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1. Management of patients with severe asthma: results from a survey among allergists and clinical immunologists of the Central Italy Inter-Regional Section of SIAAIC

Author: Carli, G., Farsi, A., Bormioli, S., Ridolo, E., Fassio, F., Pucci, S., Montevecchi, M., Riparbelli, M., Cosmi, L., Parronchi, P., and Rossi, O.
Subjects: Allergists, Allergy, Adherence, Immunology, ICS/LABA, Immunology and Allergy, Corticosteroids, Immunologic diseases. Allergy, RC581-607, Letters to the Editor, Molecular Biology, Asthma, Biologic therapy
Abstract: Background Asthma, and severe asthma in particular, is often managed within a specialized field with allergists and clinical immunologists playing a leading role. In this respect, the National Scientific Society SIAAIC (Società Italiana di Allergologia, Asma ed Immunologia Clinica), structured in Regional and Inter-Regional sections, interviewed a large number of specialists involved in the management of this respiratory disease. Methods A survey entitled “Management of patients with asthma and severe asthma” based on 17 questions was conducted through the SIAAIC newsletter in 2019 thanks to the collaboration between GlaxoSmithKline S.p.A. and the Inter-Regional Section of SIAAIC of Central Italy. Results Fifty-nine allergists and clinical immunologists participated to the survey, and 40 of them completed the entire questionnaire. Almost all of the specialists (88%) reported that asthma control was achieved in above 50% of their patients, even if only one third (32%) actually used validated clinical tools such as asthma control test (ACT). Poor adherence to inhaled therapy was recognized as the main cause of asthma control failure by 60% of respondents, and 2–5 min on average is dedicated to the patient inhaler technique training by two-thirds of the experts (65%). Maintenance and as-needed therapy (SMART/MART) is considered an appropriate approach in only a minority of the patients (25%) by one half of the respondents (52%). A high number of exacerbations despite the maximum inhalation therapy were recognized as highly suspicious of severe asthma. Patients eligible for biological therapies are 3–5% of the patients, and almost all the responders (95%) agreed that patients affected by severe asthma need to be managed in specialized centers with dedicated settings. Biological drugs are generally prescribed after 3–6 months from the initial access to the center, and once started, the follow-up is initially programmed monthly, and then every 3–6 months after the first year of treatment (96% of responders). After phenotyping and severity assessment, comorbidities (urticaria, chronic rhinosinusitis with or without nasal polyps, vasculitis, etc.) are the drivers of choice among the different biological drugs. In the management of severe asthma, general practitioners (GPs) should play a central role in selecting patients and referring them to specialized centers while Scientific Societies should train GPs to appropriately recognize difficult asthma and promote public disease awareness campaigns. Conclusions This survey which collects the point of view of allergists and clinical immunologists from Central Italy highlights that asthma control is still not measured with validated instruments. There is a general consensus that severe asthma should be managed only in dedicated centers and to this aim it is essential to encourage patient selection from a primary care setting and develop disease awareness campaigns for patients.
Published: 2021

2. COVID-19 in Severe Asthma Network in Italy (SANI) patients: Clinical features, impact of comorbidities and treatments

Author: Heffler, Enrico, Detoraki, Aikaterini, Contoli, Marco, Papi, Alberto, Paoletti, Giovanni, Malipiero, Giacomo, Brussino, Luisa, Crimi, Claudia, Morrone, Daniela, Padovani, Marianna, Guida, Giuseppe, Gerli, Alberto Giovanni, Centanni, Stefano, Senna, Gianenrico, Paggiaro, Pierluigi, Blasi, Francesco, Canonica, Giorgio Walter, SANI Working Group, Bonavia, M, Bucca, C, Caiaffa, Mf, Calabrese, C, Camiciottoli, G, Caruso, C, Conte, Me, Corsico, Ag, Cosmi, L, Costantino, Mt, Crimi, N, D’Alò, S, D’Amato, M, Del Giacco, S, Farsi, A, Favero, E, Foschino, Bmp, Guarnieri, G, Lo Cicero, S, Lombardi, C, Macchia, L, Mazza, F, Menzella, F, Milanese, M, Montuschi, P, Montagni, M, Nucera, E, Parente, R, Passalacqua, G, Patella, V, Pelaia, G, Pini, L, Puggioni, F, Ricciardi, L, Ricciardolo, Flm, Richeldi, L, Ridolo, E, Rolla, G, Santus, P, Scichilone, N, Solidoro, P, Spadaro, G, Vianello, A, Viviano, V, Yacoub, Mr, Zappa, Mc, Heffler E., Detoraki A., Contoli M., Papi A., Paoletti G., Malipiero G., Brussino L., Crimi C., Morrone D., Padovani M., Guida G., Gerli A.G., Centanni S., Senna G., Paggiaro P., Blasi F., Canonica G.W., Bonavia M., Bucca C., Caiaffa M.F., Calabrese C., Camiciottoli G., Caruso C., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Farsi A., Favero E., Foschino B.M.P., Guarnieri G., Cicero S.L., Lombardi C., Macchia L., Mazza F., Menzella F., Milanese M., Montuschi P., Montagni M., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Puggioni F., Ricciardi L., Ricciardolo F.L.M., Richeldi L., Ridolo E., Rolla G., Santus P., Scichilone N., Solidoro P., Spadaro G., Vianello A., Viviano V., Yacoub M.R., and Zappa M.C.
Subjects: severe asthma, medicine.medical_specialty, 2019-20 coronavirus outbreak, COVID-19, Severe Asthma Network in Italy, inflammation, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Severe asthma, Population, Immunology, MEDLINE, Omalizumab, Settore MED/10 - Malattie Dell'Apparato Respiratorio, NO, Internal medicine, Diabetes mellitus, Severity of illness, medicine, Immunology and Allergy, Risk factor, Letters to the Editor, education, Letter to the Editor, Asthma, education.field_of_study, business.industry, Incidence (epidemiology), Mortality rate, COVID-19, medicine.disease, Comorbidity, Severe Asthma Network in Italy, inflammation, Cohort, business, Mepolizumab, medicine.drug
Abstract: To the Editor Since the end of February 2020 Italy, first non- Asian Country, has reported an ever increasing number of COronaVIrus Disease 19 (COVID-19) patients, which has reached over 200,000 confirmed Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infected subjects and resulted in more than 34000 deaths (data updated to June 19th, 20201).Patients with asthma are potentially more severely affected by by SARS-CoV-2 infection 2 and it is well established that respiratory viral infections are associated with severe adverse outcomes in patients with asthma, including increased risk of asthma exacerbation episodes 3. Nonetheless, according to the epidemiological studies published so far, chronic pulmonary diseases are not amongst the most common clinical conditions in COVID-19 patients4About 5-10% of entire asthma population, are severe asthmatics5 and one would expect increased vulnerability to SARS-CoV-2 infection, but no data is so fare available ti confirm this hypothesis.We investigated the incidence of COVID-19, describing its clinical course, in the population of the Severe Asthma Network in Italy (SANI), one of the largest registry for severe asthma worldwide6, and in an additional Center (Azienda Ospedaliero Univeristaria di Ferrara, Ferrara, Italy). All centers, have been contacted and inquired to report confirmed (i.e. patients with positive test result for the virus SARS-CoV-2 from analysis of nasopharyngeal or oropharyngeal swab specimens) or highly suspect cases of COVID-19 (i.e. patients with symptoms, laboratory findings and lung imaging typical of COVID-19 but without access to nasopharyngeal or oropharyngeal swab specimens because of clinical contingencies/emergency) among their cohorts of severe asthma. Demographic and clinical data of the entire cohort of severe asthmatics enrolled in the study and all reported cases of confirmed or suspect cases of COVID-19, have been obtained from the registry platform and collected from the additional Center. Additional data about COVID-19 symptoms, treatment and clinical course have been collected for all cases reported.Ethical issues and statistical analysis are reported in the online supplementary material.Twenty-six (1.73%) out of 1504 severe asthmatics had confirmed (11 out of 26) or highly suspect COVID-19 (15 out 26); eighteen (69.2%) were females and mean age was 56.2 ± 10 years. The geographical distribution of COVID-19 cases is presented in Figure 1.Nine (34.6%) infected patients experienced worsening of asthma during the COVID-19 symptomatic period; four of them needed a short course of oral corticosteroids for controlling asthma exacerbation symptoms.The most frequent COVID-19 symptoms reported were fever (100% of patients), malaise (84.6%), cough (80.8%), dyspnea (80.8%), headache (42.3%) and loss of smell (42.3%). Four patients (15.3%) have been hospitalized, one of which in intensive care unit; among hospitalized patients, two (7.7%) died for COVID-19 interstitial pneumonia. No deaths have been reported among the non-hospitalized patients.Severe asthmatics affected by COVID-19, had a significantly higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) compared to non-infected severe asthma patients (15.4% vs 3.8%, p=0.002; odds ratio: 4.7). No difference was found in other comorbidities (including rhinitis, chronic rhinosinusitis with or without nasal polyps, bronchiectasis, obesity, gastroesophageal reflux, arterial hypertension, cardiovascular diseases).Twenty-one patients with COVID-19 were on biological treatments: 15 (71%) were on anti-IL-5 or anti-IL5R agents (Mepolizumab n= 13; Benralizumab n=2 - counting for the 2.9% of all severe asthmatics treated with anti-IL5 in our study population) and 6 (29%) were on anti IgE (Omalizumab - 1.3% of all severe asthmatics treated with omalizumab in our study population).Table I summarizes demographic and clinical characteristics of the 26 COVID-19 patients.In conclusion, in our large cohort of severe asthmatics, COVID-19 was infrequent, not supporting the concept of asthma as a particularly susceptible condition to SARS-COV2 infection 2. This is in line with the first published large epidemiological data on COVID-19 patients, in which asthma is under-reported as comorbidity4. The COVID-19 related mortality rate in our cohort of patients was 7.7%, lower than the COVID-19 mortality rate in the general population (14.5% in Italy 1). These findings suggest that severe asthmatics are not at high risk of the SARS-CoV-2 infection and of severe forms of COVID-19. There are potentially different reasons for this. Self-containment is the first, because of the awareness of virus infections acting as a trigger for exacerbations, and therefore they could have acted with greater caution, scrupulously respecting social distancing, lockdown and hygiene rules of prevention, and being more careful in regularly taking asthma medications.Another possible explanation stands in the intrinsic features of type-2 inflammation, that characterizes a great proportion of severe asthmatics. Respiratory allergies and controlled allergen exposures are associated with significant reduction in angiotensin-converting enzyme 2 (ACE2) expression 7, the cellular receptor for SARS-CoV-2. Interestingly, ACE2 and Transmembrane Serine Protease 2 (TMPRSS2) (another protein mediating SARS-CoV-2 cell entry) have been found highly expressed in asthmatics with concomitant NIDDM8, the only comorbidity that was more frequent reported in our COVID-19 severe asthmatics.The third possible explanation refers to the possibility that inhaled corticosteroids (ICS) might prevent or mitigate the development of Coronaviruses infections. By definition, patients with severe asthma are treated with high doses of ICS 5 and this may have had a protective effect for SARS-CoV-2 infection.Noteworthy, among the patients of our case-series of severe asthmatics with COVID-19, the proportion of those treated anti-IL5 biologics was higher (71%) compared to the number of patients treated with anti-IgE (29%). Although the number of cases is too small to draw any conclusion, it is tempting to speculate that different biological treatments can have specific and different impact on antiviral immune response. In addition we may speculate of the consequence of blood eosinophils reduction: eosinopenia has been reported in 52-90% of COVID-19 patients worldwide and it has been suggested as a risk factor for more severe COVID-19 9.In conclusion, in our large cohort of severe asthmatics only a small minority experienced symptoms consistent with COVID-19, and these patients had peculiar clinical features including high prevalence of NIDDM as comorbidity. Further real-life registry-based studies are needed to confirm our findings and to extend the evidence that severe asthmatics are at low risk of developing COVID-19.
Published: 2021

