Giuseppe Pingitore - Academia.edu (original) (raw)

Papers by Giuseppe Pingitore

Research paper thumbnail of Can we stop the atopic march? Not Allergol 2015;33(2)-71-76

Research paper thumbnail of La prevenzione del respiro sibilante. Prevenzione secondaria e terziaria in età prescolare

Research paper thumbnail of Environmental interventions for mite-induced asthma: a journey between systematic reviews, contrasting evidence and clinical practice

European annals of allergy and clinical immunology, 2013

House dust mites (HDM) are one of the most important sources of indoor allergens worldwide. Expos... more House dust mites (HDM) are one of the most important sources of indoor allergens worldwide. Exposure to high environmental levels of dust mite allergen is associated with an increased risk of sensitization, asthma and deterioration of lung function. On the basis of these data, it would be logical to assume that asthmatic patients with mite allergy could benefit from a reduction of exposure to these allergens. Several environmental prophylactic actions against HDM, either physical or chemical have been tried, alone or in different combinations. However, a recent Cochrane Systematic Review did not detect specific clinical benefits from the use of prophylactic environmental measures in asthmatic patients sensitive to HDM and concluded that such measures can no longer be recommended as they are ineffective. This paper presents the results of a web-based questionnaire, administered to more than 200 Italian paediatricians, and shows that physicians' behaviour in real life is very far ...

Research paper thumbnail of Adherence issues related to sublingual immunotherapy as perceived by allergists

Patient Preference and Adherence, 2010

Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat al... more Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.

Research paper thumbnail of Pest sensitization to cockroach, mouse, and rat: An Italian multicenter study

Research paper thumbnail of Management of BNT162b2 mRNA COVID-19 vaccine in children aged 5–11 years with allergies, asthma, and immunodeficiency: consensus of the Italian Society of Pediatric Allergy and Immunology (SIAIP)

Italian Journal of Pediatrics

BNT162b2 vaccine, developed by BioNTech and Pfizer ha recently approved for use in children aged ... more BNT162b2 vaccine, developed by BioNTech and Pfizer ha recently approved for use in children aged 5 to 11 years. Recent data show evidence of safety on the administration and serious adverse events have been rarely reported. However, allergic systemic reactions could occur. In some cases, a correct allergic evaluation allows identifying patients at risk of developing an anaphylactic reaction. Risk assessment of allergic reactions to COVID-19 vaccines is useful to limit contraindications to vaccination and help to safely vaccinate people supposed to be at risk of allergic reactions.

Research paper thumbnail of Digital health in the management of allergic diseases

Acta bio-medica : Atenei Parmensis, Nov 29, 2021

In recent years there has been an important implementation in the medical field of both Mobile He... more In recent years there has been an important implementation in the medical field of both Mobile Health, such as the use of mobile communication devices, and of other telemedicine tools in general, with the aim of supporting the supervision of diseases from the moment of the first diagnosis to the therapeutic follow-up. In fact, Digital Health can also have a very positive impact on the management of allergic patients, who are known to have the greatest need for regular monitoring, simplifying contact between doctor and patient, but there is still a need to improve implementation regulations, define certification programs and adequate reimbursement systems, as well as to guarantee a high level of attention to the protection of sensitive data. The hope is that one positive outcome of the Covid-19 pandemic will be an acceleration, by all stakeholders involved, of the process of the modernization of health care.

Research paper thumbnail of United airway disease

Acta bio-medica : Atenei Parmensis, Nov 29, 2021

Nose and lungs are considered as anatomic and functional unit, as they share morphological, patho... more Nose and lungs are considered as anatomic and functional unit, as they share morphological, pathophysiological and immunological basis. Allergic rhinitis and asthma often coexist in the same individual, and the treatment of one also improves the symptoms of the other (one airway, one disease). The aim of this review is to discuss the interaction between upper and lower airways, based on recent scientific evidence and, critically, analyze the important implications the new findings have for the future therapy and prevention of these common diseases.

Research paper thumbnail of Iconographies supplémentaires de l'article : Molecular profiles of IgE to Phleum pratense in children with grass pollen allergy: Implications for specific immunotherapy

Research paper thumbnail of Vitamina D, Allergie Ed Asma

Nonostante il suo ruolo "fisiologico" rimanga quello di favorire l'assorbimento intestinale di ca... more Nonostante il suo ruolo "fisiologico" rimanga quello di favorire l'assorbimento intestinale di calcio rendendolo così disponibile per le ossa, negli ultimi anni si è assistito ad un crescente interesse per il ruolo che la vitamina D pare rivestire in varie patologie, in primis le patologie autoimmuni e tumorali. Cercheremo qui di analizzare se e quali siano al momento le reali evidenze riguardo il ruolo della vitamina D nelle comuni patologie pneumoallergologiche infantili.

