Gennaro D'Amato - Academia.edu (original) (raw)
Papers by Gennaro D'Amato
WAO Journal, 2022
An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Co... more An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) started in Wuhan, Hubei Province, China and quickly spread around the world. Current evidence is contradictory on the association of asthma with COVID-19 and associated severe outcomes. Type 2 inflammation may reduce the risk for severe COVID-19. Whether asthma diagnosis may be a risk factor for severe COVID-19, especially for those with severe disease or non-allergic phenotypes, deserves further attention and clarification. In addition, COVID-19 does not appear to provoke asthma exacerbations, and asthma therapeutics should be continued for patients with exposure to COVID-19. Changes in the intensity of pollinization, an earlier start and extension of the pollinating season, and the increase in production and allergenicity of pollen are known direct effects that air pollution has on physical, chemical, and biological properties of the pollen grains. They are influenced and triggered by meteorological variables that could partially explain the effect on COVID-19. SARS-CoV-2 is capable of persisting in the environment and can be transported by bioaerosols which can further influence its transmission rate and seasonality. The COVID-19 pandemic has changed the behavior of adults and children globally. A general trend during the pandemic has been human isolation indoors due to school lockdowns and loss of job or implementation of virtual work at home. A consequence of this behavior change would presumably be changes in indoor allergen exposures and reduction of inhaled outdoor allergens. Therefore, lockdowns during the pandemic might have improved some specific allergies, while worsening others, depending on the housing conditions.
PubMed, Sep 21, 2017
An increasing body of evidence shows the occurrence of asthma epidemics, sometimes also severe, d... more An increasing body of evidence shows the occurrence of asthma epidemics, sometimes also severe, during thunderstorms in the pollen season in various geographical zones. The main hypothesis explaining association between thunderstorms and asthma claims that thunderstorms can concentrate pollen grains at ground level; these grains may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20-30 minutes of a thunderstorm, patients suffering from pollen allergy may inhale a high concentration of the allergenic material dispersed into the atmosphere, which can, in turn, induce asthmatic reactions, often severe. Subjects without asthma symptoms but affected by seasonal rhinitis can also experience an asthma attack. All subjects affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe bronchial obstruction. Considering this background, it is useful to predict thunderstorms during pollen season and, thus, to prevent thunderstorm-related clinical event. However, it is also important to focus on therapy, and it is not sufficient that subjects at risk of asthma follow a correct therapy with bronchodilators, but they also need to inhale corticosteroids, using both in case of emergency.
Journal of Allergy and Clinical Immunology, 2017
Pulmonary Pharmacology & Therapeutics, 2003
Formoterol Turbuhaler has been suggested for as-needed use in asthmatic patients. We investigated... more Formoterol Turbuhaler has been suggested for as-needed use in asthmatic patients. We investigated whether regular treatment with formoterol would modify the dose-response curves to formoterol in patients with partially reversible COPD. In this randomised, doubleblind, cross-over study taking place over four non-consecutive days 16 outpatients with moderate to severe COPD, who were under regular treatment with formoterol Turbuhaler (18 mg in two daily doses) from at least 4 months, inhaled a conventional dose of formoterol Turbuhaler 9 mg or placebo. Two hours later, a FEV 1 value was established, following which a dose-response curve to formoterol (4.5 mg/inhalation) or placebo was constructed using four inhalations (1 þ 1 þ 2)-total cumulative delivered dose of 18 mg formoterolwith the following sequences: (1) formoterol pre-treatment þ formoterol 18 mg, (2) formoterol pre-treatment þ placebo, (3) placebo pretreatment þ formoterol 18 mg, (4) placebo pre-treatment þ placebo. Formoterol 9 mg induced significant (P , 0.0001) bronchodilation at 2 h after inhalation (best mean increase in FEV 1 : 0.170 L). Afterwards, dose-dependent increases in FEV 1 occurred with formoterol (maximum mean increase from 2-h value with formoterol: 0.072 after formoterol pre-treatment, and 0.201 L after placebo pre-treatment). Both maximum values of bronchodilation after the last inhalation of formoterol were statistically different (P , 0.001) from 2-h levels. These results show that dose-dependent bronchodilatation of formoterol is maintained despite regular treatment.