3. Reply to: Kow CS et al. Are severe asthma patients at higher risk of developing severe outcomes from COVID-19?

Author: Heffler, Enrico, Detoraki, Aikaterini, Contoli, Marco, Papi, Alberto, Paoletti, Giovanni, Malipiero, Giacomo, Brussino, Luisa, Crimi, Claudia, Morrone, Daniela, Padovani, Marianna, Guida, Giuseppe, Gerli, Alberto Giovanni, Centanni, Stefano, Senna, Gianenrico, Paggiaro, Pierluigi, Blasi, Francesco, Canonica, Giorgio Walter, SANI Working Group, Bonavia, M., Bucca, C., Caiaffa, M. F., Calabrese, C., Camiciottoli, G., Caruso, C., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D’Alò, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, B. M. P., Guarnieri, G., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Montagni, M., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler E., Detoraki A., Contoli M., Papi A., Paoletti G., Malipiero G., Brussino L., Crimi C., Morrone D., Padovani M., Guida G., Gerli A.G., Centanni S., Senna G., Paggiaro P., Blasi F., Canonica G.W., Bonavia M., Bucca C., Caiaffa M.F., Calabrese C., Camiciottoli G., Caruso C., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Farsi A., Favero E., Foschino B.M.P., Guarnieri G., Lo Cicero S., Lombardi C., Macchia L., Mazza F., Menzella F., Milanese M., Montuschi P., Montagni M., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Puggioni F., Ricciardi L., Ricciardolo F.L.M., Richeldi L., Ridolo E., Rollav G., Santus P., Scichilone N., Solidoro P., Spadaro G., Vianello A., Viviano V., Yacoub M.R., and Zappa M.C.
Subjects: severe asthma, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Severe asthma, Immunology, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, COVID-19, severe asthma, COPD, NO, Humans, SARS-CoV-2, Asthma, COVID-19, Internal medicine, Correspondence, medicine, COPD, Immunology and Allergy, COVID, business.industry, asthma, medicine.disease, Italy, business
Published: 2020

4. THE RELEVANCE OF NASAL CYTOLOGY IN THE WORKUP OF HOUSE DUST MITE-INDUCED ALLERGIC RHINITIS

Author: Gelardi, M, Puccinelli, P, Incorvaia, C, Passalacqua, G, Ciprandi, G, Barberi, S, Barbone, B, Ferraro, A, Foresi, A, Galli, E, Gani, F, La Mantia, I, Peroni, D, Ridolo, E, Senna, Ge, Ricciardi, L, Riccio, Am, Romano, A, Rossi, O, Scala, G, Quranta, N, and Testi, S
Subjects: Pulmonary and Respiratory Medicine, House dust mite, medicine.medical_specialty, allergic rhinitis, biology, business.industry, Immunology, allergic rhinitis, nasal cytology, allergen immunotherapy, biology.organism_classification, Dermatology, nasal cytology, 03 medical and health sciences, 0302 clinical medicine, Nasal cytology, 030220 oncology & carcinogenesis, medicine, allergen immunotherapy, Immunology and Allergy, business, 030215 immunology
Published: 2018

5. Allergic rhinitis: the eligible candidate to mite immunotherapy in the real world

Author: Ciprandi, Giorgio, Natoli, Valentina, Puccinelli, Paola, Incorvaia, Cristoforo, Barberi, Salvatore, Foresi, A, Galli, E., Gani, F., Gelardi, M., Lamantia, I., Peroni, D., Ridolo, E., Senna, G. E., Ricciardi, Luisa, Romano, A., Rossi, O., Scala, G., and Testi, S.
Subjects: Pulmonary and Respiratory Medicine, Keywords: Allergen immunotherapy, House dust mite allergy, Allergic rhinitis, Asthma, Real life, Allergen immunotherapy, Allergy, Pediatrics, medicine.medical_specialty, medicine.medical_treatment, Real life, Allergic rhinitis, 03 medical and health sciences, Drug treatment, 0302 clinical medicine, medicine, Mite, Immunology and Allergy, Letter to the Editor, Asthma, House dust mite, biology, business.industry, General Medicine, Immunotherapy, biology.organism_classification, medicine.disease, Natural history, 030228 respiratory system, House dust mite allergy, Immunology, allergen immunotherapy, house dust mite allergy, allergic rhinitis, business, 030215 immunology
Abstract: As standard drug treatment of allergic rhinitis (AR) is not completely satisfactory, allergen immunotherapy (AIT) represents the only current treatment with the potential to modify the natural history. House dust mite (HDM) allergy is very common. The aim of the current experience was to describe the clinical profile of HDM-allergic patients with AR who received AIT in a real world model, such as allergy clinics. Globally, 239 patients (126 adults and 113 children; 107 females and 132 males; mean age 21 years, age range 6–56 years) were evaluated. AIT was prescribed in 59 patients (24.7%), 44 adults (35%) and 15 children (13.3%). The current findings deriving from this real world multicentre study are consistent with previous investigations on HDM-AIT and define some clinical characteristics of the eligible candidate to this treatment. In fact, severity of ocular-nasal symptoms and over-use of symptomatic medications may typify the ideal candidate to HDM-AIT and SLIT was the preferred choice.
Published: 2017

6. Cross-sectional comparison of the characteristics of respiratory allergy in immigrants and Italian children

Author: Lombardi, C., Fiocchi, A., Raffetti, E., Donato, F., Canonica, G., Passalacqua, G., Costantino, M., LA GRUTTA, Stefania, Landi, M., Marcucci, F., Marseglia, G., Pajno, G., Ridolo, E., Tosca, M., Valvassori, E., Lombardi, C., Fiocchi, A., Raffetti, E., Donato, F., Canonica, G., Passalacqua, G., Costantino, M., La Grutta, S., Landi, M., Marcucci, F., Marseglia, G., Pajno, G., Ridolo, E., Tosca, M., and Valvassori, E.
Subjects: Male, Pediatrics, medicine.medical_specialty, Allergy, Adolescent, media_common.quotation_subject, Immunology, Immigration, Allergic asthma, Emigrants and Immigrants, Disease, Epidemiology, Allergic rhiniti, medicine, Ethnicity, Respiratory Hypersensitivity, Immunology and Allergy, Humans, Genetic Predisposition to Disease, Child, Children, media_common, Asthma, business.industry, Respiratory disease, Respiratory allergy, Infant, medicine.disease, Cross-Sectional Studies, Italy, Clinical diagnosis, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business, Immigrant
Abstract: Background: Immigrants represent a good epidemiological model to evaluate the relative influence of environmental and inherited factors on the development of allergy. Several studies on allergy in adults have been published, but few data in children are available. We aimed to investigate the differences, between Italian and immigrant children, in clinical characteristics of respiratory allergy. Methods: This was a multicentre cross-sectional study involving children born in Italy from Italian parents and children born either in Italy or abroad from immigrants. Children referred firstly for allergic respiratory disease (rhinitis/asthma), with an ascertained clinical diagnosis and IgE sensitization to inhalants, were included. Demographic features, comorbidities, severity of disease, and sensitization profile were compared between Italians and immigrants, separating also those born in Italy from immigrant parents and those born abroad. Results: One hundred and sixty-five immigrant allergic children were enrolled (100 male, mean age 8.3 yr), 128 of whose had both parents immigrated. Italian children were 237 (156 male, mean age 8.4 yr). The Italian and immigrant children were similar, apart from pet's ownership and family size. There was no difference in the severity of rhinitis/asthma between the groups, whereas significant differences were found in the pattern of sensitization: immigrant children were more frequently sensitized to house dust mites (73.3% vs. 51%, respectively; p = 0.002) and less to grass (41.8% vs. 57.8%; p = 0.002); this was retained also in monosensitized children. Immigrant children born in Italy (n = 105) had a lower prevalence of rhinitis vs. Italians (68.3% vs. 87.6%, respectively, p = 0.003) and of sensitization to grass (28.3% vs. 49.5%, respectively, p = 0.008). No difference was found among macro-regions of origin and demographic or clinical features. Conclusions: Immigrant children born either in Italy or abroad did not show significant differences in the clinical pattern of the respiratory allergic disease when compared to children born from Italian parents. © 2014 John Wiley & Sons A/S.
Published: 2014

7. The possible influence of the environment on respiratory allergy: a survey on immigrants to Italy

Author: Lombardi, C, Canonica, Gw, Passalacqua, G, Igram, Italian Group on Respiratory Allergy in Migrants: Antonicelli, L, Ariano, R, Asero, R, Berra, D, Bignardi, D, Corsico, A, Costantino, Mt, Crivellaro, M, Gani, F, Folletti, I, Incorvaia, C, Liccardi, G, Marcer, G, Marogna, M, Milanese, M, Minale, P, Musarra, A, Nebiolo, F, Ridolo, E, Rolla, Giovanni, Senna, G, Schiappoli, M, Siracusa, A, Voltolini, S, Yacoub, Mr, and Zanon, P.
Subjects: Male, Pediatrics, Allergy, Time Factors, Immigration, hygiene hypothesis, Atopy, respiratory allergy, Immunology and Allergy, Medicine, Family history, Betula, Rhinitis, media_common, education.field_of_study, Respiratory allergy, Cupressus, Middle Aged, Italy, Female, Ambrosia, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, media_common.quotation_subject, Immunology, Population, Emigrants and Immigrants, Environment, Poaceae, Young Adult, Hygiene hypothesis, Respiratory Hypersensitivity, Animals, Humans, education, Aged, Skin Tests, Asthma, business.industry, Blattellidae, Allergens, medicine.disease, Cross-Sectional Studies, Parietaria, business, Demography
Abstract: Background Respiratory allergy is influenced and determined by genetic and environmental factors. Migration is a good model to indirectly evaluate the possible influence of environment. Objective To assess the clinical characteristics of respiratory allergy in immigrants to Italy, in comparison with the Italian population. Methods The clinical/demographic data of those immigrants stably living in Italy and referred for the first time to allergy services for respiratory allergy were collected in a multicenter survey. All the patients underwent a standard diagnostic workup. A matched Italian population was also examined. Results Six hundred ninety-eight immigrants and 859 Italians had at least one positive skin test and were analyzed. Most of the patients were referred to the allergy units by their general practitioners. In those patients, the demographic characteristics were not different, except for family size. Immigrants had less family history of atopy. Only 16% had a clinical history of allergy before migration. The time elapsed between migration and onset of symptoms was 5.3 ± 3.1 years, with a minimum of 0.5 and a maximum of 7 years. A higher rate of monosensitization was seen among immigrants, and the severity of their asthma/rhinitis was greater than in Italians. No difference was seen in the pattern of sensitizations. Conclusion In this population of immigrants, environmental factors play a relevant role in the onset of respiratory allergies.
Published: 2011
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8. SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

Author: Laura Romanini, Francesco Gaeta, Matteo Passamonti, Stefano Pucci, Giovanni Cerri, Antonino Romano, Cristoforo Incorvaia, Marina Mauro, Fulvio Stacul, Mona-Rita Yacoub, Eustacchio Nettis, Rocco Luigi Valluzzi, Eleonora Savi, Michele Galluzzo, Sergio Testi, Paolo Ricci, Oliviero Rossi, Elisabetta Di Leo, Emanuele Grassedonio, Patrizia Bonadonna, Paolo Montuschi, Erminia Ridolo, Maria Teresa Costantino, Alfonso Reginelli, Costantino, M. T., Romanini, L., Gaeta, F., Stacul, F., Valluzzi, R. L., Passamonti, M., Bonadonna, P., Cerri, G., Pucci, S., Ricci, P., Savi, E., Galluzzo, M., Mauro, M., Grassedonio, E., Yacoub, M. R., Reginelli, A., Testi, S., Ridolo, E., Nettis, E., Di Leo, E., Rossi, O., Montuschi, P., Incorvaia, C., Romano, A., Costantino M.T., Romanini L., Gaeta F., Stacul F., Valluzzi R.L., Passamonti M., Bonadonna P., Cerri G., Pucci S., Ricci P., Savi E., Galluzzo M., Mauro M., Grassedonio E., Yacoub M.R., Reginelli A., Testi S., Ridolo E., Nettis E., Di Leo E., Rossi O., Montuschi P., Incorvaia C., and Romano A.
Subjects: lcsh:Immunologic diseases. Allergy, radiologic contrast media, hypersensitivity reactions, low-osmolar contrast agents, diagnosis, management, medicine.medical_specialty, Allergy, Hypersensitivity reactions, Referral, Immunology, Review, Culprit, Radiologic contrast media, 03 medical and health sciences, 0302 clinical medicine, Diagnosis, Hypersensitivity reaction, medicine, Immunology and Allergy, Medical history, In patient, Low-osmolar contrast agents, Intensive care medicine, Molecular Biology, business.industry, Low-osmolar contrast agent, medicine.disease, Management, 030228 respiratory system, Radiological weapon, Premedication, business, lcsh:RC581-607, Anaphylaxis, Diagnosi, 030215 immunology
Abstract: Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.
Published: 2020
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9. Severe asthma: One disease and multiple definitions

Author: Maria Teresa Costantino, Luigi Macchia, Angelo Corsico, Andrea Airoldi, Carla Galeone, Zappa Maria Cristina, Paolo Tarsia, Foschino Barbaro Maria Pia, Silvia Ruggeri, Pierluigi Paggiaro, Lorenzo Cosmi, A. Farsi, Vitina Maria Anna Carriero, Arianna Bassi, Francesca Bertolini, Giovanni Passalacqua, Fulvia Chieco Bianchi, Carlo Lombardi, Salvatore Lo Cicero, Giovanni Rolla, Carmen Durante, Rocco Rinaldo, Elena Parazzini, Arianna Aruanno, Maria Rita Marchi, Chiara Folli, Alessandra Arcolaci, Carlo Pasculli, Fabio Luigi Massimo Ricciardolo, Vittorio Viviano, Alvise Berti, Stefano Del Giacco, Andrea Manfredi, Roberta Barlassina, Agata Valentina Frazzetto, Pierachille Santus, Luisa Brussino, Anna del Colle, Marco Bonavia, Dina Visca, Nicola Scichilone, Patrizia Pignatti, Enrico Heffler, Francesca Racca, Giuseppe Santini, Nucera Eleonora, Giovanna Elisiana Carpagnano, Linda Di Pietro, Stefano Centanni, Maria Elisabetta Conte, Vincenzo Patella, Monna Rita Yacoub, Diego Bagnasco, Nunzio Crimi, Anna Maria Riccio, Stefania Isola, Margherita Deidda, Gabriella Guarnieri, Giuseppe Guida, Elena Minenna, Manuela Latorre, Gianna Camiciottoli, Maria Vittoria Verrillo, Luca Richeldi, Marcello Montagni, Francesca Cicero, Maria Filomena Caiaffa, Antonio Spanevello, Cecilia Calabrese, Carlo Barbetta, Elisabetta Favero, Gianenrico Senna, Giuliana Amato, Amelia Grosso, Federica Vita, Francesco Blasi, Luisa Ricciardi, Carola Condoluci, Massimo Triggiani, Enrico Maggi, Mariacarmela Di Proietto, Giulia Carli, Roberta Parente, Eleonora Savi, Chiara Roncallo, Paolo Montuschi, Luciana D'Elia, Francesco Mazza, Simona D’Alo, Patrizia Ruggiero, Francesca Puggioni, Matteo Bonini, Simone Luraschi, Francesco Menzella, Leonello Fuso, Marco Caminati, Martina Flora, Mariachiara Braschi, Cristiano Caruso, Angela Rizzi, Sandra Iannacone, Rikki Frank Canevari, Andrea Vianello, D’Amato Maria, Manlio Milanese, Stefania Colantuono, Giorgio Walter Canonica, Giulia Scioscia, Laura Pini, Elisa Testino, Erminia Ridolo, Joyce Rolo, Elisa Turchet, Pelaia Gerolamo, Danilo Di Bona, Laura De Ferrari, Francesca Cherubino, Alice D’Adda, Marianna Lilli, Giuseppe Spadaro, Stefano Pucci, Caterina Detoraki, Chiara Allegrini, Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, C., Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco D., Paggiaro P., Latorre M., Folli C., Testino E., Bassi A., Milanese M., Heffler E., Manfredi A., Riccio A.M., De Ferrari L., Blasi F., Canevari R.F., Canonica G.W., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano G.E., Colle A.D., Scioscia G., Gerolamo P., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Lombardi C., Spadaro G., Detoraki C., Menzella F., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Rolla G., Brussino L., Frazzetto A.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Senna G., Caminati M., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., Lo Cicero S., Bagnasco, D, Paggiaro, P, Latorre, M, Folli, C, Testino, E, Bassi, A, Milanese, M, Heffler, E, Manfredi, A, Riccio, A, De Ferrari, L, Blasi, F, Frank Canevari, R, Canonica, G, Passalacqua, G, Guarnieri, G, Patella, V, Foschino Barbaro, M, Carpagnano, G, del Colle, A, Scioscia, G, Gerolamo, P, Puggioni, F, Racca, F, Favero, E, Iannacone, S, Savi, E, Montagni, M, Camiciottoli, G, Allegrini, C, Lombardi, C, Spadaro, G, Detoraki, C, Menzella, F, Galeone, C, Ruggiero, P, Yacoub, R, Verrillo, M, Rolla, G, and Lo Cicero, S
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Severe asthma, Immunology, Nice, Disease, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Article, Pulmonary function testing, Internal medicine, Biological treatment, Classification, Definition, medicine, Immunology and Allergy, Respiratory function, computer.programming_language, Biological therapies, business.industry, Settore MED/09 - MEDICINA INTERNA, RC581-607, Severe asthma, Classification, Definition, Biological treatment, Biological treatment, Classification, Definition, Severe asthma, Immunologic diseases. Allergy, business, computer
Abstract: Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.
Published: 2021

10. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author: Diego Bagnasco, Massimiliano Povero, Lorenzo Pradelli, Luisa Brussino, Giovanni Rolla, Marco Caminati, Francesco Menzella, Enrico Heffler, Giorgio Walter Canonica, Pierluigi Paggiaro, Gianenrico Senna, Manlio Milanese, Carlo Lombardi, Caterina Bucca, Andrea Manfredi, Rikki Frank Canevari, Giovanni Passalacqua, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Elisiana Carpagnano, Anna del Colle, Giulia Scioscia, Pelaia Gerolamo, Manuela Latorre, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Giuseppe Spadaro, Caterina Detoraki, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Gisella Colombo, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Francesco Blasi, Alice D'Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D'Amato Maria, Maria Vittoria Verrillo, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Eleonora Aletti, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Nucera Eleonora, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D'Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, Salvatore Lo Cicero, Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco, Diego, Povero, Massimiliano, Pradelli, Lorenzo, Brussino, Luisa, Rolla, Giovanni, Caminati, Marco, Menzella, Francesco, Heffler, Enrico, Canonica, Giorgio Walter, Paggiaro, Pierluigi, Senna, Gianenrico, Milanese, Manlio, Lombardi, Carlo, Bucca, Caterina, Manfredi, Andrea, Canevari, Rikki Frank, Passalacqua, Giovanni, Guarnieri, Gabriella, Patella, Vincenzo, Foschino Barbaro, Maria Pia, Carpagnano, Elisiana, D' Amato, Maria, Verrillo, Mariavittoria, Zappa, Maria Cristina, Lo Cicero, Salvatore, Di Proietto, Maria Carmela, Walter Canonica, Giorgio, Frank Canevari, Rikki, Spadaro, Giuseppe, Bagnasco D., Povero M., Pradelli L., Brussino L., Rolla G., Caminati M., Menzella F., Heffler E., Canonica G.W., Paggiaro P., Senna G., Milanese M., Lombardi C., Bucca C., Manfredi A., Canevari R.F., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano E., Colle A.D., Scioscia G., Gerolamo P., Latorre M., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Spadaro G., Detoraki C., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Colombo G., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., Blasi F., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Aletti E., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., and Lo Cicero S.
Subjects: OR, Odds Ratio, Pediatrics, Severe asthma, Exacerbation, Anti IL-5, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, gastroesophageal reflux disease, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, ICS, inhaled corticosteroid, Rate ratio, OCS, Oral Corticosteroids, law.invention, LAMA, long acting muscarinic antagonist, 0302 clinical medicine, Randomized controlled trial, fractional nitric oxide, Interquartile range, law, long acting beta 2 agonist, Odds Ratio, Immunology and Allergy, RR, Rate Ratio, 030223 otorhinolaryngology, Pharmacoeconomic, LOS, Length of stay, LOS, IQR, LAMA, MEP, Mepolizumab, OR, CI, SD, Standard Deviation, MEP, ACT, Asthma Control Test, Comorbiditie, CI, Confidence Intervals, medicine.drug, lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, interquartile range, long acting muscarinic antagonist, Immunology, LABA, LABA, long acting beta 2 agonist, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, Severe asthma, Anti IL-5, RR, Article, Rate Ratio, chronic obstructive pulmonary disease, 03 medical and health sciences, OCS, Oral Corticosteroid, Asthma Control Test, Confidence Intervals, FeNO, fractional nitric oxide, RCTs, Randomized Controlled Trial, medicine, COPD, GERD, gastroesophageal reflux disease, FeNO, IQR, interquartile range, SD, Asthma, RCTs, Oral Corticosteroids, business.industry, GERD, medicine.disease, ICS, inhaled corticosteroids, ACT, Comorbidity, Randomized Controlled Trials, CI, Confidence Interval, RCTs, Randomized Controlled Trials, COPD, chronic obstructive pulmonary disease, 030228 respiratory system, ICS, Standard Deviation, Length of stay, inhaled corticosteroids, lcsh:RC581-607, business
Abstract: Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.
Published: 2021

11. Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects

Author: Nicola Scichilone, Gabriella Guarnieri, Amelia Grosso, Ilaria Baiardini, Pietro Pirina, Antonio Molino, Federica Albicini, Vincenzo Patella, Fulvio Braido, Rita Raccanelli, Andrea Vianello, F. Di Marco, G. Steinhilber, Carolina Lombardi, Mariangiola Crivellaro, Erminia Ridolo, Alida Benfante, Erica Gini, Manlio Milanese, R. De Tullio, Mario Polverino, Maria Teresa Costantino, Angelo Corsico, Giovanni Rolla, Marcello Cottini, Silvia Terraneo, Marco Caminati, Milanese, M., Terraneo, S., Baiardini, I., Di Marco, F., Corsico, A., Molino, A., Scichilone, N., Albicini, F., Benfante, A., Braido, F., Caminati, M., Costantino, M. T., Cottini, M., Crivellaro, M., De Tullio, R., Gini, E., Grosso, A., Guarnieri, G., Lombardi, C., Patella, V., Pirina, P., Polverino, M., Raccanelli, R., Ridolo, E., Rolla, G., Steinhilber, G., Vianello, A., Milanese M., Terraneo S., Baiardini I., Di Marco F., Corsico A., Molino A., Scichilone N., Albicini F., Benfante A., Braido F., Caminati M., Costantino M.T., Cottini M., Crivellaro M., De Tullio R., Gini E., Grosso A., Guarnieri G., Lombardi C., Patella V., Pirina P., Polverino M., Raccanelli R., Ridolo E., Rolla G., Steinhilber G., and Vianello A.
Subjects: Vital capacity, ACT, asthma control test, Exacerbation, SAE, severe asthma exacerbation, SF12, chlorofluorocarbons, mental health composite score, EDUCA, elderly and device use in chronic asthma, PCS, physical health composite score, AHDS, hospital anxiety depression scale, Asthma, CFC, chlorofluorocarbons, Device misuse, Education, Elderly, FEV1, forced expiratory volume 1s second, FVC, forced vital capacity, ICS, inhaled corticosteroids, LABA, long-acting β2 agonist, LAMA, long-acting muscarinic antagonists, MCS, mental health composite score, PROs, patient-reported outcomes, SF12, short form health survey, mMRC, modified medical research council, EDUCA, FEV1, 0302 clinical medicine, Immunology and Allergy, Medicine, 030223 otorhinolaryngology, biology, severe asthma exacerbation, modified medical research council, LAMA, SAE, Lama, elderly and device use in chronic asthma, Metered-dose inhaler, Dry-powder inhaler, CFC, PCS, patient-reported outcomes, mMRC, lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, long-acting β2 agonist, medicine.medical_specialty, Immunology, LABA, physical health composite score, Article, AHDS, 03 medical and health sciences, FEV1/FVC ratio, long-acting muscarinic antagonists, forced vital capacity, Internal medicine, forced expiratory volume 1s second, business.industry, Inhaler, asthma control test, biology.organism_classification, medicine.disease, ACT, FVC, MCS, hospital anxiety depression scale, 030228 respiratory system, ICS, PROs, short form health survey, inhaled corticosteroids, lcsh:RC581-607, business
Abstract: Background: Adherence to inhaled drugs is linked to patients’ satisfaction with their device, and an incorrect use can negatively affect the outcomes of asthma treatment. We speculated that this is particularly true in elderly asthmatic subjects. Aim: We performed a national pre-post interventional multicentre study, enrolling moderate-to-severe asthmatic subjects aged ≥65 years treated with fixed inhaled combination drugs by dry powder inhaler (DPI) or pressurized metered dose inhaler (pMDI). Adherence and critical errors were evaluated by means of validated questionnaires at first visit (V1) and after 3–6 months (V2). At V1, subjects underwent intensive training on the correct use of their device by physical demonstration. Results: A total of 411 asthmatics (F/M: 238/173, mean age±SD: 72 ± 5 years) participated to the study. At V1, 50% of the study subjects showed an Asthma Control Test (ACT) score ≤19 despite GINA step 3 and 4 treatment, and 40% had experienced at least one severe asthma exacerbation in the previous year. Poor adherence to treatment was recorded in 43% of subjects, and at least one error in using the device was registered in 56% of subjects. At V2, available for 318 patients, both the percentage of individuals with poor adherence and with at least one critical error significantly decreased (from 46% to 25%, and from 49% to 25%, respectively; p
Published: 2019

12. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies

Author: Bousquet, Jean, Cristol, Jean-Paul, Czarlewski, Wienczyslawa, Anto, Josep M, Martineau, Adrian, Haahtela, Tari, Fonseca, Susana C, Iaccarino, Guido, Blain, Hubert, Fiocchi, Alessandro, Canonica, G Walter, Fonseca, Joao A, Vidal, Alain, Choi, Hak-Jong, Kim, Hyun Ju, Le Moing, Vincent, Reynes, Jacques, Sheikh, Aziz, Akdis, Cezmi A, Zuberbier, Torsten, Amir Hamzah Abdul Latiff, Baharudin, Abdullah, Werner, Aberer, Nancy, Abusada, Ian, Adcock, Alejandro, Afani, Ioana, Agache, Xenofon, Aggelidis, Jenifer, Agustin, Cezmi, A Akdis, Mübeccel, Akdis, Mona, Al-Ahmad, Abou Al-Zahab Bassam, Hussam, Alburdan, Oscar, Aldrey-Palacios, Emilio Alvarez Cuesta, Hiba Alwan Salman, Ashraf, Alzaabi, Salma, Amade, Gene, Ambrocio, Rosana, Angles, Isabella, Annesi-Maesano, Ignacio, J Ansotegui, Josep, M Anto, Paula Ara Bardajo, Stefania, Arasi, Margarete, Arrais, Hasan, Arshad, Maria-Cristina, Artesani, Estrella, Asayag, Francesca, Avolio, Khuzama, Azhari, Claus, Bachert, Diego, Bagnasco, Ilaria, Baiardini, Nissera, Bajrović, Petros, Bakakos, Sergio Bakeyala Mongono, Christine, Balotro-Torres, Sergio, Barba, Cristina, Barbara, Elsa, Barbosa, Bruno, Barreto, Joan, Bartra, Xavier, Basagana, Eric, D Bateman, Lkhagvaa, Battur, Anna, Bedbrook, Martín Bedolla Barajas, Bianca, Beghé, Antra, Bekere, Elizabeth, Bel, Ali Ben Kheder, Mikael, Benson, Elena-Camelia, Berghea, Karl-Christian, Bergmann, Roberto, Bernardini, David, Bernstein, Mike, Bewick, Slawomir, Bialek, Artur, Białoszewski, Thomas, Bieber, Nils, E Billo, Maria-Beatrice, Bilo, Carsten, Bindslev-Jensen, Leif, Bjermer, Hubert, Blain, Irina, Bobolea, Malgorzata Bochenska Marciniak, Christine, Bond, Attilio, Boner, Matteo, Bonini, Sergio, Bonini, Sinthia, Bosnic-Anticevich, Isabelle, Bosse, Sofia, Botskariova, Jacques, Bouchard, Louis-Philippe, Boulet, Rodolphe, Bourret, Philippe, Bousquet, Fulvio, Braido, Andrew, Briggs, Christopher, E Brightling, Jan, Brozek, Luisa, Brussino, Roland, Buhl, Roxana, Bumbacea, Rosalva, Buquicchio, María-Teresa Burguete Cabañas, Andrew, Bush, William, W Busse, Jeroen, Buters, Fernan, Caballero-Fonseca, Moïses, A Calderon, Mario, Calvo, Paulo, Camargos, Thierry, Camuzat, R Canevari, F, Antonio, Cano, G Walter Canonica, Arnaldo, Capriles-Hulett, Luis, Caraballo, Vicky, Cardona, Kai-Hakon, Carlsen, Jonas Carmona Pirez, Jorge, Caro, Warner, Carr, Pedro, Carreiro-Martins, Fredelita, Carreon-Asuncion, Ana-Maria, Carriazo, Carme Carrion, Y Ribas, Thomas, Casale, Mary-Ann, Castor, Elizabeth, Castro, G Caviglia, A, Lorenzo, Cecchi, Alfonso Cepeda Sarabia, Maciej, Chalubinski, Ramanathan, Chandrasekharan, Yoon-Seok, Chang, Victoria, Chato-Andeza, Lida, Chatzi, Christina, Chatzidaki, Niels, H Chavannes, Claudia Chaves Loureiro, Aurora-Alejandra Chavez Garcia, Marta, Chelninska, Yuzhi, Chen, Lei, Cheng, Sharon, Chinthrajah, Tomas, Chivato, Ekaterine, Chkhartishvili, George, Christoff, Henry, Chrystyn, Derek, K Chu, Antonio, Chua, Alexander, Chuchalin, Kian Fan Chung, Alberto, Cicerán, Cemal, Cingi, Giorgio, Ciprandi, Ieva, Cirule, Ana-Carla, Coelho, Enrico, Compalati, Jannis, Constantinidis, Jaime Correia de Sousa, Elisio Manuel Costa, David, Costa, María Del Carmen Costa Domínguez, André, Coste, Cottini, M, Linda, Cox, Carlos, Crisci, Maria Angiola Crivellaro, Alvaro, A Cruz, John, Cullen, Adnan, Custovic, Biljana, Cvetkovski, Wienczyslawa, Czarlewski, Gennaro, D'Amato, Jane da Silva, Ronald, Dahl, Sven-Erik, Dahlen, Vasilis, Daniilidis, Louei Darjazini Nahhas, Ulf, Darsow, Janet, Davies, Frédéric de Blay, Giulia De Feo, Eloisa De Guia, José-Ricardo De la Torre Navarrete, Chato De Los Santos, Esteban De Manuel Keenoy, Govert De Vries, Diana, Deleanu, Pascal, Demoly, Judah, Denburg, Philippe, Devillier, Alain, Didier, Sanja Dimic Janjic, Maria, Dimou, Anh Tuan Dinh-Xuan, Ratko, Djukanovic, Maria Do Ceu Texeira, Dejan, Dokic, Margarita Gabriela Domínguez Silva, Habib, Douagui, Nikolaos, Douladiris, Maria, Doulaptsi, Gérard, Dray, Ruta, Dubakiene, Eve, Dupas, Stephen, Durham, Marzia, Duse, Mark, Dykewicz, Didier, Ebo, Natalija, Edelbaher, Thomas, Eiwegger, Patrik, Eklund, Yehia, El-Gamal, Zeinab, A El-Sayed, Shereen, S El-Sayed, Magda, El-Seify, Regina, Emuzyte, Lourdes, Enecilla, Marina, Erhola, Heidilita, Espinoza, Jesús Guillermo Espinoza Contreras, John, Farrell, Lenora, Fernandez, Paola Fimbres Jimenez, Antje Fink Wagner, Alessandro, Fiocchi, Wytske, J Fokkens, Lenia, Folletti, Joao, A Fonseca, Jean-François, Fontaine, Francesco, Forastiere, Jose Miguel Fuentes Pèrez, Emily, Gaerlan-Resureccion, Mina, Gaga, José Luis Gálvez Romero, Amiran, Gamkrelidze, Alexis, Garcia, Cecilia Yvonne García Cobas, María de la Luz Hortensia García Cruz, Valeria Garcia Ortiz, Jacques, Gayraud, Matteo, Gelardi, Bilun, Gemicioglu, Dimitra, Gennimata, Sonya, Genova, José, Gereda, Roy Gerth van Wijk, Antonio, Giuliano, René-Maximiliano, Gomez, Miguel-Ange Gonzalez Ballester, Sandra González Diaz, Maia, Gotua, Christos, Grigoreas, Ineta, Grisle, Marta, Guidacci, Nick, Guldemond, Zdenek, Gutter, Antonieta, Guzmán, Tari, Haahtela, Ramsa, Halloum, David, Halpin, Eckard, Hamelmann, Suleiman, Hammadi, Richard, Harvey, Enrico, Heffler, Joachim, Heinrich, Adnan, Hejjaoui, Birthe, Hellquist-Dahl, Luiana Hernández Velázquez, Mark, Hew, Elham, Hossny, Peter, Howarth, Martin, Hrubiško, Yunuen Rocío Huerta Villalobos, Marc, Humbert, Salina, Husain, Michael, Hyland, Guido, Iaccarino, Moustafa, Ibrahim, Nataliya, Ilina, Maddalena, Illario, Cristoforo, Incorvaia, Antonio, Infantino, Carla, Irani, Zhanat, Ispayeva, Juan Carlos Ivancevich, Edgardo Ej Jares, Deborah, Jarvis, Ewa, Jassem, Klemen, Jenko, Rubén Darío Jiméneracruz Uscanga, Sebastian, L Johnston, Guy, Joos, Maja, Jošt, Kaja, Julge, Ki-Suck, Jung, Jocelyne, Just, Marek, Jutel, Igor, Kaidashev, Omer, Kalayci, Fuat, Kalyoncu, Jeni, Kapsali, Przemyslaw, Kardas, Jussi, Karjalainen, Carmela, A Kasala, Michael, Katotomichelakis, Loreta, Kavaliukaite, Kazi, S Bennoor, Thomas, Keil, Paul, Keith, Musa, Khaitov, Nikolai, Khaltaev, You-Young, Kim, Bruce, Kirenga, Jorg, Kleine-Tebbe, Ludger, Klimek, Fanny, W Ko, Bernard Koffi N'Goran, Evangelia, Kompoti, Peter, Kopač, Gerard, Koppelman, Anja Koren Jeverica, Seppo, Koskinen, Mitja, Košnik, Tomasz, Kostka, Kosta, V Kostov, Marek, L Kowalski, Tanya, Kralimarkova, Karmen Kramer Vrščaj, Helga, Kraxner, Samo, Kreft, Vicky, Kritikos, Dmitry, Kudlay, Mikael, Kuitunen, Inger, Kull, Piotr, Kuna, Maciej, Kupczyk, Violeta, Kvedariene, Marialena, Kyriakakou, Nika, Lalek, Massimo, Landi, Stephen, Lane, Désiree, E Larenas-Linnemann, Susanne, Lau, Daniel, Laune, Jorge, Lavrut, Lan, Le, Martina, Lenzenhuber, Gualtiero, Leo, Marcus, Lessa, Michael, Levin, Jing, Li, Philip, Lieberman, Giuseppe, Liotta, Brian, Lipworth, Xuandao, Liu, Rommel, Lobo, Karin, C Lodrup Carlsen, Carlo, Lombardi, Renaud, Louis, Stelios, Loukidis, Olga, Lourenço, Jorge, A Luna Pech, Bojan, Madjar, Enrico, Maggi, Antoine, Magnan, Bassam, Mahboub, Alpana, Mair, Anke-Hilse Maitland van der Zee, Mika, Makela, Michael, Makris, Hans-Jorgen, Malling, Mariana, Mandajieva, Patrick, Manning, Manolis, Manousakis, Pavlos, Maragoudakis, Gianluigi, Marseglia, Gailen, Marshall, Mohammad Reza Masjedi, Jorge, F Máspero, Juan José Matta Campos, Marcus, Maurer, Sandra, Mavale-Manuel, Cem, Meço, Erik, Melén, Giovanni, Melioli, Elisabete, Melo-Gomes, Eli, O Meltzer, Enrica, Menditto, Andrew, Menzies-Gow, Hans, Merk, Jean-Pierre, Michel, Yann, Micheli, Neven, Miculinic, Luís, Midão, Florin, Mihaltan, Nikolaos, Mikos, Manlio, Milanese, Branislava, Milenkovic, Dimitrios, Mitsias, Bassem, Moalla, Giuliana, Moda, María Dolores Mogica Martínez, Yousser, Mohammad, Frances-Montserrat, Moharra, Mostafa, Moin, Mathieu, Molimard, Isabelle, Momas, Monique, Mommers, Alessandro, Monaco, Stephen, Montefort, Lucia-Elvira, Montenegro, Riccardo, Monti, Dory, Mora, Mario, Morais-Almeida, Ralph, Mösges, Badr Eldin Mostafa, Joaquim, Mullol, Lars, Münter, Antonella, Muraro, Ruth, Murray, Antonio, Musarra, Tihomir, Mustakov, Robert, Naclerio, Kari, C Nadeau, Rachel, Nadif, Alla, Nakonechna, Leyla, Namazova-Baranova, Gretchen, Navarro-Locsin, Hugo, Neffen, Kristof, Nekam, Angelos, Neou, Eustachio, Nettis, Daniel, Neuberger, Laurent, Nicod, Stefania, Nicola, Verena, Niederberger-Leppin, Marek, Niedoszytko, Antonio, Nieto, Ettore, Novellino, Elizabete, Nunes, Dieudonné, Nyembue, Robyn, E O'Hehir, Cvetanka, Odjakova, Ken, Ohta, Yoshitaka, Okamoto, Kimi, Okubo, Brian, Oliver, Gabrielle, L Onorato, Maria Pia Orru, Solange, Ouédraogo, Kampadilemba, Ouoba, Francisco-Javier, Padilla, Pier Luigi Paggiaro, Aris, Pagkalos, Pajno, Giovanni Battista, Gianni, Pala, P Palaniappan, S, Isabella, Pali-Schöll, Susanna, Palkonen, Stephen, Palmer, Carmen Panaitescu Bunu, Petr, Panzner, Nikos, G Papadopoulos, Vasilis, Papanikolaou, Alberto, Papi, Bojidar, Paralchev, Giannis, Paraskevopoulos, Hae-Sim, Park, Giovanni, Passalacqua, Vincenzo, Patella, Ian, Pavord, Ruby, Pawankar, Soren, Pedersen, Susete, Peleve, Simona, Pellegino, Ana, Pereira, Mariana, Pereira, Tamara, Pérez, Andrea, Perna, Diego, Peroni, Oliver, Pfaar, Nhân, Pham-Thi, Bernard, Pigearias, Isabelle, Pin, Konstantina, Piskou, Constantinos, Pitsios, Davor, Plavec, Dagmar, Poethig, Wolfgang, Pohl, Antonija Poplas Susic, Todor, A Popov, Fabienne, Portejoie, Paul, Potter, Lars, Poulsen, Alexandra, Prados-Torres, Fotis, Prarros, David, Price, Emmanuel, Prokopakis, Francesca, Puggioni, Elisa, Puig-Domenech, Robert, Puy, Klaus, Rabe, Silvia, Rabotti, Filip, Raciborski, Josephine, Ramos, Cristina, Recalcati, Marysia, T Recto, Shereen, M Reda, Frederico, S Regateiro, Norbert, Reider, Sietze, Reitsma, Susana, Repka-Ramirez, Erminia, Ridolo, Janet, Rimmer, Daniela Rivero Yeverino, José Angelo Rizzo, Carlos, Robalo-Cordeiro, Graham, Roberts, Karen, Robles, Nicolas, Roche, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Giovanni, Rolla, Christine, Rolland, Regina, Roller-Wirnsberger, Miguel Roman Rodriguez, Antonino, Romano, Jan, Romantowski, Philippe, Rombaux, Joel, Romualdez, Jose, Rosado-Pinto, Nelson, Rosario, Lanny, Rosenwasser, Oliviero, Rossi, Menachem, Rottem, Philip, W Rouadi, Nikoleta, Rovina, Irma Rozman Sinur, Mauricio, Ruiz, Lucy Tania Ruiz Segura, Dermot, Ryan, Hironori, Sagara, Daiki, Sakai, Daiju, Sakurai, Wafaa, Saleh, Johanna, Salimaki, Konstantinos, Samitas, Boleslaw, Samolinski, María Guadalupe Sánchez Coronel, Mario, Sanchez-Borges, Jaime, Sanchez-Lopez, Melissa, Sansonna, Codrut, Sarafoleanu, Faradiba Sarquis Serpa, Joaquin, Sastre, Eleonora, Savi, Agne, Savonyte, Bisher, Sawaf, Glenis, K Scadding, Sophie, Scheire, Peter, Schmid-Grendelmeier, Juan Francisco Schuhl, Holger, Schunemann, Maria, Schvalbová, Jorgen, Schwarze, Nicola, Scichilone, Gianenrico, Senna, Cecilia, Sepúlveda, Elie, Serrano, Sara, Shamai, Aziz, Sheikh, Mike, Shields, Vasil, Shishkov, Nikos, Siafakas, Alexander, Simeonov, Estelle Fer Simons, Juan Carlos Sisul, Brigita, Sitkauskiene, Ingelbjorg, Skrindo, Tanja Soklič Košak, Dirceu, Solé, Martin, Sondermann, Talant, Sooronbaev, Manuel, Soto-Martinez, Manuel, Soto-Quiros, Barnaro Sousa Pinto, Milan, Sova, Michael, Soyka, Krzysztof, Specjalski, Annette, Sperl, Otto, Spranger, Sofia, Stamataki, Lina, Stefanaki, Cristiana, Stellato, Rafael, Stelmach, Timo, Strandberg, Petra, Stute, Abirami, Subramaniam, Charlotte Suppli Ulrik, Michael, Sutherland, Silvia, Sylvestre, Aikaterini, Syrigou, Luis Taborda Barata, Nadejda, Takovska, Rachel, Tan, Frances, Tan, Vincent, Tan, Ing Ping Tang, Masami, Taniguchi, Line, Tannert, Pongsakorn, Tantilipikorn, Jessica, Tattersall, Filippo, Tesi, Uta, Thieme, Carel, Thijs, Mike, Thomas, Teresa, To, Ana Maria Todo-Bom, Alkis, Togias, Peter-Valentin, Tomazic, Vesna, Tomic-Spiric, Sanna, Toppila-Salmi, Maria-José Torres Jaen, Elina, Toskala, Massimo, Triggiani, Nadja, Triller, Katja, Triller, Ioanna, Tsiligianni, Uberti, M, Ruxandra, Ulmeanu, Jure, Urbancic, Marilyn Urrutia Pereira, Martina, Vachova, Felipe, Valdés, Rudolf, Valenta, Marylin Valentin Rostan, Antonio, Valero, Arunas, Valiulis, Mina, Vallianatou, Erkka, Valovirta, Michiel Van Eerd, Eric Van Ganse, Marianne van Hage, Olivier, Vandenplas, Tuula, Vasankari, Dafina, Vassileva, Cesar Velasco Munoz, Maria Teresa Ventura, Cécilia, Vera-Munoz, Frédéric, Viart, Dilyana, Vicheva, Pakit, Vichyanond, Petra, Vidgren, Giovanni, Viegi, Claus, Vogelmeier, Leena Von Hertzen, Theodoros, Vontetsianos, Dimitris, Vourdas, Vu Tran Thien Quan, Martin, Wagenmann, Samantha, Walker, Dana, Wallace, Yun De Wang, Susan, Waserman, Katrin, Wehner, Magnus, Wickman, Sian, Williams, Dennis, Williams, Nicola, Wilson, Gary, Wong, Kent, Woo, Lucyna, Wozniak, John, Wright, Piotr, Wroczynski, Paraskevi, Xepapadaki, Plamen, Yakovliev, Masao, Yamaguchi, Kwok, Yan, Yoke Yeow Yap, Mais, Yassin, Barbara, Yawn, Panayiotis, Yiallouros, Arzu, Yorgancioglu, Shigemi, Yoshihara, Ian, Young, Osman, B Yusuf, Asghar, Zaidi, Fares, Zaitoun, Petra, Zalud, Heather, Zar, T Zedda, M, Mario, E Zernotti, Luo, Zhang, Nanshan, Zhong, Mihaela, Zidarn, Torsten, Zuberbier, Celia, Zubrinich, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Humboldt University Of Berlin, Berlin Institute of Health (BIH), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Central Hospital [Finland] (HUCH), Departamento de Geociencias, Ambiente e Ordenamento do Territorio (DGAOT), Universidade do Porto = University of Porto, University of Naples Federico II = Università degli studi di Napoli Federico II, Euromov (EuroMov), Université de Montpellier (UM), IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), Center of Research in Health Technologies and Information Systems (CINTESIS), AgroParisTech, World Institute of Kimchi [Gwangju], Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Edinburgh, Universität Zürich [Zürich] = University of Zurich (UZH), Humboldt-Universität zu Berlin, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-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 National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), University of Helsinki, Universidade do Porto, University of Naples Federico II, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), MORNET, Dominique, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Bousquet J., Cristol J.-P., Czarlewski W., Anto J.M., Martineau A., Haahtela T., Fonseca S.C., Iaccarino G., Blain H., Fiocchi A., Canonica G.W., Fonseca J.A., Vidal A., Choi H.-J., Kim H.J., Le Moing V., Reynes J., Sheikh A., Akdis C.A., Zuberbier T., Abdul Latiff A.H., Abdullah B., Aberer W., Abusada N., Adcock I., Afani A., Agache I., Aggelidis X., Agustin J., Akdis M., Al-Ahmad M., Al-Zahab Bassam A., Alburdan H., Aldrey-Palacios O., Alvarez Cuesta E., Alwan Salman H., Alzaabi A., Amade S., Ambrocio G., Angles R., Annesi-Maesano I., Ansotegui I.J., Ara Bardajo P., Arasi S., Arrais M., Arshad H., Artesani M.-C., Asayag E., Avolio F., Azhari K., Bachert C., Bagnasco D., Baiardini I., Bajrovic N., Bakakos P., Bakeyala Mongono S., Balotro-Torres C., Barba S., Barbara C., Barbosa E., Barreto B., Bartra J., Basagana X., Bateman E.D., Battur L., Bedbrook A., Bedolla Barajas M., Beghe B., Bekere A., Bel E., Ben Kheder A., Benson M., Berghea E.-C., Bergmann K.-C., Bernardini R., Bernstein D., Bewick M., Bialek S., Bialoszewski A., Bieber T., Billo N.E., Bilo M.-B., Bindslev-Jensen C., Bjermer L., Bobolea I., Bochenska Marciniak M., Bond C., Boner A., Bonini M., Bonini S., Bosnic-Anticevich S., Bosse I., Botskariova S., Bouchard J., Boulet L.-P., Bourret R., Bousquet P., Braido F., Briggs A., Brightling C.E., Brozek J., Brussino L., Buhl R., Bumbacea R., Buquicchio R., Burguete Cabanas M.-T., Bush A., Busse W.W., Buters J., Caballero-Fonseca F., Calderon M.A., Calvo M., Camargos P., Camuzat T., Canevari F., Cano A., Canonican G.W., Capriles-Hulett A., Caraballo L., Cardona V., Carlsen K.-H., Carmona Pirez J., Caro J., Carr W., Carreiro-Martins P., Carreon-Asuncion F., Carriazo A.-M., CarrionyRibas C., Casale T., Castor M.-A., Castro E., Caviglia A.G., Cecchi L., Cepeda Sarabia A., Chalubinski M., Chandrasekharan R., Chang Y.-S., Chato-Andeza V., Chatzi L., Chatzidaki C., Chavannes N.H., Chaves Loureiro C., Chavez Garcia A.-A., Chelninska M., Chen Y., Cheng L., Chinthrajah S., Chivato T., Chkhartishvili E., Christoff G., Chrystyn H., Chu D.K., Chua A., Chuchalin A., Chung K.F., Ciceran A., Cingi C., Ciprandi G., Cirule I., Coelho A.-C., Compalati E., Constantinidis J., Correia de Sousa J., Costa E.M., Costa D., del Carmen Costa Dominguez M., Coste A., Cottini M., Cox L., Crisci C., Crivellaro M.A., Cruz A.A., Cullen J., Custovic A., Cvetkovski B., D'Amato G., da Silva J., Dahl R., Dahlen S.-E., Daniilidis V., Darjazini Nahhas L., Darsow U., Davies J., de Blay F., De Feo G., De Guia E., De la Torre Navarrete J.-R., De los Santos C., De Manuel Keenoy E., De Vries G., Deleanu D., Demoly P., Denburg J., Devillier P., Didier A., Dimic Janjic S., Dimou M., Dinh-Xuan A.T., Djukanovic R., Do Ceu Texeira M., Dokic D., Dominguez Silva M.G., Douagui H., Douladiris N., Doulaptsi M., Dray G., Dubakiene R., Dupas E., Durham S., Duse M., Dykewicz M., Ebo D., Edelbaher N., Eiwegger T., Eklund P., El-Gamal Y., El-Sayed Z.A., El-Sayed S.S., El-Seify M., Emuzyte R., Enecilla L., Erhola M., Espinoza H., Espinoza Contreras J.G., Farrell J., Fernandez L., Fimbres Jimenez P., Fink Wagner A., Fokkens W.J., Folletti L., Fontaine J.-F., Forastiere F., Fuentes Perez J.M., Gaerlan-Resureccion E., Gaga M., Galvez Romero J.L., Gamkrelidze A., Garcia A., Garcia Cobas C.Y., de la Luz Hortensia Garcia Cruz M., Ortiz V.G., Gayraud J., Gelardi M., Gemicioglu B., Gennimata D., Genova S., Gereda J., Gerth van Wijk R., Giuliano A., Gomez R.-M., Gonzalez Ballester M.-A., Gonzalez Diaz S., Gotua M., Grigoreas C., Grisle I., Guidacci M., Guldemond N., Gutter Z., Guzman A., Halloum R., Halpin D., Hamelmann E., Hammadi S., Harvey R., Heffler E., Heinrich J., Hejjaoui A., Hellquist-Dahl B., Hernandez Velazquez L., Hew M., Hossny E., Howarth P., Hrubisko M., Huerta Villalobos Y.R., Humbert M., Husain S., Hyland M., Ibrahim M., Ilina N., Illario M., Incorvaia C., Infantino A., Irani C., Ispayeva Z., Ivancevich J.C., Jares E.E., Jarvis D., Jassem E., Jenko K., Jimeneracruz Uscanga R.D., Johnston S.L., Joos G., Jost M., Julge K., Jung K.-S., Just J., Jutel M., Kaidashev I., Kalayci O., Kalyoncu F., Kapsali J., Kardas P., Karjalainen J., Kasala C.A., Katotomichelakis M., Kavaliukaite L., Bennoor K.S., Keil T., Keith P., Khaitov M., Khaltaev N., Kim Y.-Y., Kirenga B., Kleine-Tebbe J., Klimek L., Ko F.W., Koffi N'Goran B., Kompoti E., Kopac P., Koppelman G., Koren Jeverica A., Koskinen S., Kosnik M., Kostka T., Kostov K.V., Kowalski M.L., Kralimarkova T., Kramer Vrscaj K., Kraxner H., Kreft S., Kritikos V., Kudlay D., Kuitunen M., Kull I., Kuna P., Kupczyk M., Kvedariene V., Kyriakakou M., Lalek N., Landi M., Lane S., Larenas-Linnemann D.E., Lau S., Laune D., Lavrut J., Le L., Lenzenhuber M., Leo G., Lessa M., Levin M., Li J., Lieberman P., Liotta G., Lipworth B., Liu X., Lobo R., Lodrup Carlsen K.C., Lombardi C., Louis R., Loukidis S., Lourenco O., Luna Pech J.A., Madjar B., Maggi E., Magnan A., Mahboub B., Mair A., Maitland van der Zee A.-H., Makela M., Makris M., Malling H.-J., Mandajieva M., Manning P., Manousakis M., Maragoudakis P., Marseglia G., Marshall G., Masjedi M.R., Maspero J.F., Matta Campos J.J., Maurer M., Mavale-Manuel S., Meco C., Melen E., Melioli G., Melo-Gomes E., Meltzer E.O., Menditto E., Menzies-Gow A., Merk H., Michel J.-P., Micheli Y., Miculinic N., Midao L., Mihaltan F., Mikos N., Milanese M., Milenkovic B., Mitsias D., Moalla B., Moda G., Mogica Martinez M.D., Mohammad Y., Moharra F.-M., Moin M., Molimard M., Momas I., Mommers M., Monaco A., Montefort S., Montenegro L.-E., Monti R., Mora D., Morais-Almeida M., Mosges R., Mostafa B.E., Mullol J., Munter L., Muraro A., Murray R., Musarra A., Mustakov T., Naclerio R., Nadeau K.C., Nadif R., Nakonechna A., Namazova-Baranova L., Navarro-Locsin G., Neffen H., Nekam K., Neou A., Nettis E., Neuberger D., Nicod L., Nicola S., Niederberger-Leppin V., Niedoszytko M., Nieto A., Novellino E., Nunes E., Nyembue D., O'Hehir R.E., Odjakova C., Ohta K., Okamoto Y., Okubo K., Oliver B., Onorato G.L., Orru M.P., Ouedraogo S., Ouoba K., Padilla F.-J., Paggiaro P.L., Pagkalos A., Pajno G., Pala G., Palaniappan S., Pali-Scholl I., Palkonen S., Palmer S., Panaitescu Bunu C., Panzner P., Papadopoulos N.G., Papanikolaou V., Papi A., Paralchev B., Paraskevopoulos G., Park H.-S., Passalacqua G., Patella V., Pavord I., Pawankar R., Pedersen S., Peleve S., Pellegino S., Pereira A., Pereira M., Perez T., Perna A., Peroni D., Pfaar O., Pham-Thi N., Pigearias B., Pin I., Piskou K., Pitsios C., Plavec D., Poethig D., Pohl W., Poplas Susic A., Popov T.A., Portejoie F., Potter P., Poulsen L., Prados-Torres A., Prarros F., Price D., Prokopakis E., Puggioni F., Puig-Domenech E., Puy R., Rabe K., Rabotti S., Raciborski F., Ramos J., Recalcati C., Recto M.T., Reda S.M., Regateiro F.S., Reider N., Reitsma S., Repka-Ramirez S., Ridolo E., Rimmer J., Rivero Yeverino D., Rizzo J.A., Robalo-Cordeiro C., Roberts G., Robles K., Roche N., Rodriguez Gonzalez M., Rodriguez Zagal E., Rolla G., Rolland C., Roller-Wirnsberger R., Roman Rodriguez M., Romano A., Romantowski J., Rombaux P., Romualdez J., Rosado-Pinto J., Rosario N., Rosenwasser L., Rossi O., Rottem M., Rouadi P.W., Rovina N., Rozman Sinur I., Ruiz M., Ruiz Segura L.T., Ryan D., Sagara H., Sakai D., Sakurai D., Saleh W., Salimaki J., Samitas K., Samolinski B., Sanchez Coronel M.G., Sanchez-Borges M., Sanchez-Lopez J., Sansonna M., Sarafoleanu C., Sarquis Serpa F., Sastre J., Savi E., Savonyte A., Sawaf B., Scadding G.K., Scheire S., Schmid-Grendelmeier P., Schuhl J.F., Schunemann H., Schvalbova M., Schwarze J., Scichilone N., Senna G., Sepulveda C., Serrano E., Shamai S., Shields M., Shishkov V., Siafakas N., Simeonov A., Simons E.F., Sisul J.C., Sitkauskiene B., Skrindo I., Soklic Kosak T., Sole D., Sondermann M., Sooronbaev T., Soto-Martinez M., Soto-Quiros M., Pinto B.S., Sova M., Soyka M., Specjalski K., Sperl A., Spranger O., Stamataki S., Stefanaki L., Stellato C., Stelmach R., Strandberg T., Stute P., Subramaniam A., Suppli Ulrik C., Sutherland M., Sylvestre S., Syrigou A., Taborda Barata L., Takovska N., Tan R., Tan F., Tan V., Tang I.P., Taniguchi M., Tannert L., Tantilipikorn P., Tattersall J., Tesi F., Thieme U., Thijs C., Thomas M., To T., Todo-Bom A.M., Togias A., Tomazic P.-V., Tomic-Spiric V., Toppila-Salmi S., Torres Jaen M.-J., Toskala E., Triggiani M., Triller N., Triller K., Tsiligianni I., Uberti M., Ulmeanu R., Urbancic J., Urrutia Pereira M., Vachova M., Valdes F., Valenta R., Valentin Rostan M., Valero A., Valiulis A., Vallianatou M., Valovirta E., Van Eerd M., Van Ganse E., van Hage M., Vandenplas O., Vasankari T., Vassileva D., Velasco Munoz C., Ventura M.T., Vera-Munoz C., Viart F., Vicheva D., Vichyanond P., Vidgren P., Viegi G., Vogelmeier C., Von Hertzen L., Vontetsianos T., Vourdas D., Tran Thien Quan V., Wagenmann M., Walker S., Wallace D., De Wang Y., Waserman S., Wehner K., Wickman M., Williams S., Williams D., Wilson N., Wong G., Woo K., Wozniak L., Wright J., Wroczynski P., Xepapadaki P., Yakovliev P., Yamaguchi M., Yan K., Yap Y.Y., Yassin M., Yawn B., Yiallouros P., Yorgancioglu A., Yoshihara S., Young I., Yusuf O.B., Zaidi A., Zaitoun F., Zalud P., Zar H., Zedda M.T., Zernotti M.E., Zhang L., Zhong N., and Zidarn M.
Subjects: MAPK/ERK pathway, ARIA group, Allergy, [SDV]Life Sciences [q-bio], NF-KAPPA-B, debelost, Review, Pharmacology, Resveratrol, PROTECTS, chemistry.chemical_compound, 0302 clinical medicine, RESPIRATORY SYNDROME CORONAVIRUS, ENDOPLASMIC-RETICULUM STRESS, Medicine and Health Sciences, Immunology and Allergy, Medicine, OXIDATIVE STRESS, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, 2. Zero hunger, 0303 health sciences, RESPIRATORY, INSULIN-RESISTANCE, Muscle cell proliferation, SULFORAPHANE, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, SIGNALING PATHWAY, Signal transduction, Life Sciences & Biomedicine, Pulmonary and Respiratory Medicine, NRF2 ACTIVATORS, MUSCLE-CELL PROLIFERATION, Immunology, 610 Medicine & health, Lung injury, Settore MED/10 - Malattie Dell'Apparato Respiratorio, ACUTE LUNG INJURY, 03 medical and health sciences, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, udc:616.9, odpornost proti inzulinu, SULFORAPHANE PROTECTS, Transcription factor, PI3K/AKT/mTOR pathway, 030304 developmental biology, Science & Technology, business.industry, SARS-CoV-2, food, medicine.disease, chemistry, hranila, SYNDROME CORONAVIRUS, business, hrana, GREEN TEA
Abstract: There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.
Published: 2020
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13. Omalizumab in elderly patients with chronic spontaneous urticaria: An Italian real-life experience

Author: Erminia Ridolo, Eustachio Nettis, A. Pannofino, Gianenrico Senna, Stefano Pucci, Alessia Gatta, Danilo Villalta, Enrico Heffler, Anna Radice, A. Romano, S. D'Alò, A. D'Angelo, M. Di Gioacchino, Mona-Rita Yacoub, Riccardo Senter, Sebastiano Gangemi, Elisabetta Di Leo, Michela Mineni, G. Stefanizzi, A. Martignago, Maria Pia Conte, S. Fichera, Luigi Macchia, Francesco Gaeta, A. Vignoli, Ilaria Baiardini, Enrico Maggi, Giuseppe Spadaro, A de Paulis, Donatella Macchia, Giselda Colombo, Angelo Vacca, Walter Canonica, Silvia Peveri, Maria Teresa Costantino, E. Favero, Eleonora Savi, Luca Cegolon, I. Zaza, F. Lodi Rizzini, S. Capretti, Mauro Cancian, Paola Lucia Minciullo, Oliviero Rossi, G. De Feo, M. Bisaccia, L. La Rosa, Roberta Parente, Aikaterini Detoraki, Nettis, Eustachio, Cegolon, Luca, Di Leo, Elisabetta, Canonica, Walter Giorgio, Detoraki, Aikaterini, Baiardini, I., Bisaccia, M., Cancian, M., Capretti, S., Colombo, G., Conte, M., Costantino, M. T., D'Alò, S., D'Angelo, A., De Feo, G., Di Gioacchino, M., Favero, E., Fichera, S., Gaeta, F., Gangemi, S., Gatta, A., Heffler, E., La Rosa, L., Lodi Rizzini, F., Macchia, D., Macchia, L., Maggi, E., Martignago, A., Minciullo, P., Mineni, M., Pannofino, A., Parente, R., Peveri, S., Pucci, S., Radice, A., Ridolo, E., Romano, A., Rossi, O., Savi, E., Senna, G. E., Senter, R., Spadaro, G., Stefanizzi, Antonio, Vacca, A., Vignoli, A., Villalta, D. R., Yacoub, M., Zaza, I., Nettis, E., Cegolon, L., Di Leo, E., Canonica, W. G., Detoraki, A., D'Alo, S., and Stefanizzi, G.
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Urticaria, Immunology, Chronic spontaneous urticaria, omalizumab, elderly patients, Drug Resistance, Drug resistance, Omalizumab, 030207 dermatology & venereal diseases, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, Anti-Allergic Agents, 80 and over, medicine, Humans, Immunology and Allergy, In patient, Young adult, Adverse effect, Aged, Aged, 80 and over, Chronic Disease, Female, Histamine H1 Antagonists, Middle Aged, Treatment Outcome, Histamine H1 Antagonist, Study drug, Angioedema, business.industry, Anti-Allergic Agent, 030228 respiratory system, Observational study, medicine.symptom, business, medicine.drug, Human
Abstract: Background Omalizumab therapy is effective and safe in patients with chronic spontaneous urticaria (CSU) resistant to nonsedating histamine 1 (H 1 ) antihistamines (nsAHs). Objective To evaluate the efficacy and safety of omalizumab in elderly (aged ≥65 years) patients with nonsedating H 1 -antihistamine–refractory CSU in a real-life setting. Methods Patients with nonsedating H 1 -antihistamine–refractory CSU (n = 322) treated with omalizumab administered every 4 weeks in doses of 300 mg for 24 weeks were divided into 2 groups according to age at omalizumab treatment onset: 15 to 64 years and 65 years or older. Treatment response was assessed using a 7-day urticaria activity score (UAS7). Adverse effects of omalizumab therapy were recorded. Results Among patients, 32 (9.9%) were 65 years or older. At baseline, CSU characteristics were generally similar among the groups, although the presence of angioedema was statistically significantly lower in patients younger than 65 years. Any differences in weekly itch severity score, hive score, and UAS7 between the 2 age groups were not significant at weeks 4, 12, and 24, with the exception of the hive score at 24 weeks and the UAS7 at week 24. No significant between-group differences were seen in the proportion of patients with a UAS7 of 6 or lower and with a UAS7 score of 0 at weeks 4, 12, 24, and 40. The proportion of patients with at least one adverse event reported as suspected to be caused by study drug was 10% in the younger group vs 6.3% in the older group ( P = .53). Conclusion Our study found that omalizumab is a well-tolerated and effective therapy for elderly patients with nonsedating H 1 -antihistamine–refractory CSU.
Published: 2018

14. Management of allergic disease in the elderly: key considerations, recommendations and emerging therapies

Author: Matteo Gelardi, Vincenzo Patella, Nicola Scichilone, Maria Teresa Ventura, Erminia Ridolo, Ventura, M., Scichilone, N., Gelardi, M., Patella, V., and Ridolo, E.
Subjects: Male, Aging, Allergy, medicine.medical_specialty, AIT-allergen immunotherapy, Health Services for the Aged, Immunology, Drug allergy, dermatological allergie, anaphylaxi, Disease, Settore MED/10 - Malattie Dell'Apparato Respiratorio, elderly, Food allergy, Hypersensitivity, medicine, Humans, Immunology and Allergy, Asthma, immunosenescence, food allergy, business.industry, Medicine (all), Atopic dermatitis, medicine.disease, Dermatology, Patient Compliance, Female, allergic rhiniti, business, allergic asthma, drug allergy, Anaphylaxis, Adverse drug reaction, Human
Abstract: The number of people over 65 is increasing around the world. At present, between 5 and 10% of allergic diseases affect the elderly. In particular, rhinitis is increasing worldwide; the presence of high comorbidity makes the therapy of asthma even more complicated. With reference to dermatological allergies, the dryness of the skin favors the onset of allergic contact and atopic dermatitis, while the senescence of mucous membranes and the impaired secretion of polymeric IgA could be linked to food allergy. Overcoming the problem of adverse drug reaction is limited by the diagnostic difficulty in patients taking multiple drugs. In addition, some drugs, such as β-blockers, angiotensin-converting enzyme (ACE)-inhibitors and NSAIDs, are relevant factors of urticaria and anaphylaxis. The aim of this review is to provide updated diagnostic and therapeutic guidelines through a better understanding of the pathophysiologic mechanisms, preventive measures and adherence to therapy.
Published: 2015
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15. Allergic diseases in the elderly: biological characteristics and main immunological and non-immunological mechanisms

Author: Giorgio Walter Canonica, Stefano Del Giacco, Nicola Scichilone, Livio Simioni, Maria Teresa Ventura, Erminia Ridolo, Vincenzo Patella, Roberto Paganelli, Matteo Bonini, Paola Lucia Minciullo, Giovanni Passalacqua, Sebastiano Gangemi, Carlo Lombardi, Ventura M.T., Scichilone N., Paganelli R., Minciullo P.L., Patella V., Bonini M., Passalacqua G., Lombardi C., Simioni L., Ridolo E., Del Giacco S.R., Gangemi S., and Canonica G.W.
Subjects: 0301 basic medicine, Aging, Allergy, Urticaria, medicine.medical_treatment, Immunology, Environmental pollution, Review, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, Elderly, Immune system, Anaphylaxi, Food allergy, medicine, Immunology and Allergy, Anaphylaxis, Molecular Biology, Asthma, business.industry, Conjunctiviti, Immunotherapy, Conjunctivitis, medicine.disease, Drug reaction, 030104 developmental biology, age, Life expectancy, business
Abstract: Life expectancy and the number of elderly people are progressively increasing around the world. Together with other pathologies, allergic diseases also show an increasing incidence in geriatric age. This is partly due to the growing emphasis on a more accurate and careful diagnosis of the molecular mechanisms that do not allow to ignore the real pathogenesis of many symptoms until now unknown, and partly to the fact that the allergic people from 20 years ago represent the elderly population now. Moreover, environmental pollution predisposes to the onset of allergic asthma and dermatitis which are the result of internal pathologies more than the expression of allergic manifestations. At the same time the food contamination permits the onset of allergic diseases related to food allergy. In this review we provide the state of the art on the physiological changes in the elderly responsible for allergic diseases, their biological characteristics and the major immunological and extra immunological mechanisms. Much emphasis is given to the management of several diseases in the elderly, including anaphylactic reactions. Moreover, some new features are discussed, such as management of asthma with the support of physical activity and the use of the AIT as prevention of respiratory diseases and for the purpose of a real and long lasting benefit. The mechanisms of adverse reactions to drugs are also discussed, due to their frequency in this age, especially in polytherapy regimens. Study of the modifications of the immune system is also of great importance, as regards to the distribution of the lymphocytes and also the presence of a chronic inflammatory disease related to the production of cytokines, especially in prevision of all the possible therapies to be adopted to allow an active and healthy aging.
Published: 2017
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16. Catching allergy by a simple questionnaire

Author: Cristoforo Incorvaia, Paola Rottoli, Massimo Landi, Nicola Scichilone, Gilda Nardi, Erminia Ridolo, Vincenzo Castella, Serena Buttafava, Nico Sciolla, Giorgio Walter Canonica, Beniamino Cucchi, Paola Puccinelli, Sebastiano Gangemi, Maurizio Galimberti, Giovanni Passalacqua, Paolo Raviolo, Franco Frati, Maria Teresa Costantino, Alessandro Fiocchi, Germano Bettoncelli, Galimberti, M., Passalacqua, G., Incorvaia, C., Castella, V., Costantino, M., Cucchi, B., Gangemi, S., Nardi, G., Raviolo, P., Rottoli, P., Scichilone, N., Sciolla, N., Bettoncelli, G., Landi, M., Ridolo, E., Buttafava, S., Puccinelli, P., Canonica, G., Fiocchi, A., and Frati, F.
Subjects: lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Allergy, Referral, medicine.medical_treatment, Immunology, Allergy testing, Primary care, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Pharmacists, Allergic rhinitis, Cohen's kappa, Allergic rhiniti, medicine, Immunology and Allergy, Original Research, business.industry, medicine.disease, Primary care physicians, Test (assessment), Primary care physician, Nasal spray, Pharmacist, Allergists, lcsh:RC581-607, business
Abstract: Background Identifying allergic rhinitis requires allergy testing, but the first-line referral for rhinitis are usually primary care physicians (PCP), who are not familiar with such tests. The availability of easy and simple tests to be used by PCP to suggest allergy should be very useful. Methods The Respiratory Allergy Prediction (RAP) test, based on 9 questions and previously validated by a panel of experts, was evaluated in this study. Results An overall number of 401 patients (48.6% males, age range 14–62 years) with respiratory symptoms was included. Of them, 89 (22.2%) showed negative results to SPT, while 312 (77.8%) had at least one positive result to SPT. Cohen’s kappa coefficient showed that all questions had an almost perfect excellent agreement between pre and post-test. The algorithm of decision-tree growth Chi-squared Automatic Interaction Detector showed that answering yes to the question 4 (Your nasal/ocular complains do usually start or worsen during the spring?), 6 (Did you ever had cough or shortness of breath, even during exercise?) and 8 (Do you use nasal sprays frequently?) gave a probability to have a positive SPT of 85%. Conclusions These findings show that RAP test can be proposed as an useful tool to be used by physician other than allergists when evaluating patients with rhinitis, suggesting the need of allergy testing. Electronic supplementary material The online version of this article (doi:10.1186/s40413-015-0067-y) contains supplementary material, which is available to authorized users.
Published: 2015

17. Choosing wisely: Practical considerations on treatment efficacy and safety of asthma in the elderly

Author: Carlo Lombardi, Fulvio Braido, Matteo Bonini, Vincenzo Patella, Giovanni Rolla, Domenico Schiavino, Oliviero Rossi, Alessandra Vultaggio, Caterina Bucca, G. Steinhilber, Stefano Del Giacco, Enrico Heffler, Giovanni Passalacqua, Manlio Milanese, Andrea Matucci, Nicola Scichilone, Roberto Paganelli, Marco Caminati, Gianenrico Senna, Giorgio Walter Canonica, Erminia Ridolo, Maria Teresa Ventura, Scichilone, N., Ventura, M., Bonini, M., Braido, F., Bucca, C., Caminati, M., Del Giacco, S., Heffler, E., Lombardi, C., Matucci, A., Milanese, M., Paganelli, R., Passalacqua, G., Patella, V., Ridolo, E., Rolla, G., Rossi, O., Schiavino, D., Senna, G., Steinhilber, G., Vultaggio, A., and Canonica, G.
Subjects: Allergy, medicine.medical_specialty, Aging, Immunology, Alternative medicine, Disease, Review, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Asthma, Therapy, medicine, Immunology and Allergy, Intensive care medicine, Molecular Biology, Non pharmacological, COPD, business.industry, Settore MED/09 - MEDICINA INTERNA, medicine.disease, Treatment efficacy, respiratory tract diseases, Clinical trial, business
Abstract: The prevalence of asthma in the most advanced ages is similar to that of younger ages. However, the concept that older individuals may suffer from allergic asthma has been largely denied in the past, and a common belief attributes to asthma the definition of "rare" disease. Indeed, asthma in the elderly is often underdiagnosed or diagnosed as COPD, thus leading to undertreatment of improper treatment. This is also due to the heterogeneity of clinical and functional presentations of geriatric asthma, including the partial loss of reversibility and the lower occurrence of the allergic component in this age range. The older asthmatic patients are also characterized the coexistence of comorbid conditions that, in conjunction with age-associated structural and functional changes of the lung, may contribute to complicate the management of asthma. The current review addresses the main issues related to the management of allergic asthma in the geriatric age. In particular, the paper aims at revising current pharmacological and non pharmacological treatments for allergic asthmatics of advanced ages, primarily focusing on their safety and efficacy, although most behaviors are an arbitrary extrapolation of what has been tested in young ages. In fact, age has always represented an exclusion criterion for eligibility to clinical trials. Experimental studies and real life observations specifically testing the efficacy and safety of therapeutic approaches in allergic asthma in the elderly are urgently needed.
Published: 2015
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18. RhinAsthma patient perspective: a short daily asthma and rhinitis QoL assessment

Author: Ilaria Baiardini, Nicola Scichilone, Carolina Lombardi, Giuseppe Girbino, F. Gani, Oliviero Rossi, Erminia Ridolo, Sara Balestracci, E. Stagi, Martin K. Church, Gianenrico Senna, Alberto Bordo, Fulvio Braido, Giorgio Walter Canonica, Braido, F., Baiardini, I., Stagi, E., Scichilone, N., Rossi, O., Lombardi, C., Ridolo, E., Gani, F., Balestracci, S., Girbino, G., Senna, G., Bordo, A., Church, M., and Canonica, G.
Subjects: Adult, Male, medicine.medical_specialty, Rhinitis, Allergic, Perennial, Psychometrics, Adolescent, Visual analogue scale, assessment, Concordance, Immunology, Population, Settore MED/10 - Malattie Dell'Apparato Respiratorio, rhinitis, Allergic, Cronbach's alpha, Quality of life, Surveys and Questionnaires, 80 and over, medicine, Surveys and Questionnaire, Immunology and Allergy, Humans, daily practice, education, Asthma, Aged, Aged, 80 and over, education.field_of_study, business.industry, asthma, quality of life, Female, Middle Aged, Rhinitis, Allergic, Quality of Life, medicine.disease, Perennial, humanities, rhiniti, Convergent validity, Physical therapy, business, Psychometric, Human
Abstract: Background The present study aimed to develop a short validated patient-completed questionnaire, the RhinAsthma Patient Perspective (RAPP), to assess the health-related quality of life (HRQoL) in patients with asthma and comorbid allergic rhinitis in clinical practice. Methods A provisional RAPP questionnaire was formed from candidate items identified through retrospective analysis of 333 RHINASTHMA questionnaires. This was then tested on 150 asthma patients with allergic rhinitis. Results Psychometric analyses identified eight items fitting a unidimensional model to form RAPP. Internal consistency (Cronbach's alpha coefficient > 0.8) and agreement with RHINASTHMA (r = −0.31, P = 0.0001) were excellent. Criterion, discriminant, and convergent validity were good. Reliability in 47 stable patients was very good (intra-class and concordance correlation coefficients were 0.90 and 0.89, respectively). Responsiveness in 103 patients with health improvement or deterioration was significantly associated with changes in Global Rating Scale (r = −0.4965, P
Published: 2012

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18 results on '"Ridolo, E."'

1. Management of patients with severe asthma: results from a survey among allergists and clinical immunologists of the Central Italy Inter-Regional Section of SIAAIC

2. COVID-19 in Severe Asthma Network in Italy (SANI) patients: Clinical features, impact of comorbidities and treatments

3. Reply to: Kow CS et al. Are severe asthma patients at higher risk of developing severe outcomes from COVID-19?

4. THE RELEVANCE OF NASAL CYTOLOGY IN THE WORKUP OF HOUSE DUST MITE-INDUCED ALLERGIC RHINITIS

5. Allergic rhinitis: the eligible candidate to mite immunotherapy in the real world

6. Cross-sectional comparison of the characteristics of respiratory allergy in immigrants and Italian children

7. The possible influence of the environment on respiratory allergy: a survey on immigrants to Italy

8. SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

9. Severe asthma: One disease and multiple definitions

10. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

11. Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects

12. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies

13. Omalizumab in elderly patients with chronic spontaneous urticaria: An Italian real-life experience

14. Management of allergic disease in the elderly: key considerations, recommendations and emerging therapies

15. Allergic diseases in the elderly: biological characteristics and main immunological and non-immunological mechanisms

16. Catching allergy by a simple questionnaire

17. Choosing wisely: Practical considerations on treatment efficacy and safety of asthma in the elderly

18. RhinAsthma patient perspective: a short daily asthma and rhinitis QoL assessment

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18 results on '"Ridolo, E."'

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Select search scope, currently: Articles

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books, media & more in Jio Institute collections

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journal articles & other e-resources