Research paper thumbnail of Component resolved diagnosis and risk assessment in food allergy

Acta bio-medica : Atenei Parmensis, 2021

Allergy testing should only be performed in the context of the clinical history as history provi... more Allergy testing should only be performed in the context of the clinical history as history provides the cornerstone of diagnosis. In food allergy, some allergy tests often give rise to false positive results and thus can lead to unnecessary avoidance or delay on foods introduction. The use of Component Resolved Diagnosis in combination with conventional sensitization testing improves analytical and diagnostic performance and can lead to the reduction of diagnostic oral food challenges. Component Resolved Diagnosis can be helpful in identifying some risks for the allergic child. Molecular diagnosis can help also in predicting the development of the allergy march, in severe reactions (lipid transfer protein, seed storage proteins, etc.) in food allergy and for potential clinical cross-reactivity.

Research paper thumbnail of febbraio 2010 • anno XXIV Ma c'è l'asma in Africa? Diagnosi differenziale delle congiuntiviti allergiche a cura della Commissione rinocongiuntivite della siaiP Cellule T H 17 nella patologia umana: buone o cattive? Ruolo della nuova linea cellulare nelle patologie infiammatorie croniche e autoimm...

VaCCiNi I correlati immunologici di protezione indotti dalle vaccinazioni a cura della Commission... more VaCCiNi I correlati immunologici di protezione indotti dalle vaccinazioni a cura della Commissione Vaccini della siaiP

Research paper thumbnail of Infective complications and exposure to antibiotics during pregnancy and in the first year of life and development of asthma in children

Research paper thumbnail of L’Italian Pediatric Allergy Network:un’opportunità di ricerca per i clinici

32 Fare ricerca clinica non e un’impresa facile in Italia. La routine quotidiana ed i mille probl... more 32 Fare ricerca clinica non e un’impresa facile in Italia. La routine quotidiana ed i mille problemi che assillano il pediatra richiedono il 99% delle sue energie e del suo entusiasmo. Clinici ospedalieri e universitari devono troppo spesso rinunciare ad avviare un progetto nuovo, a verifi care un’ipotesi suggerita dalla esperienza clinica, a seguire un’idea innovativa. E diffi cile trovare collaborazioni, fi nanziare reattivi, avvalersi di consulenti statistici, preparare la documentazione per i comitati etici, motivare i giovani o i dipendenti perche diano “quel qualcosa in piu” per fare ricerca. Cosi, la creativita italiana, che tutti ci riconoscono e molti ci invidiano, non riesce sempre a tradursi in risultati scientifi ci apprezzabili. Quali soluzioni? Lamentarsi? Prendersela con il “Paese”, con l’”Universita”, il “Sistema?”. Un’alternativa possibile e riunire le forze, dividere i ruoli secondo le competenze, evitare i confl itti “di bottega”, mettere da parte l’orgoglio, e – ...

Research paper thumbnail of Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Allergy, Jan 20, 2017

Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in ... more Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. We examined 1120 children (age 4-18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD™ ). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA. The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by high...

Research paper thumbnail of Abstracts from the Food Allergy and Anaphylaxis Meeting 2016

Clinical and Translational Allergy, 2017

Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.

Research paper thumbnail of Perioperative Anaphylaxis: Epidemiology

International Journal of Immunopathology and Pharmacology, 2011

The clinical diagnosis of an anesthesia-related immediate hypersensitivity reaction is a difficul... more The clinical diagnosis of an anesthesia-related immediate hypersensitivity reaction is a difficult task for clinicians. Anaphylaxis may present as cardiovascular collapse or airway obstruction, associated or not with cutaneous manifestations. Drug hypersensitivity reactions that occur during anesthesia are responsible for significant morbidity and mortality and socio-economic costs. Perioperative anaphylaxis is becoming more common, probably because of the more frequent use of anesthesia and the increasing complexity of the drugs used. However, despite increased awareness of anaphylactic reactions to drugs and compounds used in anesthesia, their incidence remains poorly defined. Moreover, current epidemiological data should be carefully evaluated since the various studies published concerned non-homogeneous populations and gave differing definitions of drug hypersensitivity.