Allergo Journal, 2014
Climate change and air pollution-E ects on pollen allergy and other allergic respiratory diseases.
Multidisciplinary Respiratory Medicine, 2014
Increased asthma severity is not only associated with enhanced recurrent hospitalization and mort... more Increased asthma severity is not only associated with enhanced recurrent hospitalization and mortality but also with higher social costs. Several cases of asthma are atopic in nature, with the trigger for acute asthma attacks and chronic worsening of inflammation being allergens inducing an immune, IgE mediated response. Anti-inflammatory treatments are effective for most of asthma patients, but there are subjects whose disease is incompletely controlled by inhaled or systemic corticosteroids and these patients account for about 50% of the healthcare costs of asthma. Omalizumab is a biological engineered, humanized recombinant monoclonal anti-IgE antibody developed for the treatment of allergic diseases and with clear efficacy in adolescent and adult patients with severe allergic asthma. The anti-IgE antibody inhibits IgE functions blocking free serum IgE and inhibiting their binding to cellular receptors. By reducing serum IgE levels and IgE receptor expression on inflammatory cells in the context of allergic cascade, omalizumab has demonstrated to be a very useful treatment of atopic asthma, improving quality of life of patients with severe persistent allergic asthma that is inadequately controlled by currently available asthma medications. Several trials have demonstrated that this therapy is well tolerated and significantly improves symptoms and disease control, reducing asthma exacerbations and the need to use high dosage of inhaled corticosteroids.
World Allergy Organization Journal, 2015
Annali dell'Istituto superiore di sanita
Climate change, air pollution, temperature increase and other environmental variables are modifyi... more Climate change, air pollution, temperature increase and other environmental variables are modifying air quality, contributing to the increase of prevalence of allergic respiratory diseases. Allergies are complex diseases characterized by multilevel interactions between individual susceptibility, response to immune modulation and environmental exposures to physical, chemical and biological agents. Occupational allergies introduce a further complexity to these relationships by adding occupational exposure to both the indoor and outdoor ones in the living environment. The aim of this paper is to overview climate-related allergy affecting environmental and occupational health, as literature data are scanty in this regard, and to suggest a management model of this risk based on a multidisciplinary approach, taking the case of biological pollution, with details on exposure and prevention. The management of climate-related occupational allergy should take into account preventive health str...
Both the prevalence and severity of respiratory allergic diseases such as bronchial asthma have i... more Both the prevalence and severity of respiratory allergic diseases such as bronchial asthma have increased in recent years. Among the factors implicated in this "epidemic" are indoor and outdoor airborne pollutants. Urbanisation with its high levels of vehicle emissions and Westernised lifestyle parallels the increase in respiratory allergy in most industrialised countries, and people who live in urban areas tend to be more affected by the disease than those of rural areas. In atopic subjects, exposure to air pollution increases airway responsiveness to aeroallergens. Pollen is a good model with which to study the interrelationship between air pollution and respiratory allergic diseases. Biological aerosols carrying antigenic proteins, such as pollen grains or plantderived paucimicronic components, can produce allergic symptoms. By adhering to the surface of these airborne allergenic agents, air pollutants could modify their antigenic properties. Several factors influence this interaction, i.e., type of air pollutant, plant species, nutrient balance, climatic factors, degree of airway sensitisation and hyperresponsiveness of exposed subjects. However, the airway mucosal damage and the impaired mucociliary clearance induced by air pollution may facilitate the penetration and the access of inhaled allergens to the cells of the immune system, and so promote airway sensitisation. As a consequence, an enhanced immunoglobulin E-mediated response to aeroallergens and enhanced airway inflammation favoured by air pollution could account for the increasing prevalence of allergic respiratory diseases in urban areas.
