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2. Foreword

Author

Caffarelli, C., Calvani, M., Cardinale, F., Chiappini, E., Ciprandi, G., Cravidi, C., Duse, M., Galli, E., Licari, A., Manti, S., Martelli, A., Minasi, D., Del Giudice, M. M., Pajno, G. B., Ricci, G., Tosca, M. A., and Marseglia, G. L.

Subjects
Italy, Hypersensitivity, Humans, Foreword, Child, Delivery of Health Care
Abstract

The management of chronic diseases are paramount in health care in these days. Among them, there has been an expansion of allergic and immunologic diseases, especially in children. Thanks to the action of the Italian Society of Pediatric Allergy and Immunology (SIAIP), the quality level of care has progressively grown. SIAIP developed a task force with the purpose of proposing updated models for assessing, and prescribing treatment in the allergy and immunology field that have been issued in this supplement. In a very difficult time for everyone, current developments covering a broad range of topics in the field are presented. All Authors have to be thanked, since they have participated with passion and have taken valuable time away from their professional and private interests. We hope that the readership will enjoy these papers.

Published
2020

3. Malignant insulinoma, a very rare cause of pediatric hypoglycemia

Author

Cannavò, L., Cucinotta, U., Zirilli, G., Mario Lima, Pajno, G. B., Wasniewska, M., and Valenzise, M.

Subjects
Pancreatic Neoplasms, Humans, Insulinoma, Child, neuroendocrine tumor, Hypoglycemia, hypoglycemia, insulinoma, neuroendocrine tumor, seizures, seizures
Published
2020

4. EAACI Guidelines on allergen immunotherapy:IgE-mediated food allergy

Author

Pajno, G. B., Fernandez-Rivas, M., Arasi, S., Roberts, G., Akdis, C. A., Alvaro-Lozano, M., Beyer, K., Bindslev-Jensen, C., Burks, W., Ebisawa, M., Eigenmann, P., Knol, E., Nadeau, K. C., Poulsen, L. K., van Ree, R., Santos, A. F., du Toit, G., Dhami, S., Nurmatov, U., Boloh, Y., Makela, M., O'Mahony, L., Papadopoulos, N., Sackesen, C., Agache, I., Angier, E., Halken, S., Jutel, M., Lau, S., Pfaar, O., Ryan, D., Sturm, G., Varga, E. M., van Wijk, R. G., Sheikh, A., Muraro, A., Pajno, G. B., Fernandez-Rivas, M., Arasi, S., Roberts, G., Akdis, C. A., Alvaro-Lozano, M., Beyer, K., Bindslev-Jensen, C., Burks, W., Ebisawa, M., Eigenmann, P., Knol, E., Nadeau, K. C., Poulsen, L. K., van Ree, R., Santos, A. F., du Toit, G., Dhami, S., Nurmatov, U., Boloh, Y., Makela, M., O'Mahony, L., Papadopoulos, N., Sackesen, C., Agache, I., Angier, E., Halken, S., Jutel, M., Lau, S., Pfaar, O., Ryan, D., Sturm, G., Varga, E. M., van Wijk, R. G., Sheikh, A., and Muraro, A.

Abstract

Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA-AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE-mediated Food Allergy, aims to provide evidence-based recommendations for active treatment of IgE-mediated food allergy with FA-AIT. Immunotherapy relies on the delivery of gradually increasing doses of specific allergen to increase the threshold of reaction while on therapy (also known as desensitization) and ultimately to achieve post-discontinuation effectiveness (also known as tolerance or sustained unresponsiveness). Oral FA-AIT has most frequently been assessed: here, the allergen is either immediately swallowed (OIT) or held under the tongue for a period of time (SLIT). Overall, trials have found substantial benefit for patients undergoing either OIT or SLIT with respect to efficacy during treatment, particularly for cow's milk, hen's egg, and peanut allergies. A benefit post-discontinuation is also suggested, but not confirmed. Adverse events during FA-AIT have been frequently reported, but few subjects discontinue FA-AIT as a result of these. Taking into account the current evidence, FA-AIT should only be performed in research centers or in clinical centers with an extensive experience in FA-AIT. Patients and their families should be provided with information about the use of FA-AIT for IgE-mediated food allergy to allow them to make an informed decision about the therapy.

Published
2018

5. Allergen immunotherapy for IgE-mediated food allergy : a systematic review and meta-analysis

Author

Nurmatov, U., Dhami, S., Arasi, S., Pajno, G. B., Fernandez-Rivas, M., Muraro, A., Roberts, G., Akdis, C., Alvaro-Lozano, M., Beyer, K., Bindslev-Jensen, C., Burks, W., du Toit, G., Ebisawa, M., Eigenmann, P., Knol, E., Mäkelä, Mika, Nadeau, K. C., O'Mahony, L., Papadopoulos, N., Poulsen, L. K., Sackesen, C., Sampson, H., Santos, A. F., van Ree, R., Timmermans, F., Sheikh, A., Clinicum, Department of Dermatology, Allergology and Venereology, and HUS Inflammation Center