Research paper thumbnail of Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Italian journal of pediatrics, Jan 23, 2017

Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment... more Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one century ago, and performed in the early years with allergenic extracts of poor quality and definition. After the mechanism of allergic reaction were recognized, the practice of AIT was refined, leading to remarkable improvement in the efficacy and safety profile of the treatment. Currently AIT is accepted and routinely prescribed worldwide for respiratory allergies and hymenoptera venom allergy. Both the subcutaneous (SCIT) and sublingual (SLIT) routes of administration are used in the pediatric population.AIT is recommended in allergic rhinitis/conjunctivitis with/without allergic asthma, with an evidence of specific IgE-sensitization towards clinically relevant inhalant allergens. Long-term studies provided evidence that AIT can also prevent the onset of asthma and of new sensiti...

Research paper thumbnail of 6th International Symposium on Molecular Allergology (ISMA)

Clinical and Translational Allergy, 2016

Background: Delayed food anaphylaxis upon consumption of red meat is attributed to specific IgE-a... more Background: Delayed food anaphylaxis upon consumption of red meat is attributed to specific IgE-antibodies directed to galactose-α-1,3-galactose (α-Gal). Anaphylactic reactions may occur after ingestion of meat from different mammals, mainly beef and pork, but reactions to lamb, rabbit or horse have also been reported. In particular, pork kidney has been shown to trigger symptoms that were more severe and occurred within a shorter delay. The objective of the present study was the identification and characterization of pork kidney proteins carrying α-Gal carbohydrates and mediating delayed allergic reactions through specific IgE to α-Gal. Materials and methods: A cohort of 59 patients with specific IgE to α-Gal was screened by immunoblot for IgE-reactive proteins in pork kidney extract. Proteins were purified by affinity chromatography and identified by Edman sequencing and peptide mass fingerprinting. Isolated proteins were used in immunoassays using patient sera and α-Gal specific antibodies. Allergenicity was assayed in basophil activation and skin prick test. Results: Multiple IgE-binding proteins were detected in protein extracts of pork kidney by immunoblot using patient sera and an anti-α-Gal antibody. Reactive bands were located in the high molecular weight range of 100 to ≥200 kDa. Two major IgE-binding proteins were identified as porcine angiotensin I converting enzyme (ACE I) and aminopeptidase N (AP-N). IgE-binding to both proteins was lost by periodate treatment, resulting in oxidation of carbohydrates. Addition of α-Gal inhibited IgE-reactivity to both peptidases. Allergenicity was confirmed by activation of patient basophils and positive skin prick tests. Conclusions: Two IgE-reactive cell membrane peptidases carrying α-Gal epitopes were identified in pork kidney, a tissue which is known as potent inducer of red meat-induced anaphylaxis. Allergenicity and clinical relevance of these proteins were confirmed in patients with delayed anaphylaxis to red meat by skin prick test and basophil activation.

Research paper thumbnail of Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification

Allergy, 2016

Pollen food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, c... more Pollen food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, comorbidities and response to treatment. Our study aims to classify different endotypes of PFS based on IgE sensitization to panallergens. We examined 1271 Italian children (age 4-18y) with seasonal allergic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by questionnaire. Skin prick tests were performed with commercial pollen extracts. IgE to panallergens: Phl p 12 (profilin), Bet v 1 (PR-10) and Pru p 3 (nsLTP), were tested by ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clustering method was applied within PFS population. PFS was observed in 300/1271 children (24%). Cluster analysis identified five PFS endotypes linked to panallergen IgE sensitization: 1) Co-sensitization to ≥2 panallergens (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;multi-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;); 2-4) sensitization to either profilin, or nsLTP, or PR-10 (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;mono-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;); 5) no sensitization to panallergens (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;). These endotypes showed peculiar characteristics: 1) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;multi-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: severe disease with frequent allergic comorbidities and multiple offending foods; 2) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Profilin PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: OAS triggered by Cucurbitaceae; 3) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;LTP PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: living in Southern Italy, OAS triggered by hazelnut and peanut; 4) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;PR-10 PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: OAS triggered by Rosaceae; 5) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no-panallergen&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; PFS: mild disease and OAS triggered by kiwifruit . In a Mediterranean country characterized by multiple pollen exposures, PFS is a complex and frequent complication of childhood SAR, with five distinct endotypes marked by peculiar profiles of IgE sensitization to panallergens. Prospective studies in cohorts of PFS patients are now required to test whetherthis novel classification may be useful for diagnostic and therapeutic purposes in the clinical practice. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Can we stop the atopic march? Not Allergol 2015;33(2)-71-76

