Domenico Gargano - Academia.edu (original) (raw)

Papers by Domenico Gargano

Authorea (Authorea), Apr 21, 2023

Background: Eosinophilic esophagitis (EoE) is increasingly diagnosed in patients with dysphagia a... more Background: Eosinophilic esophagitis (EoE) is increasingly diagnosed in patients with dysphagia and upper gastroenteric symptoms. Elimination diets and/or pharmacologic agents may accomplish temporary remission, but long-term control is challenging. Type-2 immunity to ingested antigens can induce EoE histopathology via non-IgE-dependent mechanisms, possibly involving IgG4 and IL-10 production. To elucidate the contribution of IgG4-and IL-10-producing cells to EoE pathogenesis, we examined their frequencies and association with clinical and histologic endpoints in adult EoE patients given a two-food elimination diet (TFED). Methods: Sixteen patients with EoE were prescribed a TFED. Biopsies collected at baseline and follow-up were used for immunofluorescent detection of IgG4-and IL-10-expressing cells and serum food-specific IgG4 were measured. All variables were correlated with established histologic measures of disease activity. Results: Patients exhibited significant clinical improvement and significant reduction in esophageal eosinophilia and overall histology. A significant decrease in the frequencies of IL-10-expressing cells was also observed, which correlated with histologic changes. In contrast, a concomitant decline in serum and esophageal IgG4, while substantial, did not correlate with IL-10 +-cell frequencies or any histologic parameter of EoE activity. Conclusions: The close association of esophageal IL-10 expression with histologic features and their changes after a TFED suggests a critical role of this cytokine in EoE pathogenesis. Conversely, IgG4 serum and mucosal expression, while reflecting the level of exposure to relevant food antigens, is not obviously related to EoE histopathology or IL-10 expression. Studies are needed to characterize IL-10 cellular sources and their functions in EoE progression and treatment response. Changes in IgG4 and IL-10 expression in adults with eosinophilic esophagitis on a two-food elimination diet Running Title: Diet-induced IgG4 and IL-10 changes in eosinophilic esophagitis

Digestive and Liver Disease, 2021

Rhinology journal, 2021

Before the onset of COVID-19 pandemic, the use of protective face masks outside the healthcare se... more Before the onset of COVID-19 pandemic, the use of protective face masks outside the healthcare setting was a "cultural" or "occasional" event, to reduce the spread of seasonal flu virus or the inhalation of chemicals in highly polluted geographic areas, respectively (1,2). In many occupational settings the use of protective masks is common to avoid exposure to paints/solvents or allergens e.g. where animals are handled (3-5). Although face masks might protect from allergens, surprisingly, so far very few studies have investigated the efficacy of masks in protecting from common outdoor allergens like pollens. Godoh et al. documented a reduced penetration of Japanese cedar pol

European Annals of Allergy and Clinical Immunology

Anaphylaxis is the most severe systemic hypersensitivity reaction, it can be caused by a number o... more Anaphylaxis is the most severe systemic hypersensitivity reaction, it can be caused by a number of well identified triggers such as foods, drugs, stinging insects and facilitated by predisposing clinical conditions. However, sometimes anaphylaxis shows up with uncommon or peculiar characteristics which could delay diagnosis and therapeutic treatment. In this report we aimed to describe less accounted/difficult-to-approach shapes of anaphylaxis to facilitate clinicians to suspect these severe reactions even in uncommon conditions. We choose to present data on anaphylaxis regarding simulation, mode of exposure to sensitizing agents, pregnancy, exposure to animals, intimate behaviour, psychological stress, and other situations. Impact statement Sometimes anaphylaxis can occur with uncommon or peculiar characteristics which could delay diagnosis and therapeutic treatment. We aimed to describe less accounted/difficult-to-approach shapes of anaphylaxis to facilitate clinicians to suspect these severe reactions even in uncommon conditions.

European Annals of Allergy and Clinical Immunology, 2021

Placebo challenge could be a useful model to study stress-induced bronchial obstruction in asthma... more Placebo challenge could be a useful model to study stress-induced bronchial obstruction in asthmatics suffering from psychological stress and suspected adverse drug reaction. Such obstruction should be a likely effect of stress-induced cholinergic hyper-tone. Authorship: All authors contributed equally in the writing and revision of the manuscript. Conflict of interest and financial resources. All authors declare that they have no conflict of interest and that the study has been carried out without any financial support.

