Susanna Voltolini - Academia.edu (original) (raw)

Papers by Susanna Voltolini

Research paper thumbnail of A case of peripheral and eosphagatic hypereosinophilia and food wllergy after liver’s transplantation in adult

Clinical and Translational Allergy, 2011

From one year of liver's transplantation and cyclosporin (CSA) maintenance treatment(100 mg a day... more From one year of liver's transplantation and cyclosporin (CSA) maintenance treatment(100 mg a day), a 43 years old women presented with abdominal pain and diarrhea immediately after eating milk and egg. She underwent the transplantation after an acute liver toxicity caused by isoniazid during tuberculosis treatment. Increasing hyperosinophilia (40%) and eosinophilic oesophagitis (EE) presented with food allergy. Total IgE were low (45UI).

Research paper thumbnail of ELISA in diagnosis of respiratory allergy. A comparison with RAST and skin tests

Allergy

An enzyme-linked immunosorbent assay (ELISA), employing beta-galactosidase conjugated anti-IgE, w... more An enzyme-linked immunosorbent assay (ELISA), employing beta-galactosidase conjugated anti-IgE, was used for the determination of specific IgE antibodies to common inhalant allergens (Dermatophagoides pt. and f., Parietaria and four grass pollens) in serum samples from 82 adult patients with asthma and/or rhinitis. A total of 194 analysis were carried out and the results were compared with those of skin tests and RAST. The correlation coefficient (r) between ELISA and RAST results was high (r = 0.95); the correlation between skin tests and ELISA (r = 0.93) was greater than that between skin tests and RAST (r = 0.90). No significant differences were found among the allergens used. We conclude that the version of ELISA used develops an overall good correlation with skin tests and RAST and seems to provide a satisfactory alternative to RAST for allergy diagnosis.

Research paper thumbnail of Long-term hyposensitization and adverse immunologic responses. A laboratory evaluation

Annals of allergy

Ninety atopic patients with allergic asthma and/or rhinitis were classified into three groups: gr... more Ninety atopic patients with allergic asthma and/or rhinitis were classified into three groups: group A, consisting of 30 patients never subjected to immunotherapy; group B, 30 patients receiving immunotherapy for various allergies for 3 to 24 months; group C, 30 patients receiving immunotherapy for 5 or more years. The following studies were performed using standard techniques: quantitative determination of serum immunoglobulin concentrations IgA, IgG, IgM, rheumatoid factor, C3 and C4 concentrations, antinuclear antibodies (ANA). Circulating immune complexes were detected by a competitive immuno-enzyme assay. No statistical differences were found in the groups studied for every parameter considered. Although signs and symptoms of autoimmune disease were not present, an elevated incidence of ANA in the entire group (23.3%) was found.

Research paper thumbnail of Sublingual immunotherapy in Parietaria pollen-induced rhinitis: A double-blind study

Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología

A double-blind, placebo-controlled study of immunotherapy was conducted in 31 patients with aller... more A double-blind, placebo-controlled study of immunotherapy was conducted in 31 patients with allergic rhinitis due to Parietaria pollen to evaluate the efficacy and safety of high doses of allergen via the sublingual route. The patients were assessed before and after a 10-month period of treatment by clinical (symptom-medication scores and specific nasal reactivity) and immunological (total IgE, specific IgE, IgG and IgG4 antibodies) parameters. High doses of Parietaria extract corresponding to a cumulative dose of 105 BU for each patient were administered with negligible side effects. The actively treated patients had significantly lower medication scores than those on placebo (p < 0.05) when the maximum pollen count was recorded, and at the end of the trial they showed a significant decrease in nasal reactivity (p < 0.02) and a significant increase in serum specific IgG4 (p = 0.02). No differences were detected in any of these parameters in the placebo group. Possible explanations for the mechanisms of sublingual immunotherapy are proposed.

Research paper thumbnail of A double-blind comparative trial of astemizole and terfenadine for the treatment of hay fever

Allergie et immunologie

Astemizole, a new long acting and non sedative antihistamine, and Terfenadine, an H1 antagonist w... more Astemizole, a new long acting and non sedative antihistamine, and Terfenadine, an H1 antagonist widely used, were compared in a randomized double-blind study over 4 weeks in 55 patients suffering from hay fever. The clinical symptoms were recorded daily from each patient on a 4-point scale from 0 = none to 3 = severe. After 2 weeks of therapy and at the end, the total clinical score was evaluated and both the investigator and the patient made an overall assessment of the therapeutic effect. Both drugs were effective in reducing nasal and ocular symptoms, but the clinical response tended to be better with Astemizole than Terfenadine. The difference between the two drugs, however, was statistically significant (p less than 0.05) only after 2 weeks of treatment. Some side effects, including drowsiness, were observed with similar incidence in both treatment groups. Astemizole appears to be a simple, effective and safe therapy for hay fever.