Subjects
safety, ORAL TOLERANCE INDUCTION, food allergy, PEANUT ALLERGY, desensitization, CHILDREN, CONTROLLED-TRIAL, DOUBLE-BLIND, EGG ALLERGY, SUBLINGUAL IMMUNOTHERAPY, 3121 General medicine, internal medicine and other clinical medicine, sustained unresponsiveness, COWS MILK ALLERGY, allergen immunotherapy, ANAPHYLACTIC REACTIONS
Abstract

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is developing Guidelines for Allergen Immunotherapy (AIT) for IgE-mediated Food Allergy. To inform the development of clinical recommendations, we sought to critically assess evidence on the effectiveness, safety and cost-effectiveness of AIT in the management of food allergy. Methods: We undertook a systematic review and meta-analysis that involved searching nine international electronic databases for randomized controlled trials (RCTs) and nonrandomized studies (NRS). Eligible studies were independently assessed by two reviewers against predefined eligibility criteria. The quality of studies was assessed using the Cochrane Risk of Bias tool for RCTs and the Cochrane ACROBAT-NRS tool for quasi-RCTs. Random-effects meta-analyses were undertaken, with planned subgroup and sensitivity analyses. Results: We identified 1814 potentially relevant papers from which we selected 31 eligible studies, comprising of 25 RCTs and six NRS, studying a total of 1259 patients. Twenty-five trials evaluated oral immunotherapy (OIT), five studies investigated sublingual immunotherapy, and one study evaluated epicutaneous immunotherapy. The majority of these studies were in children. Twenty-seven studies assessed desensitization, and eight studies investigated sustained unresponsiveness postdiscontinuation of AIT. Meta-analyses demonstrated a substantial benefit in terms of desensitization (risk ratio (RR) = 0.16, 95% CI 0.10, 0.26) and suggested, but did not confirm sustained unresponsiveness (RR = 0.29, 95% CI 0.08, 1.13). Only one study reported on disease-specific quality of life (QoL), which reported no comparative results between OIT and control group. Meta-analyses revealed that the risk of experiencing a systemic adverse reaction was higher in those receiving AIT, with a more marked increase in the risk of local adverse reactions. Sensitivity analysis excluding those studies judged to be at high risk of bias demonstrated the robustness of summary estimates of effectiveness and safety of AIT for food allergy. None of the studies reported data on health economic analyses. Conclusions: AIT may be effective in raising the threshold of reactivity to a range of foods in children with IgE-mediated food allergy whilst receiving (i.e. desensitization) and post-discontinuation of AIT. It is, however, associated with a modest increased risk in serious systemic adverse reactions and a substantial increase in minor local adverse reactions. More data are needed in relation to adults, long term effects, the impact on QoL and the cost-effectiveness of AIT.

Published
2017

6. Allergen immunotherapy for IgE-mediated food allergy: protocol for a systematic review

Author

Saçkesen, Cansın (ORCID 0000-0002-1115-9805 & YÖK ID 182537), Dhami, S.; Nurmatov, U.; Pajno, G. B.; Fernandez-Rivas, M.; Muraro, A.; Roberts, G.; Akdiş, C.; Alvaro-Lozano, M.; Beyer, K.; Bindslev-Jensen, C.; Burks, W.; du Toit, G.; Ebisawa, M.; Eigenmann, P.; Knol, E.; Makela, M.; Nadeau, K. C.; O'Mahony, L.; Papadopoulos, N.; Poulsen, L.; Sampson, H.; Santos, A.; van Ree, R.; Timmermans, F.; Sheikh, A., School of Medicine, Department of Pediatrics, Saçkesen, Cansın (ORCID 0000-0002-1115-9805 & YÖK ID 182537), Dhami, S.; Nurmatov, U.; Pajno, G. B.; Fernandez-Rivas, M.; Muraro, A.; Roberts, G.; Akdiş, C.; Alvaro-Lozano, M.; Beyer, K.; Bindslev-Jensen, C.; Burks, W.; du Toit, G.; Ebisawa, M.; Eigenmann, P.; Knol, E.; Makela, M.; Nadeau, K. C.; O'Mahony, L.; Papadopoulos, N.; Poulsen, L.; Sampson, H.; Santos, A.; van Ree, R.; Timmermans, F.; Sheikh, A., School of Medicine, and Department of Pediatrics

Abstract

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for IgE-mediated food allergy. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in IgE-mediated food allergy. Methods: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. Discussion: The findings from this review will be used to inform the development of recommendations for EAACI's Guidelines on AIT., EAACI

Published
2016

7. Immune response to sublingual immunotherapy in children allergic to mites

Author

Barberi, S., Villa, M. P., Pajno, G. B., La Penna, F., Barreto, M., Cardelli, P., Amodeo, R., Tabacco, F., Caminiti, L., and Giorgio Ciprandi

Subjects
Male, Mites, Adolescent, Administration, Sublingual, Immunoglobulin E, sublingual immunotherapy, house dust mites, t cell subsets, children, cytokine production, Desensitization, Immunologic, Hypersensitivity, Animals, Cytokines, Humans, Female, sublingual immunotherapy, cytokine production, T cell subsets, children, house dust mites, Child, T cell subsets
Abstract

