylactic reactions to Hymenoptera stings and positive results to skin tests and sIgE measurement with whole venom from Vespula spp. and Polistes dominula were included in the study. Sera from all patients were analyzed by CAP-inhibition (Thermo Fisher Scientific, Uppsala, Sweden) and MA diagnostics with recombinant Ves v 1, Ves v 5 and Pol d 5.

Results: By the data obtained from MA technique, VIT would have been prescribed to 7 patients for Polistes, to 6 for Vespula, and to 41 for both venoms. With the data from CAP inhibition, it would have been a prescription to 15 patients for Polistes, to 28 for Vespula, and to 11 for both venoms. A good concordance between the results of MA and CAP-inhibition was found only when the value in kU/l of Ves v 5 were about twice those of Pol d 5, and vice versa.

Conclusions: These findings suggest that in the choice of the venom to be used for VIT CAP-inhibition remains a pivotal tool, because the significance of in vitro inhibition is definite and provides a diagnostic importance higher than MA in patients with positive tests to both Vespula and Polistes spp.
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http://dx.doi.org/10.1186/s12948-016-0040-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745150PMC
February 2016

How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients.

Intern Emerg Med 2015 Dec 20;10(8):937-41. Epub 2015 May 20.

Allergy Unit, Verona University Hospital, Verona, Italy.

Self-administered adrenaline through an auto-injector is the main out-of-hospital treatment for anaphylaxis, and patients should be trained to promptly and correctly use the device. The aim of the study was to verify the proper use of the device and the correct drug administration, and to identify possible misuse by patients. In seven Italian Allergy clinics, patients who were previously provided with self-injectable adrenaline were recruited at the follow-up visit required for the renewal of their prescription. All patients completed a questionnaire covering details of their allergic reactions, and knowledge of the device. The correct use was verified by the physician using a trainer with a four-step examination. 242 patients were included; 46 patients (18 %) did not always carry the auto-injector, and 35 patients (14 %) reported situations in which they were doubtful about whether to use adrenaline. Only 39 % of patients properly managed the device, while some patients (6 %) failed in all four steps. The majority of patients considered it appropriate to use adrenaline at the onset of respiratory symptoms (56 %). The factor most closely related to proper use of the device was the education of the patient (p = 0.03), while age and the time from first prescription did not affect the ability to properly use the auto-injector. Even though accurate training is conducted, many patients are still unable to properly use the adrenaline auto-injector in case of anaphylaxis. Allergists should review the instructions provided to the patients every time a renewal of the auto-injector is prescribed.
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http://dx.doi.org/10.1007/s11739-015-1255-zDOI Listing
December 2015

The bacterial lysate Lantigen B reduces the number of acute episodes in patients with recurrent infections of the respiratory tract: the results of a double blind, placebo controlled, multicenter clinical trial.

Immunol Lett 2014 Dec 3;162(2 Pt B):185-93. Epub 2014 Nov 3.

Allergy & Respiratory Diseases Department, University of Genoa, IRCCS A.O.U. San Martino - IST, Lg. Benzi, 10, 16132 Genova, Italy.

Studies in the 1970s and 1980s reported that bacterial lysates (BL) had a prophylactic effect on recurrent respiratory tract infections (RRTI). However, controlled clinical study procedures have evolved substantially since then. We performed a trial using updated methods to evaluate the efficacy of Lantigen B®, a chemical BL. This double blind, placebo controlled, multi-center clinical trial had the primary objective of assessing the capacity of Lantigen B to significantly reduce the total number of infectious episodes in patients with RRTI. Secondary aims were the RRTI duration, the frequency and the severity of the acute episodes, the use of drugs and the number of missed workdays. In the subgroup of allergic patients with RRTI, the number of allergic episodes (AE) and the use of anti-allergic drugs were also evaluated. One hundred and sixty patients, 79 allocated to the treated group (TG) and 81 to the placebo group (PG), were enrolled; 30 were lost during the study and 120 (79 females and 38 males) were evaluated. The PG had 1.43 episodes in the 8-months of follow-up while the TG had 0.86 episodes (p=0.036). A similar result was observed in the allergic patients (1.80 and 0.86 episodes for the PG and the TG, respectively, p=0.047). The use of antibiotics was reduced (mean 1.24 and 2.83 days of treatment for the TG and the PG). Logistic regression analysis indicated that the estimated risk of needing antibiotics and NSAIDs was reduced by 52.1 and 30.6%, respectively. With regard to the number of AE, no significant difference was observed between the two groups, but bronchodilators, antihistamines and local corticosteroids were reduced by 25.7%, 56.2% and 41.6%, respectively, in the TG. Lantigen B significantly reduced the number of infectious episodes in patients with RRTI. This finding suggests a first line use of this drug for the prophylaxis of infectious episodes in these patients.
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http://dx.doi.org/10.1016/j.imlet.2014.10.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173099PMC
December 2014

Association between a low IgE response to Phl p 5 and absence of asthma in patients with grass pollen allergy.

Clin Mol Allergy 2013 Dec 5;11(1). Epub 2013 Dec 5.

Medical and Scientific Department, Stallergenes, Viale Certosa 2, Milan 20155, Italy.

Background: The introduction of component-resolved diagnosis was a great advance in diagnosis of allergy. In particular, molecular allergy techniques allowed investigation of the association between given molecular profiles and clinical expression of allergy. We evaluated the possible correlation between the level of specific IgE (sIgE) to single components of Phleum pratense and clinical issues such as the severity of allergic rhinitis (AR) and the presence or absence of asthma.

Methods: The study included 140 patients with rhinitis and/or asthma caused by sensitization to grass pollen. sIgE to Phl p 1, Phl p 5, Phl p 7, and Phl p 12 from Phleum pratense were measured, and the correlation between the stage of AR according to Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines and the presence of asthma was studied by multivariate logistic regression in terms of sIgE and ARIA stage, while univariate logistic regression was used for IgE and a dichotomic classification of asthma as present or absent.

Results: Ten patients had intermittent AR, 48 had mild persistent AR, and 82 had severe persistent AR. Asthma was present in 86 patients and absent in 54. A significant correlation was found between severe persistent AR and presence of asthma (p < 0.01). The only significant correlation between clinical data and sIgE values was that of low values of sIgE to Phl p 5 and absence of asthma (p < 0.01).

Conclusions: This preliminary finding suggests that low values of sIgE to Phl p 5 are correlated with the absence of asthma in patients with grass-pollen induced allergy. The data, provided they are confirmed by further studies, could be useful when selecting patients who are candidates for allergen immunotherapy, since a higher risk of asthma could be used as a selection criterion for using this approach.
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http://dx.doi.org/10.1186/1476-7961-11-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176493PMC
December 2013