Research paper thumbnail of Allergy to pollens from Betulaceae and Corylaceae in a Mediterranean area (Genoa, Italy) – A ten-year retrospective study

Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología

Allergy to pollens from Betulaceae and Corylaceae is becoming a leading problem in Genoa, a north... more Allergy to pollens from Betulaceae and Corylaceae is becoming a leading problem in Genoa, a northern Mediterranean area in Italy. The results of a 10-year retrospective study on combined observations both on the aerobiological presence of Betulaceae and Corylaceae pollens (Alnus, Corylus, Ostrya) and on the incidence of positive SPT in the allergic population living in the same area are reported. Among 3473 patients suffering from seasonal respiratory allergy with positive SPT to one or more pollens, 558 (16.06%) showed SPT positivity to Betulaceae and/or Corylaceae pollens, both isolated and associated with other allergens. These patients suffered from winter or early spring hay fever, with a high incidence of bronchial asthma. A statistically significant increase (0.02 < p < 0.05) in the number of these sensitizations from 1981 to 1990 has been observed. Some possible explanations for this phenomenon, including an increase in the total amount of local airborne pollens, are suggested. About 24% of the patients with positive SPT to these pollens referred oral allergic syndrome associated with the ingestion of some foods, especially apples and nuts, with or without other additional clinical symptoms.

Research paper thumbnail of Indoor air quality and bronchial asthma in allergic patients

Annali di igiene: medicina preventiva e di comunità

Research paper thumbnail of Can serum white birch ( Betula verrucosa ) pollen antigen (Bet v 1) immunoglobulin E measurement distinguish between sensitization and allergy?

International Forum of Allergy & Rhinology, 2015

In clinical practice, it is fundamental to distinguish between sensitization and allergy, mainly ... more In clinical practice, it is fundamental to distinguish between sensitization and allergy, mainly with respect to polysensitized patients. The aim of this study was to evaluate whether serum immunoglobulin E (IgE) to white birch (Betula verrucosa) pollen antigen (Bet v 1) assessment might be able to differentiate simple sensitization from true allergy. In total, 197 subjects (100 females; mean age 44.9 years) with serum Bet v 1 IgE positivity and history of nasal symptoms were evaluated. Subjects were subdivided in 2 groups: allergic and sensitized. Allergic patients were 58.4% of the total; they had higher serum Bet v 1 IgE levels than sensitized subjects (p < 0.001). A serum IgE to Bet v 1 value >8.94 kilo units of allergen per liter (kUA/L) was able to differentiate between sensitization and allergy (area under the receiver operating characteristic curve [AUC] = 0.76; diagnostic odds ratio, ie, degree of agreement between health status and dichotomized IgE levels [DOR] = 6.5). Gender and season when the blood was drawn influenced IgE levels. Serum Bet v 1 IgE measurement may be able to differentiate sensitization from allergy in subjects with sensitization to Betulaceae pollen allergens. Thus, Bet v 1 IgE measurement should be considered a useful step in the management of patients with allergic rhinitis due to Betulaceae pollen allergens.

Research paper thumbnail of Successful desensitization to natalizumab in a skin test--positive patient: a case report

European annals of allergy and clinical immunology

Relevant interest has been focused on rapid desensitization for drug hypersensitivity and on its ... more Relevant interest has been focused on rapid desensitization for drug hypersensitivity and on its use for reactions to monoclonal antibodies. Natalizumab is a highly effective therapy for multiple sclerosis but its use can be limited by hypersensitivity reactions. Herein we present a case of a 36-year-old male patient with multiple sclerosis who started natalizumab therapy due to rapid neurological deterioration. During the second infusion he developed a reaction involving urticaria, erythema and angioedema. Natalizumab sensitization was demonstrated by a positive result on the intradermal test. The anti-natalizumab IgG neutralizing antibody assay was negative. Lacking any alternative, equally effective treatment, he underwent a rapid intravenous desensitization protocol. Desensitization was successfully repeated eleven times and the patient's neurological conditions improved and remained stable after one year. This case demonstrates that rapid desensitization is a safe and effec...