Multidisciplinary Respiratory Medicine, 2016
Despite major advances in the treatment of asthma and the development of several asthma guideline... more Despite major advances in the treatment of asthma and the development of several asthma guidelines, people still die of asthma currently. According to WHO estimates, approximately 250,000 people die prematurely each year from asthma. Trends of asthma mortality rates vary very widely across countries, age and ethnic groups. Several risk factors have been associated with asthma mortality, including a history of near-fatal asthma requiring intubation and mechanical ventilation, hospitalization or emergency care visit for asthma in the past year, currently using or having recently stopped using oral corticosteroids (a marker of event severity), not currently using inhaled corticosteroids, a history of psychiatric disease or psychosocial problems, poor adherence with asthma medications and/or poor adherence with (or lack of) a written asthma action plan, food allergy in a patient with asthma. Preventable factors have been identified in the majority of asthma deaths. Inadequate education of patients on recognising risk and the appropriate action needed when asthma control is poor, deficiencies in the accuracy and timing of asthma diagnosis, inadequate classification of severity and treatment, seem to play a part in the majority of asthma deaths. Improvements in management, epitomized by the use of guided self-management systems of care may be the key goals in reducing asthma mortality worldwide
Multidisciplinary respiratory medicine, 2015
The major changes to our world are those involving the atmosphere and the climate, including glob... more The major changes to our world are those involving the atmosphere and the climate, including global warming induced by anthropogenic factors, with impact on the biosphere and human environment. Studies on the effects of climate changes on respiratory allergy are still lacking and current knowledge is provided by epidemiological and experimental studies on the relationship between allergic respiratory diseases, asthma and environmental factors, like meteorological variables, airborne allergens and air pollution. Epidemiologic studies have demonstrated that urbanization, high levels of vehicle emissions and westernized lifestyle are correlated with an increased frequency of respiratory allergy, mainly in people who live in urban areas in comparison with people living in rural areas. However, it is not easy to evaluate the impact of climate changes and air pollution on the prevalence of asthma in general and on the timing of asthma exacerbations, although the global rise in asthma prev...
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, Jan 14, 2016
The fifth report issued by the Intergovernmental Panel on Climate Change forecasts that greenhous... more The fifth report issued by the Intergovernmental Panel on Climate Change forecasts that greenhouse gases will increase global temperature as well as the frequency of extreme weather phenomena. An increasing body of evidence shows the occurrence of severe asthma epidemics during thunderstorms in the pollen season, in various geographical zones. The main hypotheses explaining association between thunderstorms and asthma claim that thunderstorms can concentrate pollen grains at ground level which may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20-30 minutes of a thunderstorm, patients suffering from pollen allergies may inhale a high concentration of the allergenic material that is dispersed into the atmosphere, which in turn can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis can also experience an asthma attack. All subjects affected by polle...
The Journal of Allergy and Clinical Immunology: In Practice, 2015
Background: Data on allergic sensitization to horse allergen in modern urban areas are scarce. Th... more Background: Data on allergic sensitization to horse allergen in modern urban areas are scarce. The aim of this study was to investigate the characteristics of allergic sensitization and the modality of exposure to horse allergens in atopic patients living in an urban area and without occupational exposure to horse and/or horse-derived materials. Methods: From among 1822 consecutive outpatients, we selected all subjects who had an immediate skin reaction to horse dander. We recorded the patients' clinical history including a meticulous evaluation of the possibility and eventual modality of horse exposure, and the results of skin-prick tests (SPT) and total/specific IgE antibody analyses. Results: Of 1201 SPT-positive patients, 35 (3.43%) were sensitized to horse dander. No patient was mono-sensitized. Six individuals reported having direct horse contact, 10 subjects had occasional contact with horse owners (indirect exposure), and 19 denied direct or indirect exposure to horses or horse allergens. Twenty of the 35 horse-sensitized patients reported both nasal and bronchial symptoms, 14 had rhinitis without asthma and one had asthma without rhinitis. Conclusions: Our results suggest that allergic sensitization to horse allergens is more frequent than expected in urban-dwelling subjects without direct or occupational exposure to horses. Highly atopic individuals or individuals who are sensitized to common pet dander a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r m e d Respiratory Medicine (2009) 103, 414e420
Summary In order to evaluate the age of ouset of respiratory allergic symptoms we examined 2315 ... more Summary In order to evaluate the age of ouset of respiratory allergic symptoms we examined 2315 patients (656 children and 1659 adults) coming to our clinic as out patients. Each patient underwent the following diagnostic tests: anamnestic and clinical examination, skin-tests for the most common allergens and, when requested, Radioallergosorbent test (RAST) and specific and non specific BPT.We selected 278 children
Respiratory Medicine, 2001
Evidence suggests that allergic respiratory diseases such as hay fever and bronchial asthma have ... more Evidence suggests that allergic respiratory diseases such as hay fever and bronchial asthma have become more common world-wide in the last two decades, and the reasons for this increase are still largely unknown. A major responsible factor could be outdoor air pollution, derived from cars and other vehicles. Studies have demonstrated that urbanization and high levels of vehicle emissions and westernized lifestyle is correlated with the increasing frequency of pollen-induced respiratory allergy. People who live in urban areas tend to be more affected by polleninduced respiratory allergy than those from of rural areas.