Research paper thumbnail of La prevenzione del respiro sibilante. Prevenzione secondaria e terziaria in età prescolare

Research paper thumbnail of Environmental interventions for mite-induced asthma: a journey between systematic reviews, contrasting evidence and clinical practice

European annals of allergy and clinical immunology, 2013

House dust mites (HDM) are one of the most important sources of indoor allergens worldwide. Expos... more House dust mites (HDM) are one of the most important sources of indoor allergens worldwide. Exposure to high environmental levels of dust mite allergen is associated with an increased risk of sensitization, asthma and deterioration of lung function. On the basis of these data, it would be logical to assume that asthmatic patients with mite allergy could benefit from a reduction of exposure to these allergens. Several environmental prophylactic actions against HDM, either physical or chemical have been tried, alone or in different combinations. However, a recent Cochrane Systematic Review did not detect specific clinical benefits from the use of prophylactic environmental measures in asthmatic patients sensitive to HDM and concluded that such measures can no longer be recommended as they are ineffective. This paper presents the results of a web-based questionnaire, administered to more than 200 Italian paediatricians, and shows that physicians' behaviour in real life is very far ...

Research paper thumbnail of Adherence issues related to sublingual immunotherapy as perceived by allergists

Patient Preference and Adherence, 2010

Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat al... more Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.

Research paper thumbnail of Pest sensitization to cockroach, mouse, and rat: An Italian multicenter study

Research paper thumbnail of Management of BNT162b2 mRNA COVID-19 vaccine in children aged 5–11 years with allergies, asthma, and immunodeficiency: consensus of the Italian Society of Pediatric Allergy and Immunology (SIAIP)

Italian Journal of Pediatrics

BNT162b2 vaccine, developed by BioNTech and Pfizer ha recently approved for use in children aged ... more BNT162b2 vaccine, developed by BioNTech and Pfizer ha recently approved for use in children aged 5 to 11 years. Recent data show evidence of safety on the administration and serious adverse events have been rarely reported. However, allergic systemic reactions could occur. In some cases, a correct allergic evaluation allows identifying patients at risk of developing an anaphylactic reaction. Risk assessment of allergic reactions to COVID-19 vaccines is useful to limit contraindications to vaccination and help to safely vaccinate people supposed to be at risk of allergic reactions.

Research paper thumbnail of Digital health in the management of allergic diseases

Acta bio-medica : Atenei Parmensis, Nov 29, 2021

In recent years there has been an important implementation in the medical field of both Mobile He... more In recent years there has been an important implementation in the medical field of both Mobile Health, such as the use of mobile communication devices, and of other telemedicine tools in general, with the aim of supporting the supervision of diseases from the moment of the first diagnosis to the therapeutic follow-up. In fact, Digital Health can also have a very positive impact on the management of allergic patients, who are known to have the greatest need for regular monitoring, simplifying contact between doctor and patient, but there is still a need to improve implementation regulations, define certification programs and adequate reimbursement systems, as well as to guarantee a high level of attention to the protection of sensitive data. The hope is that one positive outcome of the Covid-19 pandemic will be an acceleration, by all stakeholders involved, of the process of the modernization of health care.

Research paper thumbnail of United airway disease

Acta bio-medica : Atenei Parmensis, Nov 29, 2021

Nose and lungs are considered as anatomic and functional unit, as they share morphological, patho... more Nose and lungs are considered as anatomic and functional unit, as they share morphological, pathophysiological and immunological basis. Allergic rhinitis and asthma often coexist in the same individual, and the treatment of one also improves the symptoms of the other (one airway, one disease). The aim of this review is to discuss the interaction between upper and lower airways, based on recent scientific evidence and, critically, analyze the important implications the new findings have for the future therapy and prevention of these common diseases.

Research paper thumbnail of Iconographies supplémentaires de l'article : Molecular profiles of IgE to Phleum pratense in children with grass pollen allergy: Implications for specific immunotherapy

Research paper thumbnail of Vitamina D, Allergie Ed Asma

Nonostante il suo ruolo "fisiologico" rimanga quello di favorire l'assorbimento intestinale di ca... more Nonostante il suo ruolo "fisiologico" rimanga quello di favorire l'assorbimento intestinale di calcio rendendolo così disponibile per le ossa, negli ultimi anni si è assistito ad un crescente interesse per il ruolo che la vitamina D pare rivestire in varie patologie, in primis le patologie autoimmuni e tumorali. Cercheremo qui di analizzare se e quali siano al momento le reali evidenze riguardo il ruolo della vitamina D nelle comuni patologie pneumoallergologiche infantili.