European Annals of Allergy and Clinical Immunology, 2019

Clinical and Molecular Allergy, 2018

Background: The query "are there animals at home?" is usually administered for collecting informa... more Background: The query "are there animals at home?" is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods: Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results: A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150-20.75%) or indirect contact (103-14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions: Only 213 patients (29.46%) would be classified as "exposed to animals" and 510 (70.54%) as "not exposed" according to usual query. Our classification has shown that many "not-exposed" subjects (399-55.19%) were "really exposed". The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals.

Journal of Clinical Medicine

Background: Recent studies have evaluated the upper esophageal sphincter (UES) with high-resoluti... more Background: Recent studies have evaluated the upper esophageal sphincter (UES) with high-resolution manometry (HRM) in some esophageal diseases, but not eosinophilic esophagitis (EoE). The aim of our study was to evaluate the function of the UES across EoE, gastroesophageal reflux disease (GERD), functional dysphagia (FD), and the relationship with esophageal symptoms, esophageal body contraction, and esophagogastric junction (EGJ) metrics. Methods: HRM was performed on 30 EoE, 18 GERD, and 29 FD patients according to the Chicago Classification 3.0. The study data were exported to the online analysis platform Swallow Gateway. The UES was assessed in terms of UES Resting Pressure (UES-RP), UES Basal Pressure (UES-BP), UES Integrated Relaxation Pressure (UES-IRP), UES Relaxation Time (UES-RT), Basal UES Contractile Integral (Basal UES-CI), Post-Deglutitive UES Contractile Integral (Post-Deglutitive UES-CI), and Proximal Contractile Integral (PCI). Results: ANOVA analysis showed signif...

Journal of Asthma, 2021

Objective: The prevalence of asthma in Italy is estimated to be around 4%; it affects approximate... more Objective: The prevalence of asthma in Italy is estimated to be around 4%; it affects approximately 2,000,000 citizens, and up to 80-90% of patients have mild-to-moderate asthma. Despite the clinical relevance of mild-to-moderate asthma, longitudinal observational data are very limited, including data on disease progression (worsening vs. improvement), the response to treatment, and prognosis. Studies are needed to develop long-term, observational, real-life research in large cohorts. The primary outcomes of this study will be based on prospective observation and the epidemiological evolution of mild and moderate asthma. Secondary outcomes will include patient-reported outcomes, treatments over time, disease-related functional and inflammatory patterns, and environmental and lifestyle influences. Methods: This study, called the Mild/Moderate Asthma Network of Italy (MANI), is a research initiative launched by the Italian Respiratory Society and the Italian Society of Allergology, Asthma and Clinical Immunology. MANI is a cluster-based, real world, cross-sectional, prospective, observational cohort study that includes 20,000 patients with mild-to-moderate asthma. (ClinicalTrials.gov Identifier: NCT04796844). Results and conclusion: Despite advances in asthma care, several research gaps remain to be addressed through clinical research. This study will add important new knowledge about long-term disease history, the transferability of clinical research results to daily practice, the efficacy of currently recommended strategies, and their impact on the burden and evolution of the disease.

Translational medicine @ UniSa, 2013

Basing on the current knowledge, this paper is aimed to review the core characteristics of the mo... more Basing on the current knowledge, this paper is aimed to review the core characteristics of the most relevant therapeutic agents (steroids and antihistamines), administered to prevent perioperative anaphylaxis. Moreover, the Authors propose the validation of a Global Anaphylactic Risk Score, built up by recording the individual scores related to the most relevant anaphylaxis parameters (i.e. medical history, symptoms and medication for asthma, rhinitis and urticaria etc) and by adding them on all together; the score could be used in the preoperative phase to evaluate the global anaphylactic risk and to prescribe risk-oriented premedication protocols.