Therapeutics and clinical risk management, 2007
Bronchial asthma is recognized as a highly prevalent health problem in the developed and developi... more Bronchial asthma is recognized as a highly prevalent health problem in the developed and developing world with significant social and economic consequences. Increased asthma severity is not only associated with enhanced recurrent hospitalization and mortality but also with higher social costs. The pathogenetic background of allergic-atopic bronchial asthma is characterized by airway inflammation with infiltration of several cells (mast cells, basophils, eosinophils, monocytes, and T-helper (Th)2 lymphocytes). However, in atopic asthma the trigger factors for acute attacks and chronic worsening of bronchial inflammation are aeroallergens released by pollens, dermatophagoides, and pets, which are able to induce an immune response by interaction with IgE antibodies. Currently anti-inflammatory treatments are effective for most asthma patients, but there are asthmatic subjects whose disease is not completely controlled by inhaled or systemic corticosteroids and who account for a signifi...
WAO Journal, 2022
An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Co... more An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) started in Wuhan, Hubei Province, China and quickly spread around the world. Current evidence is contradictory on the association of asthma with COVID-19 and associated severe outcomes. Type 2 inflammation may reduce the risk for severe COVID-19. Whether asthma diagnosis may be a risk factor for severe COVID-19, especially for those with severe disease or non-allergic phenotypes, deserves further attention and clarification. In addition, COVID-19 does not appear to provoke asthma exacerbations, and asthma therapeutics should be continued for patients with exposure to COVID-19. Changes in the intensity of pollinization, an earlier start and extension of the pollinating season, and the increase in production and allergenicity of pollen are known direct effects that air pollution has on physical, chemical, and biological properties of the pollen grains. They are influenced and triggered by meteorological variables that could partially explain the effect on COVID-19. SARS-CoV-2 is capable of persisting in the environment and can be transported by bioaerosols which can further influence its transmission rate and seasonality. The COVID-19 pandemic has changed the behavior of adults and children globally. A general trend during the pandemic has been human isolation indoors due to school lockdowns and loss of job or implementation of virtual work at home. A consequence of this behavior change would presumably be changes in indoor allergen exposures and reduction of inhaled outdoor allergens. Therefore, lockdowns during the pandemic might have improved some specific allergies, while worsening others, depending on the housing conditions.
PubMed, Sep 21, 2017
An increasing body of evidence shows the occurrence of asthma epidemics, sometimes also severe, d... more An increasing body of evidence shows the occurrence of asthma epidemics, sometimes also severe, during thunderstorms in the pollen season in various geographical zones. The main hypothesis explaining association between thunderstorms and asthma claims that thunderstorms can concentrate pollen grains at ground level; these grains may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20-30 minutes of a thunderstorm, patients suffering from pollen allergy may inhale a high concentration of the allergenic material dispersed into the atmosphere, which can, in turn, induce asthmatic reactions, often severe. Subjects without asthma symptoms but affected by seasonal rhinitis can also experience an asthma attack. All subjects affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe bronchial obstruction. Considering this background, it is useful to predict thunderstorms during pollen season and, thus, to prevent thunderstorm-related clinical event. However, it is also important to focus on therapy, and it is not sufficient that subjects at risk of asthma follow a correct therapy with bronchodilators, but they also need to inhale corticosteroids, using both in case of emergency.
