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1. Gadolinium-Based Contrast Agents Hypersensitivity: A Case Series

Author

Nucera E, Urbani S, Buonomo A, De Pasquale T, Rizzi A, Aruanno A, and Pucci S

Subjects
gadolinium-based contrast agents, hypersensitivity, ige-mediated reactions, Immunologic diseases. Allergy, RC581-607
Abstract

Eleonora Nucera,1 Sara Urbani,1 Alessandro Buonomo,1 Tiziana De Pasquale,2 Angela Rizzi,1 Arianna Aruanno,1 Stefano Pucci2 1Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; 2Civitanova Marche Hospital, Civitanova Marche, ItalyCorrespondence: Eleonora NuceraAllergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito, 1, Rome, 00168, ItalyTel +39 3394475931Fax +06 30156999Email eleonora.nucera@policlinicogemelli.itAbstract: Gadolinium-based contrast agents (GBCAs) are considered to be safe, although sometimes patients report a hypersensitivity reaction when undergoing magnetic resonance imaging (MRI). The mechanisms of these reactions and of the sensitization to GBCAs are still largely unknown. We describe four cases of patients who experienced immediate adverse reactions to GBCAs with a demonstrated cutaneous hypersensitivity suggesting an IgE-mediated mechanism.Keywords: gadolinium-based contrast agents, hypersensitivity, IgE-mediated reactions

Published
2021

3. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M.E., Corsico, A.G., Cosmi, L., Costantino, M.T., Crimi, N., D’Alò, S., D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B.P.M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, L., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F.L.M., Ricciardi, L., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M.R., Zappa, M.C., Canonica, Giorgio Walter, Malvezzi, Luca, Blasi, Francesco, Paggiaro, Pierluigi, Mantero, Marco, Senna, Gianenrico, and Heffler, Enrico

Published
2020
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4. Latex Allergy: Current Status and Future Perspectives

Author

Nucera E, Aruanno A, Rizzi A, and Centrone M

Subjects
latex, immunotherapy, desensitization., Immunologic diseases. Allergy, RC581-607
Abstract

Eleonora Nucera,* Arianna Aruanno,* Angela Rizzi,* Michele Centrone* Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCSS, Università Cattolica del Sacro Cuore, Rome, Italy*These authors contributed equally to this workCorrespondence: Eleonora NuceraAllergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo F. Vito, 1, Rome 00168, ItalyEmail eleonora.nucera@policlinicogemelli.itAbstract: Allergy to natural rubber latex (NRLA) from Hevea brasiliensis is a relevant public health issue, in particular in healthcare workers and groups at risk. Clinical manifestations of NRLA can range from mild skin disorders to life-threatening systemic reactions. Prevention measures remain the gold-standard treatment for patients suffering from NRLA, but the only etiological therapy able to influence the natural history of NRLA is specific desensitization. This review aims to underline the epidemiological, clinical and diagnostic aspects of NRLA, and carries out a complete and wide-ranging review of the current literature on NRLA management and immunotherapy.Keywords: latex, immunotherapy, desensitization

Published
2020

6. The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey

Author

Montera, M C, Giordano, A, Asperti, C, Aruanno, Arianna, Barzaghi, C E, Bignardi, D, Borrelli, P, Bommarito, L, Busa, Mattia Fernando, Calafiore, P, Carusi, V, Cinquini, M, Cortellini, G, Cocchi, Riccardo, D'Auria, F, De Caro, F, Demonte, A, Di Leo, E, Di Lizia, M, Di Rienzo, A, Fumagalli, Francesca, Kihlgren, P, Lodi Rizzini, F, Macchia, D, Manzotti, G, Marra, A M, Mileto, P, Mietta, S, Montagni, M, Nettis, E, Nucera, Eleonora, Peveri, S, Pivetta, D, Pirisi, M, Ramirez, G A, Rivolta, F, Rizzi, Angela, Savoia, Andrea Alessio, Pedicini, A, Scarpa, A, Zisa, G, Yacoub, M-R, Aruanno, A, Busa, M, Cocchi, R, Fumagalli, F, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), Savoia, A, Montera, M C, Giordano, A, Asperti, C, Aruanno, Arianna, Barzaghi, C E, Bignardi, D, Borrelli, P, Bommarito, L, Busa, Mattia Fernando, Calafiore, P, Carusi, V, Cinquini, M, Cortellini, G, Cocchi, Riccardo, D'Auria, F, De Caro, F, Demonte, A, Di Leo, E, Di Lizia, M, Di Rienzo, A, Fumagalli, Francesca, Kihlgren, P, Lodi Rizzini, F, Macchia, D, Manzotti, G, Marra, A M, Mileto, P, Mietta, S, Montagni, M, Nettis, E, Nucera, Eleonora, Peveri, S, Pivetta, D, Pirisi, M, Ramirez, G A, Rivolta, F, Rizzi, Angela, Savoia, Andrea Alessio, Pedicini, A, Scarpa, A, Zisa, G, Yacoub, M-R, Aruanno, A, Busa, M, Cocchi, R, Fumagalli, F, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), and Savoia, A

Abstract

Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.

Published
2023

7. Therapeutic Strategies to Prevent the Recurrence of Nasal Polyps after Surgical Treatment: An Update and In Vitro Study on Growth Inhibition of Fibroblasts

Author

Rizzi, Angela, Gammeri, L., Cordiano, R., Valentini, Mariagrazia, Centrone, M., Marrone, S., Inchingolo, Riccardo, Lohmeyer, F. M., Cavaliere, C., Ria, Francesco, Cadoni, Gabriella, Gangemi, S., Nucera, Eleonora, Rizzi A. (ORCID:0000-0002-6795-746X), Valentini M., Inchingolo R. (ORCID:0000-0003-2843-9966), Ria F. (ORCID:0000-0002-8444-0307), Cadoni G. (ORCID:0000-0001-8244-784X), Nucera E. (ORCID:0000-0002-0565-7680), Rizzi, Angela, Gammeri, L., Cordiano, R., Valentini, Mariagrazia, Centrone, M., Marrone, S., Inchingolo, Riccardo, Lohmeyer, F. M., Cavaliere, C., Ria, Francesco, Cadoni, Gabriella, Gangemi, S., Nucera, Eleonora, Rizzi A. (ORCID:0000-0002-6795-746X), Valentini M., Inchingolo R. (ORCID:0000-0003-2843-9966), Ria F. (ORCID:0000-0002-8444-0307), Cadoni G. (ORCID:0000-0001-8244-784X), and Nucera E. (ORCID:0000-0002-0565-7680)

Abstract

Chronic rhinosinusitis with nasal polyps (CRSwNP) is the most bothersome phenotype of chronic rhinosinusitis, which is typically characterized by a Type 2 inflammatory reaction, comorbidities and high rates of nasal polyp recurrence, causing severe impact on quality of life. Nasal polyp recurrence rates, defined as the number of patients undergoing revision endoscopic sinus surgery, are 20% within a 5 year period after surgery. The cornerstone of CRSwNP management consists of anti-inflammatory treatment with local corticosteroids. We performed a literature review regarding the therapeutic strategies used to prevent nasal polyp recurrence after surgical treatment. Finally, we report an in vitro study evaluating the efficacy of lysine-acetylsalicylic acid and other non-steroidal anti-inflammatory drugs (ketoprofen and diclofenac) on the proliferation of fibroblasts, obtained from nasal polyp tissue samples. Our study demonstrates that diclofenac, even more so than lysine-acetylsalicylic acid, significantly inhibits fibroblast proliferation and could be considered a valid therapeutic strategy in preventing CRSwNP recurrence.

Published
2023

8. Allergic reactions to midazolam: A case series from an Italian allergy unit

Author

Nucera, E., Parrinello, G., Buonomo, A., Aruanno, A., Rizzi, A., Nucera E. (ORCID:0000-0002-0565-7680), Parrinello G., Buonomo A., Rizzi A. (ORCID:0000-0002-6795-746X), Nucera, E., Parrinello, G., Buonomo, A., Aruanno, A., Rizzi, A., Nucera E. (ORCID:0000-0002-0565-7680), Parrinello G., Buonomo A., and Rizzi A. (ORCID:0000-0002-6795-746X)

Abstract

Midazolam is a short-acting benzodiazepine with central nervous system depressing action, commonly used for conscious sedation for various procedures and for its pharmacologic properties. In literature, severe adverse reactions to this drug are described, but only in few cases positive allergological tests were demonstrated. The authors collected herein five clinical cases of different allergic reactions to midazolam demonstrated by positive skin tests. The 1° case is a suspected Kounis syndrome with cardiorespiratory arrest during an elective video laparoscopic cholecystectomy. The 2° and 5° cases are two systemic reactions with involvement of the skin and the gastrointestinal/respiratory system during elective surgeries in two patients with clinical history of atopia, while the 3° and 4° cases are local skin reactions in correspondence with the infusion site of midazolam during the execution of a colonoscopy. All the patients performed a complete allergological evaluation for the reaction involved drugs. In all cases, only the intradermal test (IDT) with midazolam at 0.5 mg/mL was positive. Allergological tests performed in 10 healthy controls with negative results supported the diagnosis. Therefore, midazolam is often considered a safe drug, because it does not have any active metabolites, in rare cases, it could cause different types of allergic adverse reactions: from severe anaphylaxis with cardiorespiratory arrest to simple local skin reactions. Skin tests remain the first line in the diagnosis of an immediate-type hypersensitivity to midazolam; even if they could lose in sensitivity with increasing latency from the event. However the concentrations recommended by current guidelines of European Network for Drug Allergy (ENDA) and the European Academy of Allergy and Clinical Immunology (EAACI) drug allergy interest groups might not rule out some false-positive reactions due to an irritant effect that should be considered. In doubt cases, other allergological o

Published
2021

9. Clinical features associated with a doctor-diagnosis of bronchiectasis in the Severe Asthma Network in Italy (SANI) registry