Reumatismo, 2011

L a rettocolite ulcerosa (RCU) è una patologia caratterizzata dalla costante flogosi della mucosa... more L a rettocolite ulcerosa (RCU) è una patologia caratterizzata dalla costante flogosi della mucosa del colon, accompagnata talvolta da manifestazioni extraintestinali, più frequentemente a carico dell'apparato articolare e meno della cute e dell'occhio (1). L'artrite, con coinvolgimento assiale e/o periferico, che nella nostra popolazione è documentata nel 62% dei pazienti con RCU attiva (2), è caratterizzata da assenza del fattore reumatoide (FR), ed è compresa tra le spondiloartriti sieronegative (SpA) (3). Recentemente il nostro gruppo ha dimostrato che nel 54% dei pazienti con RCU si riscontrano manifestazioni allergiche IgE-mediate (4). Per tale motivo l'artrite e l'atopia possono essere considerate le due più frequenti condizioni patologiche associate alla RCU. La funzione del sistema immune è basata su complessi meccanismi regolatori tuttora non completamente compresi. I linfociti T helper (Th), divisi in due sottogruppi, sono caratterizzati da una differente produzione citochinica: interleuchina 2 ed interferone gamma da cellule Th1, interleuchina 4, 5, 6, e 10 da cellule Th2 (5). L'interleuchina 10 inibisce le cellule Th1, mentre l'interferone gamma Spondiloartriti sieronegative e patologia allergica nei pazienti con rettocolite ulcerosa * Seronegative spondyloarthropathies and allergic diseases in patients with ulcerative colitis

Digestive and Liver Disease, 2001

Background and Aim: in recent studies we have docummted semnegative spondylotibmpathy (SPA) and a... more Background and Aim: in recent studies we have docummted semnegative spondylotibmpathy (SPA) and atopy in 62% and 54% of patients affected by ulcerative colitis (UC), respectively. Accordiily, we have hypothesized that SpA and atopy are the ~mmmtest extraintestinal features of our UC population. The aim of this research was to study the presence of IgE-mediated allergic disease (AD), allergic contact dermatitis (ACD) and SpA in patients tiected by UC, evaluating possible relationships behveen the diseases. Patients and Methods: 45 consecutive UC 0uQaticnts (M/F 30/15, mean age 3wl4 yrs), were graded according to clinical, endoscopic and histologic activity scams. SpA was diagnosed acwrding to the European Spondyloartbmpathy Study Group criteria. AD was detected by skin prick tests and coniirmed by specific pmvocation tests, while ACD was diamwsed using the Eumwm standard series of oatch tests. 37 patients's spouses or partners (M/F14/23, m& age 356ti9.98 yrs) served as c&ols. Results: 22 pat& (48.9%) bad l&sided colitis and 23 (51.1%) uancolitis. 30 patients (66.7%) were classified in remission end 15 (33.3%) in mild-m&rate disc& activity. I4 &ent, (jl .l%) and 1 contml subject (2.7%) showed SpA @==O.OOl). Diagnosis of rhinitis, conjunctivitis or asthma was made in 19 patients (42.2%) and in 5 contmls (13.5%) @=O.G04), while ACD was found in 9 (26%) and in 4 (10.3%) (p=O.26), respectively. Only 2 patients had a cm~cmrent SpA and AD @=o.Ol), while SpA and ACD coexisted in 5 @=O.l I). Conclusiot~~: nohvithsbmding the bigb frequency of AD and SpA found in UC. the concurrence of AD and SpA or ACD is an mumal finding, while SpA and ACD may ofim coexist. These data suggest that AD and SpA, as well as AD and ACD, are strongly polarized conditions tending to mutual exclusion. In one group, the association of UC with AD but not with SpA or ACD seems to indicate a predominant T-helper-2 cell response, whereas, in another group, the presence of SpA or ACD without AD seems to indicate a predominant T-belper-I cell response.