Research paper thumbnail of Component resolved diagnosis and risk assessment in food allergy

Acta bio-medica : Atenei Parmensis, 2021

Allergy testing should only be performed in the context of the clinical history as history provi... more Allergy testing should only be performed in the context of the clinical history as history provides the cornerstone of diagnosis. In food allergy, some allergy tests often give rise to false positive results and thus can lead to unnecessary avoidance or delay on foods introduction. The use of Component Resolved Diagnosis in combination with conventional sensitization testing improves analytical and diagnostic performance and can lead to the reduction of diagnostic oral food challenges. Component Resolved Diagnosis can be helpful in identifying some risks for the allergic child. Molecular diagnosis can help also in predicting the development of the allergy march, in severe reactions (lipid transfer protein, seed storage proteins, etc.) in food allergy and for potential clinical cross-reactivity.

Research paper thumbnail of febbraio 2010 • anno XXIV Ma c'è l'asma in Africa? Diagnosi differenziale delle congiuntiviti allergiche a cura della Commissione rinocongiuntivite della siaiP Cellule T H 17 nella patologia umana: buone o cattive? Ruolo della nuova linea cellulare nelle patologie infiammatorie croniche e autoimm...

VaCCiNi I correlati immunologici di protezione indotti dalle vaccinazioni a cura della Commission... more VaCCiNi I correlati immunologici di protezione indotti dalle vaccinazioni a cura della Commissione Vaccini della siaiP

Research paper thumbnail of Infective complications and exposure to antibiotics during pregnancy and in the first year of life and development of asthma in children

Research paper thumbnail of L’Italian Pediatric Allergy Network:un’opportunità di ricerca per i clinici

32 Fare ricerca clinica non e un’impresa facile in Italia. La routine quotidiana ed i mille probl... more 32 Fare ricerca clinica non e un’impresa facile in Italia. La routine quotidiana ed i mille problemi che assillano il pediatra richiedono il 99% delle sue energie e del suo entusiasmo. Clinici ospedalieri e universitari devono troppo spesso rinunciare ad avviare un progetto nuovo, a verifi care un’ipotesi suggerita dalla esperienza clinica, a seguire un’idea innovativa. E diffi cile trovare collaborazioni, fi nanziare reattivi, avvalersi di consulenti statistici, preparare la documentazione per i comitati etici, motivare i giovani o i dipendenti perche diano “quel qualcosa in piu” per fare ricerca. Cosi, la creativita italiana, che tutti ci riconoscono e molti ci invidiano, non riesce sempre a tradursi in risultati scientifi ci apprezzabili. Quali soluzioni? Lamentarsi? Prendersela con il “Paese”, con l’”Universita”, il “Sistema?”. Un’alternativa possibile e riunire le forze, dividere i ruoli secondo le competenze, evitare i confl itti “di bottega”, mettere da parte l’orgoglio, e – ...

Research paper thumbnail of Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Allergy, Jan 20, 2017

Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in ... more Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. We examined 1120 children (age 4-18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD™ ). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA. The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by high...

Research paper thumbnail of Abstracts from the Food Allergy and Anaphylaxis Meeting 2016

Clinical and Translational Allergy, 2017

Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.

Research paper thumbnail of Perioperative Anaphylaxis: Epidemiology

International Journal of Immunopathology and Pharmacology, 2011

The clinical diagnosis of an anesthesia-related immediate hypersensitivity reaction is a difficul... more The clinical diagnosis of an anesthesia-related immediate hypersensitivity reaction is a difficult task for clinicians. Anaphylaxis may present as cardiovascular collapse or airway obstruction, associated or not with cutaneous manifestations. Drug hypersensitivity reactions that occur during anesthesia are responsible for significant morbidity and mortality and socio-economic costs. Perioperative anaphylaxis is becoming more common, probably because of the more frequent use of anesthesia and the increasing complexity of the drugs used. However, despite increased awareness of anaphylactic reactions to drugs and compounds used in anesthesia, their incidence remains poorly defined. Moreover, current epidemiological data should be carefully evaluated since the various studies published concerned non-homogeneous populations and gave differing definitions of drug hypersensitivity.