Research paper thumbnail of Phenobarbital-induced DiHS and ceftriaxone hypersensitivity reaction: a case of multiple drug allergy

European annals of allergy and clinical immunology, 2009

Patients with DiHS show an increased risk of sensitization to multiple drugs. We report a case of... more Patients with DiHS show an increased risk of sensitization to multiple drugs. We report a case of a young woman who developed cutaneous rash, lymphoadenopathy, malaise and fever after the introduction of phenobarbitale. Because of these symptoms, she was treated with ceftriaxone and she experienced a severe flare-up of the cutaneous and general reaction. Allergological work-up, by cutaneous and lymphocyte transformation test, confirmed a double sensitization to phenobarbital and ceftriaxone. In conclusion, the high risk of DiHS during anticonvulsive therapy should suggest caution in using additional drugs, because of an increased risk of multiple reactions.

Research paper thumbnail of New risks from ancient food dyes: cochineal red allergy

European annals of allergy and clinical immunology, 2014

This study reports an unusual case of IgE-mediated hypersensitivity to Cochineal red or Carmine r... more This study reports an unusual case of IgE-mediated hypersensitivity to Cochineal red or Carmine red, a coloring agent of natural origin. Although the risk of anaphylactic reactions is well known, since the nineties the use of this additive seems to be nowadays on the rise. The problem of labeling of additives used in handmade food products is highlighted.

Research paper thumbnail of Chronic urticaria: importance of a medical-psychological approach

European annals of allergy and clinical immunology, 2006

Chronic urticaria is often associated with psychological factors, such as depression, anxiety and... more Chronic urticaria is often associated with psychological factors, such as depression, anxiety and stress, which may play a role not only in the genesis of the disease but also in its evolution. Aims of this study were to evaluate the utility of psychological assessments (presence of depression, impact on the quality of life and incidence of "life events" before the beginning of urticaria) in conjunction with the allergological evaluation and to provide appropriate treatment to the patients selected. Thirty subjects diagnosed as Chronic Urticaria patients were submitted to psychological assessments (semi structured interview, Beck Depression Inventory, Nottingham health Profile and Dermatology Life Quality Index). The results of the evaluation show that most of the patients experienced a "stressor" event within the six months before the onset of the cutaneous manifestation. The incidence of depression resulted very high in comparison with the general population an...

Research paper thumbnail of Management of patients at risk for adverse reactions to local anesthetics: analysis of 386 cases

Journal of investigational allergology & clinical immunology

Local anesthetics are among the most used drugs in clinical practice. Various types of reactions ... more Local anesthetics are among the most used drugs in clinical practice. Various types of reactions have been reported and many patients are told that they are allergic to caines or are at risk of allergic reactions. We report our experience with 386 patients using skin test and progressive subcutaneous challenge in order to select a local anesthetic that could be safely used. The patients underwent specific protocol including clinical history, prick and intradermal tests, and subcutaneous incremental challenge with a local anesthetic from the amide group which was free of preservatives and vasoconstrictors. Thirteen patients showed a positive skin test: 10 with positive prick test underwent the subsequent challenge with no reactions; the three who were also positive by the intradermal route were carefully evaluated with a different drug. Eight of the patients with negative skin tests complained of various clinical symptoms after the challenge. All the patients found the local anesthet...

Research paper thumbnail of Biochemical and immunochemical characterization of hop-hornbeam (Ostrya Carpinifolia Scop.) pollen

Aerobiologia, 2000

In the last few years Ostrya carpinifolia pollen is consideredas an important cause of respirator... more In the last few years Ostrya carpinifolia pollen is consideredas an important cause of respiratoryallergy in Mediterranean areas. The concentration ofthe pollen was measured over a period of fifteen yearsfrom 1981 to 1996 in an area around Genoa; the resultsof this study have clearly indicated an increasingtrend that correlate with persons sensitization.

Research paper thumbnail of Le calendrier pollinique de Gênes

Revue Française d'Allergologie et d'Immunologie Clinique, 1987

ABSTRACT The gathering of pollens in the atmosphere of the city of Genoa, for three consecutive y... more ABSTRACT The gathering of pollens in the atmosphere of the city of Genoa, for three consecutive years (1981–82–83) has made possible the establishment of a pollen schedule of the city. Among the herbaceous, Urticaceae (Parietaria) and Poaceae predominate ; among the trees, Cupressaceae, Corylaceae and Betulaceae (early blossoms) and also Pinaceae, Fagaceae and Oleaceae predominate in the spring-summer season. The pollination of certain species studied in detail (Urticaceae, Poaceae, Oleaceae), showed a marked increase during the three years : we have tried to explain this by analyzing meteorological factors. The frequency of skin senstizations in a population of 851 patients allergic to pollen, reflects the importance of only a few of the main elements of the schedule : first of all Parietaria (71 p. cent), followed by Graminaceae (41 p. cent) and further the Oleaceae (13.5 p. cent) and the Group Betulaceae-Corylaceae (8 p. cent).