Journal of Allergy and Clinical Immunology, 2017
Pulmonary Pharmacology & Therapeutics, 2003
Formoterol Turbuhaler has been suggested for as-needed use in asthmatic patients. We investigated... more Formoterol Turbuhaler has been suggested for as-needed use in asthmatic patients. We investigated whether regular treatment with formoterol would modify the dose-response curves to formoterol in patients with partially reversible COPD. In this randomised, doubleblind, cross-over study taking place over four non-consecutive days 16 outpatients with moderate to severe COPD, who were under regular treatment with formoterol Turbuhaler (18 mg in two daily doses) from at least 4 months, inhaled a conventional dose of formoterol Turbuhaler 9 mg or placebo. Two hours later, a FEV 1 value was established, following which a dose-response curve to formoterol (4.5 mg/inhalation) or placebo was constructed using four inhalations (1 þ 1 þ 2)-total cumulative delivered dose of 18 mg formoterolwith the following sequences: (1) formoterol pre-treatment þ formoterol 18 mg, (2) formoterol pre-treatment þ placebo, (3) placebo pretreatment þ formoterol 18 mg, (4) placebo pre-treatment þ placebo. Formoterol 9 mg induced significant (P , 0.0001) bronchodilation at 2 h after inhalation (best mean increase in FEV 1 : 0.170 L). Afterwards, dose-dependent increases in FEV 1 occurred with formoterol (maximum mean increase from 2-h value with formoterol: 0.072 after formoterol pre-treatment, and 0.201 L after placebo pre-treatment). Both maximum values of bronchodilation after the last inhalation of formoterol were statistically different (P , 0.001) from 2-h levels. These results show that dose-dependent bronchodilatation of formoterol is maintained despite regular treatment.
Allergo Journal, 2014
Climate change and air pollution-E ects on pollen allergy and other allergic respiratory diseases.
Multidisciplinary Respiratory Medicine, 2014
Increased asthma severity is not only associated with enhanced recurrent hospitalization and mort... more Increased asthma severity is not only associated with enhanced recurrent hospitalization and mortality but also with higher social costs. Several cases of asthma are atopic in nature, with the trigger for acute asthma attacks and chronic worsening of inflammation being allergens inducing an immune, IgE mediated response. Anti-inflammatory treatments are effective for most of asthma patients, but there are subjects whose disease is incompletely controlled by inhaled or systemic corticosteroids and these patients account for about 50% of the healthcare costs of asthma. Omalizumab is a biological engineered, humanized recombinant monoclonal anti-IgE antibody developed for the treatment of allergic diseases and with clear efficacy in adolescent and adult patients with severe allergic asthma. The anti-IgE antibody inhibits IgE functions blocking free serum IgE and inhibiting their binding to cellular receptors. By reducing serum IgE levels and IgE receptor expression on inflammatory cells in the context of allergic cascade, omalizumab has demonstrated to be a very useful treatment of atopic asthma, improving quality of life of patients with severe persistent allergic asthma that is inadequately controlled by currently available asthma medications. Several trials have demonstrated that this therapy is well tolerated and significantly improves symptoms and disease control, reducing asthma exacerbations and the need to use high dosage of inhaled corticosteroids.
World Allergy Organization Journal, 2015
Annali dell'Istituto superiore di sanita
Climate change, air pollution, temperature increase and other environmental variables are modifyi... more Climate change, air pollution, temperature increase and other environmental variables are modifying air quality, contributing to the increase of prevalence of allergic respiratory diseases. Allergies are complex diseases characterized by multilevel interactions between individual susceptibility, response to immune modulation and environmental exposures to physical, chemical and biological agents. Occupational allergies introduce a further complexity to these relationships by adding occupational exposure to both the indoor and outdoor ones in the living environment. The aim of this paper is to overview climate-related allergy affecting environmental and occupational health, as literature data are scanty in this regard, and to suggest a management model of this risk based on a multidisciplinary approach, taking the case of biological pollution, with details on exposure and prevention. The management of climate-related occupational allergy should take into account preventive health str...
