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Adolescents (Ad) constitute a difficult to manage population among individuals suffering from asthma. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic Ad living in the Campania region (Southern Italy). Sixteen Allergy units or Centers belonging to the Italian Association of Hospital and Territorial Allergologists (AAIITO, Campania region) participated in this cross-sectional study. A case report form (CRF) was specifically designed for this study and commercial allergen extracts used for screening SPTs were provided by ALK-Abelló Group (Milan, Italy). A total of 443 patients were examined (females, f 220, 49.6 %; males, m 223, 50.3%). Dust mites represent the most common sensitizing agents in allergic Ad living in Campania region (Dermatoph. pteronyssinus 67.4% and Dermatoph. farinae 66.5%), followed by Parietaria (58.9%), grasses (45.8%), Artemisia vulgaris (16.7%), Olea Europaea (32.2%), dog dander (17.1%), cat dander (20.0%), Alternaria alternata (8.1%), Cupressus sempervirens (4.9%), Betula pendula (4.7%), other allergens (19.4%). An interesting comparison has been made between clinical data of our Ad with data of elderly patients (E). The role of allergic sensitization is significantly higher in Ad compared to E. Dermatophagoides pteronyssinus is the first sensitizing allergen in Ad and the last in E. Parietaria constitutes the first sensitizing pollen both in Ad and E, the percentage of sensitization is higher in Ad. Another important difference is the higher prevalence of As, as only symptom, in E compared to Ad (19.7% versus 7.6%). In conclusion, our findings confirm the high prevalence and clinical significance of airway allergic sensitization in the adolescents living in Campania region.

Anxiety 34 37 36 Headache 28 23 26 Abdominal pain 1 3 2 Weakness 13 4 9 Depression 5 0 3 Impaired sleep 4 8 7 Nicturia 7 0 5 Chest pain 11 7 9 Excitement 13 6 10 Nonlocalized pain 4 4 4 Hunger 3 4 3 Lack of appetite 5 5 5 Fever 1 3 2 Nausea 1 5 4 Urticaria 3 0 2 Palpitation 28 23 26 Heartburn 11 7 10 Generalized itching 22 30 25 Non respiratory symptoms in asthma as possible predictors of exacerbations Gennaro Liccardi, MD, Gennaro Baldi, MD, Adriano Berra, MD, Emanuela Carpentieri, MD, Marina Cutajar, MD, Maria D’Amato, MD, Mario Del Donno, MD, Bruno Del Prato, MD, Ilenia Folletti, MD, Federica Gani, MD, Domenico Gargano, MD, Domenico Giannattasio, MD, Michele Giovannini, MD, Antonio Infantino, MD, Carlo Lombardi, MD, Mario Lo Schiavo, MD, Francesco Madonna, MD, Mauro Maniscalco, MD, Antonio Meriggi, MD, Manlio Milanese, MD, Carmen Montera, MD, Antonio Pio, MD, Maria Russo, PhD, Antonello Salzillo, MD, Patrizia Scavalli, MD, Nicola Scichilone, MD, Bruno Sposato, MD, Anna Stanziola, MD, Antonio Starace, MD, Alessandro Vatrella, MD, Gennaro D’Amato, MD, and Giovanni Passalacqua, MD

Background: Gastroesophageal reflux disease (GORD) is characterized by typical reflux symptoms and multiple atypical extraesophageal symptoms. Gastric asthma is a prominent extraesophageal manifestation of GORD. There is persistent debate about the pathophysiologic mechanisms triggering asthma by GOR. Methods: We conducted a review of the literature. Results: The pathogenic mechanism could be either a vagally transmitted reflex or an intratracheal aspiration of refluxed material. In both hypotheses, the role of inflammatory mediators has been proposed. Conclusions: Neurogenic inflammation is a good theoretic basis for a pathogenic interpretation of the disorder. In atopic patients, food allergy has been recently proposed as a possible cause of GOR and associated respiratory symptoms, and it should be considered in the diagnostic work-up of all patients with GORD.

Allergic diseases and seronegative spondyloarthropathies are frequently observed in ulcerative colitis (UC). In this report we have investigated possible relationships between IgE-mediated allergic disease (AD), allergic contact dermatitis (ACD) and seronegative spondyloarthropathy (SpA) in UC patients at different grades and extensions of mucosa inflammation.Forty-five UC consecutive outpatients were graded according to clinical, endoscopic and histologic activity scores. SpA was diagnosed according to the European Spondyloarthropathy Study Group criteria. AD was detected by skin prick tests and confirmed by specific provocation tests, while ACD was diagnosed using the European standard series of patch tests. Thirty-seven patients' spouses or partners served as controls.Fourteen patients and 1 control subject showed SpA (P = 0.001). Diagnosis of rhinitis, conjunctivitis or asthma was made in 19 patients and in 5 controls (P = 0.004), while ACD was found in 10 and in 4 (P = 0.17), respectively. In UC, AD coexisted with SpA in 2 cases (P = 0.01), AD with ACD in 1 case (P = 0.03) and ACD with SpA in 5 (P = 0.24).Notwithstanding the high frequency of AD and SpA found in UC, the concurrence of AD with SpA or ACD is an unusual finding, while SpA and ACD may coexist. These data suggest that, in UC, atopy and seronegative arthritis, as well as atopy and delayed-type allergy, are strongly polarized conditions tending to mutual exclusion. In UC, the presence of AD without SpA or ACD, and of SpA or ACD without AD may indicate subgroups of patients in which T-helper-2 cell or T-helper-1 cell responses predominate.

Background: Clinical complaints in atopic subjects with asthma and rhinitis occur more frequently in the presence of high total and allergen-specific IgE serum levels. Here we report on the relationship between total and allergen-specific IgE serum levels and presence of symptoms in an unselected farmer population sensitized to Tetranychus urticae (TU). Methods: Farmers were recruited as previously described. Total IgE and allergen-specific IgE were measured by immunoassay in TU-positive skin prick test (SPT) farmers (n = 58) and two control groups including Dermatophagoides pteronyssinus (Dp)-positive SPT subjects (n = 40) and non-atopic, TU-negative SPT healthy farmers (n = 25). Results: Both TU+ and Dp+ subjects had significantly higher total IgE values (P

Seronegative spondyloarthropathy (SpA) and allergic diseases are frequently observed in Ulcerative Colitis (UC). The aim of this study was to evaluate possible relationships between SpA, allergic contact dermatitis (ACD) and IgE-mediated allergic disease (AD) in patients with UC. Fifty consecutive UC patients were graded with clinical, endoscopic and histologic activity scores and classified on the basis of Rachmilewitz and Truelove & Richard criteria. The rheumatologic evaluation included history and physical examination. Axial and peripheral joint involvement was confirmed by radiographic and scintiscan examination. SpA was diagnosed according to the ESSG criteria. The allergologic evaluation included personal history of allergy, prick and patch exposition to airborne, food and contact allergens. AD was confirmed by specific provocation tests, while ACD was determined by using the European Standard Series. Fifty healthy subjects served as controls. Fourteen patients (28%) and 1 control subject (2%) showed SpA (p