Allergic rhinitis (AR) is characterized by Th2 polarized immune response. Specific immunotherapy modifies this arrangement restoring a physiologic Th1 profile. Sublingual immunotherapy (SLIT) is widely prescribed, but there is no early marker of response. The aim of this study is to investigate possible marker of SLIT effectiveness. Thirty children with mite allergy were studied: 15 were treated with drugs alone, 15 with SLIT and drugs on demand. The study lasted 2 years. Visual analogue scale (VAS) for symptoms and medication score were evaluated. Serum cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, IFN-gamma, MCP-1, and TNF-alpha) were assessed by ELISA before and after 1 and 2 year SLIT. SLIT-treated children obtained a significant improvement of symptoms and a reduction of drug use, whereas children treated with a drug alone did not obtained any change. IL-10 significantly increased, whereas Th2-dependent and pro-inflammatory cytokines significantly decreased. In conclusion, the present study demonstrates that 2-year SLIT is capable of inducing immunologic hyporeactivity to mites.

Published
2011

9. Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Author

Vassilios Fanos, Fabio Cardinale, Salvatore Barberi, Alberto Villani, Carlo Caffarelli, Giovanni Simeone, Elena Chiappini, Roberto Bernardini, Monica Malventano, Luca De Franciscis, Annalisa Capuano, Stefano Luciani, Renato Turra, Stefania Zanconato, Domenico Minasi, Paolo Becherucci, Annamaria Bianchi, Marzia Duse, Paolo Biasci, Marcello Bergamini, Francesca Santamaria, Giuseppe Di Mauro, Serenella Castronuovo, Adima Lamborghini, Gian Luigi Marseglia, Francesco Paravati, Giovanni Battista Pajno, Alberto Martelli, Elio Novembre, Gabriella Di Mauro, Francesco Macrì, Giorgio Piacentini, Maria Carmen Verga, Giovanna Tezza, Iride Dello Iacono, Lucia Leonardi, Mattia Doria, Michele Miraglia Del Giudice, Giovanna De Castro, Raffaele Falsaperla, Luciana Indinnimeo, Riccardo Lubrano, Valentina Ferraro, Renato Cutrera, Lucia Diaferio, Vito Leonardo Miniello, Giampaolo Ricci, Melissa Borrelli, Gabriella Pozzobon, Agostino Nocerino, Germana Nardini, Francesco Di Mauro, Fabio Decimo, Anna Maria Zicari, Diego Peroni, Mariangela Tosca, Maria Di Cicco, Fabio Midulla, Luigi Masini, Amelia Licari, Carlo Alfaro, Valeria Caldarelli, Caterina Di Mauro, Elena Galli, Carlo Capristo, Cristina Piersantelli, Sergio Renzo Morandini, Massimo Landi, Giovanni Cerimoniale, Valter Spanevello, Daniele Giovanni Ghiglioni, Ahmad Kantar, Dora Di Mauro, Cristina Di Mauro, Giovanni Corsello, Attilio Varricchio, Duse, M., Santamaria, F., Verga, M. C., Bergamini, M., Simeone, G., Leonardi, L., Tezza, G., Bianchi, A., Capuano, A., Cardinale, F., Cerimoniale, G., Landi, M., Malventano, M., Tosca, M., Varricchio, A., Zicari, A. M., Alfaro, C., Barberi, S., Becherucci, P., Bernardini, R., Biasci, P., Caffarelli, C., Caldarelli, V., Capristo, C., Castronuovo, S., Chiappini, E., Cutrera, R., De Castro, G., De Franciscis, L., Decimo, F., Iacono, I. D., Diaferio, L., Di Cicco, M. E., Di Mauro, C., Di Mauro, D., Di Mauro, F., Di Mauro, G., Doria, M., Falsaperla, R., Ferraro, V., Fanos, V., Galli, E., Ghiglioni, D. G., Indinnimeo, L., Kantar, A., Lamborghini, A., Licari, A., Lubrano, R., Luciani, S., Macri, F., Marseglia, G., Martelli, A. G., Masini, L., Midulla, F., Minasi, D., Miniello, V. L., del Giudice, M. M., Morandini, S. R., Nardini, G., Nocerino, A., Novembre, E., Pajno, G. B., Paravati, F., Piacentini, G., Piersantelli, C., Pozzobon, G., Ricci, G., Spanevello, V., Turra, R., Zanconato, S., Borrelli, M., Villani, A., Corsello, G., Peroni, D., Duse, Marzia, Santamaria, Francesca, Verga, Maria Carmen, Bergamini, Marcello, Simeone, Giovanni, Leonardi, Lucia, Tezza, Giovanna, Bianchi, Annamaria, Capuano, Annalisa, Cardinale, Fabio, Cerimoniale, Giovanni, Landi, Massimo, Malventano, Monica, Tosca, Mariangela, Varricchio, Attilio, Zicari, Anna Maria, Alfaro, Carlo, Barberi, Salvatore, Becherucci, Paolo, Bernardini, Roberto, Biasci, Paolo, Caffarelli, Carlo, Caldarelli, Valeria, Capristo, Carlo, Castronuovo, Serenella, Chiappini, Elena, Cutrera, Renato, De Castro, Giovanna, De Franciscis, Luca, Decimo, Fabio, Iacono, Iride Dello, Diaferio, Lucia, Di Cicco, Maria Elisa, Di Mauro, Caterina, Di Mauro, Cristina, Di Mauro, Dora, Di Mauro, Francesco, Di Mauro, Gabriella, Doria, Mattia, Falsaperla, Raffaele, Ferraro, Valentina, Fanos, Vassilio, Galli, Elena, Ghiglioni, Daniele Giovanni, Indinnimeo, Luciana, Kantar, Ahmad, Lamborghini, Adima, Licari, Amelia, Lubrano, Riccardo, Luciani, Stefano, Macrì, Francesco, Marseglia, Gianluigi, Martelli, Alberto Giuseppe, Masini, Luigi, Midulla, Fabio, Minasi, Domenico, Miniello, Vito Leonardo, Del Giudice, Michele Miraglia, Morandini, Sergio Renzo, Nardini, Germana, Nocerino, Agostino, Novembre, Elio, Pajno, Giovanni Battista, Paravati, Francesco, Piacentini, Giorgio, Piersantelli, Cristina, Pozzobon, Gabriella, Ricci, Giampaolo, Spanevello, Valter, Turra, Renato, Zanconato, Stefania, Borrelli, Melissa, Villani, Alberto, Corsello, Giovanni, Di Mauro, Giuseppe, Peroni, Diego, and Marzia Duse, Francesca Santamaria, Maria Carmen Verga, Marcello Bergamini, Giovanni Simeone, Lucia Leonardi, Giovanna Tezza, Annamaria Bianchi, Annalisa Capuano, Fabio Cardinale, Giovanni Cerimoniale, Massimo Landi, Monica Malventano, Mariangela Tosca, Attilio Varricchio, Anna Maria Zicari, Carlo Alfaro, Salvatore Barberi, Paolo Becherucci, Roberto Bernardini, Paolo Biasci, Carlo Caffarelli, Valeria Caldarelli, Carlo Capristo, Serenella Castronuovo, Elena Chiappini, Renato Cutrera, Giovanna De Castro, Luca De Franciscis, Fabio Decimo, Iride Dello Iacono, Lucia Diaferio, Maria Elisa Di Cicco, Caterina Di Mauro, Cristina Di Mauro, Dora Di Mauro, Francesco Di Mauro, Gabriella Di Mauro, Mattia Doria, Raffaele Falsaperla, Valentina Ferraro, Vassilios Fanos, Elena Galli, Daniele Giovanni Ghiglioni, Luciana Indinnimeo, Ahmad Kantar, Adima Lamborghini, Amelia Licari, Riccardo Lubrano, Stefano Luciani, Francesco Macrì, Gianluigi Marseglia, Alberto Giuseppe Martelli, Luigi Masini, Fabio Midulla, Domenico Minasi, Vito Leonardo Miniello, Michele Miraglia Del Giudice, Sergio Renzo Morandini, Germana Nardini, Agostino Nocerino, Elio Novembre, Giovanni Battista Pajno, Francesco Paravati, Giorgio Piacentini, Cristina Piersantelli, Gabriella Pozzobon, Giampaolo Ricci, Valter Spanevello, Renato Turra , Stefania Zanconato, Melissa Borrelli, Alberto Villani, Giovanni Corsello, Giuseppe Di Mauro, Diego Peroni