Both the prevalence and severity of respiratory allergic diseases such as bronchial asthma have i... more Both the prevalence and severity of respiratory allergic diseases such as bronchial asthma have increased in recent years. Among the factors implicated in this "epidemic" are indoor and outdoor airborne pollutants. Urbanisation with its high levels of vehicle emissions and Westernised lifestyle parallels the increase in respiratory allergy in most industrialised countries, and people who live in urban areas tend to be more affected by the disease than those of rural areas. In atopic subjects, exposure to air pollution increases airway responsiveness to aeroallergens. Pollen is a good model with which to study the interrelationship between air pollution and respiratory allergic diseases. Biological aerosols carrying antigenic proteins, such as pollen grains or plantderived paucimicronic components, can produce allergic symptoms. By adhering to the surface of these airborne allergenic agents, air pollutants could modify their antigenic properties. Several factors influence this interaction, i.e., type of air pollutant, plant species, nutrient balance, climatic factors, degree of airway sensitisation and hyperresponsiveness of exposed subjects. However, the airway mucosal damage and the impaired mucociliary clearance induced by air pollution may facilitate the penetration and the access of inhaled allergens to the cells of the immune system, and so promote airway sensitisation. As a consequence, an enhanced immunoglobulin E-mediated response to aeroallergens and enhanced airway inflammation favoured by air pollution could account for the increasing prevalence of allergic respiratory diseases in urban areas.
Multidisciplinary Respiratory Medicine, 2016
Despite major advances in the treatment of asthma and the development of several asthma guideline... more Despite major advances in the treatment of asthma and the development of several asthma guidelines, people still die of asthma currently. According to WHO estimates, approximately 250,000 people die prematurely each year from asthma. Trends of asthma mortality rates vary very widely across countries, age and ethnic groups. Several risk factors have been associated with asthma mortality, including a history of near-fatal asthma requiring intubation and mechanical ventilation, hospitalization or emergency care visit for asthma in the past year, currently using or having recently stopped using oral corticosteroids (a marker of event severity), not currently using inhaled corticosteroids, a history of psychiatric disease or psychosocial problems, poor adherence with asthma medications and/or poor adherence with (or lack of) a written asthma action plan, food allergy in a patient with asthma. Preventable factors have been identified in the majority of asthma deaths. Inadequate education of patients on recognising risk and the appropriate action needed when asthma control is poor, deficiencies in the accuracy and timing of asthma diagnosis, inadequate classification of severity and treatment, seem to play a part in the majority of asthma deaths. Improvements in management, epitomized by the use of guided self-management systems of care may be the key goals in reducing asthma mortality worldwide
Multidisciplinary respiratory medicine, 2015
The major changes to our world are those involving the atmosphere and the climate, including glob... more The major changes to our world are those involving the atmosphere and the climate, including global warming induced by anthropogenic factors, with impact on the biosphere and human environment. Studies on the effects of climate changes on respiratory allergy are still lacking and current knowledge is provided by epidemiological and experimental studies on the relationship between allergic respiratory diseases, asthma and environmental factors, like meteorological variables, airborne allergens and air pollution. Epidemiologic studies have demonstrated that urbanization, high levels of vehicle emissions and westernized lifestyle are correlated with an increased frequency of respiratory allergy, mainly in people who live in urban areas in comparison with people living in rural areas. However, it is not easy to evaluate the impact of climate changes and air pollution on the prevalence of asthma in general and on the timing of asthma exacerbations, although the global rise in asthma prev...