Research paper thumbnail of An unusual case of meat allergy

Clinical and Translational Allergy, 2011

Research paper thumbnail of Local immunotherapy with extract in asthma

Journal of Allergy and Clinical Immunology, 1991

ABSTRACT Local immunotherapy (LIT) with Dermatophagoides extract or placebo were administered to ... more ABSTRACT Local immunotherapy (LIT) with Dermatophagoides extract or placebo were administered to two groups of 11 patients with allergic asthma in a double-blind fashion. All patients received cromolyn sodium (20 mg four times a day) during treatments. Bronchial provocation tests with allergen and methacholine were performed before, 1 week, and 4 weeks after the end of treatments. Symptom score, drug consumption, and peak expiratory flow were monitored daily from 2 weeks before to 4 weeks after treatments. Compared to baseline, early bronchial sensitivity to allergen was significantly reduced both 1 week (p less than 0.0005) and 4 weeks (p less than 0.01) after LIT but not after placebo administration. Late bronchial reaction to allergen occurred similarly after placebo administration and LIT. However, in the group with LIT, the severity of late reaction was unchanged after treatment in spite of the significantly larger doses of allergen administered to provoke the early asthmatic reaction. Neither symptom score, nor drug consumption, nor peak expiratory flow were significantly different in the two groups before and during the treatment period even though both symptom score and drug consumption tended to be reduced after LIT. We conclude that LIT may be an effective and safe alternative to traditional immunotherapy.

Research paper thumbnail of Food allergy to Boletus edulis☆☆☆★

Journal of Allergy and Clinical Immunology, 1998

ABSTRACT J Allergy Clin Immunol 1998;101:850-1.

Research paper thumbnail of Effect of seasonal exposure to pollen on specific bronchial sensitivity in allergic patients

Journal of Allergy and Clinical Immunology, 1990

Bronchial provocation tests with aerosol of birch extract were performed before and after pollen ... more Bronchial provocation tests with aerosol of birch extract were performed before and after pollen season in 11 sensitized subjects. Changes of metacholine bronchial responsiveness and serum-specific IgE level were also assessed. In five patients who did not take steroids to control their symptoms, both early and late asthmatic responses to inhaled allergen were enhanced after season, whereas IgE serum level, but not methacholine sensitivity, was significantly increased. In six patients who needed steroids, neither responses to allergen nor IgE serum level and methacholine sensitivity were significantly changed after season. For the whole group, the increase in immediate bronchial sensitivity to allergen was positively correlated with the increase in specific IgE antibodies. We conclude that seasonal exposure to pollen has, in sensitized patients, a priming effect on bronchial mucosa that may be blunted by steroid treatment. The increased production of specific IgE antibodies appears to be an important mechanism for this priming effect.

Research paper thumbnail of Oral antihistamine/decongestant treatment compared with intranasal corticosteroids in seasonal allergic rhinitis

Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 1995

This international, multicentre, randomized, double-blind, double-dummy, parallel-group trial was... more This international, multicentre, randomized, double-blind, double-dummy, parallel-group trial was undertaken to compare the efficacy and tolerability of once-daily astemizole-D (10 mg astemizole plus 240 mg pseudoephedrine) with beclomethasone nasal spray (0.05 mg/ml) two puffs/nostril administered twice daily in a total of 204 patients with seasonal allergic rhinitis. Treatment duration was 4 weeks. Although investigator assessments of symptom severity were generally comparable in the two treatment groups throughout the trial, statistically significant differences in favour of astemizole-D for sneezing and ocular symptoms were apparent at the end of the 4-week treatment period (P &amp;amp;lt; 0.05). Patient diary data support these findings, with significant differences in favour of the antihistamine/decongestant combination reported for ocular symptoms after 2 weeks of treatment (P &amp;amp;lt; 0.05) and non-significant trends for sneezing after 2 weeks and ocular symptoms over the entire treatment period (P = 0.07). Use of rescue medication for ocular symptoms was also significantly lower in the astemizole-D treatment group (P &amp;amp;lt; 0.05). A wide range of adverse experiences were reported, however, there were no statistically significant differences in the type or incidence of those between the two treatment groups. In conclusion, astemizole-D appears to be at least as effective and well tolerated as intranasal beclomethasone in the treatment of seasonal allergic rhinitis, providing at least comparable relief from all nasal symptoms including congestion and significantly greater relief from ocular symptoms than the topical steroid.