Subjects
Male, Delphi Technique, Rhinosinusitis, Respiratory Tract Diseases, Delphi method, Rhinosinusiti, Laryngitis, Adrenal Cortex Hormone, Pediatrics, 0302 clinical medicine, Adrenal Cortex Hormones, Multidisciplinary approach, Inhaled corticosteroid, 030212 general & internal medicine, Child, Respiratory Tract Disease, Rhiniti, Societies, Medical, Rhinitis, education.field_of_study, Inhaled corticosteroids, Wheezing, General Medicine, Settore MED/38, Systematic review, Italy, Laryngotracheitis, Child, Preschool, Laryngotracheiti, Female, medicine.symptom, Human, medicine.medical_specialty, Consensus, Adolescent, Population, Consensu, RJ1-570, 03 medical and health sciences, Intervention (counseling), Administration, Inhalation, medicine, Laryngospasm, Humans, Adenoid hypertrophy, education, Intensive care medicine, Asthma, business.industry, Research, Infant, medicine.disease, 030228 respiratory system, business
Abstract

Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.

Published
2021

10. Prospective evaluation of autoimmune and non-autoimmune subclinical hypothyroidism in down syndrome children

Author

Giorgia Pepe, Domenico Corica, Luisa De Sanctis, Mariacarolina Salerno, Maria Felicia Faienza, Daniele Tessaris, Gerdi Tuli, Iris Scala, Laura Penta, Angela Alibrandi, Giovanni Battista Pajno, Tommaso Aversa, Malgorzata Wasniewska, Pepe, G., Corica, D., de Sanctis, L., Salerno, M., Faienza, M. F., Tessaris, D., Tuli, G., Scala, I., Penta, L., Alibrandi, A., Pajno, G. B., Aversa, T., and Wasniewska, M.