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, Jan 14, 2016
The fifth report issued by the Intergovernmental Panel on Climate Change forecasts that greenhous... more The fifth report issued by the Intergovernmental Panel on Climate Change forecasts that greenhouse gases will increase global temperature as well as the frequency of extreme weather phenomena. An increasing body of evidence shows the occurrence of severe asthma epidemics during thunderstorms in the pollen season, in various geographical zones. The main hypotheses explaining association between thunderstorms and asthma claim that thunderstorms can concentrate pollen grains at ground level which may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20-30 minutes of a thunderstorm, patients suffering from pollen allergies may inhale a high concentration of the allergenic material that is dispersed into the atmosphere, which in turn can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis can also experience an asthma attack. All subjects affected by polle...
The Journal of Allergy and Clinical Immunology: In Practice, 2015
Background: Data on allergic sensitization to horse allergen in modern urban areas are scarce. Th... more Background: Data on allergic sensitization to horse allergen in modern urban areas are scarce. The aim of this study was to investigate the characteristics of allergic sensitization and the modality of exposure to horse allergens in atopic patients living in an urban area and without occupational exposure to horse and/or horse-derived materials. Methods: From among 1822 consecutive outpatients, we selected all subjects who had an immediate skin reaction to horse dander. We recorded the patients' clinical history including a meticulous evaluation of the possibility and eventual modality of horse exposure, and the results of skin-prick tests (SPT) and total/specific IgE antibody analyses. Results: Of 1201 SPT-positive patients, 35 (3.43%) were sensitized to horse dander. No patient was mono-sensitized. Six individuals reported having direct horse contact, 10 subjects had occasional contact with horse owners (indirect exposure), and 19 denied direct or indirect exposure to horses or horse allergens. Twenty of the 35 horse-sensitized patients reported both nasal and bronchial symptoms, 14 had rhinitis without asthma and one had asthma without rhinitis. Conclusions: Our results suggest that allergic sensitization to horse allergens is more frequent than expected in urban-dwelling subjects without direct or occupational exposure to horses. Highly atopic individuals or individuals who are sensitized to common pet dander a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r m e d Respiratory Medicine (2009) 103, 414e420
Summary In order to evaluate the age of ouset of respiratory allergic symptoms we examined 2315 ... more Summary In order to evaluate the age of ouset of respiratory allergic symptoms we examined 2315 patients (656 children and 1659 adults) coming to our clinic as out patients. Each patient underwent the following diagnostic tests: anamnestic and clinical examination, skin-tests for the most common allergens and, when requested, Radioallergosorbent test (RAST) and specific and non specific BPT.We selected 278 children
Respiratory Medicine, 2001
Evidence suggests that allergic respiratory diseases such as hay fever and bronchial asthma have ... more Evidence suggests that allergic respiratory diseases such as hay fever and bronchial asthma have become more common world-wide in the last two decades, and the reasons for this increase are still largely unknown. A major responsible factor could be outdoor air pollution, derived from cars and other vehicles. Studies have demonstrated that urbanization and high levels of vehicle emissions and westernized lifestyle is correlated with the increasing frequency of pollen-induced respiratory allergy. People who live in urban areas tend to be more affected by polleninduced respiratory allergy than those from of rural areas.
Therapeutics and clinical risk management, 2007
Bronchial asthma is recognized as a highly prevalent health problem in the developed and developi... more Bronchial asthma is recognized as a highly prevalent health problem in the developed and developing world with significant social and economic consequences. Increased asthma severity is not only associated with enhanced recurrent hospitalization and mortality but also with higher social costs. The pathogenetic background of allergic-atopic bronchial asthma is characterized by airway inflammation with infiltration of several cells (mast cells, basophils, eosinophils, monocytes, and T-helper (Th)2 lymphocytes). However, in atopic asthma the trigger factors for acute attacks and chronic worsening of bronchial inflammation are aeroallergens released by pollens, dermatophagoides, and pets, which are able to induce an immune response by interaction with IgE antibodies. Currently anti-inflammatory treatments are effective for most asthma patients, but there are asthmatic subjects whose disease is not completely controlled by inhaled or systemic corticosteroids and who account for a signifi...