Research paper thumbnail of Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Italian journal of pediatrics, Jan 23, 2017

Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment... more Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one century ago, and performed in the early years with allergenic extracts of poor quality and definition. After the mechanism of allergic reaction were recognized, the practice of AIT was refined, leading to remarkable improvement in the efficacy and safety profile of the treatment. Currently AIT is accepted and routinely prescribed worldwide for respiratory allergies and hymenoptera venom allergy. Both the subcutaneous (SCIT) and sublingual (SLIT) routes of administration are used in the pediatric population.AIT is recommended in allergic rhinitis/conjunctivitis with/without allergic asthma, with an evidence of specific IgE-sensitization towards clinically relevant inhalant allergens. Long-term studies provided evidence that AIT can also prevent the onset of asthma and of new sensiti...

Research paper thumbnail of 6th International Symposium on Molecular Allergology (ISMA)

Clinical and Translational Allergy, 2016

Background: Delayed food anaphylaxis upon consumption of red meat is attributed to specific IgE-a... more Background: Delayed food anaphylaxis upon consumption of red meat is attributed to specific IgE-antibodies directed to galactose-α-1,3-galactose (α-Gal). Anaphylactic reactions may occur after ingestion of meat from different mammals, mainly beef and pork, but reactions to lamb, rabbit or horse have also been reported. In particular, pork kidney has been shown to trigger symptoms that were more severe and occurred within a shorter delay. The objective of the present study was the identification and characterization of pork kidney proteins carrying α-Gal carbohydrates and mediating delayed allergic reactions through specific IgE to α-Gal. Materials and methods: A cohort of 59 patients with specific IgE to α-Gal was screened by immunoblot for IgE-reactive proteins in pork kidney extract. Proteins were purified by affinity chromatography and identified by Edman sequencing and peptide mass fingerprinting. Isolated proteins were used in immunoassays using patient sera and α-Gal specific antibodies. Allergenicity was assayed in basophil activation and skin prick test. Results: Multiple IgE-binding proteins were detected in protein extracts of pork kidney by immunoblot using patient sera and an anti-α-Gal antibody. Reactive bands were located in the high molecular weight range of 100 to ≥200 kDa. Two major IgE-binding proteins were identified as porcine angiotensin I converting enzyme (ACE I) and aminopeptidase N (AP-N). IgE-binding to both proteins was lost by periodate treatment, resulting in oxidation of carbohydrates. Addition of α-Gal inhibited IgE-reactivity to both peptidases. Allergenicity was confirmed by activation of patient basophils and positive skin prick tests. Conclusions: Two IgE-reactive cell membrane peptidases carrying α-Gal epitopes were identified in pork kidney, a tissue which is known as potent inducer of red meat-induced anaphylaxis. Allergenicity and clinical relevance of these proteins were confirmed in patients with delayed anaphylaxis to red meat by skin prick test and basophil activation.

Research paper thumbnail of Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification

Allergy, 2016

Pollen food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, c... more Pollen food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, comorbidities and response to treatment. Our study aims to classify different endotypes of PFS based on IgE sensitization to panallergens. We examined 1271 Italian children (age 4-18y) with seasonal allergic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by questionnaire. Skin prick tests were performed with commercial pollen extracts. IgE to panallergens: Phl p 12 (profilin), Bet v 1 (PR-10) and Pru p 3 (nsLTP), were tested by ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clustering method was applied within PFS population. PFS was observed in 300/1271 children (24%). Cluster analysis identified five PFS endotypes linked to panallergen IgE sensitization: 1) Co-sensitization to ≥2 panallergens (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;multi-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;); 2-4) sensitization to either profilin, or nsLTP, or PR-10 (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;mono-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;); 5) no sensitization to panallergens (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;). These endotypes showed peculiar characteristics: 1) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;multi-panallergen PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: severe disease with frequent allergic comorbidities and multiple offending foods; 2) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Profilin PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: OAS triggered by Cucurbitaceae; 3) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;LTP PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: living in Southern Italy, OAS triggered by hazelnut and peanut; 4) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;PR-10 PFS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;: OAS triggered by Rosaceae; 5) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no-panallergen&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; PFS: mild disease and OAS triggered by kiwifruit . In a Mediterranean country characterized by multiple pollen exposures, PFS is a complex and frequent complication of childhood SAR, with five distinct endotypes marked by peculiar profiles of IgE sensitization to panallergens. Prospective studies in cohorts of PFS patients are now required to test whetherthis novel classification may be useful for diagnostic and therapeutic purposes in the clinical practice. This article is protected by copyright. All rights reserved.