Subjects
Male, medicine.medical_specialty, Down syndrome, Thyroiditis, Adolescent, Endocrinology, Diabetes and Metabolism, autoimmune subclinical hypothyroidism, non-autoimmune subclinical hypothyroidism, 030209 endocrinology & metabolism, Hashimoto Disease, autoimmune subclinical hypothyroidism, non-autoimmune subclinical hypothyroidism, Down Syndrome, Gastroenterology, Group B, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, Medicine, Humans, Euthyroid, Prospective Studies, Prospective cohort study, Child, Preschool, Subclinical infection, business.industry, Thyroid disease, Autoantibody, Thyroiditis, Autoimmune, General Medicine, medicine.disease, Child, Disease Progression, Down Syndrome, Hashimoto Disease, Prospective Studies, Thyroiditis, Autoimmune, 030220 oncology & carcinogenesis, Child, Preschool, Disease Progression, Down Syndrome, Female, Thyroid function, business, Autoimmune
Abstract

Objective To evaluate the prevalence and natural course of autoimmune and non-autoimmune subclinical hypothyroidism (SH) in Down syndrome (DS) children and adolescents. Design Prospective multicenter study. Methods For the study, 101 DS patients with SH (TSH 5–10 mIU/L; FT4 12–22 pmol/L), aged 2–17 years at SH diagnosis were enrolled. Annual monitoring of TSH, FT4, BMI, height, and L-thyroxine dose was recorded for 5 years. Thyroid autoimmunity was tested at diagnosis and at the end of follow-up. Results Thirty-seven out of 101 patients displayed autoantibody positivity (group A); the remaining 64 were classified as non-autoimmune SH (group B). Group A was characterized by higher median age at SH diagnosis and by more frequent family history of thyroid disease (6.6 vs 4.7 years, P = 0.001; 32.4% vs 7.8%, P = 0.001 respectively), whereas congenital heart defects were more common in group B (65.6% vs 43.2%, P = 0.028). Gender, median BMI (SDS), height (SDS), FT4, and TSH were similar in both groups. At the end of follow-up: 35.1% of group A patients developed overt hypothyroidism (OH) vs 17.2% of group B (P = 0.041); 31.25% of group B vs 10.8% of group A became biochemically euthyroid (P = 0.02); and 37.8% of group A vs 51.5% of group B still had SH condition (P = 0.183). Logistic regression suggested autoimmunity (OR = 3.2) and baseline TSH values (OR = 1.13) as predictive factors of the evolution from SH to OH. Conclusions In DS children, non-autoimmune SH showed higher prevalence and earlier onset. The risk of thyroid function deterioration over time seems to be influenced by thyroid autoimmunity and higher baseline TSH values.

Published
2020

11. Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology

Author

Fabio Mosca, Mauro Calvani, Domenico Minasi, Chiara Petrolini, Carlo Caffarelli, Carlo Pietrasanta, Elena Chiappini, Arabella Martelli, Lorenza Pugni, Marzia Duse, G B Pajno, Mariangela Tosca, Sara Manti, Gian Luigi Marseglia, Fabio Cardinale, M. Miraglia Del Giudice, Amelia Licari, Chiappini, E., Petrolini, C., Caffarelli, C., Calvani, M., Cardinale, F., Duse, M., Licari, A., Manti, S., Martelli, A., Minasi, D., Miraglia Del Giudice, M., Pajno, G. B., Pietrasanta, C., Pugni, L., Tosca, M. A., Mosca, F., and Marseglia, G. L.

Subjects
Pediatrics, medicine.medical_specialty, Vaccination schedule, Hexavalent vaccines, Preterm infants, Vaccines, Review, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Humans, Medicine, Age Factor, Hexavalent vaccine, Vaccines, Combined, 030212 general & internal medicine, Neonatology, Adverse effect, Immunization Schedule, Age Factors, Infant, Infant, Newborn, Infant, Premature, Italy, Practice Guidelines as Topic, business.industry, Tetanus, Diphtheria, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Vaccination, Immunization, Preterm infant, Vaccine-preventable diseases, business, Vaccine, Human
Abstract

Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.