Research paper thumbnail of A case of peripheral and eosphagatic hypereosinophilia and food wllergy after liver’s transplantation in adult

Clinical and Translational Allergy, 2011

From one year of liver's transplantation and cyclosporin (CSA) maintenance treatment(100 mg a day... more From one year of liver's transplantation and cyclosporin (CSA) maintenance treatment(100 mg a day), a 43 years old women presented with abdominal pain and diarrhea immediately after eating milk and egg. She underwent the transplantation after an acute liver toxicity caused by isoniazid during tuberculosis treatment. Increasing hyperosinophilia (40%) and eosinophilic oesophagitis (EE) presented with food allergy. Total IgE were low (45UI).

Research paper thumbnail of ELISA in diagnosis of respiratory allergy. A comparison with RAST and skin tests

Allergy

An enzyme-linked immunosorbent assay (ELISA), employing beta-galactosidase conjugated anti-IgE, w... more An enzyme-linked immunosorbent assay (ELISA), employing beta-galactosidase conjugated anti-IgE, was used for the determination of specific IgE antibodies to common inhalant allergens (Dermatophagoides pt. and f., Parietaria and four grass pollens) in serum samples from 82 adult patients with asthma and/or rhinitis. A total of 194 analysis were carried out and the results were compared with those of skin tests and RAST. The correlation coefficient (r) between ELISA and RAST results was high (r = 0.95); the correlation between skin tests and ELISA (r = 0.93) was greater than that between skin tests and RAST (r = 0.90). No significant differences were found among the allergens used. We conclude that the version of ELISA used develops an overall good correlation with skin tests and RAST and seems to provide a satisfactory alternative to RAST for allergy diagnosis.

Research paper thumbnail of Long-term hyposensitization and adverse immunologic responses. A laboratory evaluation

Annals of allergy

Ninety atopic patients with allergic asthma and/or rhinitis were classified into three groups: gr... more Ninety atopic patients with allergic asthma and/or rhinitis were classified into three groups: group A, consisting of 30 patients never subjected to immunotherapy; group B, 30 patients receiving immunotherapy for various allergies for 3 to 24 months; group C, 30 patients receiving immunotherapy for 5 or more years. The following studies were performed using standard techniques: quantitative determination of serum immunoglobulin concentrations IgA, IgG, IgM, rheumatoid factor, C3 and C4 concentrations, antinuclear antibodies (ANA). Circulating immune complexes were detected by a competitive immuno-enzyme assay. No statistical differences were found in the groups studied for every parameter considered. Although signs and symptoms of autoimmune disease were not present, an elevated incidence of ANA in the entire group (23.3%) was found.

Research paper thumbnail of Sublingual immunotherapy in Parietaria pollen-induced rhinitis: A double-blind study

Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología

A double-blind, placebo-controlled study of immunotherapy was conducted in 31 patients with aller... more A double-blind, placebo-controlled study of immunotherapy was conducted in 31 patients with allergic rhinitis due to Parietaria pollen to evaluate the efficacy and safety of high doses of allergen via the sublingual route. The patients were assessed before and after a 10-month period of treatment by clinical (symptom-medication scores and specific nasal reactivity) and immunological (total IgE, specific IgE, IgG and IgG4 antibodies) parameters. High doses of Parietaria extract corresponding to a cumulative dose of 105 BU for each patient were administered with negligible side effects. The actively treated patients had significantly lower medication scores than those on placebo (p &lt; 0.05) when the maximum pollen count was recorded, and at the end of the trial they showed a significant decrease in nasal reactivity (p &lt; 0.02) and a significant increase in serum specific IgG4 (p = 0.02). No differences were detected in any of these parameters in the placebo group. Possible explanations for the mechanisms of sublingual immunotherapy are proposed.

Research paper thumbnail of A double-blind comparative trial of astemizole and terfenadine for the treatment of hay fever

Allergie et immunologie

Astemizole, a new long acting and non sedative antihistamine, and Terfenadine, an H1 antagonist w... more Astemizole, a new long acting and non sedative antihistamine, and Terfenadine, an H1 antagonist widely used, were compared in a randomized double-blind study over 4 weeks in 55 patients suffering from hay fever. The clinical symptoms were recorded daily from each patient on a 4-point scale from 0 = none to 3 = severe. After 2 weeks of therapy and at the end, the total clinical score was evaluated and both the investigator and the patient made an overall assessment of the therapeutic effect. Both drugs were effective in reducing nasal and ocular symptoms, but the clinical response tended to be better with Astemizole than Terfenadine. The difference between the two drugs, however, was statistically significant (p less than 0.05) only after 2 weeks of treatment. Some side effects, including drowsiness, were observed with similar incidence in both treatment groups. Astemizole appears to be a simple, effective and safe therapy for hay fever.

Research paper thumbnail of Allergy to pollens from Betulaceae and Corylaceae in a Mediterranean area (Genoa, Italy) – A ten-year retrospective study

Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología

Allergy to pollens from Betulaceae and Corylaceae is becoming a leading problem in Genoa, a north... more Allergy to pollens from Betulaceae and Corylaceae is becoming a leading problem in Genoa, a northern Mediterranean area in Italy. The results of a 10-year retrospective study on combined observations both on the aerobiological presence of Betulaceae and Corylaceae pollens (Alnus, Corylus, Ostrya) and on the incidence of positive SPT in the allergic population living in the same area are reported. Among 3473 patients suffering from seasonal respiratory allergy with positive SPT to one or more pollens, 558 (16.06%) showed SPT positivity to Betulaceae and/or Corylaceae pollens, both isolated and associated with other allergens. These patients suffered from winter or early spring hay fever, with a high incidence of bronchial asthma. A statistically significant increase (0.02 &lt; p &lt; 0.05) in the number of these sensitizations from 1981 to 1990 has been observed. Some possible explanations for this phenomenon, including an increase in the total amount of local airborne pollens, are suggested. About 24% of the patients with positive SPT to these pollens referred oral allergic syndrome associated with the ingestion of some foods, especially apples and nuts, with or without other additional clinical symptoms.

Research paper thumbnail of Indoor air quality and bronchial asthma in allergic patients

Annali di igiene: medicina preventiva e di comunità

Research paper thumbnail of Can serum white birch ( Betula verrucosa ) pollen antigen (Bet v 1) immunoglobulin E measurement distinguish between sensitization and allergy?

International Forum of Allergy & Rhinology, 2015

In clinical practice, it is fundamental to distinguish between sensitization and allergy, mainly ... more In clinical practice, it is fundamental to distinguish between sensitization and allergy, mainly with respect to polysensitized patients. The aim of this study was to evaluate whether serum immunoglobulin E (IgE) to white birch (Betula verrucosa) pollen antigen (Bet v 1) assessment might be able to differentiate simple sensitization from true allergy. In total, 197 subjects (100 females; mean age 44.9 years) with serum Bet v 1 IgE positivity and history of nasal symptoms were evaluated. Subjects were subdivided in 2 groups: allergic and sensitized. Allergic patients were 58.4% of the total; they had higher serum Bet v 1 IgE levels than sensitized subjects (p &amp;amp;amp;amp;lt; 0.001). A serum IgE to Bet v 1 value &amp;amp;amp;amp;gt;8.94 kilo units of allergen per liter (kUA/L) was able to differentiate between sensitization and allergy (area under the receiver operating characteristic curve [AUC] = 0.76; diagnostic odds ratio, ie, degree of agreement between health status and dichotomized IgE levels [DOR] = 6.5). Gender and season when the blood was drawn influenced IgE levels. Serum Bet v 1 IgE measurement may be able to differentiate sensitization from allergy in subjects with sensitization to Betulaceae pollen allergens. Thus, Bet v 1 IgE measurement should be considered a useful step in the management of patients with allergic rhinitis due to Betulaceae pollen allergens.

Research paper thumbnail of Successful desensitization to natalizumab in a skin test--positive patient: a case report

European annals of allergy and clinical immunology

Relevant interest has been focused on rapid desensitization for drug hypersensitivity and on its ... more Relevant interest has been focused on rapid desensitization for drug hypersensitivity and on its use for reactions to monoclonal antibodies. Natalizumab is a highly effective therapy for multiple sclerosis but its use can be limited by hypersensitivity reactions. Herein we present a case of a 36-year-old male patient with multiple sclerosis who started natalizumab therapy due to rapid neurological deterioration. During the second infusion he developed a reaction involving urticaria, erythema and angioedema. Natalizumab sensitization was demonstrated by a positive result on the intradermal test. The anti-natalizumab IgG neutralizing antibody assay was negative. Lacking any alternative, equally effective treatment, he underwent a rapid intravenous desensitization protocol. Desensitization was successfully repeated eleven times and the patient's neurological conditions improved and remained stable after one year. This case demonstrates that rapid desensitization is a safe and effec...

Research paper thumbnail of Phenobarbital-induced DiHS and ceftriaxone hypersensitivity reaction: a case of multiple drug allergy

European annals of allergy and clinical immunology, 2009

Patients with DiHS show an increased risk of sensitization to multiple drugs. We report a case of... more Patients with DiHS show an increased risk of sensitization to multiple drugs. We report a case of a young woman who developed cutaneous rash, lymphoadenopathy, malaise and fever after the introduction of phenobarbitale. Because of these symptoms, she was treated with ceftriaxone and she experienced a severe flare-up of the cutaneous and general reaction. Allergological work-up, by cutaneous and lymphocyte transformation test, confirmed a double sensitization to phenobarbital and ceftriaxone. In conclusion, the high risk of DiHS during anticonvulsive therapy should suggest caution in using additional drugs, because of an increased risk of multiple reactions.

Research paper thumbnail of New risks from ancient food dyes: cochineal red allergy

European annals of allergy and clinical immunology, 2014

This study reports an unusual case of IgE-mediated hypersensitivity to Cochineal red or Carmine r... more This study reports an unusual case of IgE-mediated hypersensitivity to Cochineal red or Carmine red, a coloring agent of natural origin. Although the risk of anaphylactic reactions is well known, since the nineties the use of this additive seems to be nowadays on the rise. The problem of labeling of additives used in handmade food products is highlighted.

Research paper thumbnail of Chronic urticaria: importance of a medical-psychological approach

European annals of allergy and clinical immunology, 2006

Chronic urticaria is often associated with psychological factors, such as depression, anxiety and... more Chronic urticaria is often associated with psychological factors, such as depression, anxiety and stress, which may play a role not only in the genesis of the disease but also in its evolution. Aims of this study were to evaluate the utility of psychological assessments (presence of depression, impact on the quality of life and incidence of "life events" before the beginning of urticaria) in conjunction with the allergological evaluation and to provide appropriate treatment to the patients selected. Thirty subjects diagnosed as Chronic Urticaria patients were submitted to psychological assessments (semi structured interview, Beck Depression Inventory, Nottingham health Profile and Dermatology Life Quality Index). The results of the evaluation show that most of the patients experienced a "stressor" event within the six months before the onset of the cutaneous manifestation. The incidence of depression resulted very high in comparison with the general population an...

Research paper thumbnail of Management of patients at risk for adverse reactions to local anesthetics: analysis of 386 cases

Journal of investigational allergology & clinical immunology

Local anesthetics are among the most used drugs in clinical practice. Various types of reactions ... more Local anesthetics are among the most used drugs in clinical practice. Various types of reactions have been reported and many patients are told that they are allergic to caines or are at risk of allergic reactions. We report our experience with 386 patients using skin test and progressive subcutaneous challenge in order to select a local anesthetic that could be safely used. The patients underwent specific protocol including clinical history, prick and intradermal tests, and subcutaneous incremental challenge with a local anesthetic from the amide group which was free of preservatives and vasoconstrictors. Thirteen patients showed a positive skin test: 10 with positive prick test underwent the subsequent challenge with no reactions; the three who were also positive by the intradermal route were carefully evaluated with a different drug. Eight of the patients with negative skin tests complained of various clinical symptoms after the challenge. All the patients found the local anesthet...

Research paper thumbnail of Biochemical and immunochemical characterization of hop-hornbeam (Ostrya Carpinifolia Scop.) pollen

Aerobiologia, 2000

In the last few years Ostrya carpinifolia pollen is consideredas an important cause of respirator... more In the last few years Ostrya carpinifolia pollen is consideredas an important cause of respiratoryallergy in Mediterranean areas. The concentration ofthe pollen was measured over a period of fifteen yearsfrom 1981 to 1996 in an area around Genoa; the resultsof this study have clearly indicated an increasingtrend that correlate with persons sensitization.

Research paper thumbnail of Le calendrier pollinique de Gênes

Revue Française d'Allergologie et d'Immunologie Clinique, 1987

ABSTRACT The gathering of pollens in the atmosphere of the city of Genoa, for three consecutive y... more ABSTRACT The gathering of pollens in the atmosphere of the city of Genoa, for three consecutive years (1981–82–83) has made possible the establishment of a pollen schedule of the city. Among the herbaceous, Urticaceae (Parietaria) and Poaceae predominate ; among the trees, Cupressaceae, Corylaceae and Betulaceae (early blossoms) and also Pinaceae, Fagaceae and Oleaceae predominate in the spring-summer season. The pollination of certain species studied in detail (Urticaceae, Poaceae, Oleaceae), showed a marked increase during the three years : we have tried to explain this by analyzing meteorological factors. The frequency of skin senstizations in a population of 851 patients allergic to pollen, reflects the importance of only a few of the main elements of the schedule : first of all Parietaria (71 p. cent), followed by Graminaceae (41 p. cent) and further the Oleaceae (13.5 p. cent) and the Group Betulaceae-Corylaceae (8 p. cent).

Research paper thumbnail of An unusual case of meat allergy

Clinical and Translational Allergy, 2011

Research paper thumbnail of Local immunotherapy with extract in asthma

Journal of Allergy and Clinical Immunology, 1991

ABSTRACT Local immunotherapy (LIT) with Dermatophagoides extract or placebo were administered to ... more ABSTRACT Local immunotherapy (LIT) with Dermatophagoides extract or placebo were administered to two groups of 11 patients with allergic asthma in a double-blind fashion. All patients received cromolyn sodium (20 mg four times a day) during treatments. Bronchial provocation tests with allergen and methacholine were performed before, 1 week, and 4 weeks after the end of treatments. Symptom score, drug consumption, and peak expiratory flow were monitored daily from 2 weeks before to 4 weeks after treatments. Compared to baseline, early bronchial sensitivity to allergen was significantly reduced both 1 week (p less than 0.0005) and 4 weeks (p less than 0.01) after LIT but not after placebo administration. Late bronchial reaction to allergen occurred similarly after placebo administration and LIT. However, in the group with LIT, the severity of late reaction was unchanged after treatment in spite of the significantly larger doses of allergen administered to provoke the early asthmatic reaction. Neither symptom score, nor drug consumption, nor peak expiratory flow were significantly different in the two groups before and during the treatment period even though both symptom score and drug consumption tended to be reduced after LIT. We conclude that LIT may be an effective and safe alternative to traditional immunotherapy.

Research paper thumbnail of Food allergy to Boletus edulis☆☆☆★

Journal of Allergy and Clinical Immunology, 1998

ABSTRACT J Allergy Clin Immunol 1998;101:850-1.

Research paper thumbnail of Effect of seasonal exposure to pollen on specific bronchial sensitivity in allergic patients

Journal of Allergy and Clinical Immunology, 1990

Bronchial provocation tests with aerosol of birch extract were performed before and after pollen ... more Bronchial provocation tests with aerosol of birch extract were performed before and after pollen season in 11 sensitized subjects. Changes of metacholine bronchial responsiveness and serum-specific IgE level were also assessed. In five patients who did not take steroids to control their symptoms, both early and late asthmatic responses to inhaled allergen were enhanced after season, whereas IgE serum level, but not methacholine sensitivity, was significantly increased. In six patients who needed steroids, neither responses to allergen nor IgE serum level and methacholine sensitivity were significantly changed after season. For the whole group, the increase in immediate bronchial sensitivity to allergen was positively correlated with the increase in specific IgE antibodies. We conclude that seasonal exposure to pollen has, in sensitized patients, a priming effect on bronchial mucosa that may be blunted by steroid treatment. The increased production of specific IgE antibodies appears to be an important mechanism for this priming effect.

Research paper thumbnail of Oral antihistamine/decongestant treatment compared with intranasal corticosteroids in seasonal allergic rhinitis

Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 1995

This international, multicentre, randomized, double-blind, double-dummy, parallel-group trial was... more This international, multicentre, randomized, double-blind, double-dummy, parallel-group trial was undertaken to compare the efficacy and tolerability of once-daily astemizole-D (10 mg astemizole plus 240 mg pseudoephedrine) with beclomethasone nasal spray (0.05 mg/ml) two puffs/nostril administered twice daily in a total of 204 patients with seasonal allergic rhinitis. Treatment duration was 4 weeks. Although investigator assessments of symptom severity were generally comparable in the two treatment groups throughout the trial, statistically significant differences in favour of astemizole-D for sneezing and ocular symptoms were apparent at the end of the 4-week treatment period (P &amp;amp;lt; 0.05). Patient diary data support these findings, with significant differences in favour of the antihistamine/decongestant combination reported for ocular symptoms after 2 weeks of treatment (P &amp;amp;lt; 0.05) and non-significant trends for sneezing after 2 weeks and ocular symptoms over the entire treatment period (P = 0.07). Use of rescue medication for ocular symptoms was also significantly lower in the astemizole-D treatment group (P &amp;amp;lt; 0.05). A wide range of adverse experiences were reported, however, there were no statistically significant differences in the type or incidence of those between the two treatment groups. In conclusion, astemizole-D appears to be at least as effective and well tolerated as intranasal beclomethasone in the treatment of seasonal allergic rhinitis, providing at least comparable relief from all nasal symptoms including congestion and significantly greater relief from ocular symptoms than the topical steroid.