Gennaro Liccardi, Luigino Calzetta, Adriano Berra , Rosa Caiazzo, Francesco Califano, Anna Ciccar... more Gennaro Liccardi, Luigino Calzetta, Adriano Berra , Rosa Caiazzo, Francesco Califano, Anna Ciccarelli, Marina Cutajar, Maria D’Amato, Fabio De Bartolomeis, Iride Dello Iacono, Domenico Gargano , Mario Lo Schiavo, Francesco Madonna, Mauro Maniscalco, Manlio Milanese , Carmen Montera , Raffaele Narducci, Gerardo Papa, Alfonso Pedicini , Giusy Sabatino, Carlo Sacerdoti, Alfonso Savoia, Anna Stanziola , Maria Beatrice Bilò , Paola Rogliani

The Journal of Allergy and Clinical Immunology: In Practice, 2015

European annals of allergy and clinical immunology, 2014

Although cockroach (CR) is an important cause of allergic sensitization worldwide, only a few dat... more Although cockroach (CR) is an important cause of allergic sensitization worldwide, only a few data are available in Italy and in a previous study we have observed, in Naples area, a low prevalence of CR sensitization. We sought to perform a prospective study for assessing the prevalence of allergic sensitization to CR in a sample of atopic population living in Campania district area (Southern Italy). Ten Allergy Units or Centres of Campania district participated in this cross-sectional study. Each centre was required to collect the results of at least 100 allergy consultations in consecutive outpatients referred for actual or suspected respiratory allergy. We registered demographic data, type and duration of respiratory symptoms, pets ownership, possible exposure to CR allergens, results of the skin prick tests (SPTs). A total of 1477 patients were examined, 985 (66.68%) had a SPTs positivity to at least one allergen. In this context, ninety were sensitized to CR, thus the overall s...

European annals of allergy and clinical immunology, 2012

Until now no data on allergic sensitization to rodents allergens in Western Europe and Italy are ... more Until now no data on allergic sensitization to rodents allergens in Western Europe and Italy are available. The aim of this report was to investigate clinical significance and characteristics of IgE-mediated sensitization to mouse/rat (M/Rt) allergens in atopic subjects not occupationally exposed to these animals and living in urban area of Naples. In 1765 consecutive outpatients, we selected all subjects with an immediate skin reaction to M/WRt dander clinical history including a carefijul evaluation ofthe modality of exposure, the results of skin-prick tests (SPTs) and specific IgE antibodies were recorded. Among 1185 SPT-positive patients, 22 were sensitized to M/Rt dander (respectively 1.60% and 0.59%). No patient was mono-sensitized Only three of 22 patients reported indoor conditions suggesting presence of rodents allergens at home. All patients exhibited low degree of SPT positivity and low levels of circulating IgE antibodies to M/WRt. Highfrequency of concomitant allergic s...

Scandinavian Journal of Gastroenterology, 2000

Data on allergy in ulcerative colitis (UC) have led to conflicting conclusions without proving an... more Data on allergy in ulcerative colitis (UC) have led to conflicting conclusions without proving any causal association. In this report we have investigated the presence of allergy and its possible relation with chronic colonic inflammation in patients with UC. Fifty UC patients underwent clinical, endoscopic, and histologic evaluations. The allergologic study included family/personal history; prick/patch exposition to airborne, food, and contact allergens; total serum IgE; and quantification of eosinophils in peripheral blood and intestinal mucosa. Diagnosis of rhinitis, conjunctivitis, and asthma was confirmed by specific provocation tests. Fifty healthy subjects were studied as control group. A higher prevalence of allergic symptoms was found in patients (56%) and their first-degree relatives (52%) than in controls (18% and 26%) (P < 0.0001; P = 0.008). In patients skin tests showed increased rates of immediate (54%) and delayed-type (20%) hypersensitivity compared with controls (30% and 6%) (P= 0.01; P= 0.03). Diagnosis of allergic IgE-mediated disease was made in 19 cases and 6 controls (P= 0.01), and allergic contact dermatitis in 10 and 3, respectively (P= 0.03). IgE levels were higher in UC patients than in controls (P=0.02). No dose-response relationship was found between degree of colonic tissue eosinophilia and clinical. endoscopic, and histologic disease severity. The degree of colonic tissue eosinophilia was higher in the presence of skin reactivity to food allergens. UC patients frequently show several markers of allergy. In particular, our data suggest an association between ulcerative colitis, tissue eosinophilia, and type-I allergy.

Annals of Internal Medicine, 2000

Nutrients

Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerance... more Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food—along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning ...