European annals of allergy and clinical immunology Journal Impact Factor & Information

Publisher: Associazione allergologi immunologi territoriali e ospedalieri; Associazione italiana allergologi territoriali e ospedalieri

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Current impact factor: 0.00

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ISSN 1764-1489
OCLC 213052917
Material type Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal

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    ABSTRACT: It's well known that iv. immunoglobulins may be useful to overcome habitual abortions, but the mechanisms at the base of a successful outcome and the likelihoods are still unknown. In one hundred and sixty women with habitual abortions and one hundred and sixty healthy mothers, we evaluated blood IgG subclasses; among the patients, sixteen merely showed IgG subclass deficiency, after leaving out any autoimmunity and/or coagulation disorders. All the patients (100%) showed IgG3, twelve (75%) IgG1, eight (50%) IgG4 and six (37,5%) IgG2 deficiency; healthy control people's IgG subclasses fell in normal range in 156 women, but just four women showed IgG2 and IgG4 deficiency with neither immune deficiency's clinical marks nor increased vulnerability to infections. All the patients were treated with whole immunoglobulins iv. infusion (200 mg/kg/monthly) all over the pregnancy. The successful pregnancy rate is very high (> 90%): 100% out of women showing IgG1 (12/12), 87,5% of IgG3 (14/16), 75% of IgG4 (6/8) and 66% of IgG2 deficiency (4/6) had successful pregnancies. The Odd's Ratio between IgG subclass deficiency and recurrent abortions is 4,33 with confidence interval of 95%; chi square value is 7.68 (p < 0.025). Low dose immunoglobulin infusion is the only effective way to reach successful pregnancy, despite previous habitual abortions in patients suffering from IgG subclass deficiency without autoimmunity and/or coagulation disorders, likely restoring idiotype-antiidiotype network; showing evidence of IgG subclasses deficiency (mostly IgG1 and IgG3) may help identify patients who can benefit from iv. immunoglobulin treatment.
    European annals of allergy and clinical immunology 05/2015; 47(3):91-4.
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    ABSTRACT: Attempts aimed at inducing food tolerance through oral food desensitization (OFD) for the treatment of IgE-mediated food allergies are increasing. In Italy, a number of allergy centres offer this procedure. To collect information on how these centres are organized, how patients are selected, the methods used to administer OFD and how adverse reactions are managed. A questionnaire was e-mailed to all the Italian allergy centres offering OFD. The survey shows a high degree of variability between centres. A correct diagnosis of food allergy is crucial for selecting patients for OFD. In the Italian allergy centres, oral food challenges are mostly open label (84%), but in 16% of cases they are single-blind (8%) or double-blind (8%). A high proportion of allergy centres (83%) offer OFD to children presenting forms of anaphylaxis triggered by traces - or very low doses - of food allergen. The majority of allergy centres (76%) enroll patients over 3 years of age, with 44% enrolling patients above the age of 5. Not-controlled asthma, unreliability of parents in the management of OFD and/or risk of adverse events, are the main reasons for exclusion from the procedure. Although OFD may sometimes be successful and may be considered a valid alternative to an elimination diet, further randomized controlled trials are needed, in order to clarify some controversial points, such as the characteristics of the child undergoing OFD, and the methods of food preparation and administration. Moreover, further studies should further investigate OFD safety, efficacy and costs.
    European annals of allergy and clinical immunology 05/2015; 47(3):68-76.
  • European annals of allergy and clinical immunology 05/2015; 47(3):103-4.
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    ABSTRACT: Background. Attempts aimed at inducing food tolerance through oral food desensitization (OFD) for the treatment of IgE-mediated food allergies are increasing. In Italy, a number of allergy centres offer this procedure. Objective. To collect information on how these centres are organized, how patients are selected, the methods used to administer OFD and how adverse reactions are managed. Methods. A questionnaire was e-mailed to all the Italian allergy centres offering OFD. Results. The survey shows a high degree of variability between centres. A correct diagnosis of food allergy is crucial for selecting patients for OFD. In the Italian allergy centres, oral food challenges are mostly open label (84%), but in 16% of cases they are single-blind (8%) or double-blind (8%). A high proportion of allergy centres (83%) offer OFD to children presenting forms of anaphylaxis triggered by traces - or very low doses - of food allergen. The majority of allergy centres (76%) enroll patients over 3 years of age, with 44% enrolling patients above the age of 5. Not-controlled asthma, unreliability of parents in the management of OFD and/or risk of adverse events, are the main reasons for exclusion from the procedure. Conclusion. Although OFD may sometimes be successful and may be considered a valid alternative to an elimination diet, further randomized controlled trials are needed, in order to clarify some controversial points, such as the characteristics of the child undergoing OFD, and the methods of food preparation and administration. Moreover, further studies should further investigate OFD safety, efficacy and costs.
    European annals of allergy and clinical immunology 05/2015; 47(3):68-76.
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    ABSTRACT: Bronchiectasis are common in Common Variable Immunodeficiency. These patients are prone to infection, leading to progressive lung destruction and accelerated FEV1 decline. 40 year-old man, with recurrent respiratory infections, autoimmunity and diarrhea since age 7. At 17 CVID was diagnosed and IVIgG was started. During the following years, respiratory symptoms progressively worsened and bronchiectasis was found on thoracic computed tomography. Bronchoscopy revealed Pseudomonas aeruginosa in bronchoalveolar lavage and bronchial secretions cultures. Eradication therapy led to clinical improvement. This case report stresses the importance of regular microbiological screening and appropriate antibiotherapy. Early/aggressive treatment may significantly impact on patients' evolution.
    European annals of allergy and clinical immunology 05/2015; 47(3):95-8.
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    ABSTRACT: Allergen Immunotherapy (AIT) is able to restore a physiological Th1 response and Tregs function. This effect is allergen-specific, even though it has been reported that it may also be non-specific, such as also extended to allergens not used in AIT. This immunological phenomenon may also be of clinical nature. This case report shows that a poly-allergic patient, successfully treated with Parietaria extract, also achieved a clinical tolerance towards other causal allergens, such as mites and cat. Of course, this was an anecdote, but it is reasonable to prospect the hypothesis that a bystander clinical effect may be observed during AIT in poly-allergic patients.
    European annals of allergy and clinical immunology 03/2015; 47(2):62-63.
  • European annals of allergy and clinical immunology 03/2015; 47(2):36-37.
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    ABSTRACT: From the literature, patients with a history of anaphylaxis to hymenoptera venom and positive specific IgE have shown a correlation between elevated tryptase levels and two clinical situations: systemic mastocytosis and an increased risk of reactions to venom immunotherapy or hymenoptera sting. Other clinical scenarios could explain elevated tryptase levels. A 67 year old male (P1) and a 77 year old male (P2) were evaluated for previous severe anaphylaxis to hymenoptera sting. They underwent standard diagnostic work-up for hymenoptera venom allergy. Having found elevated tryptase levels, these were followed by a bone marrow biopsy to rule out systemic mastocytosis. P1: specific IgE and skin tests were positive for Vespula species; tryptase 52.8 ng/ml; P2: specific IgE and skin tests were positive for Vespa cabro and tryptase 153 ng/ml. Bone marrow biopsy results were negative for mastocytosis. We carried out magnetic resonance imaging, in P1 to better characterize the severe osteoporosis and in P2 because during physical examination a pulsating mass had been identified in the mesogastrium, and an aneurysm of the abdominal aorta which required surgical intervention in both patients was detected. Eight months after surgery, tryptase levels had diminished significantly (P1: 11.6 ng/ml and P2: 14.5 ng/ml). The elevated tryptase levels were correlated to abdominal aneurysm in both patients. In fact, post-surgery tryptase levels dramatically decreased. These two cases demonstrate that high tryptase levels in subjects with a history of hymenoptera venom anaphylaxis can be associated to undiagnosed aneurysmatic disease.
    European annals of allergy and clinical immunology 03/2015; 47(2):58-61.
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    ABSTRACT: Eczema is one of the most common chronic inflammatory skin diseases, affecting about 20% of children. The pathogenic mechanisms of eczema are still not fully understood, and current treatment of moderate-severe eczema is often difficult. Recently, it has been suggested that Vitamin D plays a key role in this disease, even if mechanisms are only partially known. The purpose of our study was to assess the 25-Hydroxyvitamin D serum levels in a pediatric population suffering from chronic eczema (IgE-mediated and non-IgE-mediated), and to correlate these phenotypes with the SCORAD severity and selected clinical and biological parameters. Moreover, we aimed to evaluate whether a supplementation of Vitamin D3 could affect the same clinical and laboratory parameters. 89 children with chronic eczema were enrolled in the study. Severity of eczema was assessed with the SCORAD index. Past and present history was taken, and patients were divided into two groups according to the state of sensitization. According to a randomization schedule, the enrolled children were assigned to the following groups: supplementation group, which received a daily oral Vitamin D3 supplementation (2000 IUs) for 3 months; control group which received no supplementation. Vitamin D concentrations in patients with moderate and severe eczema were not statistically different from Vitamin D concentration detected in the serum of patients with mild eczema. Furthermore, we did not find any correlation between Vitamin D levels, total IgEs and SCORAD index, both in the Sensitized and in the Not-Sensitized group. The Vitamin D3 supplementation did not influence the SCORAD severity or the total IgEs concentration. To our knowledge, our study is the first one that shows no correlation between serum levels of Vitamin D, eczema severity and IgE sensitization in a pediatric population suffering from chronic eczema.
    European annals of allergy and clinical immunology 03/2015; 47(2):41-47.
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    ABSTRACT: Severe asthma is a challenging disease, and omalizumab has been an important tool to help clinicians address more efficiently this problem. Besides reduction of free and total serum IgE levels, there are a number of other immunologic effects of omalizumab that may be of relevance in its therapeutic action. We report two mite-allergic severe asthmatic patients successfully treated with omalizumab for one year. Clinically, patients improved gradually, with no further need for systemic steroids or emergency department visits during that treatment period, and with Asthma Control Test (ACT) scores showing controlled disease, although pulmonary function didn't show any significant improvement. Immunologically, we observed marked down-regulation of surface IgE and FcεRI on basophils, plasmacytoid and myeloid dendritic cells, as well as a reduction of basophil activation after specific allergen stimulation. These effects were clearly evident immediately after one month but were enhanced at 3, 6 and 12 months of omalizumab treatment, suggesting an advantage to continuing this therapy, and raising the hypothesis of some markers being useful to assess immunological responses to omalizumab, which could assist in the clinician's decision to stop or to restart this treatment.
    European annals of allergy and clinical immunology 03/2015; 47(2):38-40.
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    ABSTRACT: The relationship between hypersensitivity to NSAID and atopic status is still incompletely defined. Previous studies found a high prevalence of atopic diseases in multiple NSAID reactors. The present study aimed to investigate whether this is the case also in Italian adults hypersensitive to NSAIDs. Skin tests with a large panel of seasonal and perennial airborne allergens were carried out in 252 patients with a clear-cut history of acute urticaria induced by nonsteroidal anti-inflammatory drugs. Patients were classified as single or multiple NSAID reactors based on clinical history, presence/absence of chronic urticaria, re-challenge with the reported offending drug in case of doubt history, and oral challenges with aspirin or propionic acid derivatives. Single NSAID reactors showed a much higher prevalence of atopic diseases than multiple NSAID reactors either with or without chronic urticaria (61% vs 19% and 19%, respectively; p < 0.001). As a difference from previous reports, in Italian patients hypersensitive to NSAID atopy is much more prevalent among single reactors, a finding that indirectly supports the possible IgE-mediated origin of this type of adverse drug reaction.
    European annals of allergy and clinical immunology 03/2015; 47(2):48-53.
  • European annals of allergy and clinical immunology 01/2015; 47(1):27-32.
  • European annals of allergy and clinical immunology 01/2015; 47(1):22-4.
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    ABSTRACT: Hypereosinophilic syndromes are characterized by sustained overproduction of eosinophils, leading to eosinophilic infiltration, mediator release and multi-organ damage. A 67 year old male was referred to our Department for investigation of a persistent mild-to-moderate eosinophilia, identified 10 years previously and unresponsive to corticosteroid treatment. No other alterations were present in his differential blood count and physical examination was unremarkable. Allergic, rheumatologic and iatrogenic causes of eosinophilia were excluded by clinical history, skin-prick tests and blood and stool analysis. Iliac crest bone marrow aspiration and biopsy were performed, revealing normal cellularity with an increased eosinophil count (6%). RT-PCR of the aspirate revealed the presence of transcripts of ETV6/PDGFR-beta t(5;12) gene fusion. Karyotype analysis was normal and no mutation in PDFGR-alpha was identified. There was no evidence in analytic or imaging studies of cardiac, skin, neurologic, pulmonary or splenic involvement. A skin biopsy showed no evidence of pathologic infiltration. Initially the patient was treated with a 100 mg daily dose of imatinib mesylate, a specific inhibitor of the tyrosine-kinase domain of PDGFR. Subsequently, the daily dosage was increased to 200 mg/day to obtain eosinophil count normalization. Currently, he is under monthly hematologic and hepatic function screening. No drug side effects have been reported. This patient was diagnosed with a rare myeloproliferative variant of hypereosinophilic syndrome due to a t(5;12) ETV6/PDGFR-beta translocation. Imatinib mesylate, previously used successfully in syndromes associated with PDFGR-alpha mutations, showed efficacy in the context of this mutation as well.
    European annals of allergy and clinical immunology 01/2015; 47(1):15-9.
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    ABSTRACT: Anaphylaxis is a rapid onset serious allergic reaction which may be fatal. It is usually triggered by an agent such as a food, insect sting, or medication, through a mechanism involving immunoglobulin E (IgE) and the high-affinity IgE receptor on mast cells or basophils. Anaphylaxis has been rarely described which results from pollen antigen exposure. Here, we present unusual anaphylaxis, which results from inhaled pollen antigen in a 15-year-old boy.
    European annals of allergy and clinical immunology 01/2015; 47(1):20-1.
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    ABSTRACT: Atopic dermatitis (AD) is an inflammatory, chronically relapsing and highly pruritic skin disorder that considerably effects patients' life. Dermatology Life Quality Index (DLQI) is often applied in clinical research in order to evaluate the impact of AD on daily performance of patients. The aim of the study was to evaluate the long-term effect of allergen specific immunotherapy (ASIT) on the quality of life in AD patients. 15 patients suffering from AD, allergic to house dust mites or grass pollen allergens, who were previously treated with ASIT participated in the study. Our treatment with allergy vaccinations was performed during the time period between 1995 and 2001. DLQI questionnaires have been filled by the patients before the treatment, after termination of ASIT and after 2 - 12 years of the observational period. The statistical tests revealed a significant difference between the DLQI before ASIT was introduced and after termination of ASIT. Every answer except two (describing the influence of skin condition on preventing from working or studying and on sexual life) of these periods also disclosed statistically significant difference. As for the relation between the DLQI after ASIT and the actual one the tests revealed non significant difference, also regarding to every single answer of the questionnaire. In relation to improvement of quality of life in AD patients, this study confirms the effectiveness of ASIT and it discloses the persistence of its results in long-term aspect.
    European annals of allergy and clinical immunology 01/2015; 47(1):5-9.