Author

Malipiero, G., Paoletti, G., Blasi, F., Paggiaro, P., Senna, G., Latorre, M., Caminati, M., Carpagnano, G. E., Crimi, N., Spanevello, A., Aliberti, S., Canonica, G. W., Heffler, E., Bonavia, M., Bucca, C., Caiaffa, M. F., Calabrese, C., Camiciottoli, G, Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, B. M. P., Guarnieri, G., Guida, 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., 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
Pulmonary and Respiratory Medicine, Severe asthma, Pediatrics, medicine.medical_specialty, bronchiectasis, macromolecular substances, registry, phenotypes, real-life, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Humans, Immunology and Allergy, Medicine, Registries, 030212 general & internal medicine, Bronchiectasis, business.industry, musculoskeletal, neural, and ocular physiology, Public Health, Environmental and Occupational Health, medicine.disease, Asthma, respiratory tract diseases, Italy, nervous system, 030228 respiratory system, Quality of Life, business
Abstract

Several severe asthma comorbidities have been identified: an emerging one is bronchiectasis. We evaluated the frequency of bronchiectasis on severe asthma in a real-life setting, through the 'Severe Asthma Network Italy' (SANI) registry.SANI registry encompasses demographic, clinical, functional and inflammatory data of Italian severe asthmatics. Data obtained by the enrolled patients were analyzed, focusing the attention on those patients with concomitant clinically relevant bronchiectasis.About 15.5% patients have bronchiectasis. Bronchiectasis diagnosis was associated with a higher prevalence of chronic rhinosinusitis with nasal polyps (54.6% vs. 38%, p = 0.001) and higher serum IgE levels (673.4 vs. 412.1 kUI/L, p = 0.013). Patients with bronchiectasis had worse asthma control (ACT: 16.7 vs 18.2, p = 0.013), worse quality of life (AQLQ: 4.08 vs. 4.60, p = 0.02) and lower lung function (FEVsevere asthma associated with bronchiectasis represents a particularly severe asthma variant, possibly driven by an eosinophilic endotype. We, therefore, suggest that bronchiectasis should necessarily be assessed in severe asthmatic patients.

Published
2020
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10. Clinical and quality of life assessment in patients with latex allergy during COVID-19 pandemic: Possible protective role of continuous latex immunotherapy

Author

Di Rienzo, A, Urbani, Sara, Longhino, David, Sarnari, Caterina, Buonomo, Alessandro, Rizzi, Angela, Aruanno, Arianna, Nucera, Eleonora, Urbani, S, Longhino, D, Sarnari, C, Buonomo, A, Rizzi, A (ORCID:0000-0002-6795-746X), Aruanno, A, Nucera, E (ORCID:0000-0002-0565-7680), Di Rienzo, A, Urbani, Sara, Longhino, David, Sarnari, Caterina, Buonomo, Alessandro, Rizzi, Angela, Aruanno, Arianna, Nucera, Eleonora, Urbani, S, Longhino, D, Sarnari, C, Buonomo, A, Rizzi, A (ORCID:0000-0002-6795-746X), Aruanno, A, and Nucera, E (ORCID:0000-0002-0565-7680)

Abstract

Introduction: During COVID-19 pandemic, the massive use of Personal Protective Equipment could provoke severe adverse reactions in latex allergy patients and could negatively affect their quality of life. Methods: Trough a survey the study aimed: (a) to evaluate the incidence of allergic reactions in patients with latex allergy during the SARS-CoV-2 pandemic; (b) to evaluate the protective role of continuous latex sublingual immunotherapy (SLIT) during this period; and (c) to evaluate quality of life of natural rubber latex allergy (NRLA) patients during the pandemic. Results: 67 patients (9 males and 58 females, mean age of 45.9 +/- 11.4 years) suffering from latex allergy were included in the present study. We recorded among our patients 13 cases (34.2%) of urticarial/angioedema (U/A), 9 cases (23.6%) of respiratory symptoms (dyspnoea, shortness of breath and wheezing) and 7 cases (18.4%) of anaphylaxis. In patients who underwent continuous SLIT, we observed less cases of U/A (p < 0.001), respiratory symptoms (p < 0.001), anaphylaxis (p = 0.003), hospitalizations (p = 0.014) and a lower therapy administration. We compared the results of SF-36 questionnaire in patients who underwent continuous and not-continuous SLIT with a significance differences score between these two groups. Conclusions: Our study is the first that investigated the clinical and quality of life effects of COVID-19 pandemic in NRLA patients.

Published
2022

11. Mometasone Furoate in Non-Allergic Rhinitis: A Real-Life Italian Study

Author

Rizzi, Angela, Parrinello, Giuseppe, De Corso, Eugenio, Tricarico, Laura, Centrone, M., Di Rienzo, A., Laface, Chiara, Passali, Giulio Cesare, Cadoni, Gabriella, Inchingolo, Riccardo, Paludetti, Gaetano, Galli, Jacopo, Nucera, Eleonora, Rizzi A. (ORCID:0000-0002-6795-746X), Parrinello G., De Corso E., Tricarico L., Laface C., Passali G. C. (ORCID:0000-0002-8176-0962), Cadoni G. (ORCID:0000-0001-8244-784X), Inchingolo R., Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Nucera E. (ORCID:0000-0002-0565-7680), Rizzi, Angela, Parrinello, Giuseppe, De Corso, Eugenio, Tricarico, Laura, Centrone, M., Di Rienzo, A., Laface, Chiara, Passali, Giulio Cesare, Cadoni, Gabriella, Inchingolo, Riccardo, Paludetti, Gaetano, Galli, Jacopo, Nucera, Eleonora, Rizzi A. (ORCID:0000-0002-6795-746X), Parrinello G., De Corso E., Tricarico L., Laface C., Passali G. C. (ORCID:0000-0002-8176-0962), Cadoni G. (ORCID:0000-0001-8244-784X), Inchingolo R., Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), and Nucera E. (ORCID:0000-0002-0565-7680)

Abstract

Background: In order to evaluate the efficacy of intranasal mometasone furoate in patients with non-allergic rhinitis (NAR), a real-life, observational, prospective study is performed. Methods: Thirty-one patients (age 18-64 years) receive intranasal (mometasone furoate, 200 mu g b.i.d. for 15 consecutive days per month for 6 consecutive months), plus isotonic nasal saline. The cytologic pattern of local inflammation, nasal airflow, through peak nasal inspiratory flow (PNIF), quality of life (QoL), through the rhinitis quality of life questionnaire (RQLQ), the sinonasal outcome test (SNOT-22), the short-form 36-item health survey (SF-36v2), and the combined symptom medication score (CSMS), and, finally, olfactory function, through Sniffin' sticks-16 identification test (SSIT-16), are evaluated at baseline and after treatment. Results: NARNE is the most frequent cytological pattern (48% of the total sample). The therapeutic response shows improvement in olfactory function and QoL. Conclusions: The results of this study confirm that intranasal mometasone furoate is an effective treatment for patients with NAR.

Published
2022

12. Sensitization to Gibberellin-Regulated Protein (Peamaclein) Among Italian Cypress Pollen–Sensitized Patients

Author

Asero, R, primary, Abbadessa, S, additional, Aruanno, A, additional, Barilaro, G, additional, Barzaghi, C, additional, Bignardi, D, additional, Bilò, MB, additional, Borro, M, additional, Bresciani, M, additional, Busa, M, additional, Buzzulini, F, additional, Cavaliere, C, additional, Cecchi, L, additional, Ciccarelli, A, additional, Cortellini, G, additional, Cucinelli, F, additional, Deleonardi, G, additional, Emiliani, F, additional, Farsi, A, additional, Ferrarini, E, additional, Franchini, M, additional, Ingrassia, A, additional, Lippolis, D, additional, Losappio, L, additional, Marra, AM, additional, Martini, M, additional, Masieri, S, additional, Mauro, M, additional, Mazzolini, M, additional, Muratore, L, additional, Murzilli, F, additional, Nucera, E, additional, Pastorello, EA, additional, Pinter, E, additional, Polillo, BR, additional, Pravettoni, V, additional, Quercia, O, additional, Rizzi, A, additional, Russello, M, additional, Sacerdoti, C, additional, Scala, E, additional, Scarpa, A, additional, Schroeder, J, additional, Uasuf, CG, additional, Villalta, D, additional, Yang, B, additional, Mistrello, G, additional, Amato, S, additional, and Lidholm, J, additional

Published
2022
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14. Detection of Gibberellin-Regulated Protein (Peamaclein) Sensitization among Italian Cypress Pollen-Sensitized Patients

Author

Asero, R, Abbadessa, S, Aruanno, A, Barilaro, G, Barzaghi, C, Bignardi, D, Bilò, M B, Borro, M, Bresciani, M, Busa, M, Buzzulini, F, Cavaliere, C, Cecchi, L, Ciccarelli, A, Cortellini, G, Cucinelli, F, Deleonardi, G, Emiliani, F, Farsi, A, Ferrarini, E, Franchini, M, Ingrassia, A, Lippolis, D, Losappio, L, Marra, A M, Martini, M, Masieri, S, Mauro, M, Mazzolini, M, Muratore, L, Murzilli, F, Nucera, E, Pastorello, E A, Pinter, E, Polillo, B R, Pravettoni, V, Quercia, O, Rizzi, A, Russello, M, Sacerdoti, C, Scala, E, Scala, G, Scarpa, A, Schroeder, J, Uasuf, G G, Villalta, D, Yang, B, Mistrello, G, Amato, S, Lidholm, J, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), Asero, R, Abbadessa, S, Aruanno, A, Barilaro, G, Barzaghi, C, Bignardi, D, Bilò, M B, Borro, M, Bresciani, M, Busa, M, Buzzulini, F, Cavaliere, C, Cecchi, L, Ciccarelli, A, Cortellini, G, Cucinelli, F, Deleonardi, G, Emiliani, F, Farsi, A, Ferrarini, E, Franchini, M, Ingrassia, A, Lippolis, D, Losappio, L, Marra, A M, Martini, M, Masieri, S, Mauro, M, Mazzolini, M, Muratore, L, Murzilli, F, Nucera, E, Pastorello, E A, Pinter, E, Polillo, B R, Pravettoni, V, Quercia, O, Rizzi, A, Russello, M, Sacerdoti, C, Scala, E, Scala, G, Scarpa, A, Schroeder, J, Uasuf, G G, Villalta, D, Yang, B, Mistrello, G, Amato, S, Lidholm, J, Nucera, E (ORCID:0000-0002-0565-7680), and Rizzi, A (ORCID:0000-0002-6795-746X)

Abstract

Background: Peach gibberellin-regulated protein (peamaclein) has recently emerged as a relevant food allergen in cypress pollen-hypersensitive patients. Objective: We looked for mono-sensitization to peamaclein among Italian cypress-pollen allergic patients. Material and methods: 835 cypress pollen hypersensitive patients from 28 Italian allergy centers under went thorough interview for food-allergic reactions, and SPT with a commercial peach extracts containing peamaclein. In peach reactors, IgE to rPru p 3 was measured, and those scoring negative were enrolled as potentially mono-sensitized to peamaclein. IgE reactivity to rPru p 7 was evaluated by immunoblot and by an experimental ImmunoCAP with rPru p 7. Results: Peach SPT scored positive in 163 (19.5%) patients but 127 (77,9%) were excluded because Pru p 3 reactors. Twenty-four (14,7%, corresponding to 2.8% of the entire study population) were considered as potentially mono-sensitized to peamaclein. Their distribution did not show any geographic preference. Seventeen/24 (70,8%) had a history of food allergy, in most cases (n=15) to peach. Other offending foods included other Rosaceae, citrus fruits, fig, melon, tree nuts, and kiwi. On peach immunoblot, only 3/18 putative peamaclein allergic subjects reacted to a band at about 7kDa; 4 other patients reacted at about 50-60 kDa. Ten/18 (56%) scored positive for Pru p 7 on ImmunoCAP. Conclusion: Peamaclein allergy and sensitization prevalence seem rare in Italy. Most patients react to peach, albeit other Rosaceae fruits and several citrus fruits may also act as offending foods. Peach and cypress pollen probably share also cross-reacting allergens other than peamaclein.

Published
2020

15. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, Gw, Blasi, F., Paggiaro, PL. Senna G. E., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M. Bonini M., Bucca, C., Brussino, L., Caiaffa, M. F., Calabrese, C., Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, C., Centanni, S., 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 Barbaro, M. P., Guarnieri, G., Guida, G., Latorre, M., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagn, i. M., Montuschi, P., Nucera, E., Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Yacoub, Mr., Vianello, A., Viviano, V., Zappa, M. C., Heffler, E., Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Latorre, M., Lombardi, C., Macchia, L., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., Canonica G.W., Malvezzi L., Blasi F., Paggiaro P., Mantero M., Senna G., Heffler E., Bonavia M., Caiaffa P., Calabrese C., Camiciottoli G., Caruso C., Centanni S., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Favero E., Farsi A., Foschino B.P.M., Guarnieri G., Guida G., Latorre M., Lombardi C., Macchia L., Menzella F., Milanese M., Montuschi P., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Ricciardolo F.L.M., Ricciardi L., Richeldi L., Ridolo E., Rolla G., Santus P., Scichilone N., Solidoro P., Spadaro G., Spanevello A., Vianello A., Yacoub M.R., and Zappa M.C.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Severe asthma, Databases, Factual, Administration, Oral, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Nitric Oxide, Severity of Illness Index, Comorbidities, Oral corticosteroid, Adrenal Cortex Hormones, Internal medicine, Severity of illness, Oral corticosteroids, medicine, Prevalence, Nasal polyps, Humans, Registries, Sinusitis, Asthma, Aged, Rhinitis, Internet, Bronchiectasis, business.industry, Nasal polyp, Settore MED/09 - MEDICINA INTERNA, Atopic dermatitis, Middle Aged, medicine.disease, Comorbidities, Nasal polyps, Oral corticosteroids, Severe asthma, Italy, Concomitant, Chronic Disease, Disease Progression, Female, Comorbiditie, business
Abstract

Background The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. Results 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. Conclusion OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.

Published
2020

16. 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

17. 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

18. HLA-DRB1 haplotype associates with selection of lipid transfer protein variants as targets of food allergy

Author

Nucera, E, Valentini, M, Mezzacappa, S, Migliara, G, Chini, R, Rizzi, A, Aruanno, A, Ria, F, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), Ria, F (ORCID:0000-0002-8444-0307), Nucera, E, Valentini, M, Mezzacappa, S, Migliara, G, Chini, R, Rizzi, A, Aruanno, A, Ria, F, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), and Ria, F (ORCID:0000-0002-8444-0307)

Abstract

N/A

Published
2019

19. Diet intervention study through telemedicine assistance for systemic nickel allergy syndrome patients during the covid-19 pandemic

Author

Nucera, Eleonora, Rizzi, Angela, Chini, R., Giangrossi, S., Lohmeyer, F. M., Parrinello, Giuseppe, Musca, Tania, Miggiano, Giacinto Abele Donato, Gasbarrini, Antonio, Inchingolo, Riccardo, Nucera E. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Parrinello G., Musca T., Miggiano G. A. D. (ORCID:0000-0002-8627-5528), Gasbarrini A. (ORCID:0000-0002-7278-4823), Inchingolo R. (ORCID:0000-0003-2843-9966), Nucera, Eleonora, Rizzi, Angela, Chini, R., Giangrossi, S., Lohmeyer, F. M., Parrinello, Giuseppe, Musca, Tania, Miggiano, Giacinto Abele Donato, Gasbarrini, Antonio, Inchingolo, Riccardo, Nucera E. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Parrinello G., Musca T., Miggiano G. A. D. (ORCID:0000-0002-8627-5528), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Inchingolo R. (ORCID:0000-0003-2843-9966)

Abstract

Background: Restrictions due to the COVID-19 pandemic limited patients’ access to hospital care. The aims of this study were to assess dietary nutritional status, quality of life (QoL), and adherence to dietary therapy before and after 30-day personalized diet therapy through telenutrition tools in patients with systemic nickel allergic syndrome (SNAS). Methods: Each SNAS patient underwent the following allergological procedures: (a) face-to-face visit (nutritional visit and QoL evaluation) with prescription of one out of five personalized and balanced dietary plans different for calorie intake, (b) video call visit for dietary evaluation and assessment of adherence to diet after 15 days, and (c) video call visit for dietary and QoL evaluation and assessment of adherence to diet therapy after 30 days (end of study). Results: We enrolled 20 SNAS patients. After 15 and 30 days, we found a statistically significant improvement in anthropometric findings after diet therapy, a significant adherence rate to low-nickel diet (60% and 80%, respectively), and an improvement in QoL with an increase in almost all psychometric indices. Conclusions: Our study demonstrates that telenutrition can be a valid tool to monitor nutritional status and adherence to balanced low-Ni diet positively affecting QoL in SNAS patients during the COVID-19 pandemic.

Published
2021

20. Efficacy of omalizumab in reducing latex allergy

Author

Aruanno, A., Chini, R., Nucera, Eleonora, Nucera E. (ORCID:0000-0002-0565-7680), Aruanno, A., Chini, R., Nucera, Eleonora, and Nucera E. (ORCID:0000-0002-0565-7680)

Abstract

Omalizumab, a humanized monoclonal antibody that binds the CH3 domain near the binding site for the high affinity type-I IgE Fc receptors of human IgE, can neutralize free IgE and inhibit the IgE allergic pathway [1]. The current indications for treatment with omalizumab are limited to severe persistent allergic asthma and chronic spontaneous urticaria (CSU) when it is not controlled by conventional anti-H1 treatment at the maximum dosage. In recent years, several studies [1] have shown that omalizumab is effective in a large number of IgE-mediated and non-IgE-mediated disorders, indicating that omalizumab treatment acts on many levels and not only on immunoglobulins

Published
2021

21. Gadolinium-based contrast agents hypersensitivity: A case series

Author

Nucera, Eleonora, Urbani, Sara, Buonomo, Alessandro, De Pasquale, Tiziana Maria Angela, Rizzi, Angela, Aruanno, A., Pucci, S., Nucera E. (ORCID:0000-0002-0565-7680), Urbani S., Buonomo A., De Pasquale T., Rizzi A. (ORCID:0000-0002-6795-746X), Nucera, Eleonora, Urbani, Sara, Buonomo, Alessandro, De Pasquale, Tiziana Maria Angela, Rizzi, Angela, Aruanno, A., Pucci, S., Nucera E. (ORCID:0000-0002-0565-7680), Urbani S., Buonomo A., De Pasquale T., and Rizzi A. (ORCID:0000-0002-6795-746X)

Abstract

Gadolinium-based contrast agents (GBCAs) are considered to be safe, although sometimes patients report a hypersensitivity reaction when undergoing magnetic resonance imaging (MRI). The mechanisms of these reactions and of the sensitization to GBCAs are still largely unknown. We describe four cases of patients who experienced immediate adverse reactions to GBCAs with a demonstrated cutaneous hypersensitivity suggesting an IgE-mediated mechanism.

Published
2021

22. Systemic allergic reactions induced by labile plant-food allergens: Seeking potential cofactors. A multicenter study

Author

Asero, R., Ariano, R., Aruanno, A., Barzaghi, C., Borrelli, P., Busa, M., Celi, G., Cinquini, M., Cortellini, G., D'Auria, F., De Carli, M., Di Paolo, C., Garzi, G., Lodi Rizzini, F., Magnani, M., Manzotti, G., Marra, A., Miceli Sopo, Stefano, Murzilli, F., Nucera, Eleonora, Pinter, E., Pravettoni, V., Rivolta, F., Rizzi, Angela, Saporiti, N., Scala, E., Villalta, D., Yacoub, M. -R., Zisa, G., Miceli Sopo S. (ORCID:0000-0002-8175-6146), Nucera E. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Asero, R., Ariano, R., Aruanno, A., Barzaghi, C., Borrelli, P., Busa, M., Celi, G., Cinquini, M., Cortellini, G., D'Auria, F., De Carli, M., Di Paolo, C., Garzi, G., Lodi Rizzini, F., Magnani, M., Manzotti, G., Marra, A., Miceli Sopo, Stefano, Murzilli, F., Nucera, Eleonora, Pinter, E., Pravettoni, V., Rivolta, F., Rizzi, Angela, Saporiti, N., Scala, E., Villalta, D., Yacoub, M. -R., Zisa, G., Miceli Sopo S. (ORCID:0000-0002-8175-6146), Nucera E. (ORCID:0000-0002-0565-7680), and Rizzi A. (ORCID:0000-0002-6795-746X)

Abstract

Background: Heat-and-pepsin-sensitive plant food allergens (PR-10 and profilin) sometimes cause systemic reaction. Objective: To detect the risk factors for systemic reactions induced by labile food allergens. Methods: A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age-matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti-inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered. Results: We studied 89 patients and 81 controls. Sensitization to PR-10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P <.025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P <.025). Soy milk-induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases. Conclusion: PR-10- and profilin-induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR-10 hypersensitive patients and should be avoided.

Published
2021

26. Characteristics and treatment regimens across ERS SHARP severe asthma registries

Author

van Bragt, JJMH, Adcock, IM, Bel, EHD, Braunstahl, GJ, ten Brinke, A, Busby, J, Canonica, GW, Cao, H, Chung, KF, Csoma, Z, Dahlen, B, Davin, E, Hansen, S, Heffler, E, Horvath, I, Korn, S, Kots, M, Kuna, P, Kwon, N, Louis, R, Plaza, V, Porsbjerg, C, Ramos-Barbon, D, Richards, LB, Skrgat, S, Sont, JK, Vijverberg, SJH, Weersink, EJM, Yasinska, V, Wagers, SS, Djukanovic, R, Maitland-van der Zee, AH, Abenhardt, B, Adler, J, Alfonso, R, Ali, R, Alkameh, S, Sanchez, CA, Alvares, L, Anderson, G, Assing, K, Ayre, S, Becker, J, Bergmann, K, Bieksiene, K, Bjerring, N, Blasi, F, Bloemen, P, Blum, H, Boing, S, Bonavia, M, Bossios, A, Bourdin, A, Brons, A, Brusselle, G, Buis, J, Caiaffa, M, Calabrese, C, Camiciottoli, G, Caruso, C, Martinez, MC, Centanni, S, Serrano, CC, Corsico, A, Cosmi, L, Costantino, M, Costello, R, Crimi, N, Dahlen, S, D'Amato, M, Davies, D, Piqueras, FDGC, Decarlo, G, Deimling, A, Del Giacco, S, Campos, RD, Djandji, M, Doberer, D, Dupont, L, Dyett, K, Edelbaher, N, Edelmann, M, Ehmann, R, Ekberg-Jansson, A, Farsi, A, Favero, E, Feimer, J, Fletcher, M, Foschino, B, Frankemolle, B, Gaga, M, Gappa, M, de Pedro, JG, Rivero, JG, Gasplmayr, M, Gebhardt, R, Geldmacher, H, Geltner, C, Gerstlauer, M, Gibson, T, Giuseppe, G, Gogoll, C, Grimm-Sachs, V, Grisle, I, Grun, B, Grunewaldt, A, Guarnieri, G, Blanco, JG, Hamelmann, E, Hamerlijnck, D, Hammers-Reinhard, A, Hanon, S, Harzheim, D, Heaney, L, Hellmich, S, Herden, M, Hering, T, Herth, F, Hilberg, O, Howarth, P, Hubatsch, M, Humbert, M, Husemann, K, Idzko, M, Jackson, D, Jandl, M, Jaumont, X, Joos, G, Jost, M, Juch, M, Kabesch, M, Kaiser-Labusch, P, Kardos, P, Kassner, F, Keeley, T, Kerr, W, Kirschner, J, Klimek, L, Koca, M, Koczulla, R, Koerner-Rettberg, C, Kopac, P, Kronsbein, J, Lipinska, IK, Langer, M, Langeveld, B, Lantz, A, Lazarinis, N, Lazic, Z, Lehtimaki, L, Leuppi, J, Lombardi, C, Lommatzsch, M, Lopez-Vina, A, Luca, R, Ludviksdottir, D, Luttecke-Hecht, C, Macchia, L, Magni, T, Rivera, CM, Mastoridis, P, Mazza, F, Menzella, F, Menzies-Gow, A, Michils, A, Mihaltan, F, Milanese, M, Milger-Kneidinger, K, Molinska, J, Montagna, I, Montuschi, P, Mulleneisen, N, Esquerre, MM, Nanzer-Kelly, A, Nenasheva, N, Neurohr, C, Nucera, E, Otker, J, Oud, K, Paggiaro, P, Parente, R, Parkinson, J, Passalacqua, G, Patberg, N, Patella, V, Patino, O, Paulsson, T, Peche, R, Pelaia, G, Peress, E, de Llano, LP, Pfeffer, P, Pfister, P, Pilette, C, Sierra, CP, Pini, L, Powitz, F, Ranger, T, Rasmussen, L, Rasmussen, K, Rezelj, M, Ricciardi, L, Ricciardolo, F, Ridolo, E, Rijssenbeek-Nouwens, L, Rolla, G, Ribate, DR, Rudiger, S, Safioti, G, Sandstrom, T, Santus, P, Sauer, R, Schauerte, G, Schipmann, R, Schleich, F, Schmid, J, Schmidt, F, Schmidt, O, Schmitz, M, Schrag, T, Schroer, S, Schultz, K, Schulz, C, Scichilone, N, Sedlak, V, Selb, J, Senna, G, Sergejeva, S, Pariente, JS, Sichau, M, Simona, D, Singer, A, Skowasch, D, Smeenk, F, Smith, S, Solidoro, P, Spadaro, G, Spanevello, A, Stefansdottir, M, Steinmetz, K, Steiss, J, Stephan, M, Stieglitz, S, Suhling, H, Taube, C, Yavuz, ST, Tudoric, N, Ulrik, C, van de Ven, M, van den Elshout, F, Van Dyke, M, Van Nederveen-Bendien, S, van Veen, I, Vandenplas, O, Velthove, K, Vianello, A, Vogelberg, C, Wallen-Nielsen, E, Weersink, EJ, Wisskirchen, T, Yacoub, M, Yancey, S, Zappa, M, Zielen, S, Zimmermann, C, Zimmermann, R, Graduate School, AII - Inflammatory diseases, APH - Personalized Medicine, Pulmonology, Paediatric Pulmonology, van Bragt, J. J. M. H., Adcock, I. M., Bel, E. H. D., Braunstahl, G. -J., ten Brinke, A., Busby, J., Canonica, G. W., Cao, H., Chung, K. F., Csoma, Z., Dahlen, B., Davin, E., Hansen, S., Heffler, E., Horvath, I., Korn, S., Kots, M., Kuna, P., Kwon, N., Louis, R., Plaza, V., Porsbjerg, C., Ramos-Barbon, D., Richards, L. B., Skrgat, S., Sont, J. K., Vijverberg, S. J. H., Weersink, E. J. M., Yasinska, V., Wagers, S. S., Djukanovic, R., Maitland-Van der Zee, A. H., Abenhardt, B., Adler, J., Alfonso, R., Ali, R., Alkameh, S., Almonacid Sanchez, C., Alvares, L., Anderson, G., Assing, K., Ayre, S., Becker, J., Bergmann, K., Bieksiene, K., Bjerring, N., Blasi, F., Bloemen, P., Blum, H., Boing, S., Bonavia, M., Bossios, A., Bourdin, A., Brons, A., Brusselle, G., Buis, J., Caiaffa, M., Calabrese, C., Camiciottoli, G., Caruso, C., Castilla Martinez, M., Centanni, S., Cisneros Serrano, C., Corsico, A., Cosmi, L., Costantino, M., Costello, R., Crimi, N., Dahlen, S., D'Amato, M., Davies, D., de Borja Garcia-Cosio Piqueras, F., Decarlo, G., Deimling, A., Del Giacco, S., Diaz Campos, R., Djandji, M., Doberer, D., Dupont, L., Dyett, K., Edelbaher, N., Edelmann, M., Ehmann, R., Ekberg-Jansson, A., Farsi, A., Favero, E., Feimer, J., Fletcher, M., Foschino, B., Frankemolle, B., Gaga, M., Gappa, M., Garcia de Pedro, J., Garcia Rivero, J., Gasplmayr, M., Gebhardt, R., Geldmacher, H., Geltner, C., Gerstlauer, M., Gibson, T., Giuseppe, G., Gogoll, C., Grimm-Sachs, V., Grisle, I., Grun, B., Grunewaldt, A., Guarnieri, G., Gullon Blanco, J., Hamelmann, E., Hamerlijnck, D., Hammers-Reinhard, A., Hanon, S., Harzheim, D., Heaney, L., Hellmich, S., Herden, M., Hering, T., Herth, F., Hilberg, O., Howarth, P., Hubatsch, M., Humbert, M., Husemann, K., Idzko, M., Jackson, D., Jandl, M., Jaumont, X., Joos, G., Jost, M., Juch, M., Kabesch, M., Kaiser-Labusch, P., Kardos, P., Kassner, F., Keeley, T., Kerr, W., Kirschner, J., Klimek, L., Koca, M., Koczulla, R., Koerner-Rettberg, C., Kopac, P., Kronsbein, J., Kuprys Lipinska, I., Langer, M., Langeveld, B., Lantz, A., Lazarinis, N., Lazic, Z., Lehtimaki, L., Leuppi, J., Lombardi, C., Lommatzsch, M., Lopez-Vina, A., Luca, R., Ludviksdottir, D., Luttecke-Hecht, C., Macchia, L., Magni, T., Martinez Rivera, C., Mastoridis, P., Mazza, F., Menzella, F., Menzies-Gow, A., Michils, A., Mihalthan, F., Milanese, M., Milger-Kneidinger, K., Molinska, J., Montagna, I., Montuschi, P., Mulleneisen, N., Munoz Esquerre, M., Nanzer-Kelly, A., Nenasheva, N., Neurohr, C., Nucera, E., Otker, J., Oud, K., Paggiaro, P., Parente, R., Parkinson, J., Passalacqua, G., Patberg, N., Patella, V., Patino, O., Paulsson, T., Peche, R., Pelaia, G., Peress, E., Perez de Llano, L., Pfeffer, P., Pfister, P., Pilette, C., Pinedo Sierra, C., Pini, L., Powitz, F., Ranger, T., Rasmussen, L., Rasmussen, K., Rezelj, M., Ricciardi, L., Ricciardolo, F., Ridolo, E., Rijssenbeek-Nouwens, L., Rolla, G., Romero Ribate, D., Rudiger, S., Safioti, G., Sandstrom, T., Santus, P., Sauer, R., Schauerte, G., Schipmann, R., Schleich, F., Schmid, J., Schmidt, F., Schmidt, O., Schmitz, M., Schrag, T., Schroer, S., Schultz, K., Schulz, C., Scichilone, N., Sedlak, V., Selb, J., Senna, G., Sergejeva, S., Serrano Pariente, J., Sichau, M., Simona, D., Singer, A., Skowasch, D., Smeenk, F., Smith, S., Solidoro, P., Spadaro, G., Spanevello, A., Stefansdottir, M., Steinmetz, K., Steiss, J., Stephan, M., Stieglitz, S., Suhling, H., Taube, C., Tolga Yavuz, S., Tudoric, N., Ulrik, C., van de Ven, M., van den Elshout, F., van Dyke, M., van Nederveen-Bendien, S., van Veen, I., Vandenplas, O., Velthove, K., Vianello, A., Vogelberg, C., Wallen-Nielsen, E., Wisskirchen, T., Yacoub, M., Yancey, S., Zappa, M., Zielen, S., Zimmermann, C., Zimmermann, R., UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, van Bragt J.J.M.H., Adcock I.M., Bel E.H.D., Braunstahl G.-J., ten Brinke A., Busby J., Canonica G.W., Cao H., Chung K.F., Csoma Z., Dahlen B., Davin E., Hansen S., Heffler E., Horvath I., Korn S., Kots M., Kuna P., Kwon N., Louis R., Plaza V., Porsbjerg C., Ramos-Barbon D., Richards L.B., Skrgat S., Sont J.K., Vijverberg S.J.H., Weersink E.J.M., Yasinska V., Wagers S.S., Djukanovic R., Maitland-Van der Zee A.H., Abenhardt B., Adler J., Alfonso R., Ali R., Alkameh S., Almonacid Sanchez C., Alvares L., Anderson G., Assing K., Ayre S., Becker J., Bergmann K., Bieksiene K., Bjerring N., Blasi F., Bloemen P., Blum H., Boing S., Bonavia M., Bossios A., Bourdin A., Brons A., Brusselle G., Buis J., Caiaffa M., Calabrese C., Camiciottoli G., Caruso C., Castilla Martinez M., Centanni S., Cisneros Serrano C., Corsico A., Cosmi L., Costantino M., Costello R., Crimi N., Dahlen S., D'Amato M., Davies D., de Borja Garcia-Cosio Piqueras F., Decarlo G., Deimling A., Del Giacco S., Diaz Campos R., Djandji M., Doberer D., Dupont L., Dyett K., Edelbaher N., Edelmann M., Ehmann R., Ekberg-Jansson A., Farsi A., Favero E., Feimer J., Fletcher M., Foschino B., Frankemolle B., Gaga M., Gappa M., Garcia de Pedro J., Garcia Rivero J., Gasplmayr M., Gebhardt R., Geldmacher H., Geltner C., Gerstlauer M., Gibson T., Giuseppe G., Gogoll C., Grimm-Sachs V., Grisle I., Grun B., Grunewaldt A., Guarnieri G., Gullon Blanco J., Hamelmann E., Hamerlijnck D., Hammers-Reinhard A., Hanon S., Harzheim D., Heaney L., Hellmich S., Herden M., Hering T., Herth F., Hilberg O., Howarth P., Hubatsch M., Humbert M., Husemann K., Idzko M., Jackson D., Jandl M., Jaumont X., Joos G., Jost M., Juch M., Kabesch M., Kaiser-Labusch P., Kardos P., Kassner F., Keeley T., Kerr W., Kirschner J., Klimek L., Koca M., Koczulla R., Koerner-Rettberg C., Kopac P., Kronsbein J., Kuprys Lipinska I., Langer M., Langeveld B., Lantz A., Lazarinis N., Lazic Z., Lehtimaki L., Leuppi J., Lombardi C., Lommatzsch M., Lopez-Vina A., Luca R., Ludviksdottir D., Luttecke-Hecht C., Macchia L., Magni T., Martinez Rivera C., Mastoridis P., Mazza F., Menzella F., Menzies-Gow A., Michils A., Mihalthan F., Milanese M., Milger-Kneidinger K., Molinska J., Montagna I., Montuschi P., Mulleneisen N., Munoz Esquerre M., Nanzer-Kelly A., Nenasheva N., Neurohr C., Nucera E., Otker J., Oud K., Paggiaro P., Parente R., Parkinson J., Passalacqua G., Patberg N., Patella V., Patino O., Paulsson T., Peche R., Pelaia G., Peress E., Perez de Llano L., Pfeffer P., Pfister P., Pilette C., Pinedo Sierra C., Pini L., Powitz F., Ranger T., Rasmussen L., Rasmussen K., Rezelj M., Ricciardi L., Ricciardolo F., Ridolo E., Rijssenbeek-Nouwens L., Rolla G., Romero Ribate D., Rudiger S., Safioti G., Sandstrom T., Santus P., Sauer R., Schauerte G., Schipmann R., Schleich F., Schmid J., Schmidt F., Schmidt O., Schmitz M., Schrag T., Schroer S., Schultz K., Schulz C., Scichilone N., Sedlak V., Selb J., Senna G., Sergejeva S., Serrano Pariente J., Sichau M., Simona D., Singer A., Skowasch D., Smeenk F., Smith S., Solidoro P., Spadaro G., Spanevello A., Stefansdottir M., Steinmetz K., Steiss J., Stephan M., Stieglitz S., Suhling H., Taube C., Tolga Yavuz S., Tudoric N., Ulrik C., van de Ven M., van den Elshout F., van Dyke M., van Nederveen-Bendien S., van Veen I., Vandenplas O., Velthove K., Vianello A., Vogelberg C., Wallen-Nielsen E., Wisskirchen T., Yacoub M., Yancey S., Zappa M., Zielen S., Zimmermann C., Zimmermann R., Amsterdam UMC, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, Department of Medical Microbiology and Infection Control, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands., Medical Centre Leeuwarden, Queen's University [Belfast] (QUB), Humanitas University [Milan] (Hunimed), Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Korányi National Institute of Pulmonology (OKPI), Karolinska University Hospital [Stockholm], The European Lung Foundation (ELF), Bispebjerg and Frederiksberg Hospitals, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], University Medical Center of the Johannes Gutenberg-University Mainz, Chiesi Farmaceutici, Medical University of Łódź (MUL), GlaxoSmithKline, Brentford, Middlesex, Centre Hospitalier Universitaire de Liège (CHU-Liège), Hospital de la Santa Creu i Sant Pau, Copenhagen University Hospital, Respiratory and Allergic Diseases [Golnik, Slovenia], University Clinic of Respiratory and Allergic Diseases Golnik, Leiden University Medical Center (LUMC), Biosci Consulting, University Hospital Southampton NHS Foundation Trust, SHARP Clinical Research, Hôpital Arnaud de Villeneuve [CHRU Montpellier], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
Severe asthma, Pediatrics, MESH: Registries, MESH: Asthma, Cross-sectional study, Respiratory System, Medizin, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 0302 clinical medicine, MESH: Belgium, Belgium, Medicine research, Anti-Asthmatic Agents, Registries, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, 10. No inequality, 11 Medical and Health Sciences, Netherlands, 2. Zero hunger, education.field_of_study, SHARP CRC, MESH: Administration, Inhalation, MESH: Anti-Asthmatic Agents, 3. Good health, Europe, Italy, MESH: Poland, MESH: Sweden, medicine.drug, Pulmonary and Respiratory Medicine, medicine.medical_specialty, MESH: Hungary, Population, Investigació mèdica, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, MESH: Cross-Sectional Studies, Administration, Inhalation, MESH: Spain, medicine, Humans, education, Asma, Retrospective Studies, Asthma, Sweden, Hungary, MESH: Humans, business.industry, Settore MED/09 - MEDICINA INTERNA, MESH: Italy, MESH: Retrospective Studies, Retrospective cohort study, Original Articles, asthma, medicine.disease, Clinical trial, Cross-Sectional Studies, Clinical research, 030228 respiratory system, Spain, MESH: Netherlands, MESH: Europe, Poland, business, Body mass index, Mepolizumab
Abstract

Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m−2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day−1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day−1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.

Published
2019
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28. House dust mite allergy and shrimp allergy: a complex interaction

Author

Celi, G., primary, Brusca, I., additional, Scala, E., additional, Villalta, D., additional, Pastorello, E., additional, Farioli, L., additional, Cortellini, G., additional, Deleonardi, G., additional, Galati, P., additional, Losappio, L., additional, Manzotti, G., additional, Pirovano, B., additional, Muratore, L., additional, Murzilli, F., additional, Cucinelli, F., additional, Musarra, A., additional, Cilia, M., additional, Nucera, E., additional, Aruanno, A., additional, Ria, F., additional, Patria, M.F., additional, Varin, E., additional, Polillo, B.R., additional, Sargentini, V., additional, Quercia, O., additional, Uasuf, C.G., additional, Zampogna, S., additional, Carollo, M., additional, Graci, S., additional, and Asero, R., additional

Published
2020
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29. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, Giorgio Walter, primary, Malvezzi, Luca, additional, Blasi, Francesco, additional, Paggiaro, Pierluigi, additional, Mantero, Marco, additional, Senna, Gianenrico, additional, Heffler, Enrico, additional, Bonavia, M., additional, Caiaffa, P., additional, Calabrese, C., additional, Camiciottoli, G., additional, Caruso, C., additional, Centanni, S., additional, Conte, M.E., additional, Corsico, A.G., additional, Cosmi, L., additional, Costantino, M.T., additional, Crimi, N., additional, D’Alò, S., additional, D'Amato, M., additional, Del Giacco, S., additional, Favero, E., additional, Farsi, A., additional, Foschino, B.P.M., additional, Guarnieri, G., additional, Guida, G., additional, Latorre, M., additional, Lombardi, C., additional, Macchia, L., additional, Menzella, F., additional, Milanese, M., additional, Montuschi, P., additional, Nucera, E., additional, Parente, R., additional, Passalacqua, G., additional, Patella, V., additional, Pelaia, G., additional, Pini, L., additional, Ricciardolo, F.L.M., additional, Ricciardi, L., additional, Richeldi, L., additional, Ridolo, E., additional, Rolla, G., additional, Santus, P., additional, Scichilone, N., additional, Solidoro, P., additional, Spadaro, G., additional, Spanevello, A., additional, Vianello, A., additional, Yacoub, M.R., additional, and Zappa, M.C., additional

Published
2020
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30. Evaluation of two commercial peach extracts for skin prick testing in the diagnosis of hypersensitivity to lipid transfer protein. A multicenter study

Author

Asero, R., primary, Aruanno, A., additional, Bresciani, M., additional, Brusca, I., additional, Carollo, M., additional, Cecchi, L., additional, Cortellini, G., additional, Deleonardi, G., additional, Farsi, A., additional, Ferrarini, E., additional, Gabrielli, G., additional, Ingrassia, A., additional, Mauro, M., additional, Murzilli, F., additional, Nucera, E., additional, Onida, R., additional, Pastorello, E.A., additional, Pinter, E., additional, Rizzi, A., additional, Russello, M., additional, Sacerdoti, C., additional, Scala, E., additional, Scala, G., additional, Villalta, D., additional, Zampogna, S., additional, Amato, S., additional, and Mistrello, G., additional

Published
2020
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37. Frequency of tiotropium bromide use and clinical features of patients with severe asthma in a real-life setting: Data from the severe asthma network in Italy (sani) registry

Author

Puggioni, F., Brussino, L., Canonica, G. W., Blasi, F., Paggiaro, P., Caminati, M., Latorre, M., Heffler, E., Senna, G., Sani, Group, Bonavia, M., Caiaffa, Mf., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, Me., Corsico, Ag., Cosmi, L., Costantino, Mt., Crimi, N., D’Alo, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, Bmp., Guarnieri, G., Guida, G., Yacoub, Mr., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Paoletti, G., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardi, L., Ricciardolo, Flm., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Zappa, Mc., Concetta, Sirena., Daniela, Morrone, and Silvia, Rabotti

Subjects
lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, severe asthma, registry, long-acting muscarinic antagonists, real-ligfe, medicine.medical_specialty, Registry, Severe asthma, Respimat, real-life, Exacerbation, Long-acting muscarinic antagonists, Real-life, Umeclidinium bromide, Internal medicine, Journal of Asthma and Allergy, Immunology and Allergy, Medicine, Glycopyrronium bromide, Original Research, Asthma, Bronchiectasis, biology, business.industry, Tiotropium bromide, Lama, medicine.disease, biology.organism_classification, respiratory tract diseases, real-ligfe, lcsh:RC581-607, business, medicine.drug
Abstract

Francesca Puggioni,1,2 Luisa Brussino,3 Giorgio Walter Canonica,1,2 Francesco Blasi,4,5 Pierluigi Paggiaro,6 Marco Caminati,7,8 Manuela Latorre,6 Enrico Heffler,1,2 Gianenrico Senna7,8 On behalf of the Severe Asthma Network in Italy (SANI) group1Personalized Medicine, Asthma and Allergy – Humanitas Clinical and Research Center, IRCCS – Rozzano (MI), Milan, Italy; 2Department of Biomedical Sciences, Humanitas University – Pieve Emanuele (MI), Milan, Italy; 3Dipartimento di Scienze Mediche, SSDDU Allergologia e Immunologia Clinica, Università degli Studi di Torino, AO Ordine Mauriziano Umberto I – Torino, Torino, Italy; 4Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; 5Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; 6Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy; 7Department of Medicine, University of Verona, Verona, Italy; 8Allergy Unit and Asthma Center, Verona University Hospital, Verona, Verona, ItalyCorrespondence: Enrico HefflerPersonalized Medicine, Asthma and Allergy, Istituto Clinico Humanitas, Milan, ItalyTel +39 0288247013Fax + 39 0282246484Email enrico.heffler@hunimed.euPurpose: Patients with uncontrolled asthma despite high doses of inhaled corticosteroid therapy plus another controller are defined as severe asthmatics. Tiotropium bromide respimat (TBR) is the only long-acting muscarinic antagonists (LAMA) approved for severe asthma. The aim of this study was to explore the frequency of severe asthmatics treated with TBR and characterize their clinical features in a real-life, registry-based setting.Materials and Methods: Baseline data from the Severe Asthma Network in Italy (SANI) registry have been analyzed to determine the use of TBR and other LAMA, and to compare clinical, functional and inflammatory features associated with the use of LAMA.Results: Among a total of 698 enrolled patients, 35.9% were treated with LAMA (23.3% TBR, 4.5% tiotropium bromide handihaler, 4.5% aclidinium, 3.4% glycopyrronium bromide 0.3% umeclidinium bromide). Age of asthma onset was higher in patients taking LAMA, whom, compared to others were more frequently former smokers. They also had a higher annual exacerbation rate, experienced worst asthma control, worst disease-related quality of life and poorer lung function. Bronchiectasis was more frequently found in LAMA users (25.9% vs 13.1%).Conclusion: TBR is still underused in severe asthma in a real-life setting, while a relevant proportion of patients are treated with other LAMA that are not approved for severe asthma treatment. Patients taking LAMA have features characteristic of even more severe asthma.Keywords: severe asthma, registry, long-acting muscarinic antagonists, real-ligfe

Published
2020

38. Detection of Gibberellin-regulated protein (Peamaclein) sensitization among Italian cypress pollen-sensitized patients

Author

Asero R, Abbadessa S, Aruanno A, Barilaro G, Barzaghi C, Bignardi D, Bilò MB, Borro M, Bresciani M, Busa M, Buzzulini F, Cavaliere C, Cecchi L, Ciccarelli A, Cortellini G, Cucinelli F, Deleonardi G, Emiliani F, Farsi A, Ferrarini E, Franchini M, Ingrassia A, Lippolis D, Losappio L, Marra AM, Martini M, Masieri S, Mauro M, Mazzolini M, Muratore L, Murzilli F, Nucera E, Pastorello EA, Pinter E, Polillo BR, Pravettoni V, Quercia O, Rizzi A, Russello M, Sacerdoti C, Scala E, Scala G, Scarpa A, Schroeder J, Uasuf CG, Villalta D, Yang B, Mistrello G, Amato S, and Lidholm J

Subjects
pollen food syndrome, food allergy, cypress pollen allergy, peach, peamaclein, Settore MED/09 - MEDICINA INTERNA, food and beverages
Abstract

Background: Peach gibberellin-regulated protein (peamaclein) has recently emerged as a relevant food allergen in cypress pollen-hypersensitive patients. Objective: We looked for mono-sensitization to peamaclein among Italian cypress-pollen allergic patients. Material and methods: 835 cypress pollen hypersensitive patients from 28 Italian allergy centers under went thorough interview for food-allergic reactions, and SPT with a commercial peach extracts containing peamaclein. In peach reactors, IgE to rPru p 3 was measured, and those scoring negative were enrolled as potentially mono-sensitized to peamaclein. IgE reactivity to rPru p 7 was evaluated by immunoblot and by an experimental ImmunoCAP with rPru p 7. Results: Peach SPT scored positive in 163 (19.5%) patients but 127 (77,9%) were excluded because Pru p 3 reactors. Twenty-four (14,7%, corresponding to 2.8% of the entire study population) were considered as potentially mono-sensitized to peamaclein. Their distribution did not show any geographic preference. Seventeen/24 (70,8%) had a history of food allergy, in most cases (n=15) to peach. Other offending foods included other Rosaceae, citrus fruits, fig, melon, tree nuts, and kiwi. On peach immunoblot, only 3/18 putative peamaclein allergic subjects reacted to a band at about 7kDa; 4 other patients reacted at about 50-60 kDa. Ten/18 (56%) scored positive for Pru p 7 on ImmunoCAP. Conclusion: Peamaclein allergy and sensitization prevalence seem rare in Italy. Most patients react to peach, albeit other Rosaceae fruits and several citrus fruits may also act as offending foods. Peach and cypress pollen probably share also cross-reacting allergens other than peamaclein.

Published
2020
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43. Characteristics and treatment regimens across ERS SHARP severe asthma registries

Author

van Bragt, JJMH, Adcock, IM, Bel, EHD, Braunstahl, G-J, ten Brinke, A, Busby, J, Canonica, GW, Cao, H, Chung, KF, Csoma, Z, Dahlen, B, Davin, E, Hansen, S, Heffler, E, Horvath, I, Korn, S, Kots, M, Kuna, P, Kwon, N, Louis, R, Plaza, V, Porsbjerg, C, Ramos-Barbon, D, Richards, LB, Skrgat, S, Sont, JK, Vijverberg, SJH, Weersink, EJM, Yasinska, V, Wagers, SS, Djukanovic, R, Maitland-van der Zee, AH, Abenhardt, B, Adler, J, Alfonso, R, Ali, R, Alkameh, S, Almonacid Sanchez, C, Alvares, L, Anderson, G, Assing, K, Ayre, S, Becker, J, Bergmann, K, Bieksiene, K, Bjerring, N, Blasi, F, Bloemen, P, Blum, H, Boeing, S, Bonavia, M, Bossios, A, Bourdin, A, Brons, A, Brusselle, G, Buis, J, Caiaffa, M, Calabrese, C, Camiciottoli, G, Caruso, C, Castilla Martinez, M, Centanni, S, Cisneros Serrano, C, Corsico, A, Cosmi, L, Costantino, M, Costello, R, Crimi, N, Dahlen, S, D'Amato, M, Davies, D, Garcia-Cosio Piqueras, FDB, Decarlo, G, Deimling, A, Del Giacco, S, Diaz Campos, R, Djandji, M, Doberer, D, Dupont, L, Dyett, K, Edelbaher, N, Edelmann, M, Ehmann, R, Ekberg-Jansson, A, Farsi, A, Favero, E, Feimer, J, Fletcher, M, Foschino, B, Frankemolle, B, Gaga, M, Gappa, M, Garcia de Pedro, J, Garcia Rivero, J, Gasplmayr, M, Gebhardt, R, Geldmacher, H, Geltner, C, Gerstlauer, M, Gibson, T, Giuseppe, G, Gogoll, C, Grimm-Sachs, V, Grisle, I, Gruen, B, Gruenewaldt, A, Guarnieri, G, Gullon Blanco, J, Hamelmann, E, Hamerlijnck, D, Hammers-Reinhard, A, Hanon, S, Harzheim, D, Heaney, L, Hellmich, S, Herden, M, Hering, T, Herth, F, Hilberg, O, Howarth, P, Hubatsch, M, Humbert, M, Husemann, K, Idzko, M, Jackson, D, Jandl, M, Jaumont, X, Joos, G, Joest, M, Juech, M, Kabesch, M, Kaiser-Labusch, P, Kardos, P, Kaessner, F, Keeley, T, Kerr, W, Kirschner, J, Klimek, L, Koca, M, Koczulla, R, Koerner-Rettberg, C, Kopac, P, Kronsbein, J, Lipinska, IK, Langer, M, Langeveld, B, Lantz, A, Lazarinis, N, Lazic, Z, Lehtimaki, L, Leuppi, J, Lombardi, C, Lommatzsch, M, Lopez-Vina, A, Luca, R, Ludviksdottir, D, Luettecke-Hecht, C, Macchia, L, Magni, T, Martinez Rivera, C, Mastoridis, P, Mazza, F, Menzella, F, Menzies-Gow, A, Michils, A, Mihaltan, F, Milanese, M, Milger-Kneidinger, K, Molinska, J, Montagna, I, Montuschi, P, Muelleneisen, N, Munoz Esquerre, M, Nanzer-Kelly, A, Nenasheva, N, Neurohr, C, Nucera, E, Otker, J, Oud, K, Paggiaro, P, Parente, R, Parkinson, J, Passalacqua, G, Patberg, N, Patella, V, Patino, O, Paulsson, T, Peche, R, Pelaia, G, Peress, E, Perez de Llano, L, Pfeffer, P, Pfister, P, Pilette, C, Pinedo Sierra, C, Pini, L, Powitz, F, Ranger, T, Rasmussen, L, Rasmussen, K, Rezelj, M, Ricciardi, L, Ricciardolo, F, Ridolo, E, Rijssenbeek-Nouwens, L, Rolla, G, Romero Ribate, D, Ruediger, S, Safioti, G, Sandstrom, T, Santus, P, Sauer, R, Schauerte, G, Schipmann, R, Schleich, F, Schmid, J, Schmidt, F, Schmidt, O, Schmitz, M, Schrag, T, Schroeer, S, Schultz, K, Schulz, C, Scichilone, N, Sedlak, V, Selb, J, Senna, G, Sergejeva, S, Serrano Pariente, J, Sichau, M, Simona, D, Singer, A, Skowasch, D, Smeenk, F, Smith, S, Solidoro, P, Spadaro, G, Spanevello, A, Stefansdottir, M, Steinmetz, K, Steiss, J, Stephan, M, Stieglitz, S, Suhling, H, Taube, C, Yavuz, ST, Tudoric, N, Ulrik, C, van de Ven, M, van den Elshout, F, Van Dyke, M, Van Nederveen-Bendien, S, van Veen, I, Vandenplas, O, Velthove, K, Vianello, A, Vogelberg, C, Wallen-Nielsen, E, Weersink, EJ, Wisskirchen, T, Yacoub, M, Yancey, S, Zappa, M, Zielen, S, Zimmermann, C, Zimmermann, R, van Bragt, JJMH, Adcock, IM, Bel, EHD, Braunstahl, G-J, ten Brinke, A, Busby, J, Canonica, GW, Cao, H, Chung, KF, Csoma, Z, Dahlen, B, Davin, E, Hansen, S, Heffler, E, Horvath, I, Korn, S, Kots, M, Kuna, P, Kwon, N, Louis, R, Plaza, V, Porsbjerg, C, Ramos-Barbon, D, Richards, LB, Skrgat, S, Sont, JK, Vijverberg, SJH, Weersink, EJM, Yasinska, V, Wagers, SS, Djukanovic, R, Maitland-van der Zee, AH, Abenhardt, B, Adler, J, Alfonso, R, Ali, R, Alkameh, S, Almonacid Sanchez, C, Alvares, L, Anderson, G, Assing, K, Ayre, S, Becker, J, Bergmann, K, Bieksiene, K, Bjerring, N, Blasi, F, Bloemen, P, Blum, H, Boeing, S, Bonavia, M, Bossios, A, Bourdin, A, Brons, A, Brusselle, G, Buis, J, Caiaffa, M, Calabrese, C, Camiciottoli, G, Caruso, C, Castilla Martinez, M, Centanni, S, Cisneros Serrano, C, Corsico, A, Cosmi, L, Costantino, M, Costello, R, Crimi, N, Dahlen, S, D'Amato, M, Davies, D, Garcia-Cosio Piqueras, FDB, Decarlo, G, Deimling, A, Del Giacco, S, Diaz Campos, R, Djandji, M, Doberer, D, Dupont, L, Dyett, K, Edelbaher, N, Edelmann, M, Ehmann, R, Ekberg-Jansson, A, Farsi, A, Favero, E, Feimer, J, Fletcher, M, Foschino, B, Frankemolle, B, Gaga, M, Gappa, M, Garcia de Pedro, J, Garcia Rivero, J, Gasplmayr, M, Gebhardt, R, Geldmacher, H, Geltner, C, Gerstlauer, M, Gibson, T, Giuseppe, G, Gogoll, C, Grimm-Sachs, V, Grisle, I, Gruen, B, Gruenewaldt, A, Guarnieri, G, Gullon Blanco, J, Hamelmann, E, Hamerlijnck, D, Hammers-Reinhard, A, Hanon, S, Harzheim, D, Heaney, L, Hellmich, S, Herden, M, Hering, T, Herth, F, Hilberg, O, Howarth, P, Hubatsch, M, Humbert, M, Husemann, K, Idzko, M, Jackson, D, Jandl, M, Jaumont, X, Joos, G, Joest, M, Juech, M, Kabesch, M, Kaiser-Labusch, P, Kardos, P, Kaessner, F, Keeley, T, Kerr, W, Kirschner, J, Klimek, L, Koca, M, Koczulla, R, Koerner-Rettberg, C, Kopac, P, Kronsbein, J, Lipinska, IK, Langer, M, Langeveld, B, Lantz, A, Lazarinis, N, Lazic, Z, Lehtimaki, L, Leuppi, J, Lombardi, C, Lommatzsch, M, Lopez-Vina, A, Luca, R, Ludviksdottir, D, Luettecke-Hecht, C, Macchia, L, Magni, T, Martinez Rivera, C, Mastoridis, P, Mazza, F, Menzella, F, Menzies-Gow, A, Michils, A, Mihaltan, F, Milanese, M, Milger-Kneidinger, K, Molinska, J, Montagna, I, Montuschi, P, Muelleneisen, N, Munoz Esquerre, M, Nanzer-Kelly, A, Nenasheva, N, Neurohr, C, Nucera, E, Otker, J, Oud, K, Paggiaro, P, Parente, R, Parkinson, J, Passalacqua, G, Patberg, N, Patella, V, Patino, O, Paulsson, T, Peche, R, Pelaia, G, Peress, E, Perez de Llano, L, Pfeffer, P, Pfister, P, Pilette, C, Pinedo Sierra, C, Pini, L, Powitz, F, Ranger, T, Rasmussen, L, Rasmussen, K, Rezelj, M, Ricciardi, L, Ricciardolo, F, Ridolo, E, Rijssenbeek-Nouwens, L, Rolla, G, Romero Ribate, D, Ruediger, S, Safioti, G, Sandstrom, T, Santus, P, Sauer, R, Schauerte, G, Schipmann, R, Schleich, F, Schmid, J, Schmidt, F, Schmidt, O, Schmitz, M, Schrag, T, Schroeer, S, Schultz, K, Schulz, C, Scichilone, N, Sedlak, V, Selb, J, Senna, G, Sergejeva, S, Serrano Pariente, J, Sichau, M, Simona, D, Singer, A, Skowasch, D, Smeenk, F, Smith, S, Solidoro, P, Spadaro, G, Spanevello, A, Stefansdottir, M, Steinmetz, K, Steiss, J, Stephan, M, Stieglitz, S, Suhling, H, Taube, C, Yavuz, ST, Tudoric, N, Ulrik, C, van de Ven, M, van den Elshout, F, Van Dyke, M, Van Nederveen-Bendien, S, van Veen, I, Vandenplas, O, Velthove, K, Vianello, A, Vogelberg, C, Wallen-Nielsen, E, Weersink, EJ, Wisskirchen, T, Yacoub, M, Yancey, S, Zappa, M, Zielen, S, Zimmermann, C, and Zimmermann, R

Abstract

Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m-2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day-1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day-1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.

Published
2020

44. Characteristics and treatment regimens across ERS SHARP severe asthma registries

Author

van Bragt, J. J. M. H., Adcock, I. M., Bel, E. H. D., Braunstahl, G. -J., Ten Brinke, A., Busby, J., Canonica, G. W., Cao, H., Chung, K. F., Csoma, Z., Dahlen, B., Davin, E., Hansen, S., Heffler, E., Horvath, I., Korn, S., Kots, M., Kuna, P., Kwon, N., Louis, R., Plaza, V., Porsbjerg, C., Ramos-Barbon, D., Richards, L. B., Skrgat, S., Sont, J. K., Vijverberg, S. J. H., Weersink, E. J. M., Yasinska, V., Wagers, S. S., Djukanovic, R., Maitland-van der Zee, A. H., Nucera, Eleonora, Nucera E (ORCID:0000-0002-0565-7680), van Bragt, J. J. M. H., Adcock, I. M., Bel, E. H. D., Braunstahl, G. -J., Ten Brinke, A., Busby, J., Canonica, G. W., Cao, H., Chung, K. F., Csoma, Z., Dahlen, B., Davin, E., Hansen, S., Heffler, E., Horvath, I., Korn, S., Kots, M., Kuna, P., Kwon, N., Louis, R., Plaza, V., Porsbjerg, C., Ramos-Barbon, D., Richards, L. B., Skrgat, S., Sont, J. K., Vijverberg, S. J. H., Weersink, E. J. M., Yasinska, V., Wagers, S. S., Djukanovic, R., Maitland-van der Zee, A. H., Nucera, Eleonora, and Nucera E (ORCID:0000-0002-0565-7680)

Abstract

Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m-2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day-1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day-1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.

Published
2020

45. Modulation of gut microbiota in patients with IBS and systemic nickel allergy after diet and probiotic supplementation: a pilot study

Author

Caruso, C, Colantuono, S, Celi, Giuseppe, Salerno, Leo Massimo, De Martino, G, Ianiro, Gianluca, Casale, C, Nucera, Eleonora, Del Giacco, S, Gasbarrini, Antonio, Celi, G, Salerno, L, Ianiro, G (ORCID:0000-0002-8318-0515), Nucera, E (ORCID:0000-0002-0565-7680), Gasbarrini, A (ORCID:0000-0002-7278-4823), Caruso, C, Colantuono, S, Celi, Giuseppe, Salerno, Leo Massimo, De Martino, G, Ianiro, Gianluca, Casale, C, Nucera, Eleonora, Del Giacco, S, Gasbarrini, Antonio, Celi, G, Salerno, L, Ianiro, G (ORCID:0000-0002-8318-0515), Nucera, E (ORCID:0000-0002-0565-7680), and Gasbarrini, A (ORCID:0000-0002-7278-4823)

Abstract

N/A

Published
2020

46. Nickel allergy in lipid transfer protein sensitized patients: Prevalence and clinical features

Author

Rizzi, Angela, Chini, R., Inchingolo, Riccardo, Carusi, V., Pandolfi, Franco, Gasbarrini, Antonio, Nucera, Eleonora, Rizzi A. (ORCID:0000-0002-6795-746X), Inchingolo R. (ORCID:0000-0003-2843-9966), Pandolfi F. (ORCID:0000-0001-8799-8173), Gasbarrini A. (ORCID:0000-0002-7278-4823), Nucera E. (ORCID:0000-0002-0565-7680), Rizzi, Angela, Chini, R., Inchingolo, Riccardo, Carusi, V., Pandolfi, Franco, Gasbarrini, Antonio, Nucera, Eleonora, Rizzi A. (ORCID:0000-0002-6795-746X), Inchingolo R. (ORCID:0000-0003-2843-9966), Pandolfi F. (ORCID:0000-0001-8799-8173), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Nucera E. (ORCID:0000-0002-0565-7680)

Abstract

Nickel (Ni), the main responsible for allergic contact dermatitis worldwide, is also involved in systemic condition called “Systemic Nickel Sulfate Allergy Syndrome (SNAS).” Likewise, IgE-mediated reactivity to Lipid Transfer Protein (LTP) represents the main cause of primary food allergy in adults of Mediterranean countries. We evaluated the prevalence of SNAS in LTP allergic patients and investigated patients’ clinical features with double sensitization (LTP and Ni). A retrospective, single-center, observational study was conducted performing a complete allergological work-up including: (1) skin prick tests; (2) serum specific IgE for plant food allergens and rPru p3 (LTP); (3) patch test with 5% Ni sulfate in petrolatum. We enrolled 140 LTP allergic patients of which 36 patients (25.7% of sample) showed additional positivity to Ni patch test. Patients with double sensitization were more frequently females and reported fewer cutaneous symptoms. Higher values of sIgE for peach, apple, peanut, walnut, grain, corn, and garlic were found in LTP allergic patients, while higher values for hazelnut in the other subgroup. The prevalence of SNAS in the LTP allergic population is clinically relevant. Moreover, the clinical and immunological profiles of patients with double sensitization were different from patients monosensitized to LTP.

Published
2020

47. Oral CorticoSteroid sparing with biologics in severe asthma: A remark of the Severe Asthma Network in Italy (SANI)

Author

Canonica, G. W., Blasi, F., Paggiaro, P., Senna, G., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M., Bonini, Matteo, Brussino, L., Bucca, C., Caiaffa, M. F., Calabrese, Anna Chiara, Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, Corrado Maria Roberto, Centanni, S., 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 Barbaro, M. P., Guarnieri, G., Guida, Maria Grazia, Latorre, M., Lo Cicero, Stefano, Lombardi, Celestino Pio, Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagni, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, Luca, Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler, E., Bonini M. (ORCID:0000-0002-3042-0765), Calabrese C., Caruso C., Guida G., Lo Cicero S., Lombardi C. (ORCID:0000-0001-8910-6693), Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), Canonica, G. W., Blasi, F., Paggiaro, P., Senna, G., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M., Bonini, Matteo, Brussino, L., Bucca, C., Caiaffa, M. F., Calabrese, Anna Chiara, Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, Corrado Maria Roberto, Centanni, S., 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 Barbaro, M. P., Guarnieri, G., Guida, Maria Grazia, Latorre, M., Lo Cicero, Stefano, Lombardi, Celestino Pio, Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagni, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, Luca, Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler, E., Bonini M. (ORCID:0000-0002-3042-0765), Calabrese C., Caruso C., Guida G., Lo Cicero S., Lombardi C. (ORCID:0000-0001-8910-6693), Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), and Richeldi L. (ORCID:0000-0001-8594-1448)

Abstract

According to the data derived from several national and international registries, including SANI (Severe Asthma Network Italy), and considering the strong impact that frequent or regular use of oral corticosteroid has on quality of life (QoL) of severe asthmatics, as well as on the costs for managing corticosteroid-related diseases, oral corticosteroid sparing up to withdrawal should be considered a primary outcome in the management of severe asthma. New biologics have clearly demonstrated that this effect is possible, with concomitant reduction in the rate of exacerbations and in symptom control. Then, there is no reason for using so frequently oral corticosteroid before having explored all alternatives currently available for a large part of severe asthmatics.

Published
2020

48. Adverse reaction to Ficus Carica: reported case of a possible cross-reactivity with Der p1

Author

Urbani, Sara, Aruanno, A, Nucera, Eleonora, Urbani, S, Nucera, E (ORCID:0000-0002-0565-7680), Urbani, Sara, Aruanno, A, Nucera, Eleonora, Urbani, S, and Nucera, E (ORCID:0000-0002-0565-7680)

Abstract

Background: Ficus carica is an edible fruit, belonging to the Moraceae family, rarely described as cause of food allergy. We describe the first case of fig allergy that occurred as a cross-reactivity between fig and Derp 1. Case presentation: We present a case of a 10-years-old-girl, with a history of no-seasonal mild intermittent rhinitis, who experienced an immediate reaction after ingestion of a fresh fig. Skin prick tests (SPT) with commercial extracts of food, airborne allergens, latex and panallergens (profilin, PR-10 and lipid transfer protein) were performed. SPT revealed a sensitization only for dermatophagoides farina and dermatophagoides pteronyssinus which was then confirmed with by specific IgE assay (UniCAP, Phadia, Uppsala, Sweden). We also carried out a positive SPT with a commercial fig allergen (Lofarma, Milan, Italy) and prick-by-prick (PBP) both with skin and pulp of green raw and cooked fig. Fig specific serum IgE levels were 1.08 U/ml and specific IgE for rDer p1 was 16.20 U/ml (total serum IgE = 377 U/ ml). In contrast specific IgE levels for latex, LTP, profilin, PR-10 and pollen allergens were negative. Conclusion: The ficin, the major fig allergen, belongs to cysteine protease family like Der p 1. The symptoms presented by our patient could be related to a cross reactivity between these two proteins which present a structural homology.

Published
2020

49. Metronidazole Hypersensitivity in a Patient with Angioedema and Widespread Rash

Author

Aruanno, A, Parrinello, Giuseppe, Buonomo, Alessandro, Rizzi, Angela, Nucera, Eleonora, Parrinello, G, Buonomo, A, Rizzi, A (ORCID:0000-0002-6795-746X), Nucera, E (ORCID:0000-0002-0565-7680), Aruanno, A, Parrinello, Giuseppe, Buonomo, Alessandro, Rizzi, Angela, Nucera, Eleonora, Parrinello, G, Buonomo, A, Rizzi, A (ORCID:0000-0002-6795-746X), and Nucera, E (ORCID:0000-0002-0565-7680)

Abstract

N/A

Published
2020

50. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alonzo, Silvia, D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, Gabriella, Menzella, F., Milanese, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, Luca, Ridolo, E., Marolla, Giovanna, Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., D'Alo S., Macchia L., Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), Rolla G., Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alonzo, Silvia, D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, Gabriella, Menzella, F., Milanese, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, Luca, Ridolo, E., Marolla, Giovanna, Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., D'Alo S., Macchia L., Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), and Rolla G.

Abstract

Background: The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. Results: 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. Conclusion: OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.

Published
2020

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