Published
2019
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12. 2019 ARIA Care pathways for allergen immunotherapy

Author

Dana Wallace, Karin C. Lødrup Carlsen, M. T. Ventura, Igor Kaidashev, Stephen R. Durham, Motohiro Ebisawa, Oliver Pfaar, Hae-Sim Park, Daniel Laune, Wytske Fokkens, Antonella Muraro, Moises A. Calderon, Torsten Zuberbier, Mohamed H. Shamji, Mark S. Dykewicz, Roy Gerth van Wijk, Josep M. Antó, Samantha Walker, Petr Panzner, Giorgio Walter Canonica, Nelson Rosario, Juan Carlos Ivancevich, Holger J. Schünemann, Susanne Halken, Lorenzo Cecchi, Sinthia Bosnic-Anticevich, Violeta Kvedariene, Stefania La Grutta, João Fonseca, Marek L Kowalski, Tari Haahtela, Aziz Sheikh, Montserrat Fernandez-Rivas, Nhan Pham-Thi, Isabelle Bosse, Jean Bousquet, Lan Le, Despo Ierodiakonou, Tomohisa Iinuma, Lars Jacobsen, Christine Rolland, Gert Marien, Wienczyslawa Czarlewski, Glenis Scadding, Ioana Agache, Bolesław Samoliński, Olga Lourenço, Ludger Klimek, Yoshitaka Okamoto, Ulrich Wahn, Joaquim Mullol, Erkka Valovirta, Luigi Caraballo, Sanna Toppila-Salmi, Ioanna Tsiligianni, Derek K. Chu, Ruby Pawankar, Jean Luc Fauquert, Musa Khaitov, Jorg Kleine Tebbe, Jean-François Fontaine, Victoria Cardona, Désirée Larenas-Linemann, Thomas B. Casale, Omer Kalayci, Alvaro A. Cruz, Arunas Valiulis, Anna Bedbrook, Susanne Lau, Alkis Togias, H.-J. Malling, Claus Bachert, Dermot Ryan, Elísio Costa, Giovanni Passalacqua, Ignacio J. Ansotegui, Ana Todo Bom, Marek Jutel, Enrica Menditto, Piotr Kuna, Nikolaos G. Papadopoulos, Gregoire Mercier, Mario Sánchez-Borges, Karl-Christian Bergmann, Susan Waserman, Gunter J. Sturm, Maryline Valentin-Rostan, Arzu Yorgancioglu, Giovanni Battista Pajno, Jan Brozek, George Du Toit, Robyn E O'Hehir, Peter Hellings, Graham Roberts, uBibliorum, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Center for Rhinology and Allergology, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], Department of Allergy and Immunology, Hospital Quiròn Bizkaia Erandio, UPC Research Laboratories, Allergy Department, University of Crete [Heraklion] (UOC), Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Universitat Pompeu Fabra [Barcelona] (UPF), Ghent University Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Department of Dermatology and Allergy [Berlin, Allemagne], Comprehensive Allergy Center [Berlin, Allemagne], Berlin Institute of Health (BIH)-Berlin Institute of Health (BIH), The University of Sydney, Woolcock Institute of Medical Research [Sydney], CHU Montpellier, Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], Section of Allergy and Clinical Immunology [London, UK], Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Institute for Immunological Research (University of Cartagena), University of Cartagena, Allergy Section, Department of Internal Medicine, Vall d'Hebron University Hospital [Barcelona], Division of Allergy and Immunology, Department of Medicine, Creighton University, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Universidade do Porto, Instituto de Biologia Molecular e Celular (IBMC), Universidade Federal da Bahia (UFBA), UCB Pharma, Colombes, Section of Allergy and Clinical Immunology, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute [UK], King‘s College London, Saint Louis University School of Medicine [St Louis], Sagamihara National Hospital, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Center of Research in Health Technologies and Information Systems (CINTESIS), Department of Allergology, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Helsinki University Hospital, Odense University Hospital, University Hospitals Leuven [Leuven], Chiba University Hospital, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Research Centre for Prevention and Health (RCPH), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Capital Region of Denmark, Department of Clinical Immunology, Wroclaw Medical University, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Laboratory of Molecular Immunology [Moscow, Russian Federation] (National Research Center), Institute of Immunology [Moscow, Russian Federation]-Federal Medicobiological Agency [Moscow, Russian Federation], Hacettepe University = Hacettepe Üniversitesi, Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Department of Immunology, Rheumatology and Allergy, Division of Internal Medicine, Asthma and Allergy, Medical University of Łódź (MUL)-Barlicki University Hospital, Vilnius University [Vilnius], CNR-IBIM : National Research Council-Institute of Biomedicine and Molecular Immunology, Department of Pediatric Pneumology and Immunology, Ho Chi Minh City University of Technology (HCMUT), University of Oslo (UiO), Faculty of Health Sciences and CICS-UB (Health Sciences Research Centre), 'Federico II' University of Naples Medical School, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Food Allergy Referral Centre Veneto Region [Padua, Italy], Universita degli Studi di Padova, Monash University [Melbourne], Department of Otorhinolaryngology, Department of Pediatrics, Allergy Unit, University of Messina, Ajou University School of Medicine, Department of Allergology and Clinical Immunology, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Allergy and Respiratory Diseases, University of Genoa (UNIGE), Saint Mary's Hospital [London], St Mary's Hospital [London], Department of Pediatrics, Nippon Medical School, Pediatrics, Universidade Federal do Paraná (UFPR), Medical Centre, Woodbrook Medical Centre, Medical University of Warsaw - Poland, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Department of Allergy and Clinical Immunology [Caracas, Venezuela], Centro Medico-Docente La Trinidad, The Royal National Throat, Nose and Ear Hospital, Imperial College London, Centre for Population Health Sciences, University of Edinburgh, Medical University Graz, University of Coimbra [Portugal] (UC), Vilnius University Clinic of Children's Diseases, Suomen Terveystalo Allergy Clinic, Università degli studi di Bari Aldo Moro (UNIBA), Department for Pediatric Pneumology and Immunology, Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, (MRC), Guy's Hospital [London], Nova Southeastern University (NSU), Department of Pulmonology, Manisa Celal Bayar University, Department of Dermatology, Medical School-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Association Asthme et Allergie, Internal Medicine, Bousquet, J., Pfaar, O., Togias, A., Schunemann, H. J., Ansotegui, I., Papadopoulos, N. G., Tsiligianni, I., Agache, I., Anto, J. M., Bachert, C., Bedbrook, A., Bergmann, K. -C., Bosnic-Anticevich, S., Bosse, I., Brozek, J., Calderon, M. A., Canonica, G. W., Caraballo, L., Cardona, V., Casale, T., Cecchi, L., Chu, D., Costa, E., Cruz, A. A., Czarlewski, W., Durham, S. R., Du Toit, G., Dykewicz, M., Ebisawa, M., Fauquert, J. L., Fernandez-Rivas, M., Fokkens, W. J., Fonseca, J., Fontaine, J. -F., Gerth van Wijk, R., Haahtela, T., Halken, S., Hellings, P. W., Ierodiakonou, D., Iinuma, T., Ivancevich, J. C., Jacobsen, L., Jutel, M., Kaidashev, I., Khaitov, M., Kalayci, O., Kleine Tebbe, J., Klimek, L., Kowalski, M. L., Kuna, P., Kvedariene, V., La Grutta, S., Larenas-Linemann, D., Lau, S., Laune, D., Le, L., Lodrup Carlsen, K., Lourenco, O., Malling, H. -J., Marien, G., Menditto, E., Mercier, G., Mullol, J., Muraro, A., O'Hehir, R., Okamoto, Y., Pajno, G. B., Park, H. -S., Panzner, P., Passalacqua, G., Pham-Thi, N., Roberts, G., Pawankar, R., Rolland, C., Rosario, N., Ryan, D., Samolinski, B., Sanchez-Borges, M., Scadding, G., Shamji, M. H., Sheikh, A., Sturm, G. J., Todo Bom, A., Toppila-Salmi, S., Valentin-Rostan, M., Valiulis, A., Valovirta, E., Ventura, M. -T., Wahn, U., Walker, S., CORBO UGULINO, Wallace, Waserman, S., Yorgancioglu, A., Zuberbier, T., Hospital Quirónsalud Bizkaia [Bilbao], Sagamihara National Hospital [Kanagawa, Japan], Universidade do Porto = University of Porto, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Capital Region of Denmark, Wrocław Medical University, Università degli Studi di Padova = University of Padua (Unipd), Charles University [Prague] (CU)-Medical Faculty in Pilsen, Università degli studi di Genova = University of Genoa (UniGe), Centro Médico Docente La Trinidad, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), and Hibade, Monique

Subjects
Cost effectiveness, [SDV]Life Sciences [q-bio], Cost-Benefit Analysis, Comorbidity, medicine.disease_cause, 0302 clinical medicine, Allergen, Cost of Illness, Immunology and Allergy, Medicine, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Precision Medicine, mHealth, Children, media_common, Allergen immunotherapy, Rhinitis, Disease Management, 3. Good health, [SDV] Life Sciences [q-bio], rhiniti, Treatment Outcome, Practice Guidelines as Topic, Critical Pathways, [SDV.IMM]Life Sciences [q-bio]/Immunology, Disease Susceptibility, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Attitude of Health Personnel, Immunology, Clinical Decision-Making, 03 medical and health sciences, Pharmacotherapy, rhinitis, stratification, children, media_common.cataloged_instance, Animals, Humans, European union, Intensive care medicine, allergen immunotherapy, asthma, children, mHealth, rhinitis, stratification, Asthma, business.industry, Allergens, asthma, medicine.disease, Rhinitis, Allergic, Review article, 030228 respiratory system, Desensitization, Immunologic, allergen immunotherapy, Stratification, business, Biomarkers
Abstract

Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including health professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as on the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow up of patients. This article is protected by copyright. All rights reserved.

Published
2019
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13. Allergen immunotherapy for IgE-mediated food allergy:protocol for a systematic review

Author

Lars K. Poulsen, Graham Roberts, Montserrat Fernandez-Rivas, Hugh A. Sampson, Frans Timmermans, Philippe Eigenmann, Nikolaos G. Papadopoulos, Edward F. Knol, Montserrat Alvaro-Lozano, Mika J. Mäkelä, Motohiro Ebisawa, George Du Toit, Kari C. Nadeau, Wesley Burks, Ulugbek Nurmatov, Cansin Sackesen, Cezmi A. Akdis, Giovanni Battista Pajno, Kirsten Beyer, Ronald van Ree, Alexandra F. Santos, Aziz Sheikh, Antonella Muraro, Carsten Bindslev-Jensen, Sangeeta Dhami, Liam O'Mahony, AII - Inflammatory diseases, Experimental Immunology, APH - Amsterdam Public Health, AII - Amsterdam institute for Infection and Immunity, Saçkesen, Cansın (ORCID 0000-0002-1115-9805 & YÖK ID 182537), Dhami, S., Nurmatov, U., Pajno, G. B., Fernandez-Rivas, M., Muraro, A., Roberts, G., Akdiş, C., Alvaro-Lozano, M., Beyer, K., Bindslev-Jensen, C., Burks, W., du Toit, G., Ebisawa, M., Eigenmann, P., Knol, E., Makela, M., Nadeau, K. C., O'Mahony, L., Papadopoulos, N., Poulsen, L., Sampson, H., Santos, A., van Ree, R., Timmermans, F., Sheikh, A., School of Medicine, Department of Pediatrics, Clinicum, and Department of Dermatology, Allergology and Venereology

Subjects
Pulmonary and Respiratory Medicine, Allergen immunotherapy, medicine.medical_specialty, Allergy, EUROPE, Clinical immunology, Immunology, Peanut allergy, Alternative medicine, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Ige mediated, QUALITY-OF-LIFE, Food allergy, Journal Article, Immunology and Allergy, Medicine, Intensive care medicine, METAANALYSIS, Sensitisation, Therapy, Protocol (science), ddc:618, business.industry, Quality-Of-Life, Peanut Allergy, Metaanalysis, Europe, Bias, PEANUT ALLERGY, medicine.disease, R1, 3. Good health, BIAS, 030228 respiratory system, 3121 General medicine, internal medicine and other clinical medicine, Erratum, business, Pediatrics, 030215 immunology
Abstract

Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for IgE-mediated food allergy. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in IgE-mediated food allergy. Methods: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. Discussion: The findings from this review will be used to inform the development of recommendations for EAACI's Guidelines on AIT., EAACI

Published
2016
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15. Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology.

Author

Chiappini E, Petrolini C, Caffarelli C, Calvani M, Cardinale F, Duse M, Licari A, Manti S, Martelli A, Minasi D, Miraglia Del Giudice M, Pajno GB, Pietrasanta C, Pugni L, Tosca MA, Mosca F, and Marseglia GL

Subjects
Age Factors, Humans, Infant, Infant, Newborn, Infant, Premature, Italy, Practice Guidelines as Topic, Immunization Schedule, Vaccines, Combined administration & dosage, Vaccines, Combined adverse effects
Abstract

Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48-72 h after vaccination, especially for infants at risk of recurrence of apnoea.

Published
2019
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16. Immune response to sublingual immunotherapy in children allergic to mites.

Author

Barberi S, Villa MP, Pajno GB, La Penna F, Barreto M, Cardelli P, Amodeo R, Tabacco F, Caminiti L, and Ciprandi G

Subjects
Administration, Sublingual, Adolescent, Animals, Child, Cytokines blood, Female, Humans, Hypersensitivity immunology, Immunoglobulin E blood, Male, Desensitization, Immunologic, Hypersensitivity therapy, Mites immunology
Abstract

Allergic rhinitis (AR) is characterized by Th2 polarized immune response. Specific immunotherapy modifies this arrangement restoring a physiologic Th1 profile. Sublingual immunotherapy (SLIT) is widely prescribed, but there is no early marker of response. The aim of this study is to investigate possible marker of SLIT effectiveness. Thirty children with mite allergy were studied: 15 were treated with drugs alone, 15 with SLIT and drugs on demand. The study lasted 2 years. Visual analogue scale (VAS) for symptoms and medication score were evaluated. Serum cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, IFN-gamma, MCP-1, and TNF-alpha) were assessed by ELISA before and after 1 and 2 year SLIT. SLIT-treated children obtained a significant improvement of symptoms and a reduction of drug use, whereas children treated with a drug alone did not obtained any change. IL-10 significantly increased, whereas Th2-dependent and pro-inflammatory cytokines significantly decreased. In conclusion, the present study demonstrates that 2-year SLIT is capable of inducing immunologic hyporeactivity to mites.

Published
2011

17. Tahini, a little known sesame-containing food, as an unexpected cause of severe allergic reaction.

Author

Caminiti L, Vita D, Passalacqua G, Arrigo T, Barberi S, Lombardo F, and Pajno GB

Subjects
Adult, Female, Humans, Skin Tests, Food Hypersensitivity etiology, Sesamum adverse effects
Abstract

We describe the case of a young woman with asthma and confirmed food allergy to sesame who had 2 severe systemic reactions after the inadvertent ingestion of tahini, a paste made with ground sesame seeds that is not generally known by physicians and patients as a sesame-containing food. A double-blind placebo-controlled food challenge confirmed the allergy to tahini in our patient. As new products and recipes are being introduced from around the world on a regular basis, it is essential that at-risk patients are able to obtain information about allergens used as ingredients and as potential contaminants. This should be applied not only to packaged food but also to freshly made foods, such as those served in restaurants.

Published
2006

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